Bouchra Arbach (on right), a registered nurse case-manager, walking with At Home participant, Theresa in the film "Evicted."

“Our team works with more than 80 participants and every morning we meet to go through the database and review each of their cases,” explains Greg Richmond, project leader of At Home’s Vancouver Assertive Community Treatment (ACT) team. “We sort out what needs to be done and then scatter across the city to visit our clients. This project requires an incredibly high level of organization – I’ve never seen anything like it before.”

No two ACT teams are the identical, says Richmond, but they all follow a roughly similar profile. Here’s a staff breakdown of a typical team:

1 Project Leader (the administrative lead who serves as the liaison with the At Home study)

1 Team Leader (typically a health professional such as a psychiatrist)

3 Nurses (1 nurse practitioner, 1 registered nurse, 1 psychiatric nurse)

1 Social Worker

1 Substance Abuse Counselor

1 Occupational Therapist

1 Administrative Assistant

1 Vocational Worker

1 Peer Worker

1 Housing Specialist

1 Community Development Worker

At Home caseworker, Lukas with At Home participant Tessa in the Here At Home film "The Wound Inside," which takes place in Winnipeg

Depending on their needs, each participant is assigned one team member as their primary contact. This arrangement allows the support workers to build solid connections with the participants. The relationships between participants and their support workers are key to the success of the Housing First strategy. This is why team members need something more than professional qualifications to do this job well, says Richmond.

“The bulk of the work we do is outreach, which can mean doing everything from linking up somebody’s cable to integrating them into their new community. Mostly it involves listening well and building dignifying relationships with participants. It’s very hard work helping people that the system hasn’t helped before. It requires persistence and a fundamentally positive outlook. It requires an understanding of the background to the problems the participants have experienced. Team members need to have a strong sense of social justice and be fundamentally non-judgmental. And they need to profoundly get adversity. Most importantly, they need to be able to see that people who have lived through a great deal of adversity have a great deal of strength. We need to be able to get alongside them and help them use those strengths to achieve what they want to achieve. This is not about clinicians imposing a solution on people, it’s about helping people realize their own goals.”