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It’s important to think about the physical set-up and design of the space—be it a fixed site or mobile service—in order to minimize escalation. Harm reduction leaders and others identified two important lenses with which to view physical design and set-up:

  • Sensitivity to Trauma—“Trauma-informed” is basically a sensitivity to the fact that the population being served and the staff serving them are people who have experienced trauma, and that trauma experiences can be triggered in part by the physical set-up of a space/services.
  • Safety—This means being attentive to the physical safety of your participants and staff with regard to accessibility, injury, and violence prevention.

Harm reduction leaders made clear that all decisions made about the physical design and set-up of services should consider safety and sensitivity to trauma, and should err on the side of sensitivity to trauma when they are in conflict. This is because people who are in trauma response are often the least safe when they are agitated, so it’s essential that harm reduction organizations minimize trauma reactivity responses as much as possible.

These leaders also agreed that defining the parameters of the spaces was the most important first step in designing a harm reduction space.

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One of the main goals of active listening with an agitated person is reaching affirmation and accord. You are looking to try and find ways to agree with the person who is agitated. Even if you don’t entirely agree with the person, try to find at least a small way in which they may be right, or in which you can be on the same page, or team, with them.
Mobile harm reduction services come in many forms—each shaped by local needs, available resources, and the creativity of the people providing care. From backpack outreach to vans, bikes, and home delivery, these models offer flexibility, build trust, and reach people who may never visit a fixed site. This section explores the unique strengths and limitations of different mobile approaches