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Behind the Work in association withThe Immortal Awards
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How The Garden Is Challenging Timmins to Know Their SHST About Opioids and Safe Injection Sites

08/08/2022
Advertising Agency
Toronto, Canada
148
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The Garden creative director Lindsay Eady and Safe Health Site Timmins Dr Louisa Marion Bellemare talk about combating stigma, creating snappy slogans and the truth behind safe injection sites, writes LBB’s Josh Neufeldt


Despite its many good qualities, the city of Timmins, Ontario holds the unfortunate reputation of being the centre of Canada’s opioid crisis. With a population of 41,000, the city has the country’s highest death rate from opioids per capita (72 people per 100,000), and has seen an 82% increase in opioid related deaths between the years of 2019 and 2020. In response to these concerning numbers, doctors Louisa Marion Bellemare and Julie Samson worked together to support the opening of Safe Health Site Timmins (SHST), an urgent public needs site offering opioid users a clean, safe and professionally staffed health centre designed to mitigate the harm and risk of opioid consumption.

However, SHST faced several challenges at its inception - a primary one being heavy community backlash from Timmins citizens who believed that a safe injection site would only serve to enable further drug usage within the community. Enter Toronto agency The Garden. By collaborating with SHST, the two were able to create ‘Know your SHST’, a fact-based campaign intended to destigmatise the reputation of safe injection sites by creating community discourse. 

The Garden creative director Lindsay Eady and SHST doctor Louisa Marion Bellemare spoke to LBB’s Josh Neufeldt about how they brought this campaign to life. 




LBB> What was the brief for this campaign like? What immediate ideas came to mind when you first saw it?


Lindsay> This project just started as a big problem to be solved. The ER in Timmins was flooded with overdoses from the opioid epidemic, and on top of that, the hospital beds were being used for the covid-19 pandemic. At first, we started thinking huge - like ‘how can we help decriminalise drugs in Canada’ huge - but after seeing all the well-funded and very capable organisations working towards that goal, we got more focused on a tangible goal: helping the community of Timmins get on-board with an ‘Urgent Public Health Needs Site’ as a stopgap for reducing the number of unnecessary overdoses in the community. 



LBB> What led to you choosing The Garden for this project? And what was the brief you gave to them like?


Louisa> Actually, we mutually found each other. The Garden co-founder Shane Ogilvie is originally from Timmins, and he heard through various media outlets about the significant opioid poisoning crisis which was leading to substantial deaths in his home community. He reached out to me, as (my colleague) Dr Julie Samson and I were making a big ruckus in our community about addressing the unnecessary deaths related to this opioid poisoning crisis. We had the worst opioid related death rate per 100,000 people in Ontario, and possibly the country. Shane wanted to help his home community and assist in finding a solution to reducing overdose deaths. We needed to develop a straightforward, factual and logically informative campaign to prove to the community that a safe injections site/safe consumption site (Safe Health Site Timmins (SHST)) was a necessity in our community, and would be fundamental in saving lives and providing much needed addictions treatment, including harm reduction for those who use injection drugs. 



LBB> Can you tell us more about how SHST was founded? How long did it take to get off the ground and what challenges did you face?


Louisa> It was founded by a collaborative group of people. First off, there was a community organisation called Timmins and Area Drug Strategy (TADS) who were incredibly supportive. But beyond that, our city mayor, George Pirie, made a pledge that he could and would support a safe injection site/safe consumption site, as it was the right thing to do to help those in our community who had a significant risk of death. Also, the City Council agreed to fund the site to ensure its operation for one year, until we had official funding through the government. And last but not least, our hospital, Timmins and District Hospital, played the lead role in being the operators of the SHST (hiring staff, management, training, etc.). It’s amazing (a small miracle if you ask me) that it was fully operational in approximately one year. Something like that is almost unheard of. We officially opened July 4th 2022. 

There are many challenges, but overall with the very progressive, factual and logical campaign developed by The Garden to promote the SHST, many of the barriers have been overcome relatively painlessly. The most fundamental part of the campaign, and what The Garden was exceptionally successful at doing was providing facts in response to the many comments, questions and inaccuracies posed by various community members and organisations, who due to mostly their own biases and lack of education around safe consumption sites, eventually became supportive after realising that this was a solution to what was happening in our community. Safe injection sites are not a new concept. They have been operational in Europe for years, and there is a substantial amount of evidence that supports their success in reducing death rates, making communities safer and cleaner, and saving health care dollars. 



LBB> What was the research process like for learning about safe injection sites? 


Lindsay> The research part of the project has been ongoing for the past year, and with the help of our partners at Timmins District Health, we were able to talk to volunteers at these sites, doctors and nurses, police officers and public servants, as well as people with lived experience themselves, so we could understand all aspects and sensitivities about messaging, and realities of safe injection sites. 



LBB> What were the most common misconceptions you came across? And when did you realise that you wanted to publicly challenge those misbeliefs?


Lindsay> The main misconceptions are that safe injection sites enable drug use, keep people addicted, attract addicts to communities, and waste taxpayer dollars. None of these things are true. 

Louisa> The most common misconceptions are those surrounding the idea that safe consumption sites/safe injection sites are places where people go to use drugs and get high, and that the sites are just worsening the drug problem and not helping it. People don’t realise it’s a health centre where there are discussions and services intended to aid harm reduction, including clean supplies, access to health care professionals such as nurses, social work, and direct links to community organisations including the public health unit, addictions organisations and housing. Moreover, if people want to completely stop using drugs, there is a direct link to our hospital where they can immediately access acute medical withdrawal management. It’s a place for people to dispose of their needles and it removes people from the public eye, allowing them to use drugs in a clean, safe place. They have access to washrooms so they are not using in the streets. These sites make people and communities safer. 

The core concept of the campaign was to reduce stigma and misconceptions right from the get go. To ‘nip it in the bud’ right from the start. So we came right out of the starting block by challenging the misconceptions, even back when the idea for the site was still in its infancy. To do this, we provided the community with facts meant to reduce the stigma. One of the ways this was done was through community information sessions. Here, The Garden presented information about the campaign to community organisations, including the Timmins and Area Drug Strategy.



LBB> Calling it the ‘Know your SHST’ campaign is a clever way to draw attention to a very real issue. How did you come up with the name? And what was the process of coming up with subsequent ‘SHST-related’ phrases like?


Lindsay> When we saw the proposed name for the site, it just stood out as looking like ‘shit’. At first, we thought maybe we should change, but on second thought saw an opportunity to lean into it. Timmins residents are straight-shooters, and they don’t mince words. We thought maybe we could speak their language rather than trying to tug on their heartstrings, as this was an issue that held a lot of contention. Bringing the debate to a more logical and fact-based place felt strategically more sound than going emotional. So, we used these provocative lines to draw attention and make residents rethink an issue they thought they had their minds made up on, all with a little humour, levity, and bluntness. And there was no trouble in exhausting every ‘shit’ idiom we could think of.



LBB> Projecting onto the McIntyre Headframe is a great way to draw attention to the campaign. What went into making that happen?


Lindsay> We wanted to plaster the town with whatever limited ad space we could find. Shane, The Garden co-founder, was born and raised in Timmins and suggested the McIntyre Headframe as the biggest iconic landmark in the community. So, we created three rotating messages to get projected over a few weeks of the campaign, and again this month with the launch of the actual site. 





LBB> Public engagement has been an important aspect of the ‘Know your SHST’ campaign, especially the ability to target public debates. How has engagement developed and changed throughout the course of the campaign?


Lindsay> This campaign was created for fence-sitters on the debate over safe injection sites. We felt that if we could just educate people to debunk misconceptions with the facts, then we could get community members on our side and advocating for it with us. Throughout the campaign, we saw Timmins residents who were newly armed with the facts posting screen-grabs from our website on social media to combat misperceptions other people had. Effectively, we could actually see it working in real time. 

Louisa> We wanted to get people talking, we wanted people to ask questions, and we wanted to have good factual answers to the questions. These answers needed to be straight to the point. We didn’t want anything wishy-washy. Aside from the community information sessions I mentioned, we also had organisations tour the site before it officially opened. Because of this, a great many people were in support of the project. The chief of police was in support, EMS was in full support, the mayor and council was in support, Public Health Unit was in support, Timmins and District Hospital was in support, Timmins and Area Drug Strategy was in support, and many other community organisations were too. Since then, the discussions and debates have become more factual. This isn’t a ‘pulling on heart-strings’ type of campaign, but a campaign based on truthful and demonstrated proof that these types of sites work. People are engaged, and that is key. The community now realises that even though people still have their own biases around people who use drugs, safe injection sites are part of the solution to the opioid poisoning crisis, and most importantly, will save lives.



LBB> What challenges have you faced during this project? How did you overcome them?


Lindsay> The support for this campaign from the Timmins mayor and even the chief of police has been overwhelmingly and surprisingly positive. As part of the process, we also presented the campaign to people with lived experience. One of these people was a mother whose son used drugs. I was nervous to get her feedback, thinking she might feel (like many others) that a safe injection site would’ve enabled her son to keep using drugs. But instead, she thanked us and said she wished a site like this would’ve come sooner, because then maybe her son would still be alive and with her today. That’s when it really hit me - saving even one life is so important, and makes every second of energy I put into this project worthwhile. 

Louisa> The biggest challenges were funding and finding a lead organisation. In the case of the former, the mayor and city council agreed to fund the project for one year, and so we had to work hard to secure continued provincial funding for the project. In the case of a lead organisation, we needed one who would agree to lead the project (do the hiring, payroll, training, develop the site, etc.). Luckily, the Timmins and District Hospital under manager Patrick Nowak would rise to the occasion and take on the project. Something else we had to deal with was receiving a federal exception, which would allow people to legally and safely use their own drugs safely at SHST. However, we received it recently! And finally, of course convincing people in the community that this was the right thing was a huge challenge. But as stated already, this was overcome by The Garden’s innovative campaign. It convinced people we were doing the right thing. 





LBB> What has the response been like? Have you encountered any pushback for taking on and releasing such a provocative campaign?


Lindsay> Like anything worth doing or saying, you’re going to encounter people who push back and disagree. That’s how you know you’ve touched on something real with tension. When we projected messaging on the McIntyre Headframe, some people said it was disrespectful to the mining community. Others are adamantly against the site and feel that people with addiction have ‘chosen’ that life, and they might not ever come to our side, but we moved the needle, so to speak, for those open to rethinking the issue. And that was worth the pushback from anyone else. 

Louisa> Changing culture and stigma around addictions is extremely challenging, and The Garden helped the city of Timmins break this huge barrier - allowing for a conversation about what is considered by many to be a very difficult topic. It has allowed for community engagement around people who use drugs, and has brought the realisation that when a community comes together, big things can happen. I am so proud of the city of Timmins and so thankful to have The Garden supporting this campaign. I look forward to the future, and continuing to help with improving the lives of those who use drugs. 


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