Every Wednesday at 15th and Julian streets, you can spot the social workers and staff therapists with the Harm Reduction Center: They’re standing around a colorful van, blasting upbeat music, as patient after patient drops by for clean needles, free counseling, a warm meal — or even a massage.
Each week, from 2:30 to 5 p.m., the center’s staff is on deck for whoever needs to drop in and get treatment.
“We offer free therapy, integrated mental health and substance abuse treatment to folks who might not be able to access it in traditional ways,” said Anna Berg, director of programs at the center.
Although founded in 2000, the center’s mobile services weren’t launched until 2018. There are currently four locations where their vans set up: The Mission, South of Market, the Tenderloin, and Bayview.
To each location weekly, the center sends a team of five licensed therapists who come ready to lend a listening ear and offer therapeutic guidance.
Support also extends beyond substance treatment and talk therapy: Attendees have access not only to clean needles and pipes, but also to food and water, immediate medical assistance, and massage therapy.
According to clinical social worker and staff therapist Joe Sciarrillo, who works at the Mission location, the pop-up provides about 150 meals every week; a similar number of people drop in weekly. Between all four locations, more than 600 people visit the clinics each month, about two-thirds of whom make return visits. Staff make contact with individuals some 5,000 times, either first-timers or folks who return time and again.
“Our guiding principle is ‘Come as you are,’” Sciarrillo said.
That, said Berg, is what harm reduction is: “It’s asking what the person in front of you needs, how you can best meet those immediate needs, and then how do you do that over and over again.”
All services offered by the center are free. This includes mobile-site care, private care, and referrals to rehabilitation centers. Importantly, services are highly personalized, no one needs an appointment and there are no waitlists. The center is funded by city and county grants as well as through training events for other groups for which they charge.
“Some people want to stop by just to say hello and check in, some people want to jump into a van and close the door and talk there, and some ask for private care and meet us in other clinic spaces,” said Berg. “We’re down for any and all of it. The goal is really to build connection and trust and, over time, help empower people to figure out what they want to do and then help them do it.”
Maintaining both flexibility and consistency, Berg said, is one of the most important aspects of the center’s operations. “If you want to reach vulnerable people who have a lot going on, you have to be flexible and adaptive to each person’s individual needs, while also being very stable.” The center walks this line by consistently being at the same locations every week, at the same times, with the same providers.
The absence of safe-consumption sites in San Francisco is a pressing concern for the center’s staff. Although there was a safe-consumption site proposed by St. John’s Evangelist Episcopal Church at 15th and Caledonia streets, right next to the Center’s Mission pop-up location, plans for that were delayed.
“We’ve been really disappointed in the city of San Francisco and the governor. The evidence around the effectiveness of safe-consumption sites is through the roof,” said Berg.
The effectiveness of safe-consumption sites, she said, comes not only from their ability to immediately save lives, but also because people who access safe-consumption sites are more likely to detox and seek long-term addiction treatment. “When people go to these sites, they’re building relationships with people there, and thus know who to ask for help when they’re ready,” said Berg.
“Right now, there’s no easy access to help where people are treated with kindness and not judgment,” she added. “Harm Reduction Therapy Center tries to provide kinder care, but we’re just in a few small neighborhoods on certain afternoons. We need more help.”