Reflecting on 2022 and looking ahead to the new year and our continuing harm reduction practice

As we come to the end of another year and amid what seems like a tsunami of challenges for people – the cost of living crisis, extreme weather and the upcoming festive period which, for many, is a time to spend with family and rest after a busy year, can be one of the most difficult times of the year for people experiencing homelessness – it is maybe a time to pause and reflect on the year past and look to the year ahead. 

Harm reduction is central to our approach within Simon Community Scotland

In 2022 we have been working hard to ensure that people we know who use substances are safer, feel heard and feel seen. Harm reduction is central to what we have done and will continue to do in 2023. For Simon Community Scotland – this is an area we have invested our own resources in, it is not an area we are centrally funded for – because we knew we had to do more, go further and do things differently to keep people safe. 

Simon Community Scotland continue to purposely and intentionally move to delivering a high tolerance, harm reduction model across our services 

Harm reduction for us is based on the principles of human rights, social justice and meeting people where they are at without judgement. It is about recognising that people use substances for lots of different reasons and, for many people we support, it is often about managing unresolved, untreated and unvalidated trauma and pain.  

We’ve been fortunate enough to work alongside so many people we support

Through the stories and experiences people have shared with us, we’ve been able to respond in a way that has resulted in real systemic change. Delivering high tolerance has seen us move from losing eleven people to drug related deaths across our residential services in 2020, to two people over the last two years. Two people is still too many – each person a loved and cherished family member, part of a community and part of our community. However, we are seeing a real shift in the most extreme harms associated with substance use through adopting an approach which is compassionate, realistic, understanding and which allows us to work within the legal parameters of the current system. 

This systemic change has opened up a whole new space for harm reduction within our services

This has allowed us to embed the provision of IEP (injecting equipment provision) across our services, offering low threshold 24/7 access to harm reduction tools and advice, embed harm reduction champions in our teams, introduce the WAND initiative in Glasgow, and create safe spaces where people feel that they can be a little more open, a little more trusting of the support on offer. 

2022 saw us launch our new We See You project 

The project works alongside people experiencing homelessness and providing daily, out of hours community based group work support. We are seeing a community of love, connection, companionship and hope built amongst those attending the We See You project. Providing a safe space, where people can come along as they are, seems simple but we have seen the transformative change that can happen when people feel seen, heard and held. 

We’ve worked alongside women to launch our ‘A Digital Approach to Harm Reduction’ project

Working alongside women who use substances allows us to elevate their voice, experience and expertise to create resources, support each other and challenge how services can and should be to ensure they meet their needs. We have walked alongside over 60 women in this project, reimagining and imagining how the response could and should be for women, harnessing the power of community and bringing women together to help us remodel our harm reduction response through a gendered lens. Our new By My Side app brings together this learning and combines digital inclusion with harm reduction in a new way, allowing us to connect resources, information and support directly to women in a way that works for them. 

We’ve brought together 26 harm reduction champions from across our services

These champions are key change agents in driving forward innovation, responses and change across the organisation. We’re exploring how we might respond to the individual needs of people we support while looking at the practice and system developments – the Medical Assisted Treatment Standards, the National Collaborative, the National Mission – and working collectively to ensure that people who experience homelessness have their voices and experiences included and heard in these developments. We have developed five out of ten Best Practice Guides – putting evidence and the experiences of our teams and people we support into practice guides helps us to drive forward best practice and embed our approach and ethos across our services. We have and will continue to push the limits and strive for better for people, share practice and work alongside people to get it right.

2022 saw us connect with partners across the UK, Europe and internationally to share practice, ideas and learn from each other  

We visited our Portuguese friends in Crescer, based in Lisbon, who undoubtedly have one of the most progressive approaches to addressing substance related harm through their decriminilisation model. We are working alongside the Women’s International Harm Reduction Network to develop resources for women to be hosted on our By My Side app and have connected with organisations across the UK who have been delivering high tolerance within homelessness for many years. We have lots to learn and will continue to work alongside partners to share best practice, and strive towards ensuring our approach is evidence based and modeled on ways of working that work best for people.

It’s has been another busy year for harm reduction within Simon Community Scotland yet there is still so much to do 

Scotland’s drug related deaths and harms continue to be at shockingly high levels and we know from this year’s ONS figures, and our own experiences, that this is a huge issue for people who experience homelessness. The shift nationally to more stimulant use, the associated mental health challenges and lack of treatment options poses questions on how services will respond moving into 2023.  What we know and believe in Simon Community Scotland is that it is the relationships we have with people that make the difference – we all know this. 

2023 will see us continue to put these relationships at the forefront of our approach, our thinking and our response 

The people that we support, and our community, know what needs to be done to make things better, make things easier, and – if given the opportunity – make things happen to reduce harm, keep people safer and, fundamentally, keep people alive.  

We just need to be ready to listen and act.

Written by Claire Longmuir, Head of Policy & Practice – Harm Reduction