Evaluation of a pilot medically supervised injection facility on children and young people in the community

Background<br/><br/>The Misuse of Drugs (Supervised Injecting Facilities) Act 2017 provided the legal basis in Ireland for medically supervised injecting facilities (MSIFs)<br/><br/>Aim <br/><br/>Given concerns raised during the planning process, the aim of this study was to evaluate the impact of a pilot MSIF on children and young people.<br/><br/>Method<br/><br/>This evaluation used a Bronfenbrenner Framework to explore the impact. Reflecting this framework a mixed methods study design with multiple data sources was chosen. Ethical approval was granted by the HSE, approval number 20251632-RDMLRREC. A peer organisation advised the research.<br/><br/>Findings<br/><br/>Nine parents who used the MSIF, three young people who attend or attended local primary and secondary schools, five community stakeholders (including one school principal) and seven MSIF staff were interviewed to assess their views on the MSIF and children/young people. A further thirty local people provided their views within an online quantitative survey with open comments. Retrospective committee minutes and reports from four separate groups which covered up to a fifteen-month period were reviewed. Three walking tours were completed. Finally, eleven individual structed observations of the 500-metre route around a local school and the MSIF were conducted.<br/><br/>Findings clearly indicated that the MSIF was providing an essential service for parents who inject drugs. Stakeholders, staff, and parents and the broader community consistently described reductions in visible injecting, ambulance callouts, and discarded paraphernalia, contributing to parental dignity and safer and cleaner environments for children and families. This was corroborated by the structured observation and the walking tours. <br/><br/>Young people and stakeholders highlighted that the MSIF alone cannot address the systemic challenges in the area. Persistent systemic issues such as crack cocaine use, grooming and limited youth facilities continued to place children at risk. <br/>Conclusion and impact<br/>The evidence suggests that the MSIF provides substantial public health, family-level and environmental benefits. A targeted approach at the policy level of the Bronfenbrenner Framework is urgently required to ensure that local children and young people are not left any further behind than they already are. <br/>This research will inform the Ministerial decision on the continuation or cessation of the first Irish MSIF.<br/>