Thank you, Minister Abernethy. Mr. Bromley, you’re time has expired, but if you need to get back on, please let me know. Continuing on with nursing inpatient services, I have Mr. Yakeleya.

Thank you, Mr. Chair. I want to ask the Minister on the status of the requests by the Deline leadership community support on a sort of respite care or palliative care bed units in their community. There was some discussion with the previous Minister. I’m not too sure if this Minister is up to… We had some meetings with the Minister on that request from Deline. They’re asking for a bed or so for that community. I haven’t heard. It’s pretty quiet from the department as to what’s being communicated. This is an ongoing issue with the community and the Minister. Can I get a very brief update? Thank you.

Thank you, Mr. Yakeleya. Minister Abernethy.

Thank you, Mr. Chair. At this point our priority is actually to provide training to our community health nurses so they have the knowledge, skills and ability they need to provide palliative care in the homes, so supporting individuals in their homes as opposed to moving them to a different facility or building. Once we’ve completed that training, we are able to provide palliative support in people’s homes. We’ll be able to assess the effectiveness of that and that will help inform any future direction which could include supporting some palliative beds in some communities throughout the Northwest Territories.

Mr. Chair, that’s very strange. We were going in one direction and the Minister is talking about going in the other direction, training nurses for palliative care. I thought we were moving along there. Was this supported by the community of Deline to say, okay, we’re going to go through some training, and training the nurses to provide palliative care to the community nurses? Something has gone a little wacko here. Can I get the department to respond to this?

Mr. Chair, our challenge in this fiscally tight environment that we are all currently in is the cost of putting

infrastructure in place, which will spend a vast majority of its time empty, is difficult, but we hear the communities loud and clear, all communities in the Northwest Territories who wish to have their residents as they’re going through the dying process who wish to be in home. We want to be able to support them to stay in their homes, including communities such as Deline. We want to make sure that our staff have the knowledge, skills and ability that they require in order to put support for palliative care in communities. From there, we’ll be able to make a better assessment as to whether or not it’s time to move forward with palliative care beds, which there is a significant cost to.

We’re still interested in having conversations with Deline in trying to find solutions, but in both scenarios, we do have to start by ensuring our staff have the knowledge, skills and ability to provide palliative support. Then, without the knowledge, skills and ability to provide that support, it doesn’t provide any level of care for our residents. We need to make sure that training is there as a starting point.

Mr. Chair, I’m certainly disappointed in the response from the department and the staff here on raising their hopes through discussion with the people of Deline and the palliative care beds. The Minister certainly gave reasons why this request shouldn’t be honoured and is making a left when he should be going down the right lane. I’m very disappointed by the department’s response and justifying why they’re not going to take Deline requests seriously as it was duly noted in my notes and the Minister’s meetings with the leadership and people of Deline in regards to this request. It’s been an ongoing, long, substantive request by the people in Deline. Certainly the Health department pulled the plug on this one here. I don’t even want to have a response to my comments here. I’ll leave it at that.

Thank you, Mr. Yakeleya. The Minister is flagging me for a response. Minister Abernethy.

Mr. Chair, I’m sorry the Member is disappointed. We are still interested in discussions with the community. We’ll continue to move forward with the community. We also see an opportunity here, a possible opportunity with the Deline self-government to move forward on this initiative, but at the same time, we still need to make sure that people have the training they need to provide the programs that are required in palliative care.

Thank you, Mr. Abernethy. Continuing on with nursing inpatient services, I have Mr. Moses.

Thank you, Mr. Chair. I think there’s some good discussion. I’m going to focus mine around the psychiatric nursing unit at Stanton and

also just for the whole territory, what kind of psychiatric services we have. It’s also mentioned, there’s a little paragraph that talks about the unit includes beds for withdrawal management. How many beds exactly are in that psychiatric unit and how many are allocated for withdrawal management? Thank you, Mr. Chair.

Thank you, Mr. Moses. Minister Abernethy.

Thank you, Mr. Chair We don’t have beds dedicated to withdrawal management anywhere in the Northwest Territories, but we have beds that can be used for withdrawal management. The beds at Stanton aren’t in the psych unit for withdrawal management. They’re actually in the medicine unit. I believe the unit is 12 to 18 beds, but I will confirm the number of beds in the medicine unit. When individuals need medical withdrawal in the Northwest Territories, we have beds in Inuvik and we have beds in Stanton that can be used for those purposes.

What are we doing for the small communities that just have health centres and specifically with the eight communities that don’t have nurses that can provide any kind of medical treatment for anybody that might be going through some withdrawals? Thank you, Mr. Chairman.

In the communities where there are health facilities, individuals can go to those health facilities and get referral and be brought in, through medical travel, to utilize the detox beds in either Inuvik or Yellowknife, whichever happens to be closer. For the smaller communities that don’t have nurses, we do have other types of professionals in those communities like CHRs, CHWs that we can have conversations with and they can get a doctor involved to make a referral so that an individual could come out and receive withdrawal management services in either Stanton or Inuvik, whichever happens to be closer.

Just in terms of putting this type of responsibility on the workers in the small communities to now assess what a person is going through, what kind of training are they getting in terms of knowing when to call a medevac or when to admit somebody into a health centre until they get the proper treatment that they do have?

Their responsibility is often they’re required to get in touch with Stanton emerg or Med-Response. Med-Response is actually the organization now that they’d call in to and would help do an assessment and diagnosis to determine the urgency of the situation. Med-Response, as you know, involves having physicians on the line, nurses on the line and other professionals on the line who could actually do that assessment, and they would determine whether or not a medevac is required for medical detox or whether it was something that could be facilitated

through medical travel. But the Med-Response team has the expertise to make that diagnosis, and the CHRs and CHWs that are out there in the communities have training on basic information and how to share that information with our professionals.

I know we’re unique in the North in terms of barriers and challenges, especially when it comes to the remote communities. I just want to make reference to a news article on CBC, I don’t know how many years ago, but they were talking to a psychologist or psychiatric physician that talked about not being able to do a correct assessment because he couldn’t see the individual and talk to him, so I think there are some flaws in there. I just want to put that out there.

In terms of withdrawal management, do we have a policy right now in terms of how long do we keep an individual who’s going through withdrawals so they can get the medical observations to see if there’s anything further needed such as psychiatric assessment, or whether they need to go to a psychiatric ward after they’ve gone through the withdrawals, and any cases in where somebody is self-harming and goes to the emergency ward? What are the steps taken by the Stanton or even Inuvik Hospital to ensure the safety of the individual? I’ve seen odd cases where as soon as the person sobers up they’re allowed to leave and it’s contravening our current Mental Health Act that we are currently using right now. Thank you, Mr. Chair.

Just going back to the first part where, you know, individuals who can’t see individuals. The Med-Response team has highly competent professionals and the CHRs and the CHWs in the communities will articulate what they see. I believe they’ll err on the side of caution, which is the expectation. We don’t want to put people at risk. So if individuals are in need of medical detox and the doctor on the line determines it’s necessary, they’ll come in.

With respect to how long medical detox would be required for, it’s going to depend on medical direction. When they’re in either Inuvik or Yellowknife, a physician will be involved in the file, likely one of the hospitalists in the building, and they will assess when a person is officially medically detoxed. Where they go from there is somewhat dependent on the individuals but also on the doctors. If the doctors believe that somebody might need a psych consult, they would bring in psychologists and other professionals to have those conversations with the patient. If the patient has completed the medical detox and they decide that they’re ready for treatment, we have an expedited referral process to get them into a treatment facility in the Northwest Territories.

But treatment facilities won’t work for everybody. It isn’t what everybody wants, which is why we have continuum of care options or support options for persons with addictions. They can go back to the community and engage with counsellors, they can use a Matrix program, they can use one of the on-the-land programs that are being offered by a number of the Aboriginal governments in the Northwest Territories. There are lots of different options.

As far as the specifics around the psych situations in emerg, I’m not a doctor so I don’t know the exact steps that would be followed, but I’ll see if I can get some additional information for the Member on those steps.

I agree, not everybody wants to go to treatment, but in some cases not everybody wants the help. But as caring community members, caring families, friends, they see it.

With that, I’ll just lead up into what our current Mental Health Act talks about in terms of, I guess, the substitute consent giver part in here and it’s under the Personal Directives Act. I know that some Members were concerned about the wait times that some community members have to go to treatment, and in some cases the person doesn’t want to go. But under this one act, the Personal Directives Act, it talks about who can consent on behalf of the person. It’s a child of the patient, a parent of the patient, a brother or sister of the patient, or any other relative of the patient, even a friend of the patient. So, anybody can actually give the consent through the process to do it. I think something on the news was talking this morning about four months or two months of waiting time to get counselling and when the treatment is really needed.

Are the Minister and his department informing people throughout the Northwest Territories whose family members or even people in the community are suffering that they have the right under our current Mental Health Act to proceed and get them the treatment that they want? It’s involuntary psychiatric assessment and also involuntary admission. Is the Minister making residents of the Northwest Territories aware of that provision in our Mental Health Act we’re using for residents of the Northwest Territories right now? Thank you, Mr. Chair.

Thank you, Minister Abernethy. Deputy DeLancey.

Thank you, Ms. DeLancey. Mr. Moses.