Open Letter Regarding Homeless Shelters and Harm Reduction from OpenDoors
October 9th, 2023
OpenDoors currently provides emergency shelter to around 200 people every night and so we are constantly dealing with the challenges of how to operate a shelter that will best balance the needs of a wide variety of residents, property owners, neighbors, municipal governments, and partner organizations. We are very proud of the shelter and support we are currently providing and thankful for the opportunity to do this work. There is an ongoing debate about how to best regulate shelters, and we are hoping to continue those conversations in as constructive a way as possible.
As an agency that has always been focused on helping those most in need and most difficult to serve, harm reduction and running a shelter with low-barriers is part of our mission. At the same time, we need to create a residence that is sufficiently safe for all residents, staff, and neighbors day-to-day and maintain standards enough to be sustainable in the long-run. This at times leads to very difficult decisions, such as deciding to exit someone from a shelter who has no place to go and serious medical needs. We are always trying to figure out how to make these decisions as best as possible and we greatly value constructive feedback from partners, residents, and staff.
In order to maintain safety in our shelters, we have established clear rules and a clear process for dealing with rule violations. These shelter rules, exiting protocols, and behavioral contract documents are now posted on our website. They entail strict rules against possession and use of drugs, alcohol, and drug paraphernalia on the premises, violent and aggressive behavior, and illegal activity inside and nearby the shelter. For example, people who are caught using opiates, crack or other illegal drugs inside one of our shelters will generally be exited from the shelter. Even with these rules, searching residents whenever they enter, and constant vigilance, entirely preventing drug use within our shelters is impossible. However, without these rules, it would be widespread. It is our opinion that this would make many people, such as residents that are trying to minimize their drug use, those on methadone, those in recovery, and those without addiction issues, unsafe.
This conclusion is based on feedback from our residents, most of whom want to live in a drug-free home, and the expertise of our staff. Eighty percent of our ten person management team have overcome addiction or incarceration obstacles themselves. Many of our staff members running shelters or sober houses have lived in similar places themselves. We have no rules against people that are actively dealing with addiction living in our shelters, but at the same time we know our strict rules can make it difficult and sometimes impossible for these individuals to adapt. However, we also know that given the scale, density, and location of our shelters, it is not possible to operate our shelters with even lower barriers that would take a more harm reduction approach to drug possession on-site.
Our staff already consistently struggle against on-site drug dealing and tolerate a high level of abuse, including being assaulted by residents. Our locations are constantly being subjected to intense scrutiny by neighbors, property owners, municipalities, and the media over everything from on-site drug use to people loitering outside. Not only would relaxed rules endanger staff and residents, they would endanger the permission we have to operate. Instead, by enforcing these rules, we have been able to expand our shelters and serve more people. For example, we were initially only contracted to house 60 people at Motel 6 but we increased to 120 people at almost no increased staffing cost.
OpenDoors is very much in support of harm reduction principles. As an agency, we have worked hard for two decades to reduce the criminalization of drugs in Rhode Island–we drafted the first legislation to end mandatory minimum drug sentencing years ago, were early leaders in the campaign to first criminalize and then legalize marijuana, and have continued to actively support decriminalization measures.
OpenDoors institutes harm reduction in our shelters as much as we can while also enforcing rules to curtail on-site drug use. We pass out Narcan and fentanyl test strips, train our support staff in peer recovery coaching and strength-based Motivational Interviewing techniques to help them provide non-judgemental recovery coaching, and we work with Miriam Hospital to train our staff in harm-reduction principles. We are also working to coordinate on-site Methadone distribution with CODAC.
At the same time, we have made the difficult decision to not allow ‘safe smoking kits’ or clean-needle distribution on site. This decision was made by staff that have themselves been in recovery and was made only after trying a more tolerant approach and seeing drug use on-site proliferate. While providing these tools to people at shelters increases access, it also forces others in recovery to be confronted with drug use and drug paraphernalia in their own homes where they cannot avoid it. We are working to help people in our shelters that are actively using to safely access clean needles off-site.
There is a huge need in the state for fully low-barrier shelters. We have unfortunately had to make difficult decisions to exit some individuals with very high acuity—a pregnant woman, an individual with advanced cancer, a resident with serious mental health issues–in order to maintain safety. We are continuing to learn and improve, and with each of these incidents we have reviewed our response and are working to try to minimize such difficult decisions in the future with better de-escalation, more training, and more peer recovery support. But even with these efforts there will still be many people that are not ready or able to adapt to our shelters, and these individuals currently have hardly any shelter options. Rhode Island has very few models for such very low barrier shelters. The Armory Shelter operated last winter by Amos House was an amazing program and was a particularly low barrier shelter but it benefited from a very high level of staffing, including the National Guard. Even so it struggled with a huge amount of neighborhood pushback that ultimately contributed to the end of its permit to operate.
We are committed to trying to learn from other low-barrier models, listen to feedback, and work to make shelters both as accommodating and safe as possible. We encourage partners to reach out to talk to us directly to talk about any concerns with our operations. Unfortunately, in the turmoil of all of our work amidst this crisis, it can be easy for misinformation to circulate, and we do not want this to prevent cooperation and coordination.
For example, there was a rumor that OpenDoors ‘chased off’ harm reduction workers, something we are not aware of ever happening and would certainly not condone. Recently, a photo of a sign warning that people will be ‘written up’ for hygiene problems was circulated. This sign was a mistake that was immediately caught and corrected by management months ago, although unfortunately one sign was not noticed and was left up until recently. Although we have done everything we can to encourage residents to learn proper hygiene, we have never punished any resident for hygiene issues.
The work we do to operate shelters is very difficult and we are in need of all the help we can get. We need to figure out how to provide better medical assistance and clinical therapy to our residents. We need help providing training in harm reduction and de-escalation skills to staff. We need more permanent and transitional housing options to help our residents leave shelters. We need more funding so we can pay shelter monitors better and retain more experienced and trained staff, particularly if we are going to serve higher acuity residents. Over the past two years OpenDoors has gone from running around 50 beds of transitional and permanent housing but no shelter beds to operating around 200 shelter beds. We are dedicated to helping Rhode Island through this crisis and finding housing for each person in need, a momentous goal which will require us all to work together.
Sincerely,
Dina Bruce, OpenDoors Deputy Director
Nick Horton, OpenDoors Co-Executive Director
Patrick Westfall, OpenDoors Co-Executive Director