Substance Use and Homelessness: An Inner-City Group Discussion on Marginalization in Healthcare Practices

Hanna, Nardin; Burke, Breton

doi:10.18192/uojm.v9i2.4498

Cited by 1 publication

(4 citation statements)

References 12 publications

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“…Just as in the present study, this research underscored the importance of implementing a caring and compassionate approach toward people experiencing homelessness-an approach that includes taking the time to get to know each person; listening to them; letting them rest; and adjusting to their pace, needs, and aspirations (Evans et al, 2015). In a similar vein, other authors also pointed out how the incorporation of experiential knowledge on homelessness into the development and design of future wet services is a promising way to ensure that these services meet the needs of those they set out to assist (Brown et al, 2018;Hanna & Burke, 2019).…”

Section: Adapting Institutional Regulations and Mandates To Needsmentioning

confidence: 99%

“…For reasons frequently related to alcohol use and/or mental health disorders, people experiencing homelessness often struggle to access and follow-up with the health and social services that they need (Crabtree et al, 2018;Hwang & Burns, 2014). They may also be reluctant to seek professional care due to previous negative experiences with the healthcare system (e.g., being made to feel unwelcome, dehumanized, mistreated) (Hanna & Burke, 2019). Moreover, the intersection of oppressive factors and stigma-for example, being an Indigenous person who is homeless, alcohol dependent, and in need of mental health services-exacerbates both the discrimination felt by people experiencing homelessness and their difficulties getting help (Hanna & Burke, 2019;Hedlund, 2019).…”

Section: Intervention In the Interests Of Individual Rights And Dignitymentioning

confidence: 99%

“…Various alcohol-related harm reduction initiatives have been developed to help people experiencing homelessness who are dependent on alcohol, including Managed Alcohol Programs (MAPs). MAPs are highly diverse and can take the form of day centers, although most offer medium-to long-term housing (Evans, 2012;Evans et al, 2015;Hanna & Burke, 2019;Kidd et al, 2011;Pauly et al, 2016Pauly et al, , 2018Pauly et al, , 2019Podymow et al, 2006;Stockwell et al, 2013;. MAPs primarily consist of alcohol supervision and management for people experiencing homelessness who are dependent on alcohol (Pauly et al, 2016;.…”

Section: Alcohol-related Harm Reduction Servicesmentioning

confidence: 99%

“…It should be remembered, however, that while wet services are promising in their potential capacity to meet some of the most pressing homelessness needs observed in Montréal, they cannot compensate for shortcomings in public policy or in health and social programs, particularly in terms of redressing the social inequalities that lead to people lacking the requisite conditions for autonomy (Simmel, 1989). Consequently, as wet services are being implemented, it is equally important that Canadian federal, provincial, and municipal jurisdictions engage in upstream action on the relevant underlying structural social factors-including housing, employment, and access to health and social services-that impact the poverty, vulnerability, and exclusion of people experiencing homelessness who use psychoactive substances, including alcohol (Hanna & Burke, 2019;Pauly et al, 2021). Above all, wet services must not become a means of "managing" society's most vulnerable and marginalized members, but rather (as participants in our study have suggested) serve as a gateway through which people who experience homelessness may begin a process of social reintegration, at their own pace.…”

Section: Addressing Stigma Discriminationmentioning

confidence: 99%

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Implementing Wet Services in Montréal for Highly Vulnerable People Experiencing Homelessness who Use Alcohol

Poliquin¹,

Toussaint²,

Flores-Aranda

2022

IJOH

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Context: People experiencing homelessness and alcohol dependence are highly marginalized as they struggle to access various health and social services. This study is part of a broader feasibility study on the implementation of "wet services" in Montréal, Canada. Methods: Four focus groups were conducted with 20 participants working in the field of homelessness. The objectives of this study were to gather their perspectives on the need for wet services in Montréal, define the main purpose of such services, and identify the key factors promoting their success. Results: All participants felt that wet services could meet several critical needs of many people experiencing homelessness in Montréal, and most argued that they should also be implemented without delay. According to most participants, these services should be grounded in a harm reduction philosophy, take a low-threshold approach and be accessible to the target population at all times. Participants argued that wet services should primarily aim to offer a safe place to consume alcohol whilst also serving as a place where people experiencing homelessness could meet their basic needs, reconnect socially, and access various health and social services. However, participants cited a number of financial, logistical, and organizational constraints, such as control-related mechanisms (e.g., eligibility criteria, rigid bylaws, or the institutionalization and medicalization of services), which they feared could stand in the way of achieving the objectives of wet services or perpetuate the exclusion of people experiencing homelessness. To avoid these potential problems, most participants felt that wet services should be delivered by well-established and well-funded community-based organizations, accompanied by a variety of partnership arrangements, including those with health services. Conclusion: This qualitative study contributes to the growing body of evidence on alcohol-related harm reduction services. Its findings may serve to inform the eventual implementation of wet services in Montréal and in other locations.

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Section: Adapting Institutional Regulations and Mandates To Needsmentioning

confidence: 99%