How long, when you bring someone into Dunn House, how long are they guaranteed to be in that housing situation?

Well, they hold a lease like you or me.

And that's part of the dignity.

And that's part of the accountability and the journey and having the stability.

to hold a lease, they pay rent geared to their income.

So this notion that it's all free housing, realities are that people are holding a lease like you or me.

There's stability then where they're not thinking only have 30 days, 60 days, 90 days.

Has there been any outreach from other cities to say we want to study the Dunn-House model?

I mean, how is the mobile clinic doing? What's your assessment of where it's at?

I mean, I appreciate your interest in that early on.

And I think, you know, come to where the middle ground, I would never try to espouse it as the most brilliant idea.

We've seen lots of mobile health clinics across the country that have had lots of success.

And we looked at some of the evaluations earlier in some of the original mobile health clinic initiatives.

that around 30 to 40% of people who use a mobile health clinic actually reported that they would have otherwise gone to an emergency department.

So I think it aligns with a lot of the events around trying to get primary care into spaces or to where people are at, as opposed to trying to build infrastructure and hoping folks will come in knowing that people have very busy, demanding lives and schedules, and especially during a cost of living crisis.

Tell us about this particular I think you call it the Stabilization and Connection Center.

Yeah.

Uh, as we know, that exercise or movement is one of the most powerful medicines that we have outside of the hospital or clinic spaces.

Uh, and I think when we look at a lot of the evidence around social prescribing, we've seen some really good uptake, some really good effectiveness in terms of whether it's trying to ensure people have access to healthier foods, access to more exercise programs.

And again, it's, it's not that the power of the physician's pen somehow transforms, uh, people's lives, but it's this encouragement and better integration of encouraging prevention, of encouraging some of the things that people can do to have agency in their lives, uh, to avoid seeing some thing of either chronic disease, like diabetes or, or heart failure, uh, to also issues like cancer risks.

So we know that we're seeing more and more, uh, disease burden in our system, especially with these chronic diseases we've talked about.

And so I think we're gonna have to look at various avenues of how we reach more people and ensure that people can have, uh, more supports to do it.

So I think the vouchers and incentives are an interesting component of this, but we have to be really clear about the fact that when we look at some of the evidence, being close to green space or walkable neighborhoods-

I mean, I, I'm sure some people listen to their doctors when they say, "Hey, go for a walk." I think more would listen if it was on a little piece of paper.

Mm-hmm.

Uh, but there was a lot of work in designing the space.

So as you can see at the front, uh, there's a sitting area.

Again, we're trying to rebuild trust with people who can sit, have conversations that are private.

Again, whether that's around, uh, access to various mental health and addiction supports, or really being able to have a reassessment of where they are in terms of their healthcare journey.

And then in the back of the van, there's a full clinical space.

Just like where I was working this morning, you've got a bed, the blood pressure, uh, cuffs, all of the screening tools that you would need to ensure that, uh, you can provide high-quality primary care.

But as you mentioned, this has been in, in the works for a couple years, but why, why now? Or is that timing kind of a, a, a good thing?

What's the plan going forward?

It's really about responding to the needs that are out there.

And I think really what we've been seeing is there are different branches that are in neighborhoods that have poor access to primary care.

So we're working very closely with the libraries to identify which the next set of branches would look like to ensure that people can be referred or that, again, these connections are happening between clinical teams and the library teams to best identify people or make it available for people who need healthcare supports.

And then the next extension of that is really working with some of the Toronto Community Housing data to identify buildings that have high EMS calls or emergency ambulance calls that go to the emergency department, extensively because people can't access primary care.

And so there are things that can happen right there in terms of being able to provide care through the clinic right where people live to ensure that they're getting the vital pressure check screening and bread and butter primary care that people need to stay healthy and alive and also not end up having to resort to the emergency department, which from the data and evidence we've seen has broader system impact so that the emergency department can be addressing the things they need to be addressing.

The incredible staff in the emergency department can do the great work that they've been trained to do.

And so for me, your project with TPL is actually reinforcing The part I don't like, which is changing the nature of our community libraries.

Yeah.

Yeah.

You know, it's, uh, funny you ask.

It's great.

No, I mean, it's, it's ...

The reality is, you know, Dunn House, I think, has gotten some attention, and I think it's because there's been a real collective approach to this issue.

You know, we've seen the federal, provincial, and municipal government invest in Dunn House.

Yeah.

Mm.

But when you look at the health economics, the way we've been doing things for the past few decades makes absolutely no sense, and I think there's always this y- you know, idea or conversation that even if you're a cold-blooded economist, which I don't know any cold-blooded economists, they're usually pretty fair [chuckles] and sensible.

Uh, when you look at the cost breakdown of it being over $50,000 a month to stay in a hospital ward, around 14 to $15,000 in a p- a provincial jail system, which, you know, many of us call it a de- de facto mental health system as people can't access supports, to around $6,000 for a shelter, uh, system per month to less than $4,000 for supportive housing, again, the element of housing plus the supports, uh, it's pretty clear we can't afford the status quo.

And I'm gonna really dive into some of those numbers, and I think this is really what, uh, a year in, uh, being able to release to the world-

... whose life has been changed by this intervention.

I think if you haven't had a chance to read it yet, the profile of Jason Miles by Victoria Gibson in The Last Month, uh, to me is just one of the most powerful stories of heroism of, of someone who, uh, spent years, uh, being unhoused, uh, suffering from mental health and addictions and substance use disorders, uh, and has been able to see, uh, now for the first time them working, finishing high school, going back at Dunn House to finish their credits, uh, and is now part of the Lived Experience Advisory Council for the mayor's office, uh, and is employed in terms of how they're now leading, uh, recovery groups.

They are active neighbors and members in Parkdale, uh, and advocating for more housing and more opportunities for people.

Uh, and so I, you know, every week, uh, continue to be so moved, uh, by Jason, but there are, are dozens of other stories and people that live, uh, in Dunn House that, again, when you see, to me, the trust that's being built and the care and community that's being built amongst 51 people, that part of the last year, you can't capture it in a metric.