Eric Latimer, PhD

Dr. Eric Latimer

Contact

 eric.latimer@mcgill.ca

 

6875 Boulevard LaSalle
Montréal, QC
H4H 1R3

 Office:E-3114, 3C, Perry Pavilion

 Office phone: (514) 761-6131 x2351

 Fax: (514) 762-3049

Researcher, Douglas Research Centre
Full Professor, Department of Psychiatry, McGill University
Associate Member, Department of Epidemiology, Biostatistics and Occupational Health, McGill University

Lab name: Mental health policy and economic evaluation


Division: Mental Health and Society

 

Dr Latimer’s research has mainly concerned services, and to 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 the conditions under which such programs can cover their own costs. With others, he contributed to the introduction of ACT into Québec mental health policy in 2005.

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 – 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 received systematic training to implement the strengths model. Results are still being finalized, but one key finding appears to be that higher fidelity to the strengths model promotes greater therapeutic alliance, which in turn promotes a better quality of life and other favourable outcomes.

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. 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, a result since replicated in many other countries. Dr Latimer’s work, together with regular participation in presentations with employment specialists of the Douglas Institute’s IPS program, has contributed to growing adoption of the model in the province of Québec and increasingly, French-speaking Europe.

From 2009 to 2015, Dr Latimer was also 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. Economic findings 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.

More recently, in 2015, he also co-lead Montreal’s first Point-in-time count of people experiencing homelessness 1, and lead Montreal’s second count in 2018.2 He was also the lead author on the report for the homelessness count in the province of Québec in 2018.3

Current work involves completing the study on the strengths model of case management study and a computer simulation model of homelessness (funded by the Social Sciences and Humanities Research Council).    A recently-funded project concerns the co-construction of an innovative intervention to help prevent homelessness among youth leaving care.

 

Key publications

  1. Groff, M, Latimer E, Joober R, Iyer SN, Schmitz N, Abadi S, Abdel-Baki A, Casacalenda N, Margolese HC, Jarvis GE, Malla A, “Economic Evaluation of Extended Early Intervention Service vs Regular Care Following 2 Years of Early Intervention: Secondary Analysis of a Randomized Controlled Trial” (2020), Schizophrenia Bulletin, Published online September, doi:10.1093/schbul/sbaa130
  2. Latimer EA, Rabouin D, Cao Z, Ly A, Powell G. Aubry T, Distasio J, Hwang SW, Somers JM, Bayoumi AM, Mitton C, Moodie EEM, Goering PN (2020), “Cost-effectiveness of Housing First with Assertive Community Treatment: Results from the Canadian At Home/Chez Soi trial”, Psychiatric Services, Published online August 25.
  3. A Fisher, V Mago, E Latimer (2020), “Simulating the Evolution of Homeless Populations in Canada Using Modified Deep Q-Learning (MDQL) and Modified Neural Fitted Q-Iteration (MNFQ) Algorithms’ IEEE ACCESS 8, pages 92954 – 92968, DOI:  10.1109/ACCESS.2020.2994519
  4. Latimer E, Bordeleau F, Méthot C, Barrie T, Ferkranus A, Lurie S, Whitley R (2020), “Implementation of supported employment in the context of a national Canadian program: Facilitators, barriers and strategies”, Psychiatric Rehabilitation Journal, March, 43 (1), 2-8.
  5. Latimer EA, Rabouin D, Cao Z, Ly A, Powell G, Adair CE, Sareen J, Stergiopoulos V, Somers JM, Moodie EEM, Pinto AD, Veldhuizen S, Goering PN (2019), “Cost-effectiveness of Housing First with Intensive Case Management for homeless people with mental illness:  Results from the multi-site Canadian At Home/Chez Soi trial”, August 21, JAMA Network Open.
  6. Latimer E, Bordeleau F. Dénombrement des personnes en situation d’itinérance au Québec le 24 avril 2018. Québec, QC: Ministère de la Santé et des Services sociaux; 2019 March 25, approximately 600 pages.
  7. Latimer E, Rabouin, D, Cao Z, Ly, A, Powell, G, Aubry T, Distasio J, Hwang, SW, Somers, JM, Stergiopoulos V, Veldhuizen S, Erica E.M. Moodie, E.E.M., Lesage, A, Goering, PN (2017), “The costs of services for homeless people with mental illness in five Canadian cities : Results from a large prospective follow-up study”, CMAJ Open 5(3), E576-E585, DOI:10.9778/cmajo.20170018.
  8. Poremski D*, Braithwaite E, Nisenbaum R, Stergiopoulos V, Distasio  J, Latimer E (2016), “Effects of Housing First on employment and income of homeless individuals: results of a randomized trial.”, Psychiatric services 67 (6), 603-609.
  9. Ly, A*, Latimer E (2015), “Housing first impacts on costs and associated cost offsets:  A review of the literature”, Canadian Journal of Psychiatry, 60 (11), 475-487.
  10. Poremski D*, Whitley R, Latimer E (2015), “Building trust with people receiving supported employment and Housing First services”, Psychiatric Rehabilitation Journal  Mar 30, ePub ahead of print.
  11. 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.
  12. 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.
  13. 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.
  14. 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.
  15. 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.

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 was an Associate Editor of the Canadian journal, Healthcare Policy/Politiques de santé (2011 – 2019). He teaches economic evaluation of health programs in the Department of Epidemiology, Biostatistics and Occupational Health at McGill University.

Curriculum vitae 2023

2017 McLaughlin-Gallie Visiting Professorship, Mental Health in Disadvantaged Populations, Royal College of Physicians and Surgeons of Canada
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

Key publications

1. Groff, M, Latimer E, Joober R, Iyer SN, Schmitz N, Abadi S, Abdel-Baki A, Casacalenda N, Margolese HC, Jarvis GE, Malla A, “Economic Evaluation of Extended Early Intervention Service vs Regular Care Following 2 Years of Early Intervention: Secondary Analysis of a Randomized Controlled Trial” (2020), Schizophrenia Bulletin, Published online September, doi:10.1093/schbul/sbaa130
2. Latimer EA, Rabouin D, Cao Z, Ly A, Powell G. Aubry T, Distasio J, Hwang SW, Somers JM, Bayoumi AM, Mitton C, Moodie EEM, Goering PN (2020), “Cost-effectiveness of Housing First with Assertive Community Treatment: Results from the Canadian At Home/Chez Soi trial”, Psychiatric Services, Published online August 25.
3. A Fisher, V Mago, E Latimer (2020), “Simulating the Evolution of Homeless Populations in Canada Using Modified Deep Q-Learning (MDQL) and Modified Neural Fitted Q-Iteration (MNFQ) Algorithms’ IEEE ACCESS 8, pages 92954 – 92968, DOI: 10.1109/ACCESS.2020.2994519
4. Latimer E, Bordeleau F, Méthot C, Barrie T, Ferkranus A, Lurie S, Whitley R (2020), “Implementation of supported employment in the context of a national Canadian program: Facilitators, barriers and strategies”, Psychiatric Rehabilitation Journal, March, 43 (1), 2-8.
5. Latimer EA, Rabouin D, Cao Z, Ly A, Powell G, Adair CE, Sareen J, Stergiopoulos V, Somers JM, Moodie EEM, Pinto AD, Veldhuizen S, Goering PN (2019), “Cost-effectiveness of Housing First with Intensive Case Management for homeless people with mental illness: Results from the multi-site Canadian At Home/Chez Soi trial”, August 21, JAMA Network Open.
6. Latimer E, Bordeleau F. Dénombrement des personnes en situation d’itinérance au Québec le 24 avril 2018. Québec, QC: Ministère de la Santé et des Services sociaux; 2019 March 25, approximately 600 pages.
7. Latimer E, Rabouin, D, Cao Z, Ly, A, Powell, G, Aubry T, Distasio J, Hwang, SW, Somers, JM, Stergiopoulos V, Veldhuizen S, Erica E.M. Moodie, E.E.M., Lesage, A, Goering, PN (2017), “The costs of services for homeless people with mental illness in five Canadian cities : Results from a large prospective follow-up study”, CMAJ Open 5(3), E576-E585, DOI:10.9778/cmajo.20170018.
8. Poremski D*, Braithwaite E, Nisenbaum R, Stergiopoulos V, Distasio J, Latimer E (2016), “Effects of Housing First on employment and income of homeless individuals: results of a randomized trial.”, Psychiatric services 67 (6), 603-609.
9. Ly, A*, Latimer E (2015), “Housing first impacts on costs and associated cost offsets: A review of the literature”, Canadian Journal of Psychiatry, 60 (11), 475-487.
10. Poremski D*, Whitley R, Latimer E (2015), “Building trust with people receiving supported employment and Housing First services”, Psychiatric Rehabilitation Journal Mar 30, ePub ahead of print.
11. 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.
12. 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.
13. 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.
14. 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.
15. 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.

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