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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 housing models.

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3.6 Harm Reduction Housing Models (Respress)

  1. 1. Harm Reduction Housing ModelsNational Alliance to End HomelessnessJuly 12-14, 2010Washington, DC<br />Christy Respress, MSW<br />Pathways to Housing DC<br />1<br />
  2. 2. Pathways to Housing DC: Who we Serve<br /><ul><li>Persons experiencing serious mental illnesses such as schizophrenia, bipolar disorder, and major depression
  3. 3. Experiencing chronic/long term homelessness
  4. 4. Co-occurring substance use disorders- at least 80%
  5. 5. Serious medical issues
  6. 6. Histories of trauma and violence
  7. 7. Lack of hope
  8. 8. Various stages of readiness to make change, with the majority entering with ambivalence</li></ul>2<br />
  9. 9. Pathways DC Program and Housing Services<br /><ul><li>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.
  10. 10. PSH program serving 105 people w/ intensive case management and scattered site apartments
  11. 11. Outreach Team
  12. 12. Community Support- 40 served
  13. 13. Supported Employment Program</li></ul>3<br />
  14. 14. Housing First Program Practice<br />Immediate access to permanent, independent housing <br />No requirement for sobriety or treatment<br />Harm reduction approach to services<br />Program participant sets service priorities (e.g., job, family connection, addictions Tx, psychiatric Tx, etc.)<br />Follow standard lease obligations<br />Need to visit in home at least 1x per month<br />4<br />
  15. 15. Recovery is a Process<br /><ul><li>Recovery doesn’t magically happen once someone moves into an apartment! Well….maybe sometimes.
  16. 16. Recovery is a process and looks different for each person
  17. 17. People still need support while they’re using!
  18. 18. 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</li></ul>5<br />
  19. 19. Definitions of Harm Reduction<br />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)<br /> 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).<br />6<br />
  20. 20. Harm Reduction in housing<br /><ul><li>Most people entering Pathways are not actively working on ending their addictions or obtaining psychiatric treatment.
  21. 21. Principles of harm reduction support Stages of Change- Prochaska & DiClemente
  22. 22. Most needed in early stages of precontemplation and contemplation
  23. 23. Harm reduction doesn’t mean we encourage people in their use- still want folks to stop using!</li></ul>7<br />
  24. 24. What Does Harm Reduction look like at PTHDC?<br />Addictions<br />Psychiatric<br />Medical<br />8<br />
  25. 25. Practicing harm reduction allows us to continue to provide high quality, compassionate services to people still engaged in harmful behaviors. <br />This model doesn’t discriminate against persons with disease of addiction.<br />Who needs to change? We do. Requires most staff members to approach the work in a new way.<br />9<br />
  26. 26. Communities Making the Shift<br /><ul><li>10 Year Plans to end homelessness often include Housing First. Services framework needed.
  27. 27. HUD looking for outcomes such as retention for these “hardest to serve” populations- requires a paradigm shift in how we provide services.
  28. 28. Reeducate staff so that they can keep their jobs in this new way of doing things.
  29. 29. Ex: DC’s shift </li></ul>10<br />
  30. 30. Contact Info<br />Christy Respress, MSW<br />(202) 529-2972crespress@pathwaysdc.orgwww.pathwaystohousing.org<br />11<br />

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