Housing and harm reduction

Key take-home messages

• “Some of the issues that revolve around housing readiness and access to housing being offered illustrate the “grey zones” that appear in a harm reduction approach. Thus some projects did have expectations of behavior and participation… , benefiting from the supports offered…, refusing services offered… and agreeing to a psychiatric report. While some of the harm reduction approaches have a certain number of expectations, behavioral issues that might jeopardize a client’s tenancy are addressed through support and building open, non-judgmental relationship with each resident. Motivational interviewing is used to help clients develop the desire to make positive changes through the process of articulating and pursuing their own personal goals.”
• There is increasing awareness of the concept of harm reduction, but it is not widely understood. There is a need for greater education on harm reduction and methods on how it can work in different settings. Similarly, while many communities have progressed towards adopting housing first approaches and introducing initiatives to respond to homelessness, community leadership is essential to raise awareness and foster cooperation among major stakeholders.
• Assuming a client-centered approach and focusing on individual goal setting may be the most flexible and responsive program to client needs and help to end the cycle whereby people enter programs, leave when they relapse, and try again. A client centered approach, however, does not negate the possibility of abstinence or reduction of substance use. “A client-centered approach requires access to a range of housing options — that is, wet and dry, scattered and dedicated — as well as a variety of service options for the residents. This allows clients to decide what is best for themselves, effectively reducing the chances of relapse.”
• Housing pilots and programs with harm reduction approaches require solid governance frameworks and organizational structures to ensure cohesive approaches to housing and service delivery, including ongoing review and monitoring efforts to ensure effectiveness and accountability to users, funders and the general public.
• Policy makers need to move away from an either/or approach (abstinence based or harm reduction) and acknowledge that both types of initiatives can meet the needs of different clientele.

• Determinants of Health
  • Housing
• Population(s)
  • General HIV+ population
  • General HIV- population
• Prevention
  • Drug use behaviours/harm reduction