Planning a multi-site homelessness research demonstration for people with mental illness: The relationships between national and local teams in Canada's At Home/Chez Soi project

Canada's At Home/Chez Soi Housing First research demonstration project provides an opportunity to study the dynamics of the relationships between national and local teams, because the parameters of the project were set by a national team, while local site teams planned how the research and services would be implemented in five Canadian cities. In this paper, we examine the contextual influences and the dynamics between the national team and local teams in planning local programs. This research employed a multiple case study approach that involved individual and focus group interviews with key people involved. Using common qualitative interview protocols, 122 participants were interviewed at the five sites. Grounded theory analysis of the data found that across sites, there were tensions between a collaborative approach and the need to “get things done,” between a common approach and local approaches, and between different worldviews (e.g., service vs. research, mental health consumer vs. researchers and professionals). What helped the process was the evolution of a shared commitment to the values of the Housing First approach, getting the “right” people/partners involved, providing an opportunity for local innovation in addition to the common approach, and making a conceptual distinction between the “form” and “function” of local programs. The findings lend support to the notion that contextual influences that are political and historical impinge significantly on the planning process, and that health services researchers would be well advised to understand national-local dynamics in planning in the context of this “bigger picture.”