A pair of non-profits aiding unhoused people in Hamilton, Ont. are seeking help from the city to embed harm reduction staff and services in shelters amid disproportionately high opioid death rates among men.
Executives with Good Shepherd Centre and Mission Services say a one-year pilot project would put harm reduction specialists on staff to decrease the risk of opioid poisonings, in addition to building much-needed support within the shelter system.
The proposal, which goes before a committee next week, seeks $600,000 “to implement a shelter-based harm reduction staffing enhancement” starting March 1.
Good Shepherd Hamilton COO Katharine Kalinowski says recent successes with similar programs, already a part of Mary’s Place women‘s shelter and Barrett Centre crisis, have improved outcomes with substance abuse cases.
“These workers could accompany people into the community if they were encountering barriers in accessing services or had fears, concerns or had previous bad experiences,” Kalinowski explained. “We’re looking at providing and facilitating support groups led by peer support, people with lived experience inside the shelter to ensure that they have a community.”
In 2021 and 2022, Hamilton Public Health recorded 160 opioid-related deaths in each of those years across the city. The last recorded data, between January and August of 2023, reveals the city had just over 100 fatalities. As of the end of 2022, the city’s opioid-related death rate was 63 per cent higher than the provincial rate.
Between January to September of last year, it’s estimated some 72 per cent of suspected drug-related deaths in Hamilton involved men. Amid a gap in services targeting men who use opioids, a city committee launched an application process for a supervised consumption site in a men’s shelter last year. However, no providers came forward with some sighting time and a lack of capital resources as a reason for not participating
Safety planning, access to harm reduction supplies and withdrawal management are just some of the elements specialists would manage through one on one engagements with program candidates.
Shawn MacKeigan, an associate executive director with Mission Services, says about three years ago amid the pandemic they saw “large spikes” in overdose-related incidents, including a high watermark of 80 overdoses in 2021 at their east-end hotel shelter.
In response, the agency introduced a pilot similar to the current proposal that reduced opioid-related outcomes by about 40 per cent in 2022 through enlisting staff working “through an addictions lens.”
“So from 80, we reduced it to 50, with further reductions in overdoses to 30 in 2023,” MacKeigan said.
A move from its traditional James Street North home of 70 years in 2023 to a newly renovated King East venue brought cases down further, to zero, through the implementation of washroom detection technology.
Those sensors detect occupancy, absence of movement, or depressed breathing, and alert staff if needed.
He insists the added support workers can also reduce harm by providing “fluid goals” for shelter users to realize outcomes that are of importance to them.
“Those combined factors really have demonstrated encouraging results,” he added. “We’re proud, but cautiously optimistic this can be replicated, scaled and delivered as a meaningful solution for individuals experiencing this right now.”
Hamilton’s housing services division is recommending the funding saying the pilot aligns with current emergency shelter initiatives and related federal and provincial homelessness funding programs backing harm reduction services.
“This project recognizes that current staffing models in emergency shelters do not offer the depth of support required to adequately address the complexity of issues faced by people who are living with opioid addiction and experiencing homelessness,” housing director Michelle Baird said in her recommendation.
The pilot will go before a public health committee on Monday for approval with a report going before council in Q4 of 2024, if ratified.
