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This chapter provides a case study of how people who experience mental health and substance use challenges, as well as homelessness, can be treated with extreme prejudice by the community service providers who are responsible for their care, despite knowledge of harm reduction best practices and local community-based research to determine needs. In 2020, the Integrated Care Hub (ICH) was created in Kingston, Ontario, Canada, to provide low-barrier services to people experiencing homelessness who were also in active substance use. This day-drop-in and overnight shelter also housed the region’s safe injection site. This was at the intersection of the housing crisis, the worsening drug poisoning crisis, and the COVID-19 pandemic, which saw a closure of most social services for the community’s most vulnerable and marginalized. A community-based qualitative study entitled Crystal Meth, Opiates, Overdose and Housing in Kingston, Ontario: 2021 Rapid Assessment and Response Community Needs Assessment for the Integrated Care Hub was foundational to achieving a $1.5 million grant from Health Canada’s Substance Use and Addictions Program (SUAP) to launch the “Support Not Stigma” initiative, a series of projects developed from the recommendations for policy and program delivery devised through consultation with service users. The programs ran from the summer of 2022 to the spring of 2024. However, the political climate in Ontario that sought to close services like safe injection sites over concerns with public safety, along with local political pressure from the City of Kingston that sought to eliminate a homeless encampment adjacent to the ICH, and finally growing public opinion that the ICH was a dangerous place, led to a complete reversal of harm reduction based, low barrier services at that location by fall of 2024. A highly publicized stabbing at the site in September of 2024 led to a rapid dismantling of the encampment, and the ICH fell under the new management of Addictions and Mental Health Services which has adjusted the term “low barrier” to mean case management and treatment services. With no true low-barrier shelter services available, many people experiencing homelessness who are also in active substance use have been forced back to the streets.

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Power and Politics in the Provision of Anti-oppressive Harm Reduction and Low Barrier Services to People Experiencing Multiple Mental Health Diagnoses, Active Addiction, and Homelessness in Kingston, Ontario, Canada: A Case Study of Sisyphus and His Rock

  • 章节

  • 发表日期：

    2026年

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  • Candice Christmas-Krumreich,
  • Claudia McNulty

摘要

This chapter provides a case study of how people who experience mental health and substance use challenges, as well as homelessness, can be treated with extreme prejudice by the community service providers who are responsible for their care, despite knowledge of harm reduction best practices and local community-based research to determine needs. In 2020, the Integrated Care Hub (ICH) was created in Kingston, Ontario, Canada, to provide low-barrier services to people experiencing homelessness who were also in active substance use. This day-drop-in and overnight shelter also housed the region’s safe injection site. This was at the intersection of the housing crisis, the worsening drug poisoning crisis, and the COVID-19 pandemic, which saw a closure of most social services for the community’s most vulnerable and marginalized. A community-based qualitative study entitled Crystal Meth, Opiates, Overdose and Housing in Kingston, Ontario: 2021 Rapid Assessment and Response Community Needs Assessment for the Integrated Care Hub was foundational to achieving a $1.5 million grant from Health Canada’s Substance Use and Addictions Program (SUAP) to launch the “Support Not Stigma” initiative, a series of projects developed from the recommendations for policy and program delivery devised through consultation with service users. The programs ran from the summer of 2022 to the spring of 2024. However, the political climate in Ontario that sought to close services like safe injection sites over concerns with public safety, along with local political pressure from the City of Kingston that sought to eliminate a homeless encampment adjacent to the ICH, and finally growing public opinion that the ICH was a dangerous place, led to a complete reversal of harm reduction based, low barrier services at that location by fall of 2024. A highly publicized stabbing at the site in September of 2024 led to a rapid dismantling of the encampment, and the ICH fell under the new management of Addictions and Mental Health Services which has adjusted the term “low barrier” to mean case management and treatment services. With no true low-barrier shelter services available, many people experiencing homelessness who are also in active substance use have been forced back to the streets.