Improving health and social care relationships for harm reduction

Harm Reduction in Community Mental Health Settings

“…Similarly, service users repeatedly stated that recovery was a decision they eventually made on their own, and that practitioners were most helpful when they provided supportive, nonjudgmental listening and guidance (Mancini, 2008). This is supported by other studies of drug users as well (Allman et al, 2007).…”

“…Research has demonstrated that harm reduction practices are generally supported by practitioners and clients (Allman et al, 2007;Briggs et al, 2007;Mancini, Linhorst, et al, 2008;Phillips et al, 2007), but the context in which harm reduction is provided is important. Arguments claiming that harm reduction is best ''sold'' to policymakers, practitioners, and the public as a value-neutral, evidence-based approach ignore the inherent moralistic dilemmas practitioners, particularly community mental health practitioners, face when practicing harm reduction (Fry, Treloar, & Maher, 2005;Irwin & Fry, 2007;Kleinig, 2008;Pauly, 2008).…”

“…A central tenet of harm reduction and for recovery-oriented services is that service relationships should be predicated on a model of shared decision making and citizenship (Davidson, Rowe, Tondora, & O'Connell, 2008;Marlatt, 1998). Service relationships that are paternalistic and judgmental will alienate clients and lead to resistance and eventual disengagement (Allman et al, 2007;Mancini, Hardiman, & Lawson, 2005). A common dilemma faced by the community mental health practitioners in our study is helping service users effectively negotiate the negative social, legal, and physical consequences of their continued substance use.…”

“…A third interrelated challenge is developing effective education and training resources for community mental health practitioners that can assist them in more effectively incorporating harm reduction principles and practices into their programs and daily interactions with community mental health service users. Preliminary studies indicate that the general contours of the harm reduction approach are for the most part viewed positively by practitioners and service users (Allman et al, 2007;Mancini, Linhorst, et al, 2008;Phillips, Rosenberg, & Sanikop, 2007). However, our preliminary research suggests that community mental health practitioners encounter unique ethical and moral practice dilemmas when practicing harm reduction with service users who have COD (Mancini, Linhorst, et al, 2008;Phillips et al, 2007).…”

“…Research into how social workers and other community mental health practitioners translate evidence-based practices into actual practice settings is just beginning. In the arena of community mental health, this is a vital area given that the knowledge, skills, and attitudes of practitioners often determine their ability to engage clients in services (Allman et al, 2007;McLaughlin, McKenna, & Leslie, 2000).…”