Eric Latimer

Eric Latimer

Room E-3114, Perry 3C

6875 Boulevard Lasalle
Montréal, QC
H4H 1R3

(514) 761-6131 x2351

(514) 762-3049

Research area: 
Psychosocial Research / Population Research

Research Theme: 
Mental Health and Society

Director, Mental Health and Society Research Program - Douglas Hospital Research Center
Research scientist, Douglas Hospital Research Center
Professor, Department of Psychiatry
Associate Member, Department of Epidemiology, Biostatistics and Occupational Health
McGill University

Mental health policy and economic evaluation

Dr Latimer’s research has mainly concerned services, and to a smaller extent medications, for people with severe mental illness, including homeless people. A health economist by training, his focus has mainly been twofold. First, to test evidence-based practices in Québec and Canadian settings, with an emphasis on the economic trade-offs associated with them. Second, in so doing, to use the evidence on these practices, thus reinforced by local experience, to support their introduction and development within health and social services systems, mainly in Québec.

The key practices that he has focused on since joining the Douglas Institute and McGill University in 1996 are Assertive Community Treatment (ACT), the Individual Placement and Support model of supported employment, scattered-site Housing First for people who are both homeless and mentally ill, and most recently, the strengths model of case management as developed at the School of Social Welfare in Kansas.

ACT is a team-based method for helping people with the most severe mental illnesses live more successfully in the community. Dr Latimer has helped clarify, in a widely-cited paper, the conditions under which such programs can cover their own costs [1]. With others, he contributed to the introduction of ACT into Québec mental health policy in 2005, and subsequently to the establishment of the Centre national d’excellence en santé mentale (CNESM), an agency of Québec’s Ministry of Health and Social Services. Among its mandates, the CNESM supports the development of high-fidelity (more effective) ACT teams across the province.

Individuals whose degree of impairment does not quite meet the level required for an ACT team are generally thought to require the support of a less intensive form of case management, loosely-called intensive case management (ICM). Among the various models for structuring the work of ICM teams, the strengths model appears the most promising [2] – though it is to date far from having been as widely-implemented as the ACT model. Together with a team including co-investigators from Ontario, Québec and Newfoundland, Dr Latimer obtained a $1.2 million CIHR grant (2014 – 2017) to test the hypotheses that higher fidelity (i.e., closer adherence) to the strengths model is associated with both higher quality of life for clients, and lower costs. Under this grant, ICM teams in Ontario and Québec are being systematically trained to implement the strengths model, while participants are being recruited. Careful observations of implementation at each site are being gathered for later synthesis, so that barriers and facilitators to successful implementation can be described.

With collaborators from Québec as well as the Dartmouth Psychiatric Research Centre, where the IPS model originated, Dr Latimer was the first to publish the results of an IPS trial carried out outside the United States [3]. This study showed that the IPS model is effective in countries with very different systems of support for people with severe mental illness than those in US states. Dr Latimer’s work, together with regular participation in presentations with employment specialists of the Douglas Institute’s IPS program, have contributed to growing adoption of the model in the province of Québec and increasingly, French-speaking Europe. He has also helped clarify the economic impacts of IPS [4, 5].

Since 2009, Dr Latimer has also been lead investigator of the Montreal site, and lead economist nationally, of the $110 million At Home / Chez Soi research and demonstration study on homelessness and mental illness, which tested the Housing First approach using nine concurrent trials in five Canadian cities. This very large study funded by the Mental Health Commission of Canada led the federal government to reallocate 65% of its HPS funding of homelessness programs across Canada towards Housing First programs. This type of program is now also included in Québec’s Plan d'action interministériel en itinérance 2015-2020. Economic findings to date indicate that cost offsets are always greater for high-need than for moderate-need participants, but that they are almost never sufficient, in any case, to cover the costs of the program [6-8].

1. Latimer, E., Economic Impacts of Assertive Community Treatment: A Review of The Literature. Canadian Journal of Psychiatry, 1999. 44(5): p. 443-454.

2. Latimer, E. and D. Rabouin, Soutien d'intensité variable (SIV) et rétablissement: que nous apprennent les études expérimentales et quasi-expérimentales? (Case management for moderate need clienteles: What can we learn from experimental and quasi-experimental studies?). Santé mentale au Québec, 2011. XXXVI(1): p. 13-34.

3. Latimer, E., et al., Generalisability of the individual placement and support model of supported employment: Results of a Canadian randomised controlled trial. British Journal of Psychiatry, 2006. 189: p. 65-73.

4. Latimer, E., Le soutien à l'emploi de type "placement et soutien individuels" pour les personnes atteintes de troubles mentaux graves: sa pertinence pour le Québec. Vol. MO-2008-01. 2008: AETMIS.

5. Latimer, E., Economic considerations associated with assertive community treatment and supported employment for people with severe mental illness. J Psychiatry Neurosci, 2005. 30(5): p. 355-9.

6. Latimer, E., et al., At Home/Chez Soi Project: Montréal Site Final Report. 2014, Mental Health Commission of Canada: Calgary, AB.

7. Stergiopoulos, V., et al., Effect of scattered-site housing using rent supplements and intensive case management on housing stability among homeless adults with mental illness: a randomized trial. JAMA, 2015. 313(9): p. 905-15.

8. Goering, P., et al., Rapport final du projet pancanadien Chez Soi. 2014, Commission de la santé mentale du Canada: Calgary (Alberta).

1. Stergiopoulos V, Hwang S, Gozdzik A, Nisenbaum R, Latimer E, Rabouin D, Adair C, Bourque J, Connelly J, Frankish J, Katz L, Mason K, Misir V, O’Brien K, Streiner D, Sareen J, Schütz C, Singer A, Vasiliadis HM, Goering P (2015), “Scattered-Site Housing First with Intensive Case Management for Homeless Adults with Mental Illness: 24 Month Outcomes of a Multi-Site Randomized Controlled Trial,” Journal of the American Medical Association 313(9): 909-915.

2. Latimer E, Gariepy G, Greenfield B (2014), “Cost-effectiveness of a rapid response team intervention for suicidal youths presenting at an emergency department” Can J of Psychiatry 56(6), 310 – 318.

3. Latimer E, Naidu A, Moodie E, Clark R, Malla A, Tamblyn R, Wynant W (2014), “Variation in long-term antipsychotic polypharmacy and high-dose prescribing across physicians and hospitals”, Psychiatric Services, 65 (10), 1210 – 1217.

4. Knapp M, Patel A, Curran C, Latimer E, Catty J, Becker T, Drake RE, Fioritti A, Kilian R, Lauber C, Rössler W, Tomov T, van Busschbach J, Comas-Herrera A, White S, Wiersma D, Burns T (2013), “Supported employment: Cost-effectiveness across six European sites”, World Psychiatry 12(1): 60-68.

5. Latimer E, Clark R, Malla A, Moodie E, Tamblyn R, Naidu A (2013), “Underprescribing of Clozapine and Unexplained Variation in Use across Hospitals and Regions in the Canadian Province of Québec”, Clinical Schizophrenia & Related Psychoses, April, 33-41..

6. Goering P, Streiner D, Adair C, Aubry T, Barker J, Distasio J, Hwang S, Komaroff J, Latimer E, Somers J, Zabkiewicz D (2011), "The At Home/Chez Soi trial protocol: A pragmatic, multi-site, randomized controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities", BMJ Open 1; 1-18.

7. Latimer E, Bond G, Drake R (2011), “Economic approaches to improving access to evidence-based and recovery-oriented services for people with severe mental illness”, Canadian Journal of Psychiatry 56:9, 523 – 529.

8. Latimer E (2010). “An effective intervention delivered at sub-therapeutic dose becomes an ineffective intervention” (Editorial). British Journal of Psychiatry 196, 341-342.

9. Latimer E, Lecomte T, Becker D, Drake R, Duclos I, Piat M, Lahaie N, St-Pierre MS, Therrien C, Xie H (2006), “Generalisability of the individual placement and support model of supported employment: results of a Canadian randomised controlled trial”, British Journal of Psychiatry, 189:55-73.

10. Latimer E, Bush P, Becker D, Drake R, Bond GR (2004), “How much does supported employment cost for people with severe mental illness? An exploratory survey”, Psychiatric Services 55:4, 2004, 401-406.

Dr Latimer obtained a PhD in economics from Carnegie Mellon University, in Pittsburgh, PA, in 1989. He was Assistant Professor of Health Economics at the Harvard School of Public Health from 1989 to 1996. There he carried out work concerning the practice expenses component of the Medicare Fee Schedule and Canada/US comparisons of physician service use. He also participated, with Barbara Dickey, in the economic evaluation of programs for homeless people in Boston. In 1996 he joined the Douglas Mental Health University Institute and McGill University. From 1996 to 1998 he was also a part-time researcher at the Conseil d’Évaluation des Technologies de la Santé (now Institut national d’excellence en santé et services sociaux), where he produced an influential report on the applicability of the Assertive Community Treatment (ACT) model for the care of people with severe mental illness to the province of Québec. His research interests (described in detail in another section) focus on community-based supports for people with severe mental illness, including homeless people. He has served as consultant to the Québec government and has collaborated or served as a consultant with research teams in Europe and North America. He has been a member of CIHR’s Institute for Health Services and Policy Research Advisory Board (2007 – 2010), a member of the Board of Directors of the Canadian Association for Health Services and Policy Research (2004 – 2010) (Treasurer 2006 – 2010). In 2007 – 2008 he was a Visiting Scholar at the London School of Economics, the Center for the Economics of Mental Health of King’s College London, and the Personal and Social Services Resarch Unit at the University of Kent at Canterbury. He is currently an associate editor of the Canadian journal, Healthcare Policy/Politiques de santé, and teaches economic evaluation of health programs in the Department of Epidemiology, Biostatistics and Occupational Health at McGill University.

2015 Prix Montréal Centre-Ville, « Event » category.
2015 Psychosocial Rehabilitation Canada/Réadaptation Psychosociale Canada, Pioneer Award, Recovery Research.
2012 – 2014 J. A. Bombardier Fellowship in the Quality of Mental Health Care
2001 – 2005 FRSQ Chercheur-boursier Senior
1999 – 2001 FRSQ Chercheur-boursier Junior II

Research coordinator: Christian Méthot

Statistician: Zhirong Cao

Part-time research associates: Erika Braithwaite, Guido Powell

Research assistant: Lesley Perlman

Recent Publications

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