Quebec group-home owners decry lack of supportive housing for mentally ill

Provincial government cutbacks are taking a toll on family-type group homes for adults with mental health problems who are unable to care for themselves.

In the last 10 years, nearly 700 of these homes have closed.

• Montreal's Douglas Hospital closes group home after death of mentally ill man

Despite the crying need for supportive housing for Quebecers living with profound mental illness, the future looks bleak.

"Owners are finding it harder to make a living," said Réjean Simoneau, the president of the Coalition of Adult Residential Resources of Québec, better known by its French acronym, Ressaq.

Simoneau says the average group-home owner is 60 years old, so many are close to retirement.

Closing of institutions

Family-style, government-subsidized group homes became a mainstay after the government deinstitutionalized services for the mentally ill in the 1970s and 80s. But these days, the government is focused on other options for community living, such as unsubsidized group homes or supervised apartments.

The problem is, not everyone is suited to that much independence, says Mary Surowaniec, the coalition's Montreal president.

Surowaniec runs a group home in Lasalle. She says many of her residents are elderly and could never manage living on their own.  

She takes them shopping, schedules haircuts and doctors' appointments and manages their medication. She's also there to provide meals and even helps some bathe.

"Really, this is a 24/7 job," said Surowaniec.

If she's not at home, her husband is her back-up. And when they are away on vacation, Surowaniec is responsible for hiring someone to fill in for her.

These back-up caregivers are checked for a criminal record and have to have first-aid training as well as courses on dispersing medication.

"If something happens, who's going to be responsible? It's us," said Surowaniec, who will often spend a few weeks working side-by-side breaking in her replacement so they get a good sense of the job and her expectations.

"When I want things done a particular way, it has to be that way," she said. "We're not dealing with products on a shelf, we're dealing with human lives."

Group home closures

There are cases where subsidized group homes have had their contracts terminated because of unresolved concerns.

The worst thing of it all is none of the clients have any say in anything. I think that's the saddest part: they are at the mercy of the system.- Group-home owner Mary Surowaniec

Jonathan Lalancette, a lawyer working on behalf of Ressaq, estimates there are 40 to 45 cases in arbitration right now for various reasons – about half involving concerns over quality of care.

Once a group home is closed or shut down, residents are dispersed throughout the remaining network.

Surowaniec says there are as many as 300 people in Montreal at any one time waiting for a bed at a group home like hers. 

But if she has an empty bed, she can't go out and fill it with whoever she wants. She has an exclusive contract with the Douglas Hospital. Social workers from there look at the person's needs and try to pair them with the right group home.

But if there are no beds available, they can end up in long-term care homes and hospitals or may even end up on the street, says Surowaniec.

"The worst thing of it all is none of the clients have any say in anything," she said. "I think that's the saddest part: they are at the mercy of the system."

Government 'short-sighted'

Psychiatrist Dr. James Farquhar has worked in several Montreal hospitals over the past 30 years.

He sympathizes with the challenges subsidized, accredited group-home operators like Surowaniec are facing.

They must maintain a certain level of care and trained staff, which costs money.

"It's all about the government being cheap and trying to save money off the poorest and most vulnerable people," said Farquhar.

He says the private, unregulated group homes are less costly, but – in most of the cases he's seen – they're more like rooming houses.

"Many of my patients are in [unsubsidized] private group homes for lack of any better housing," said Farquhar.

READ ALSO: 

• Mother of teen 'saved' by Douglas Hospital DBT program urges health minister to bring it back
• CBC Montreal Investigates

The CIUSSS de l'Ouest-de-l'Île-de-Montréal, the regional health agency which administers the Douglas Hospital, refused CBC's request to speak to its residential resources department about how group homes are managed and monitored.

Share your story with CBC Montreal's investigative team. Leave a message on our confidential tipline (514-597-5155), send us an email or contact us on Twitter.