Co-creating Health System Innovation with People Who Use Drugs in Central Edmonton

Study Lead: Ginetta Salvalaggio (Principal Investigator) & Renee McBeth (Co-Principal Investigator)

Funding Support: Canadian Institutes of Health Research  (CIHR)

Status: Ongoing

In partnership with Boyle Street Community Services (BSCS) and in co-development with People Who Use Drugs (PWUD) we assessed the post-COVID social services landscape to capture community member’s thoughts and experiences with services and how to improve access. Utilizing narrative and art-based research practices we conducted:

  • Asset Mapping

  • Community-Based Surveys

  • Research Ethnography

  • Participatory Sense Making (Micro Narratives)

  • Collage making

The research includes the participation of 215 people who use drugs and access BSCS and 18 clinical-researcher, trainees, and harm reduction workers. The objective is to capture PWUD voiced priorities as they relate to emerging health threats, identify community strengths and assets, and determine resources and strengths needed to implement voiced priorities.

Recommendations for service organizations:

1. Support natural helpers in the community. This could include recognition or formal positions that amplify the role and value of natural helpers and/or supports for the helper’s own well-being.

2. Create opportunities for PWUD community members to gain skills through education and knowledge sharing that supports caring for one another. Redefine education so that it includes sharing knowledge from the street and for the street across generations.

3. Tailor supports to intersectional needs including mental health supports.

4. Ensure low barrier relational connections that build trust with support workers.

5. Identify opportunities to rapidly engage during key transitions. Supports are needed to get past initial hurdles involved with transition, including connecting PWUD with housing workers and healthcare providers. In particular:

  • Wildfire displacement

  • Youth aging out of care

  • Unhoused to housed

6. Provide space for community members to store their belongings safely during the day.

7. Seek lawyers in residence to help with legal issues.

8. Foster community care, connection and visiting in an Indigenous cultural context, recognizing the significance of kîhokêwin (visiting) “as a prairie Indigenous form of knowledge transfer.”

9. Build health-promoting programming that gives community members a place to be and supports a sense of purpose, belonging, and recreation, and income generation. Including:

  1. Quiet space to decompress.

  2. Community tech hub.

  3. Writing, music, time in nature or a community garden.

  4. Creating and selling artwork.

  5. Loss and grief support.

  6. Continue to provide the community with opportunities to share their stories.

  7. Celebrate how the community supports and cares for each other.

Recommendations for health care systems:

10. Build connections between health care systems, including emergency departments and primary care providers, with health-adjacent nonprofits. Work together to create safer systems of care, and bridge access to health care when clients need it.

Recommendations for municipal policymakers:

11. Support the right of PWUD and unhoused community members to spend time in public spaces without discrimination or punishments such as displacement, confiscation of personal items or fines.

12. Fund low-barrier drop-in spaces for PWUD community members where they can access care and build a sense of community and belonging.

Recommendations for provincial policy makers

13. Fund sufficient permanent supportive housing spaces for PWUD community members, using evidence-based approaches.

14. Support PWUD to stay housed by providing opportunities to reduce risk and to learn about tenant rights and responsibilities.

15. Ensure that all voluntary approaches to equip PWUD to heal and thrive are properly resourced, and all barriers removed, before contemplating more punitive models. This includes ready access to voluntary treatment, income support commensurate with provincial liveable income, and low-barrier healthcare access points such as supervised consumption services.

To read the full article please click here

Follow the continued knowledge making and translation through this page.

Zine: Stories of the Street

One of the key arts-based knowledge mobilization is through the community developed Zine “Stores of the Street”, which includes community members personal stories, pictures of the collage making, and more. Special thanks to Veronica “Ronnie” Varewny for all their work on the Zine project.