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Table 4 Comments provided by service providers working in the mobile supervised consumption services

From: Mobile supervised consumption services in Rural British Columbia: lessons learned

Ability to respond to an overdose
 “The physical space in the unit is absolutely unacceptable. It’s unsafe when a client overdoses and unsafe for staff and clients after they use.”
 “If two overdoses were to occur at once, limited space inside makes it difficult.”
 “We knew up front that the RV is a small space and that this would provide challenges when we are responding to a serious overdose. We have developed workflows and routines to make the best use of the space.”
 “I have not had an overdose while two people are using the site, however I do think it could pose some risks if it were to happen, due to limited space.”
 “Space is very awkward and small when having to respond to overdoses”
Ability to have private/confidential conservations
 “...There are some aspects that I feel could be improved. I feel it isn’t always trauma informed and we can’t always provide confidential and optimal standard of care due to lack of space. We have a lot of requests for primary care especially in Rutland and we aren’t always able to provide the care needed that is much needed. At times participants seem to feel uncomfortable due to lack of space and don’t feel comfortable using because of all the people in the small space.”
 “The space is limited to accommodate only a small number of clients at a time, and the consumption booths are often full with clients waiting in cue to use the service. The space also does not provide adequate privacy for clients to share/discuss personal information.”
 “No space for confidential conversations either in person or via telephone due to only two areas with no sound barrier or place to meet with clients and accompanying supports.”
 “...it is a small space that doesn’t allow for much privacy for the individuals wanting to use the site. If a social worker wants to have a clinical conversation with a client it will always be within earshot of another person. If there are more than one client on the RV; or, another waiting to access for harm reduction supplies then it’s difficult to keep the momentum of a conversation moving forward. From a medical perspective there is little room for a nurse to carry out their duties as there is nowhere to examine a client. Clients have also mentioned how strange it is that two workers are so close to them while they are preparing to use.”
General size
 “Very tight space to provide consumption services and try to do Intake info with clients.”
 “There is not a lot of space in the unit itself. It feels quite full when we have two people in the site using.”
 “Simply not big enough for number of clients accessing services and staff accessibility to equipment and also confidentiality; too narrow by bathroom to walk from back to front easily for more than one person at a time; safety and visibility for staff needing to support each other is an issue.”