Harm Reduction

COVID-19 UPDATE

With the lockdowns and social isolation that began in March 2020, overdoses and deaths from substance use have increased dramatically in our buildings. We are aware of 27 such deaths from March 2020 to July 2022. People have been isolated and more stressed; they are using drugs alone; Covid-emergency money was available to tenants; bad drugs are circulating; and the agencies we had engaged to assist tenants with substance use issues stopped coming to the buildings. In response, we have secured additional supplies of Naloxone from Toronto Public Health and made it available through our on-site kitchen staff. This has been a real life-saver.

Program description

The MIND Program is a grassroots initiative begun by residents and medical service providers at 682 Warden Avenue, a Toronto Community Housing Corporation (TCHC) building in southwest Scarborough. This building houses 224 people, three-quarters of whom have been housed here following a period of homelessness. This community includes many vulnerable individuals including many who use substances. The MIND program sees the harms of substance use on individuals and the community -- these include transmission of infectious diseases, malnutrition, eviction, conflict, violence, poor health, unremitting poverty, social isolation, and premature death among others. While the City of Toronto, and the provincial and federal governments have all committed to increasing services for people who use drugs, most of the services being provided are located in the downtown area. There is little evidence that these services will be expanded to areas already under-serviced and under-resourced like this part of Scarborough.

In 2016, the MIND program applied to the City of Toronto’s Urban Health Fund for money to assess the substance use needs at 682 Warden and a nearby TCHC building at 40 Firvalley Court. Our long-term hope was to be able to provide accessible and confidential harm reduction programming and resources to members of this community. A comprehensive needs assessment was the necessary starting point from which to better understand the needs of those members of the community who use substances. An accurate understanding of the needs of this population would help the MIND program to develop and deliver effective programming as well as partner with appropriate agencies and resources in the wider community.

Funding was approved and an assessment coordinator was hired in August 2016 for a one-year project. The focus of this needs assessment was to gather accurate, candid information from residents with lived experience of drug use. Therefore, research strategies were built to get the most feedback from community members as possible. To garner feedback from the community, 61 paper surveys were completed with residents, 17 one-on-one interviews were conducted, and two focus groups were held. Five informal key-informant interviews were also held with people who provide services in the community, such as community health centres, harm reduction services and pharmacists.

The only prerequisite for residents to participate in the needs assessment was that the person identified as a person who uses drugs. Two peer workers were recruited to help engage residents and to provide crucial feedback on questions being asked in the survey, interviews and focus groups. Within the research activities, there was equal representation of residents of 682 Warden and 40 Firvalley.

Results of the assessment were presented to the community in July 2017 and published in a report in September 2017 which was distributed to the MIND board and several local agencies for review and action. Since then the MIND board has looked for ways to implement a community-based harm reduction approach using resources within these large residential buildings to address the needs identified in the assessment. The kitchens which supply the community meal program are already hubs for the buildings with trusted staff and volunteers. They already help address the need for food security identified in the assessment. So we have equipped the kitchen staff with Naloxone kits and trained them in their use. Since then they have been called on many times to attend overdoses or provide the kits to other tenants to deal with overdoses. This has been a real life-saver.

In addition we have enlisted the help of Agincourt Community Services Association and South Riverdale Community Health Centre. They now have staff visit the buildings twice a week during our meal times to offer counselling, clean equipment, and sharps disposal. Because they are on-site on a regular basis they have gained the trust of tenants needing assistance with substance use issues. Their presence has now expanded to the TCHC building at 10 Glen Everest Rd. These health providers have now accessed the services of an addictions doctor who has weekly one-on-one sessions with a number of clients from our three buildings.

Location

10 Glen Everest Road
40 Firvalley Court

682 Warden Avenue
Scarborough, Ontario