Facing the Opioid Crisis: Q&A with Denver Public Library’s Rachel Fewell

How one urban library system is responding to the epidemic in its community—and in the library itself.

Rachel Fewell Photos courtesy of Denver Public Library

Juggling responsibilities at a large urban library can be a challenge, but Rachel Fewell's job as central administrator at Denver Public Library (DPL) got even harder recently. After receiving a letter from a patron who claimed that the library was "dying," the local TV news station aired an exposé on the downtown branch, showing a video of drug users shooting up outside the library and a drug deal occurring in the building. Denver’s mayor was quoted saying he wouldn't bring his kids to the library. While the news segment may have shocked some community members, it didn't surprise Fewell. DPL has been working hard to respond to the opioid crisis that has been devastating communities across the nation. Here's what Fewell says about dealing with the bad press, responding to the opioid epidemic, and why librarians need to be talking and doing more about the crisis. How has the opioid epidemic affected your community and your library? About four years ago, we started putting sharps containers into our bathrooms in our downtown location because people had been flushing their needles down the toilet. Then we started to notice that people were breaking into those sharps containers to get needles, so we upgraded from plastic to industrial-strength containers. Our custodial staff and shelvers find needles throughout the building—in the stacks, stuck in books, out on the lawn. During the past year and a half, we have seen even more changes. We’re calling the paramedics quite a bit now, and often, it's for overdoses; we have had 11 at the library since February. We bought Narcan (a nasal spray that can reverse an overdose) for our staff to administer, and we had a reversal the very day we put it out on the floor. We're now part of a citywide effort to count the needles we find on our premises.

Denver Public Library

A local news station recently broadcast an undercover investigation about the library. Yes, we just had a big media spotlight shining on us. Over three days, people were filmed during a drug deal and shooting up. It's been tough. Our Facebook page blew up. The news station's Facebook page blew up. We had people say, "Why don’t you just let those druggies die," and "I’m never coming down to the library." Even our mayor said that if he had small kids, he would not bring them to the library—and that office is our funding agency. We've been working really hard to put out those fires and to respond to customers. We’re a space for everyone, and we do our best to root out the behavior we don’t want to see. We've had two school groups cancel for safety reasons. On the other hand, there are two school groups in the library right now, and we have summer camps going on as well. A patron sent the TV station a letter saying the library was "dying." What's your response? More than 2,500 people come through the doors of the Central Library every day. Those numbers have not declined, storytime attendance has not declined, and school, day care, and summer camp tours continue to visit our building. You recently hired two full-time social workers. What impact have they had? We had a group of staff members that was very passionate about providing services to our customers experiencing homelessness. A homeless services action committee formed to understand the gaps in services, and saw that as librarians, we could really use the professional help of a social worker. The committee put together a budget proposal, which was approved by the mayor. The position of social worker was originally a two-year position, but it since has become a full-time, permanent position. We  have put in a request for two additional social workers: a bilingual social worker, and one with experience with children and families. How are your social workers seeing the impact of the opioid crisis? Our social workers have drop-in hours every week, and during those hours there's a line of people to see them. They see a significant number of people who are addicted to opiates and seeking help. Unfortunately, here in Colorado, we don’t have the best system in place to get people that help. It's been tough, because we see people who are recovery ready, but we have to say, "Sorry, there’s a two-week waiting list. Hope you can stay sober that long." How has your staff responded? We have employees who have been here for more than 30 years, and the library was a lot different 30 years ago. I've tried to explain it by saying, "You know how Denver has changed a ton? Our profession is changing, too. We have to develop a whole new set of skills, and not just in this area." I've done a big campaign about free and equal access. We’re not judging people at the door based on their appearance. We provide information to everybody. Our social workers have created two training classes so far that I require my staff to attend—trauma-informed systems of care and resiliency training. It's helped us develop an empathetic approach. The next class we're going to create is a sort of  Homelessness 101, sharing information about what might lead someone to become homeless, trying to pull apart that it’s not this monolithic group, rather individual people with individual circumstances. I let people know that they are eligible for free counseling sessions, and we've had some staff members take advantage of that. We had two overdoses here on Saturday, and I’ve made sure to get around to thank everyone and see how they’re doing. We’re developing a culture here where we talk to each other. How has the training changed how staff interacts with patrons? It’s been incredibly positive. The training has helped us reframe how we react to situations and manage  interactions. For example, maybe you have a person with six dollars in fines—too much to check anything out—and when they are told that, they get really upset. Our social workers have helped us learn de-escalation techniques to change this situation from, "What is wrong with you?" to "What has happened to you that you’re this upset right now?" We've empowered staff to help that person and to make a one-time exception. If the patron says something like, "This is my last six dollars, and I need to buy tonight's dinner for my kids," we encourage staff to let them know that we have social workers who can connect them with resources. In the future, we'd also like to have a boundaries training for staff. We like to be customer-service oriented, but it's hard for staff to understand when they can say no. How has the epidemic affected young people and teens at the library? We see teens and children whose families are impacted by the epidemic. Our Community Resources team, which consists of two social workers and three peer navigators, works to connect them to community resources. Here in Denver, Urban Peak, the youth homeless shelter, has been closed since late April, citing safety concerns. Their outreach workers have been coming to the library frequently and are in regular communication with our Community Resources team. How does your staff respond when someone is found using drugs in the library or there's a suspected overdose? Our security department has an officer talk to the person. We also send a social worker or one of our peer navigators, people who have been homeless or are in recovery. People can be angry because you have interrupted them. They are usually embarrassed. The peer navigators might say, "I’m sorry you’re going through this. We want to help you. Let me connect you to the needle exchange program two blocks away, so at least you're injecting with clean needles. Would you like to go into rehab? Let’s see if there are options available." Security will also escort someone caught using drugs out of the building, and we let them know what they need do to get back in the library. They can call us when they are ready. We set up a meeting with the security manager, the lead social worker—and talk about behavior. Currently, we have 700 people who are banned from using the library. When there's a suspected overdose, our security staff knows what symptoms to look for. Of our 600 full-time employees, about 50 people in our system are trained to administer Narcan. We look at Narcan like we do AEDs (automated external defibrillators). We call the paramedics, but we understand that while we wait for them to arrive, the person might die. Narcan only costs about $75 a dose, and if we can save someone's life for $75, I’m all for it. Unlike many library directors, you're open to talking about these challenges, even with negative media coverage. Why? There’s an opioid epidemic. Overdose deaths are increasing. As a public space and one that welcomes everyone, it’s important for us to be honest about what the people in our communities are dealing with. I want more of us to talk about it. We’re an information profession. Why aren’t we sharing information with each other? This is not an isolated problem. We need to help people see that this is a nationwide epidemic. No matter what we do in the library, we’re not going to fix this problem. But being open and compassionate with the people dealing with it is the best thing we can do.
Megan Cottrell is a freelance reporter based in Michigan.
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Denver and Philadelphia have been in the spotlight for this issue but in reality opioid addiction is affecting all Americans. Even as a youth librarian I have noticed an uptick in DCFS supervised parent-child visitation sessions at the public library. Another step that many police departments are taking is starting up addiction amnesty programs. A lot of police are realizing they cannot arrest their way out of a public health epidemic. This idea was largely spearheaded by Gloucester, Massachusetts but they have influenced police across the country. Addicts are able to walk into a police station and turn themselves in without fear of arrest or prosecution. Instead, the police officers work with the addicts to find a treatment program for them. The Police Assisted Addition and Recovery Initiative (paariusa.org) is a great network of resources for participating police departments as well as police who are interested in implementing their own programs. A lot of police officers start out cynical because why would a drug addict willingly turn themselves into the cops...but many people really are that desperate for help. Fewell says that there are often 2 week waiting lists for addicts with her social workers and that is honestly the case for recovery ready addicts trying to get into rehab programs all over. In fall 2016 I did a ton of research to help this idea get off the ground in my own county - McHenry County, Illinois. The program is called A Way Out (https://www.co.mchenry.il.us/county-government/departments-j-z/state-s-attorney-s-office/programs-and-initiatives/a-way-out) and it began May 1, 2017. As of June 23, 2017, 20 people had already taken advantage of it. It took a lot of work with the county Substance Abuse Coalition, the State’s Attorney, police departments, a local hospital, and Not One More (notonemore.net). As librarians, we can absolutely help with providing information to our police departments. If you can do this in your city or county, it is definitely a good thing!

Posted : Jul 17, 2017 12:40




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