by Tarah Hodgkinson
September marks suicide prevention month. Numerous events and strategies are popping up around the world from RU OK? Day in Australia to #Bethe1To in the United States. All of these strategies are attempting to address suicide and mental health.
In many of the neighbourhoods where we work, suicide and mental health is a common topic. Indeed, I spent time with a rural community a few weeks ago in which residents recounted the loss of several young lives to suicide. This has only been exacerbated by the effects of COVID-19 related to social isolation and financial insecurity. Fortunately, there are suicide prevention strategies that can make a difference.
Suicide prevention can take many forms. Target hardening approaches try to increase the effort to take one’s life in the hopes of saving lives by making suicide more difficult.
Some of these efforts include physical barriers, such as fencing on tall bridges to prevent jumping. Others are somewhat unintentional, such as removing carbon monoxide from domestic gas supplies in the UK that resulted in almost a 100% decrease in suicides by gas poisoning.
HOW, BUT NOT WHY
While these kinds of target hardening prevention strategies are useful, and often successful, they do not address the why of suicide. Suicide is often the last resort, an attempt to escape inconceivable pain and trauma. This pain and trauma do not occur in a vacuum but are influenced by a person’s mental health and their environment. One example is long-term mental health problems arising from adolescent bullying in the neighborhood. Another example is adverse childhood experiences within the family.
Clearly, suicide prevention can do much more than a marketing campaign to tell people to reach out, or by making suicide more difficult.
While the risk factors for suicide range from individual to ecological, there are numerous ways that we can make our neighbourhoods and communities more resilient to suicide. These include structural changes such as affordable and accessible housing and shelter, paying people a living wage, creating neighborhood opportunities for youth and the elderly and inexpensive access to health care including locally-based, mental health and trauma-informed care.
If we are to fully address and mitigate suicide, these structural changes are integral in the creation of a healthy neighborhood.
Healthy and liveable neighbourhoods, where people are connected, cohesive and cared for play an important role in improving mental health and preventing suicide. And we all have a role to play in that kind of prevention.
Wow, what a week its been. I had a few ideas for this week’s blog, but it feels negligent not to write about what is affecting all of our communities right now. And that is COVID-19.
We are in an unprecedented time for this generation. The world is shutting down and a highly contagious flu is spreading like wildfire across our increasingly connected world. Indeed, we are witnessing a global pandemic.
Here in Australia, universities are closing their doors and classes are going online. Residents are being encouraged to stay home and avoid social gatherings. Many are panic-buying toilet paper and other necessities, leaving shelves totally empty. Grocery store chains are being forced to limit the purchase of numerous items.
More importantly, and almost completely against our ethos at SafeGrowth, people are being told to socially distance themselves from others. Major public health authorities are encouraging people to work from home (if they can), stay home if they feel sick at all and avoid large social gatherings to “flatten the curve.”
And this is the right advice. For highly contagious viruses like COVID-19, the risk of exposure is huge for people who are older, have weakened immune systems, respiratory issues, or other preconditions. Social distancing will reduce the demand on already over-burdened hospitals and their staff who, like Italy, will quickly run out of treatment facilities.
But, as we know, social distancing is not an option for many of our fellow SafeGrowth communities, who do not have access to paid sick leave or are living from paycheck to paycheck and have to work to survive. Never have these issues seemed more pressing.
Furthermore, social distancing can also lead to social isolation. By staying home and away from others, we can feel disconnected and lonely. And while social distancing is an important part of protection from viruses, as we know from research, social isolation isn’t good for our health. Just yesterday I received a message from one of my close friends at home. She has been instructed to work from home and is already feeling alone and isolated.
PARADISE BUILT IN HELL
What do we do? Well, we have many accounts of what humans do in disaster to help guide us. Eric Klinenberg’s book Heat Wave details how older women survived one of the worst heat waves in Chicago in 1995. They called each other. Every day, they sat is tubs full of water or under air conditioning or fans and called to check in on each other and stay connected.
Rebecca Solnit’s book Paradise Built in Hell, reminds us throughout human history, in disaster situations, humans engage in incredible acts of altruism. They donate more, set up relief shelters, check on their neighbours and prepare meals for those who can’t.
In this time of uncertainty, instability, and fear, we encourage our fellow SafeGrowth community to reach out and check in with each other (phone, skype, facetime, letters!) and share those extra items you may have bought with those who may be struggling.
Most importantly, be kind to one another and don’t forget to wash your hands!
by Tarah Hodgkinson
A colleague and I were discussing petty theft and property crime in his community. After consulting the community, we were told that very few people reported these incidents to the police. I asked him what he thought was going on with so many people experiencing petty theft from their property.
“It’s addiction” he responded.
This was not a new revelation. Research often finds that addiction is a driving factor for stolen property. We have discussed this a number of times in this blog.
However, the illness of addiction is rarely taken into account when convicting individuals who commit a crime just to get their next score. Consequently, the justice system becomes a revolving door for those battling substance abuse. Unable to obtain their drug of choice legitimately, they turn to illegitimate activities like petty theft, robbery or even the sex trade.
Many addictive substances like alcohol are legal and many alcoholics hold regular jobs and pay for their addiction without engaging in crime. But drug addicts who end up in criminal court are defined as burglars, robbers or sex workers. In reality, they are better defined as individuals living with substance abuse and very little support for addressing their addiction. Drug courts offer an alternative.
Drug courts take a public health approach to substance abuse disorder. All parties work together including lawyers, police, public health professionals, drug counsellors and members in the community. Unlike a traditional criminal court, drug courts are specifically focused on helping addicted offenders into long term recovery.
Drug courts are particularly important for marginalized populations that already suffer additional roadblocks on the road to recovery. While different drug courts have different configurations, they are gaining support around the world, such as in Canada, the United States and Australia.
Many crime prevention tactics in CPTED, for example, focus on preventing opportunities for property crime. However, if we don’t consider the social factors influencing some of these crimes, then those battling substance addictions merely find another way to feed their habit.
It’s easy to think that we just need harsher laws for drug use. But anyone who has dealt with addiction personally, or watched someone experience it first hand, knows that punishment and deterrence tactics rarely work.
Why do people get addicted in the first place? The answers are complex. While drug courts may not resolve every cause of addiction, they do offer a public health approach to what is largely a public health problem, not a criminal one.
Making streets safer means activating them with all kinds of tactics, including intensified bicycle usage. In 2012 the SafeGrowth blog How the Dutch Saved Their City, described how the Dutch transformed their cities by dramatically changing their road infrastructure and supporting cycling culture. Today, there are almost 900,000 bikes in Amsterdam alone, making it the country with the highest rate of bike ownership in the world.
Lately, however, Amsterdam is dealing with an interesting issue. With over 50% of Amsterdam residents using bikes as part of their daily commute, they are running out of space to park their bikes. In fact, the city is now planning on creating 40,000 new parking spots. This issue not only speaks to the significant commitment the Dutch have made to make their city streets safer and more bike friendly but has sparked an opportunity for architectural creativity.
Unlike many cities in North America, with their sprawling, car-dominated cultures, space is a significant commodity in much of Europe. Some suggestions for bike parking alternatives include underwater garages and floating barges.
However, these alternatives could pose cost and space restrictions. Therefore, bike parking in Amsterdam has begun to move upwards, rather than outwards. Impressively, architects are building vertical bike parking structures. These mimic many of the new designs for vertical car parking in countries across the world, but with an eco-friendly and street safety twist.
There is a lot of hesitation among cities to switch to create large-scale bike paths and alternative transportation. Many fear that bike paths will impede the flow of car traffic and increase congestion.
This notion is counterintuitive. In Vancouver the bike path network is constantly expanding, and with it, so too are the number of bike trips replacing car trips.
That reduces congestion, not the opposite. The attempt to build new and creative ways to park bikes in Amsterdam demonstrates that the bike culture in that city, and other cities in the Netherlands, is going strong. It offers excellent ideas for helping other cities to start rethinking their systems.
By Tarah Hodgkinson
Safe injection sites have been a point of contention for several years around the world. Some claim drug use is a public health concern needing harm reduction strategies, while others claim drug use is immoral and should remain criminalized.
Over the last few months, I have spoken to public safety organizations and police across Canada. These organizations cover everything from domestic violence to traffic safety, but the topic persistently arising remains illicit drug overdoses. For example, British Columbia recently announced a health crisis resulting from increases in overdose deaths, a situation experts believe results from lacing heroin or meth with intense potency additives like fentanyl.
Thousands die each year from these overdose deaths, almost 30,000 in the U.S. alone, and the numbers are getting worse. While illicit drug use is not new, public response to it seems to be changing. Communities are shifting away from punishment and looking towards harm reduction techniques.
In Canada, none is more famous than Insite, North America’s first supervised, and legally protected, injection location where clients are given clean needles to use in a safe environment. Furthermore, they are given access to a myriad of health services such as nurses and substance abuse counselors.
In spite of a raft of political attacks by anti-drug organizations, and claims of imperfect science, the overwhelming preponderance of research results to date on the Vancouver drug injection site are positive. This includes a comprehensive 2011 study in the prestigious UK medical journal, The Lancet.
HARM REDUCTION DOESN'T REPLACE COMMUNITY-BUILDING
Other harm reduction models are also emerging across the country. In Ottawa, a managed alcohol program helps chronically homeless and alcoholic individuals seek stability and avoid binge drinking. Harm reduction is an important community-building step to address drug overdoses in Canada.
However, community-building also means better investment in prevention and drug use alternatives. There is still very little investment in long term solutions such as detox and recovery services, job opportunities, community supports and wrap-around models – all demonstrated to have a significant impact.
A well-known example is Portugal. Over 15 years ago, Portugal decriminalized all drugs. Since doing so, drug use has declined and overdoses have plummeted. Portugal invested in health care, job creation and other social supports. These alternatives had a dramatic impact on drug-seeking behaviour.
The claim that there are not enough resources for this kind of harm reduction investment collapses when faced with contrary logic or evidence. The fact is it is far more expensive for the criminal justice system to tackle drug crime. Community reinvestment - the basic premise of SafeGrowth - is well worth the effort in dollars and lives.
by Mateja Mihinjac
During my recent visit to New York City, I was thrilled to witness the upsurge in cycling in this iconic city. As an avid cyclist, I love when cities provide infrastructure for bipedal commute.
Promoting physical and social connections through design, such as increased bike usage, fosters interaction and establishment of social ties. In SafeGrowth we know that this also influences safety and perception of safety.
New York City, the metropolis well known for its traffic congestion and yellow cabs, has followed the lead of several European and Australian cities and in the past decade expanded its cycling infrastructure. Cycling in the city has since 2005 increased by an astounding 260%, currently amounting to 450,000 daily trips.
In 2013, the city also introduced the nation’s largest bike sharing program Citi Bike, which currently offers 603 bike stations and 10.000 bikes across the city’s five boroughs. These bikes are extensively used by city dwellers and tourists alike.
Exploring Manhattan on a bike
CYCLING FOR HAPPINESS?
Replacing motorised commute with biking impacts health and social connectedness, two of the three most important contributors to happiness in urban environments.
Moreover, planning for environmentally sustainable cities that prioritize cycling and walking is intrinsically linked to socially cohesive communities.
IMPROVING CYCLING INFRASTRUCTURE
Talking to locals revealed that despite great progress, cycling infrastructure could benefit from several improvements. The first was more bike lanes and Citi Bike stations outside downtown and affluent areas, a common need in other cities.
Ironically, those living on the peripheries of the cities and those less prosperous are the ones who would most benefit from biking connectivity.
The second issue concerns safety. A 2015 article reported 90% of bike lanes in New York City were unprotected, meaning the majority were lanes without a safety buffer between cyclists and cars. This is surprising knowing that protected bike lanes can reduce the risk of injury by 90% and also increase ridership.
CYCLING FOR CITIES OF TOMORROW
Promoting cycling in progressive cities like New York is an excellent avenue for developing environmentally and socially sustainable cities. Planners should encourage future expansions of bike infrastructure in less affluent areas and designers must follow guidelines for safety and buffered lanes.
Designing future cities around cycling will contribute to overall healthier and happier cities.
How do we start community building in a place of rapid decline? How do we create social capital where none appears?
Tough questions. One answer is to learn from others with great ideas. Here is a great idea using community design.
Emily Pilloton is a brilliant, young activist architect (Watch her TED.com video. You'll see what I mean). Her book Design Revolution set the stage for how she works.
She and her partner have now launched the next act: They moved to the poorest county in North Carolina and created Project H Design, a strategy to put their ideas into action.
Emily describes Bertie County, North Carolina as the poster child for the demise of rural America. A place where downtowns are hollowed out - a "rural ghetto" with no shared vision for a collective future.
They have already done some pretty cool things (see photo above) Now they are teaching high school kids how to start transforming their own neighborhood through community design.
There is a New York Times article about it here.
My favorite is her appearance this past January on the comedy show The Colbert Report. Wait for the buffering - it's worth it.
I have added the Project H group website to my LikeMinded list in case you want to follow them. (I do!)
I can't imagine a group more likeminded to SafeGrowth.