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Harm Reduction Hacks in Focus: Space Hacks

Hacks for Participant Grievances

There are 8 hacks in this section

Building Fairness Into Our Systems

Being heard is harm reduction. A grievance process should do more than tick boxes—it should restore trust

At their most basic, grievance procedures provide a formal mechanism for your participants to have their concerns, grievances, and voices heard. Many harm reduction leaders expressed the importance of having grievance procedures in place. They emphasized that, too often, participants are re-traumatized by the provider/participant power imbalance when provider perspectives are given deference—in other words, when providers are automatically believed.

Providing a mechanism for participants to express concerns in this environment is essential, because it gives them power.

In addition to the strong ethical reason for such a mechanism, it’s also a good idea to have this instrument in place for liability concerns. This provides a safety valve that allows people a way to voice concerns before they rise to the level of liability to the organization.

With that in mind, it’s always important to consult with other stakeholders, including board members, legal counsel, and insurers, when making any decision about designing a grievance process, to ensure it is in concert with their stipulations or limitations.

Formal grievance procedures have a very classic structure that many harm reduction organizations adapt to a more restorative justice frame

All grievance procedures start with filing—some way for the person to formally state that there’s a problem. Filing procedures should be posted widely and made clear to participants, especially when they are introduced to the space or service, since this is the first step towards getting their concerns addressed.
Once you have acknowledged the concern, it’s important to move forward with as impartial an investigation as possible, as soon as possible, in order to gather facts and evidence related to the grievance.
Once an investigation has been completed and you’re ready to have a formal community meeting or hearing about it, it is time to call the stakeholders in, along with representatives to discuss the findings.
Based on the investigation and any hearings, a decision is made regarding how individuals can take restorative action. For those who have been harmed, this may include support or other services, and for the person who has done harm it may include a range of actions, depending on the concern and severity.
In addition to individual restorative action, it may be necessary to restore the community or, where possible, transform it in such a way that similar issues are avoided in the future.
If the participant is not satisfied with the outcome, they may have the option to appeal, depending on the process established by the program or organization.
Part of the restoration plan should include a timeline for follow up and reflection.
The entire process, including the complaint, investigation, restoration plan, appeal, and any follow-up actions, must be fully documented for record-keeping and future reference.
  • “Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”

  • "There isn’t a way things should be. There’s just what happens, and what we do."

    Terry Pratchett
  • "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"

    Gabor Maté
  • “When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”

    Thich Nhat Hanh
  • "I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."

    Marilou Gagnon
  • "What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."

    Kurt Vonnegut Jr.
  • "We have to be ready and able to reach clients where they are, not where we want them to be”

  • "Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."

    Thich Nhat Hanh
  • "One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."

    Jonathan Giftos
  • We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”

    Jonathan Giftos
  • "If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."

    Haven Wheelock
  • “People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”

    Danielle Sered
  • “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”

  • "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."

    Judith Lewis Herman
  • "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "

    Dominique de Villepin
  • “Boundaries help me to give all that I can and still come back tomorrow.”

  • “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”

    Mayor Jim Kenney
  • "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."

    Fred Rogers
  • "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."

    Fred Rogers
  • “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”

    Charles M. Blow
  • "We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."

    Fred Rogers
  • "One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "

  • "Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”

    Christopher Abert
  • “Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”

  • “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”

  • "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."

    Martin Luther King Jr.
  • “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”

    Audre Lorde
  • "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”

    Jules Netherland