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Reducing Harm and Housing People – Our Obligation

By Elena Lusk

What if you couldn’t hide your issues behind closed doors because you didn’t have housing that shielded you from the eyes of society? The average amount of alcohol an individual would have to consume weekly to be considered a heavy drinker is around 14 or more drinks in a week, that is about 2 or more a day. Thousands of people every day have a couple of beers or a bottle of wine when they get home and are fortunate enough to be able to have 4 walls and a roof that they can drink in every day. Maybe they are functioning alcoholics and no one has noticed or minds at work. Maybe they make enough money currently and they are able to afford rent along with buying their alcohol. There are plenty of maybe’s that go into the situation, but they still aren’t likely being cast out to the world because of the struggles they’re having. Because they aren’t sitting under a bridge or near their campsite, their door is closed and their housing is secure. Yet they are doing the same thing as someone who’s waiting in line for dinner at the local soup kitchen. 

So why shouldn’t someone who also indulges in drinking be allowed housing? Why should a substance be the reason that someone must remain outside and not be allowed help? At the end of the day, housing is a human right. And as humans, we should all be helping each other to the best that we can. Experiencing homelessness is traumatic, especially when adding in substance-related issues and more length of time without help. Dying on the streets is a reality all too common, in 2017 alone 2,525 people experiencing homelessness, with only 22 cities reporting, passed away while experiencing homelessness. It should not matter how often someone uses a substance, or if that person has an animal or, if they have the ability to get a replacement social security card without assistance; everyone deserves an opportunity to thrive and become the person they want to become no matter what, with Harm Reduction and Housing First. 

Many believe that Harm Reduction can only be seen as reducing the amount of alcohol someone consumes, changing the routine of taking drugs to a less harmful method, or something related to lessening substance use. However, Harm Reduction can stretch far beyond substance-related struggles. Most everyone reading this blog post practices some type of harm reduction daily. According to the National Highway Traffic Safety Administration, there were 37,133 lives taken by motor vehicle collisions in 2017. And yet most of us have been in a vehicle of some sort, putting ourselves at risk of harm. To mitigate the likeliness of harm to our self or others we may have intentionally worn a seatbelt, driven under the speed limit, used our turn signals, were mindful of our surroundings or any number of techniques that lead us to avoid a collision that could have taken our lives. This is an example of harm reduction that we all practice. 

Harm Reduction can also be applied to housing. If your program is getting people into housing first, and then working on other needs, such as mental health, applying for benefits or getting a job, you are practicing harm reduction. Housing First is an approach to housing that has been identified as a best practice by the US Department of Housing and Urban Development (HUD) and the National Alliance to End Homelessness (NAEH). With Housing First, you are prioritizing a household’s access to housing as the first step to prevent trauma or harm that could occur while experiencing homelessness. Housing will not stop all harmful things or reverse all traumatic events immediately, but it does increase a person’s ability to focus on the next steps in their recovery. After housing is obtained, individuals can then be assisted in developing plans and skills they need in order to stay in housing long term. Harm has been reduced by practicing Housing First. 

Which leads me to Housing First and Harm Reduction not being similar or complementary, but working in tandem with each other, Housing First is Harm Reduction. If agencies and systems require extensive rules to be met to be in and/or stay in a program or to access housing, it is not Housing First nor is it practicing harm reduction. Many agencies say that their programs are functioning from a Housing First model but have rules that restrict households from participating in their services. Rules, like requiring sobriety and abstinence from substances, not allowing pets, and needing more than one form of ID, are all examples of rules, while well-intentioned, may not produce the desired outcomes for households. Our job as providers is to reduce the harmful effects caused by homelessness, so my challenge to you is to look at Harm Reduction practices from a different point of view and start actively participating in conversations around Housing First strategies in your area. Housing ends homelessness, so let’s make that happen.

For more information on making sure that your program is Housing First visit USICH’s Housing First Checklist. And to learn more about Harm Reduction in relation to substances visit Harm Reduction Coalition’s website. For conversations around whether or not Harm Reduction is enabling people visit Iain De Jong from Org Code’s post on OrgCodes Website.

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