Inside New Start’s Harm Reduction Service
New Start’s Harm Reduction Service is one of the few places in Liverpool designed for women whose complex needs mean traditional accommodation and services are often unsafe or unsuitable.
Amanda Ehlen, Project Manager, shares how the service operates, its links and why it plays a critical role in supporting vulnerable women.
Harm Reduction – The First Step
The Harm Reduction Service offers a starting point for women who need support but are too vulnerable for hostel accommodation, especially those dealing with several complex needs.
Our nine-bed accommodation is the first step toward treatment and recovery. It feels more like a home than a hostel, offering stability, safety, and wraparound support.
We exist because of the clear gap in services for women whose experiences of addiction, mental health challenges, homelessness, and domestic abuse overlap. Many services specialise in one area, so women with multiple challenges often have nowhere to turn for support with all of their needs.
Many of the women we support are referred by homeless services. Whether they are living with addiction or have survived domestic abuse, or both, our service aims to keep women out of situations where their well-being could get worse.
Because our project is small, staff can give daily, hands-on support. This means going to appointments with residents, working with social services and health workers, and helping residents move away from environments and habits that make change difficult.
Helping women become more independent is also a key part of our service. Residents pay for their own energy and look after their rooms. These small steps help create a calmer, more stable atmosphere than they may have experienced before.
A Positive Environment
A positive environment is at the heart of our service. It helps us set boundaries that lower risk. Many women arrive from places where drinking or drug use is common. In larger hostels, it can be easier to share substances between rooms, and the local area can reinforce cycles that people are trying to break. Creating distance from these pressures gives women the space they need to begin stabilising.
Here, residents spend time together in shared spaces rather than in each other’s rooms. This helps reduce the chances of substances being passed around. Structure, routine, and community also help reduce harm. Residents lead activities such as gardening, arts and crafts, movie nights, and walks in the park. Sometimes, we go on day trips to Liverpool.
Every moment spent together is time not spent drinking or using substances alone.
The house itself feels therapeutic. People often say it’s beautiful and calm. One resident was even offered her own flat, but didn’t want to leave here because of the park views and staff support.
Peer to Peer Support
While staff support is crucial, much of the service’s success comes from community. Peers often understand each other in ways that professionals cannot. The women here often help each other after relapses, overdoses, or challenging times. For example, after one former resident returned to our safety bed after an overdose, another resident stayed with her, shared pizza, and talked about their experiences with rehab and recovery.
These connections are identifying. Survivors of domestic abuse or other trauma can find common ground and emotional safety with each other.
Women from different backgrounds often connect here. Shared spaces in the house become places where experiences are understood without judgment, and support can grow between residents. Even spending 10 minutes together over coffee in the lounge helps reduce isolation and build stability.
How Harm Reduction Works
Harm reduction means safely supporting women who are still using substances so they can lower their risk.
We define harm reduction broadly, and it includes several key parts:
- Access to prescriptions to manage heroin withdrawal.
- Links with Red Umbrella for women involved in sex work.
- Condoms, rape alarms, and on-site access to STI and Hepatitis C testing.
- Weekly consultations from a doctor through Brownlow Health.
- Education around safer injecting, wound care, needle gauge, and site rotation.
- Support for alcohol-reduction plans in partnership with CGL, including drinks diaries and supervised reduction.
Our goal isn’t immediate abstinence. Whether offering safer injecting advice or carefully managing alcohol reduction, the focus is always on reducing risk while meeting each woman’s needs to keep her safe, stable, and engaged.
Challenging Misconceptions
One of the hardest parts of our harm reduction work is facing misconceptions. Many people believe that addiction is a choice or only looks like the extreme portrayals shown on TV.
The truth is more complicated. Addictions differ depending on the drug. For example, heroin causes physical addiction, while ketamine is more mentally addictive. In the end, addiction doesn’t discriminate and is often shaped by circumstances and environment rather than character.
Weekend cocaine users may see themselves as different from regular heroin users, even though both rely on Class A drugs. This way of separating substances into ‘acceptable’ and ‘unacceptable’ categories adds to misunderstandings about addiction.
Changing perceptions is key to overcoming social stigma.
Working In Partnership
The Harm Reduction Service relies on partnerships with groups across the city, such as YMCA Together, Whitechapel Centre, Access, Red Umbrella, and Brownlow Health. These connections help us respond quickly when a resident is at risk, making sure women always have support in a crisis.
By working closely together, we have helped prevent women from getting worse, going back to hostels, or becoming homeless. Sharing information, reviewing cases, and acting as a network help us find safer places, access treatment, and give women steady support.
This collective approach helps prevent serious harm and, in some cases, saves lives.
Safety First
Women need to be safe before change is possible.
Once someone is safe, they can start building routines and find stability with the right support. For women who have lived with addiction or trauma for years, progress takes time, and specialist accommodation can really help.
For some women, success means managing gas and electricity for the first time, taking medication regularly, going to appointments, or getting involved in daily life. Even these small steps show progress. For others, success may be moving along the pathway into detox, rehab, or supported accommodation. Progress here is rarely linear. That’s why our service is designed to offer women consistent support through both the early stages of change and long-term recovery.
However, our Harm Reduction Service is limited to 12-month tenancies, and there are some things you just can’t do in that time. Some women will struggle in their own accommodation, whether they’re clean or not. There remains a clear need for more long-term specialist provision, ensuring women aren’t forced to move on before they are ready.