Expanding Harm Reduction at LAMP Community Health Center

Elizabeth Abebe, Monica Dale, Stephanie Fallico, Dawn Garrod, Stephanie Kipfer

Abstract

LAMP Community Health Centre, located in Toronto, aspires to foster a harm reduction culture throughout their agency to promote a more welcoming, non-judgmental, and supportive community. The purpose of this research project is to gain insight into how harm reduction approaches and attitudes can be expanded and implemented beyond conventional health-focused concerns. Additionally, researchers aim to identify and evaluate potential stigmas surrounding harm reduction approaches from both staff and clients. Informed by various harm reduction agency models, including the St. Ann’s Corner of Harm Reduction, researchers have developed a survey to better understand client experiences at LAMP and their insight on how LAMP currently supports all areas of needs. Data collected from the 17 surveys distributed has shown that LAMP is already supporting a harm reduction culture in many areas. The majority of client participants reported feeling both welcome and comfortable accessing services at the agency. While most respondents reported positively regarding service accessibility, data collected highlights a correlation between those with physical barriers reporting a lower level of accessibility and feeling less supported by staff. Additionally, despite data indicating that most clients feel a strong sense of dignity accessing LAMP services, those who reported a lower sense of dignity also reported staff being less attentive to their needs. Finally, along with reporting a stronger sense of mental wellness and support, respondents who access the Among Friends program at LAMP reported very positive experiences overall that exemplify a harm reduction culture.

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Visual of abstract and methods utilized throughout the project.

Introduction

Harm reduction is defined as an evidence-based, client-centered approach that is “dedicated to reducing the social, health and economic harms associated with activities such as substance use, drug distribution, sex, and sex work.” (LAMP, n.d.) & (Harm Reduction International, 2020). Its approach supports offering a wide range of accessible and non-judgmental treatment options to better assist individuals in making informed decisions about their individual needs while reducing harms with potentially hazardous activities. Its policies and practices are informed by extensive research and evidence to support that not only are programs effective, feasible, safe, and cost-effective but have proven to have a significant positive impact on individual and community health (Health Link BC, 2020). Its approaches are founded on the notion that all individuals deserve to be treated with dignity and respect, and have equal access to health and social services, regardless of where they are in their treatment journey. LAMP Community Health Center operates several harm reduction services varying from supply distribution and regular HIV/Hep C testing to educational workshops and peer-based supports. Their harm reduction programs are informed by their anti-oppression policy which is committed to elimination all forms of oppression within their services to “create and maintain a safe environment that facilitates open and respectful participation of employees, clients, volunteers, students, community, and board members (LAMP, 2017). While the harm reduction services offered at LAMP have been very successful, the agency strives to incorporate harm reduction approaches throughout its programs and services. By encouraging and supporting a harm reduction culture throughout their agency, clients may feel more comfortable accessing additional resources and LAMP programs. Creating a harm reduction environment also can encourage a more welcoming, non-judgmental, and supportive community as a whole. By finding successful harm reduction agency models and relevant research, the project strives to assist LAMP Community Health Centre in their goal to foster a harm reduction culture within their agency.

Research Methods

The research project utilized a simple random sampling method to obtain 17 client surveys. LAMP used volunteers to promote the study and recruit participants; however, all participants were self-selected. The surveys were open to anyone who accessed LAMP services. Once participants were given clear communication and consent was obtained, participants could complete the survey via Survey Monkey, on the agency’s secure tablets, or through their email address. Feedback from the surveys remained anonymous. The team did a comparative and statistical analysis at the end of the survey period, looking for patterns and key findings related to the research question. The study also used text mining and color-coding to highlight keywords and themes. The comparative analysis looked for connections between overall satisfaction levels, programs attended, and general demographics. The analysis also compared keywords and themes to overall satisfaction levels and programs.

Results

Based on the data and overall positive feedback from the surveys, there was evidence that LAMP, in many ways, operates from a Harm Reduction Culture approach. While some of the data provided feedback for improvement, there was a specific peer-support program, Among Friends, with solid evidence of this existing culture within its framework. This data suggest that LAMP can further dissect the program to grow the Harm Reduction culture within LAMP. Responses indicate that the peer-support program, Among Friends, embodies aspects of a harm reduction culture by offering stronger mental wellness/health support, attentive and helpful staff, and an overall positive experience. Keywords and themes within the data also show that the Among Friends staff are currently operating from a harm reduction approach. Overall the data connected to the peer support program showed positive and measurable impacts, such as clients’ self-described high levels of dignity and an overall satisfaction scoring of the agency. Other recommendations that came from the study reflect accessibility. Those who deemed the physical space accessible also gave a high satisfaction rate and level of dignity. Those who expressed physical barriers within the space, on average, showed a lower rating in those categories. Further exploring the accessibility within LAMP and dissecting the various ways a client may deem something accessible or inaccessible would also benefit the organization. The data suggest that building on LAMP’s accessibility appears to have the ability to improve a culture of harm reduction.

Discussions and Conclusions

Additional research and our results suggest that peer-support programming, specifically Among Friends, has effectively delivered the tools that feed into a holistic harm reduction environment. The data suggest that agencies can apply peer-support frameworks to implement and expand a culture of harm reduction.

Acknowledgements

Humber College students Monica Dale, Dawn Garrod, Stephanie Fallico, Elizabeth Abebe, and Stephanie Kipfer would like to express gratitude to the LAMP CHC community, especially Natalia Semeekina and Jacqueline St.Kitts Myers. The students would also like to thank our supervisor, Christine Mckenzie, who offered guidance and support throughout this project. Lastly, we would like to thank any participants that contributed lived experience and insight, allowing this project to come together.