Posts Tagged ‘policy’

Healthy Communities Through Harm Reduction

October 7, 2015

In part two of this three part series, Sarah outlined a difficult tension in many social service agencies’s work. Agencies like House of Friendship often walk with people using drugs or struggling with their mental health, which can manifest in behavior likely to be deemed “difficult.” When so-called difficult people are barred or restricted from service, those agencies cannot fulfill their mandate, and individuals who might need the most support receive the least, if any. In this final installment, Sarah picks up on this idea, and explores creative alternatives.

Besides barring people, what might possible alternatives to dealing with substance use or conflict in a social service agency look like? One particular framework seems to offer a different, more inclusive approach. So, today I’ll examine why increasing available harm reduction services, and adopting a harm reduction approach to working with people who use substances may be beneficial for individuals and communities.

Harm reduction is… what?

Harm reduction” means different things to different people, but I’ll say here that it is any policy or program designed to reduce drug-related harm without necessarily requiring the cessation of drug use. In other words, you need not be clean to access services, or whatever. The focus instead is on reducing the harmful consequences associated with drug use. So, harm reduction approaches and practices could include needle exchange programs, methadone clinics, crack pipe kits and “wet shelters,” all of which aim to mitigate harms without requiring abstinence.

From CATIE

The Canadian Harm Reduction Network’s communications often includes the following quotation: “to act and not be acted upon is the essence of joy.” Harm reduction is an active process, or practice. Individuals must engage in self-management, and determine (with support) realistic goals that minimize risk. It is an approach that embraces working with people where they’re at and works to provide access to services regardless of a person’s substance use. (more…)

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Community exclusion and ‘difficult’ patrons

October 5, 2015

In her first guest post, Sara started to discuss the relationship between well-being and community inclusion (or not), and the ‘reality’ that many non-profits feel under-equipped to deal some of their patrons who are experiencing mental health issues or are using drugs or alcohol. Today she continues her earlier thoughtful discussion, jumping into a Toronto organization’s survey of folks who have been refused service or have been banned from certain agencies.

In 2013, an organization called Rittenhouse completed a survey of 10 Toronto community organizations that work with these populations and found that 90% of the agencies used barring practices or restricted services as a response to client conflict. Restricting services or barring can involve asking someone to leave or preventing them from entering or accessing the service for any amount of time. Agency staff highlighted the issue that barring practices and service restrictions actually replicate punitive, exclusionary and stigmatizing approaches faced by marginalized individuals in other areas of their lives. However, data gathered through focus groups and workshops with these community organizations demonstrates that staff feel under-qualified to deal with the conflicts that arise in their spaces in non-discriminatory and supportive ways, while balancing the health, safety, and comfort of other clients and staff.

Frank Cotham at The New Yorker

Exclusion negatively affects health

Rittenhouse conducted interviews with another 30 people who identify as current or past drug users and have been barred from a community organization. Many participants reported that the service limitation impacted their access to support services, harm reduction services, and physical health services: 40% of participants reported feeling like the bar resulted in an increase in their risk of violence; 53% felt the bar resulted in an increase in their risk of contact with police; 40%  like they did not get enough chance to talk about what happened; 53% that agency staff did not understand them or their situation; and 53% reported feeling embarrassment, shame, and/or humiliation, among other findings. (more…)