Experiences with compounding surveillance and social control as a barrier to safe consumption service access

Greene, Carolyn; Urbanik, Marta‐Marika; Geldart, Rachel

doi:10.1016/j.ssmqr.2022.100055

Cited by 12 publications

(7 citation statements)

References 70 publications

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“…In contrast, some scholars that have examined policing within specific harm reduction contexts [for example, operating safe consumption sites (SCS)] have argued that police should remain excluded from the health sphere because the disciplinary conditions created by police, often under the guise of responding to social disorder, undermine public health efforts and foster distrust of police among PWUD [ 51 ]. A recent study of policing boundaries for an SCS found that from the perspective of service users and SCS staff, police should not be present at the SCS as they are a deterrent to service uptake [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Total systems failure: police officers’ perspectives on the impacts of the justice, health, and social service systems on people who use drugs

2022

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Background Police in Canada have become main responders to behavioural health concerns in the community—a role that disproportionately harms people who use drugs (PWUD). Recent calls to defund the police emphasize the need to shift responsibility for non-criminal health issues from police to health and social services. This study explores the role of police interactions in responding to PWUD within the broader institutional and structural contexts in which they operate. Methods We conducted a qualitative thematic analysis of interviews with sixteen police officers across nine jurisdictions in British Columbia, Canada. We examined police officers’ everyday policing experiences interacting with PWUD, enforcing drug laws, and working alongside other service sectors. Results Officers explained that the criminal justice system is one component of a wider network of systems that collectively fail to meet the needs of PWUD. They recognized that PWUD who interact with police often experienced intersecting structural vulnerabilities such as poverty, homelessness, and intergenerational trauma. Harmful drug laws in conjunction with inadequate treatment and housing resources contributed to a funnelling of PWUD into interactions with police. They provided several recommendations for reform including specialized health and justice roles, formalized intersectoral collaboration, and poverty reduction. Conclusions Overall, this study provides unique insights into the positioning and role of police officers within a “total systems failure” that negatively impact PWUD. Police have become responders-by-default for issues that are fundamentally related to people’s health conditions and socioeconomic circumstances. Addressing failures across the health, social, and justice systems to meet the needs of PWUD will require an examination of the shortcomings across these systems, as well as substantial funding and system reforms.

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Section: Discussionmentioning

confidence: 99%

Total systems failure: police officers’ perspectives on the impacts of the justice, health, and social service systems on people who use drugs

2022

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“…Taken as a whole, these rationales point to processes whereby potential privacy violations are deemed justifiable, surveillance practices are deemed reasonable, and institutional demands are privileged over client preference for low barrier access. Indeed, the mobilization of these rationales effaces concerns among PWUD, propelling barriers to access services ( Greene et al, 2022 ). An interrogation of the rationales forwarded to justify surveillance underscore their politically or ideologically motivated official logics, as a recent review of SCS in Alberta has illustrated ( Greene et al, 2022 ).…”

Section: Key Features Of Harm Reduction Surveillancementioning

confidence: 99%

“…Indeed, the mobilization of these rationales effaces concerns among PWUD, propelling barriers to access services ( Greene et al, 2022 ). An interrogation of the rationales forwarded to justify surveillance underscore their politically or ideologically motivated official logics, as a recent review of SCS in Alberta has illustrated ( Greene et al, 2022 ). We argue that this is far from an inevitable or necessary component of delivering health and harm reduction services to PWUD, as several innovative low threshold models providing fully anonymous access demonstrate ( Wallace et al, 2019 ).…”

Section: Key Features Of Harm Reduction Surveillancementioning

confidence: 99%

“…While some might question the frequency of such forms of institutional coordination or data sharing practices, we suggest that the question of frequency is of secondary concern given the collateral consequences on transparency and trust between service providers and PWUD. Greene and colleagues (2022) have noted that the mere perception of the convergence between policing and harm reduction services is sufficient to operate as a powerful disincentive. Efforts to meaningfully address the problems posed by such forms of institutional collaboration and data sharing across legal and health spheres require an unconditional termination of such practices.…”

Section: Potential Implications For Pwudmentioning

confidence: 99%

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Between Care and Control: Examining Surveillance Practices in Harm Reduction

Michaud

Meulen

Guţă

2022

Contemporary Drug Problems

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As harm reduction programs and services proliferate, people who use drugs (PWUD) are increasingly subjected to surveillance through the collection of their personal information, systematic observation, and other means. The data generated from these practices are frequently repurposed across various institutional sites for clinical, evaluative, epidemiological, and administrative uses. Rationales provided for increased surveillance include the more effective provision of care, service optimization, risk stratification, and efficiency in resource allocation. With this in mind, our reflective essay draws on empirical analysis of work within harm reduction services and movements to reflect critically on the impacts and implications of surveillance expansion. While we argue that many surveillance practices are not inherently problematic or harmful, the unchecked expansion of surveillance under a banner of health and harm reduction may contribute to decreased uptake of services, rationing and conditionalities tied to service access, the potential deepening of health disparities amongst some PWUD, and an overlay of health and criminal-legal systems. In this context, surveillance relies on the enlistment of a range of therapeutic actors and reflects the permeable boundary between care and control. We thus call for a broader critical dialogue within harm reduction on the problems and potential impacts posed by surveillance in service settings, the end to data sharing of health information with law enforcement and other criminal legal actors, and deference to the stated need among PWUD for meaningful anonymity when accessing harm reduction and health services.

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“…One notable exception is the research examining the experiences and perceptions of police treatment among people who use drugs (PWUD) in Canada. Scholars have documented significant primary and secondary public health impacts associated with adversarial policing, which includes the impact on PWUD’s access to harm reduction/healthcare services and the secondary effects (or consequences) that lack of service access can have on individual health and wellbeing [ 32 , 33 , 34 , 35 , 36 ]. These studies reveal that how the police treat PWUD can have critical public health implications.…”

Section: Introductionmentioning

confidence: 99%

“It Stays with You for Life”: The Everyday Nature and Impact of Police Violence in Toronto’s Inner-City

Greene

Urbanik

Samuels-Wortley

2022

IJERPH

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In recent years, police violence has amassed notable international attention from the public, practitioners, and academics alike. This paper explores experiences and perceptions of police violence in Canada, documenting the impacts of direct and vicarious experiences of police violence on inner-city residents. The study employed semi-structured interviews with 45 community members across three Toronto inner-city neighbourhoods. Using a general interview prompt guide, participants were asked a range of questions about their experiences with and perceptions of police, and particularly, of police violence in their community. The interviews were audio recorded, transcribed, thematically coded, and analyzed. All participants reported direct and/or vicarious experiences of police violence, and most described experiencing long-standing, and continual fear that police contact would result in harm to them. Further, participants described a variety of serious and negative outcomes associated with experiencing and/or witnessing police violence. Police violence in Canada is a public health issue that requires an integrated public health policy approach to address the negative outcomes associated with direct and vicarious police violence exposure.

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Experiences with compounding surveillance and social control as a barrier to safe consumption service access

Cited by 12 publications

References 70 publications

Total systems failure: police officers’ perspectives on the impacts of the justice, health, and social service systems on people who use drugs

Total systems failure: police officers’ perspectives on the impacts of the justice, health, and social service systems on people who use drugs

Between Care and Control: Examining Surveillance Practices in Harm Reduction

“It Stays with You for Life”: The Everyday Nature and Impact of Police Violence in Toronto’s Inner-City

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