Integrating harm reduction in homelessness services. The HR4H Key Principles

Currently, a substantial number of homeless organizations lack the capacity to provide services to people who use drugs or alcohol, or implement high-threshold models of access to care and support. Evidence highlights an underlying lack of information on existing targeted interventions, an insufficient how-to-knowledge among homeless professionals, and a lack of capacity to respond to the interactions between drug use, gender, sexual orientation or mental health among others. As part of the HR4Homelessnes Project, the HR4H Key Principles articulates an innovative framework and tools to support the implementation and upscale of effective services homeless who use drugs.

The HR4Homeless Key Principles builds upon desktop research on six countries, a European-wide survey on the quality and effectives of current policies and service provision systems and practices. The framework is tested and implemented in two phases through a Europe-wide Training and 6 National Capacity Building events for more than 400 homeless professionals in total. After each phase, experiences and evaluations are incorporated, and three reviews are conducted along the process by more than 40 experts, researchers, professionals, policy-makers and community representatives.

Evaluations of the implementation of the HR4H Key Principles highlights a significant improvement in the knowledge and understanding of all aspects of harm reduction, and provides evidence of the high-quality of the framework and tools. Participants self-report a great improvement in their how-to-knowledge on substance use, service typologies, and capacity to respond to the intersection between homelessness, drugs use, gender and sexual orientation, migration and mental health. Participants self-report an increased capacity to generate strategies to improve cooperation with other local stakeholders.

The HR4Homeless Key Principles successfully developed, implemented and evaluated both a framework and methodology to improve access to and the quality of homeless services for people who use drugs in Europe. As an open, iterative and evolving framework, its innovativeness lies in its capacity to take into consideration the different needs, contexts and resources across Europe; to be able to incorporate future developments in research, policy, service provision; and to translate existing experiences, practices and research into actionable guidance to respond to the conditions that influence negatively the social and health outcomes of homeless who use drugs or alcohol.