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Type of submission: Oral
Conference track: Practice
Topics: Aboriginal Communities and Harm Reduction; Integrated Harm Reduction Services
Presenting author: Katie-Sue Derejko
The theory of intersectionality suggests that inequities in populations with complex needs are shaped by interactions of various social locations. Two major barriers to wellbeing in this population are disconnected service provision and conflicting policies that guide services. Because individuals with complex needs are less likely to derive benefits from stand-alone interventions, programs require increased service integration. Although stand-alone harm reduction interventions have proven successful, those which incorporate case management/integrated services have shown superior results.
400 km south of the Arctic Circle, Yellowknife has a population of 21,000, 25% of which are Indigenous. Although services are relatively scarce, Yellowknife is the service hub of the North and migration from remote locations to the city is common.
Integrated Case Management (ICM) is a front-line, person-centered strategy for individuals with complex needs. It adopts a holistic approach to service integration, supporting individuals with on-going service adjustment and coordination that can simultaneously address drug use, homelessness, food security and criminality. Using ICM within a whole of government (WOG) approach allows for the identification/removal of structural barriers to service provision, enhancing service and policy integration.
ICM is a project funded by the Government of Northwest Territories and has received 125 referrals over the past 12-months. Preliminary data suggests individuals with complex needs are more likely to engage with services through person-centered approaches that address their most acute concerns (homelessness, food security) while simultaneously addressing drug use. ICM focuses on acute crisis while building rapport and individual self-determination to address longer standing issues, such as drug use. ICM acknowledges cultural safety issues in harm reduction interventions, which is important in Indigenous populations in Canada. A WOG approach fosters interdepartmental collaboration to service provision, suggesting harm reduction and overall wellness are most likely achieved for people with multiple complex needs through holistic integrated services across departments.