Open letter to Centretown Community Health Centre regarding changes in harm reduction services

To the Board of Directors of Centretown Community Health Centre,

We are writing because people who access harm reduction services at Centretown CHC have noticed a change in service delivery. 

Examples of changes include:

• Closure of the private, easy-to-access harm reduction room, requiring people to ask for bags of harm reduction supplies from the front desk in the public lobby space. This means that people who deserve confidentiality no longer have that option. This confidentiality includes having privacy from other workers at the Centre.
• The removal of the designated harm reduction worker. This worker provided services beyond harm reduction like connection to essential resources, including immediate access to health care, housing resources, counselling, addiction resources, etc. that otherwise people would not have received.

Time is needed to build relationships, rapport, and trust, and without a harm reduction worker people are not getting the same level of care. Some people have expressed that the only reason they came to the Centre was to connect with the harm reduction worker and that they don’t bother coming anymore.

People often need more supplies than what is offered in the bags, and having to ask for services in a public setting is humiliating and sometimes impossible for those who are living with internalized stigma or mental illness. Staff at the front desk are varied and often seem to not be trained.

The current set-up is not only not confidential, it’s impractical. The way it is set up now means that people seeking to access services may have to wait in line, and if they have to wait, even if it is just for a moment, they are more likely to leave.

Centretown Community Health Centre has a reputation for not being as harm reduction-friendly as other service providers in Ottawa, and these changes are not helping build credibility in the community.  Word of mouth has already resulted in people avoiding accessing Centretown CHC for supplies.

All of this makes members of the community feel like Centretown CHC doesn't want people who use substances to access their services. The Centre is not building a sense of belonging.

To our knowledge, there was no community consultation done to discuss these changes, and there was not any communication to inform people who use harm reduction services about any changes or to explain why they were implemented.

The Board of Directors has voted in favour of a SIS, however harm reduction services are being minimized and offered in a way that is not best practice. As Centretown CHC is well aware, there is an opioid crisis happening in our city. Now is the time for Community Health Centres to prioritize and maximize services that are meaningfully accessible to people who use substances. If the number of people accessing services is low, then the Centre needs to consult the community and make appropriate engagement changes, not reduce these life or death services. There is a significant need for harm reduction services in Centretown, and there are limited providers off of Bank Street as ACO has moved, so it is imperative that Centretown CHC offers exceptional service.

We join people who use substances in our community in asking for :

• communication as to why these changes occured;
• meaningful consultation with people who use substances about how to best provide harm reduction services (perhaps strike a harm reduction advisory board);
• a designated harm reduction worker who is available in a private, easy to access room and who is not a worker in other over-lapping areas of the Centre (to help with privacy and increasing harm reduction access);
• stop policing people who use substances (ie shaming people for needing to use the bathroom) and train ALL staff providing harm reduction about best practices;
• signage WELCOMING and ENCOURAGING people to ask for supplies is needed at the front desk.

Please remember, every time you close a door, a person who uses substances may die.

Signed,
The Campaign for Safer Consumption Sites in Ottawa


This letter is based on a petition created by clients of harm reduction services at Centretown CHC.