3.6 Harm Reduction Housing Models (Respress)
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3.6 Harm Reduction Housing Models (Respress)

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Harm reduction strategies can be very effective for housing people with substance use disorders. This workshop will explore practices that help ensure successful implementation of harm reduction ...

Harm reduction strategies can be very effective for housing people with substance use disorders. This workshop will explore practices that help ensure successful implementation of harm reduction housing models.

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  • t/a choice being at the center of program design and decision making.
  • My conversion to HF. Original fear was that we would throw people into housing w/ no services. If we are going to engage/treat this group of individuals, we need to structure our services to make them attractive/inviting
  • Common examples of harm reduction: seat belt laws, condom distribution (in our office everywhere), needle exchange, methadone
  • Some people think that by practicing harm reduction we’re encouraging more use. Ex. Of HUD folks and reduced $ on ETOH once inside.James- nobody wanted to put him in their housing program. Mumbling, feces, drinking heavily. Would have died on street. First apt. a mess in two days. Tried it again. Different services in place. Still drinking- not much! Smiling, well dressed, engaged in groups, looking for a girlfriend, etc.Edward: nobody wanted him in housing, and he didn’t want to go! If we required insight- still on street. Apt. signs on door, food cans, suspicions, now health issues. Wouldn’t have been able to treat any of this if didn’t allow to come into program in first place.
  • Addiction- Keith- budgeting for drinking, smoking, letting people in. make sure eating, in group, monitor $, involve family, intense medical servicesPsychiatric- Anthony- young, Dx w/ schizophrenia. Hates how meds make him feel. Negotiate w/ doctor. Taking apart apt. Walking in traffic.Medical- Agnes. 70 y.o Drinking, open wounds on legs, heart problems, daily wound care. Buying ETOH while shoppingStaff struggles w/ these decisions daily. Teamwork is essential- decisions not made independently
  • Need to understand in the hiring process. Ex. Of Liz as the Addictions Specialist. Open to new idea, but uncomfortable at first. Now she loves it b/c it allows her to do what was instinctual all along, and to continue to work w/ those most in need of her services.
  • Ex. Of how PTHDC started. Nobody else doing HF. Took partnership w/ community members, but original champion was DMH. Hard to get referrals b/c new way of doing housing. Now the whole community has taken it on.

3.6 Harm Reduction Housing Models (Respress) 3.6 Harm Reduction Housing Models (Respress) Presentation Transcript

  • Harm Reduction Housing ModelsNational Alliance to End HomelessnessJuly 12-14, 2010Washington, DC
    Christy Respress, MSW
    Pathways to Housing DC
    1
  • Pathways to Housing DC: Who we Serve
    • Persons experiencing serious mental illnesses such as schizophrenia, bipolar disorder, and major depression
    • Experiencing chronic/long term homelessness
    • Co-occurring substance use disorders- at least 80%
    • Serious medical issues
    • Histories of trauma and violence
    • Lack of hope
    • Various stages of readiness to make change, with the majority entering with ambivalence
    2
  • Pathways DC Program and Housing Services
    • 4 Assertive Community Treatment (ACT) teams with the capacity to serve 300 individuals. Each participant on the ACT team receives their own scattered site apartment.
    • PSH program serving 105 people w/ intensive case management and scattered site apartments
    • Outreach Team
    • Community Support- 40 served
    • Supported Employment Program
    3
  • Housing First Program Practice
    Immediate access to permanent, independent housing
    No requirement for sobriety or treatment
    Harm reduction approach to services
    Program participant sets service priorities (e.g., job, family connection, addictions Tx, psychiatric Tx, etc.)
    Follow standard lease obligations
    Need to visit in home at least 1x per month
    4
  • Recovery is a Process
    • Recovery doesn’t magically happen once someone moves into an apartment! Well….maybe sometimes.
    • Recovery is a process and looks different for each person
    • People still need support while they’re using!
    • Need a framework for delivering services while person engaging in harmful activities/behaviors, actively using drugs/alcohol, or disengaged from psychiatric/medical treatment- harm reduction
    5
  • Definitions of Harm Reduction
    Harm reduction is a set of practical strategies that reduce negative consequences of drug use, incorporating a spectrum of strategies from safer use, to managed use to abstinence. Harm reduction strategies meet drug users "where they're at," addressing conditions of use along with the use itself. (Harm Reduction Coalition)
    Harm Reduction is a set of non-judgmental strategies and approaches which aim to provide and/or enhance skills, knowledge, resources and support that people need to live safer, healthier lives. (Streetworks, 1997).
    6
  • Harm Reduction in housing
    • Most people entering Pathways are not actively working on ending their addictions or obtaining psychiatric treatment.
    • Principles of harm reduction support Stages of Change- Prochaska & DiClemente
    • Most needed in early stages of precontemplation and contemplation
    • Harm reduction doesn’t mean we encourage people in their use- still want folks to stop using!
    7
  • What Does Harm Reduction look like at PTHDC?
    Addictions
    Psychiatric
    Medical
    8
  • Practicing harm reduction allows us to continue to provide high quality, compassionate services to people still engaged in harmful behaviors.
    This model doesn’t discriminate against persons with disease of addiction.
    Who needs to change? We do. Requires most staff members to approach the work in a new way.
    9
  • Communities Making the Shift
    • 10 Year Plans to end homelessness often include Housing First. Services framework needed.
    • HUD looking for outcomes such as retention for these “hardest to serve” populations- requires a paradigm shift in how we provide services.
    • Reeducate staff so that they can keep their jobs in this new way of doing things.
    • Ex: DC’s shift
    10
  • Contact Info
    Christy Respress, MSW
    (202) 529-2972crespress@pathwaysdc.orgwww.pathwaystohousing.org
    11