After working for a decade at the Townsville Hospital and Health Service, harm reduction officer Brent Fergusson has settled on one question he can ask clients that immediately puts them at some ease.
The simple, clear and direct words with which he greets them are: “How can I help you?”
His NSP at the Alcohol, Tobacco & Other Drugs Service (ATODS) is contained within a multi-service facility.
Therefore, when people arrive, they could be wanting anything from a dental check-up to some injecting equipment.
Brent recalls an afternoon of service that shaped his attitude: “One afternoon a man came in who was thin, barefooted and messy. I said ‘Do you want some sharps, mate?’ He said, ‘Nah, I’m here for the dentist’.
“That same afternoon two guys came in wearing satin shirts, one had a bluetooth [device] in his ear; they were looking a million bucks. We had a mental health conference on. I said ‘Are you here for the conference?’ They said ‘No. We want some sharps’.
“What I’ve done since then is not ask clients ‘Do you want the usual’ or ‘Are you here for sharps’. I say to clients ‘How can I help you?’”
He uses a version of ‘walk a mile in my shoes’ philosophy: “We can use the words ‘non-judgmental’ but that is pretty hard to do.
“What I do is I put myself on the other side of the fence and ask myself ‘If this person was delivering this message to me, how would I like to hear it? How would I like to be spoken to? If my son or my wife or mate was accessing this service, how would I like them to be dealt with?’ ”
The Townsville NSP is associated with nine secondary sites as well as numerous pharmacies providing sterile injecting equipment.
Brent says he experienced his own life-change about 16 years ago which led him to do some training in the health sector, during which he was sent on placement to the Townsville NSP. Eventually, after some time in youth services where he worked on a project about teen injecting, he ended up working at the Townsville NSP.
He discovered that listening to clients and finding out about their needs was far more important and effective than him trying to direct things.
“Really listening and addressing their concerns – not just listening so I can then talk at them and get some sort of intervention to make my stats look good,” he says.
Brent says that even though an NSP worker might have had many years of regularly dealing with a particular client, that client might suddenly want some help with their injecting use and seek help to change their life.
“And usually they ask for help on a Friday afternoon when you’re nearly closed,” he says. “Other people want help straight away – the people you would least expect.”
Crucially, he tries to keep an open mind. “We all have our little ways – we judge people, we compartmentalise them, we put them in boxes,” he says.
“If you’ve seen Trainspotting, that’s what I thought a drug-user was like: dishevelled, homeless. The reality is vastly different.”
Another important part of Brent’s job is connecting not only with secondary NSPs and the local pharmacies, but also building relationships with health professionals who are in their early training.
He has created opportunities for engagement, such as getting an ‘Introduction to the NSP’ included in the induction process for all ATODS staff and students on placement. Each of these people spends at least one afternoon with him in the NSP.
“I like them to be here, sitting behind the counter with me; they get to see brief interventions in action, and get to see for themselves the high level of function from the majority of our consumers,” he says.
He also helps do an annual tutorial at James Cook University for third-year medical students in which he discusses safer injecting practices and NSP access. “The session is always a hit with the doctors-to-be,” he says.
– Andrew Stephens