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Project Inclusion Is in Order to Protect Participants’ David Fai the Culmination of That Research

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Project Inclusion Is in Order to Protect Participants’ David Fai the Culmination of That Research Pivot Legal Society is located on the unceded lands of the Coast Salish Peoples, including the territories of the xwməθkwəyəm̓ (Musqueam), Sḵwxwú7mesẖ (Squamish), and səlílwətaʔɬ/Selilwitulh̓ (Tsleil-Waututh) Nations. Over the course of this project, we visited the traditional territories of many other Nations we cannot name in order to respect our commitment to keep the communities we visited confidential. This project was made possible by AUTHORS SUPPORT FOR THIS PROJECT the 76 people who stepped forward Darcie Bennett This report was produced with to share their experiences, their DJ Larkin insights, and their wisdom. It was funding provided by the Provincial an honour to meet each and every Health Services Authority (PHSA). EDITOR one of them and to hear their stories PHSA plans, coordinates and firsthand. We would also like to thank Jackie Wong evaluates specialized health services all of the focus group participants and with BC’s regional health authorities survey respondents who contributed RESEARCHERS in order to provide equitable and to this project. We are also indebted cost-effective health care for people Noah Quastel throughout the province. In 2016, to the many frontline service Jessie Stirling providers, health care workers, PHSA contracted Pivot Legal Society and advocates across the province to undertake a research project SPECIAL THANKS TO: who took time out of their busy looking at law and policy barriers schedules to share their expertise, Nicola Aime to HIV, Hepatitis C Virus (HCV), and answer our questions, connect us Brenda Belak overdose prevention among British with participants, and host us while Chase Blair Columbians who are struggling visiting their communities. While Anna Cooper with the impacts of poverty and we cannot name you individually Karen Cooper homelessness. Project Inclusion is in order to protect participants’ David Fai the culmination of that research. The confidentiality, we are deeply grateful Olivia Gordon views expressed in this report are the for your support. Zoe Greig responsibility of the authors and are Silas Heatley not necessarily those of PHSA. PHSA Peter Kim makes no representations about Doug King the suitability of the information Katie Koncan contained in this report for any Ashra Kolhatkar purpose. Scott McAlpine Zev Moses ILLUSTRATIONS AND COVER Scott Neufeld DESIGN Madeleine Northcote Jordan Bent Asha Nygra Carly Peddle LAYOUT Celia Pinette Katrina Pacey Scott Knowles Fernande Pool Kerry Porth DESIGN Caitlin Shane Jim O’Neill Marie-Eve Sylvestre Lyndsay Watson Every legal problem is unique. The Camia Weaver legal analysis in this report is general Kaymi Yoon-Maxwell and provided for informational purposes only. If you require legal We are grateful to everyone who advice, please speak to a lawyer. contributed to this project. This project would not have been possible If you wish to reproduce a portion without you, and any errors or or the entirely of this report, please omissions in this report are the sole credit Pivot Legal Society. responsibility of the lead authors. Project Inclusion Confronting Anti-Homeless and Anti-Substance User Stigma in British Columbia Contents Executive Summary . 4 Making Stigma Visible . .4 How to Use this Report . .4 Report Summary . .5 About Pivot Legal Society . .6 About Project Inclusion . 6 Introduction and Methods . 7 What Shaped this Work . 7 Pivot’s Research Approach . .8 Ethical and Privacy Considerations . .8 Study Population . .9 Data Generation . 11 Analysis and Recommendations . 12 Report Overview . .13 PART ONE: LIVED REALITIES . .14 . Section One Homelessness in Context . 14. Pathways to Homelessness and the Stories we Tell . 15 Rational Responses to Irrational Circumstances: Moving Beyond the Stereotypes . .19 Strategic Thinking, Staying Safe . 25 Our Laws Make It Worse . .29 Section Two Substance Use in Context . 31. Approaches to Understanding Substance Use—and Why We Need Alternatives . 31 Dope Sickness Keeps People Down . 32 Getting to Normal . 33 Pathways to Substance Use . .34 Harm Reduction: We Need to Walk the Talk . .36 The Solutions Exist, but Stigma Stalls Progress . 43 PART TWO: CHANGE THE SYSTEM . 44 . Section One The Impacts of Police and Policing . 44. Findings Related to Police . 45 Police Interfere with Harm Reduction Activities. .46 Quality of Life Policing and Targeting People who Live in Public Space . 52 Racism. .57 City Cells and the Drunk Tank . .59 Abuses of Authority and Experiences of Violence . 63 Inaccessible, Ineffective Complaint Processes . 64 No Access to Police Protection . 66 A Legacy of Misconduct, A Lack of Accountability . 68 Section Two Everything Becomes Illegal: How Court-Imposed Conditions Set People up to Fail . .73 . Where Did All the Real Criminals Go? . 74 When Everyday Activity Becomes Illegal. .75 What Results from Behavioural Conditions: An Ongoing Cycle of Criminalization . 84 Paraphernalia Prohibitions: All Harm, No Good . .89 Abstinence Conditions Set People Up for Failure . 91 Red Zones Exile People from Life’s Necessities . .95 No Safety in Exemptions or Variations . 99 Bad Data Causes Real Harms . 99 Bill C-75: Law Reform and Uncertainty . 100 Final Words: Conditions Don’t Correct Behaviour—They Put People at Risk . .101 Section Three No Access, No Support: Service Gaps and Barriers. 104 Stigma Cuts People off from Basic Necessities, Public Resources . 105 Three Focus Areas: Income Support, Shelters, Hospitals . 105 Neoliberalism in Context: How BC Waged a New War on the Poor . 106 A Project of Exclusion: Income Assistance in BC . .107 Shelters . 109 Hospitals . 114 The Need for Peer-Driven Services . 116 PART THREE: MAKING STIGMA VISIBLE . 119 Why a Stigma-Auditing Process Matters for BC . 119. What is Stigma? . 120 Stigma in Law and Policy . 124 Auditing for Stigma. 125 Executive Summary MAKING STIGMA VISIBLE to them that their experiences and and serve to perpetuate it. This By centring and amplifying the their visions for change held value. report offers that analysis alongside voices and experiences of people Many individuals shared that they actionable recommendations for most affected by BC’s homelessness had instead been shown, over the change. crisis and drug policy crisis, Project course of their lives and through Inclusion identifies the legal, policy- ongoing interactions with police, HOW TO USE THIS REPORT other residents of their communities, related, and other structural barriers Project Inclusion consists of three and even some health care workers, that must be addressed in order to parts that aim to: meaningfully prevent opioid-related that their homelessness and their • provide context for the deaths and other health and safety substance use defined them and experiences and perspectives harms, particularly among people resulted in them being treated as of people experiencing who are experiencing homelessness unworthy of respect and dignity. homelessness and people who and people in deep poverty who use These two markers seemed to be use substances while living in substances. used by others to justify their daily experiences of violence, racism, poverty; Project Inclusion is the culmination of theft, threats, and ostracism. • lay out the study’s main findings, over a year of research by Pivot Legal which connect policing, court- Project Inclusion study participants Society lawyers and researchers, who and police-imposed behavioural described a diversity of life travelled to ten communities across conditions, and the provision experiences with researchers, yet BC’s five regional health authorities. of essential services with the the commonality of experiences Working from the perspective that perpetuation of stigmatizing that transcended geography and people are experts in their own practices that make people demographics was striking. In.
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