Thank you, Madam Chair. We would like to deal with Bill 55, Mental Health Act, and Committee Report 25-17(5), Report on the Review of Bill 55, Mental Health Act.

Thank you, Ms. Bisaro. Is committee agreed?

Thank you. We’ll take a break.

---SHORT RECESS

Thank you, committee. We’ll start with Bill 55, Mental Health Act. Committee has agreed to consider Bill 55, Mental Health Act. I’ll go to the Minister responsible for opening remarks. Mr. Abernethy.

I am pleased to be here to discuss Bill 55, Mental Health Act. The development of this bill has been the result of significant time and effort by the department, and would not have been possible without input and contributions from members of the Standing Committee on Social Programs, the public and front-line workers.

The primary purpose of Bill 55 is to ensure that those suffering from mental illness receive appropriate mental health care and treatment as soon as possible and in the least restrictive manner.

This legislation will modernize our current mental health framework while, at the same time, recognizing the unique needs and challenges of the Northwest Territories. It will better protect the rights of patients and those acting on their behalf, with the importance of culture and community at its core.

While the bill will address many gaps in our current mental health system, we know that the work does not end here.

I would like to take this opportunity to thank the members of the Standing Committee on Social Programs, community members and front-line workers for their significant contribution to the development of this bill.

I would be pleased to answer any questions Members may have. Thank you.

Thank you, Minister Abernethy. I will go to the chair responsible for Social Programs, the committee that considered the bill, Mr. Moses.

Thank you, Mr. Chair. As mentioned earlier during our review, when we read our document on Bill 55, there was a long consultation process. We had about 17 written submissions and we visited nine communities. We opened up our discussion on August 24th with the Minister. I appreciate the Minister and his department with the work that he did with committee over the length of this bill.

As we proceed, I believe committee members may have other questions for the Minister as we proceed with Bill 55. Thank you, Mr. Chair.

Thank you, Mr. Moses. Mr. Minister, do you have witnesses you’d like to bring into the House?

I do, Mr. Chair.

Thank you, Minister. Sergeant-at-Arms, please escort the witnesses into the Chamber.

Thank you, Minister Abernethy. Could you please introduce your witnesses.

Thank you, Mr. Chair. On my right is Debbie DeLancey, the deputy minister of Health and Social Services. On my left, Thomas Dorian, who is legal counsel.

Thank you, Minister Abernethy. Committee, we’ll go to general comments on Bill 55. General comments. Mr. Dolynny.

Thank you, Mr. Chairman. I’d like to welcome the department and the Minister here today. As this has been a very long and a very swift journey to have this bill before the House, I do want to commend the Minister and his department for getting this bill near the end of our term and I want to thank the department for assisting committee as we went from community to community to discuss the intricacies of this bill.

I guess, first and foremost – and some of this stuff may sound familiar to the department here – as I said in the clause-by-clause review, I believe what we have before is a very action-rich and a very resource-poor bill before us and what I mean by that is the fact that we’ve got a lot of new actions in order to deal with mental illness in the Northwest Territories, many of those which I support as a Member who has had the pleasure of going literally line-by-line and community-by-community to make that evaluation.

Where I feel that it is resource poor, although we have heard some indications that there will be some money invested in this, that money will pale in comparison to what really is needed to make this bill fully and truly effective. I want to just be cautious as we go through this bill and hopefully approve it here today, that the department has a big undertaking to try to get the much-needed resources. The Minister has his colleagues sitting across from us here; we have the Finance Minister here. You’re going to have to find some money, Mr. Minister, otherwise this bill won’t be as effective as we may think it is and it’s going to require some infrastructure, it’s going to require some human resources and it’s going to require a lot of community involvement.

So I do challenge the Minister to do the necessary lobbying. I know we’re going to be finishing up session here in a day or so. I know the Minister acts in his capacity up until the next Assembly is sworn in. So I’m hoping that during that period of time that we’re able to put the tools together to kind of put the necessary action items together to make sure that, again, if this bill goes through, that we’re going to have to start on that venture.

Things that I’ve noticed as we went through this act and taking this act on the road and trying to dabble in a little bit into my own medical background as a pharmacist is that – and I’m just going to say something here – according to statistics from the Centre for Addiction and Mental Health, at least 20 percent of people with mental illness also have a substance abuse problem. So there’s a clear correlation, and I’ll explain more about where this number comes from and what it means to this act, but there’s a clear indication as we investigate more and more in Canada that there is a commonality between addictions and mental health. Again, when you look at the overall aspect of this act, addictions are relatively silent. I think there’s going to be a bit of a wall there when we start rolling this out, and I’ll tell you that in a second.

What we’re seeing is that with the new paradigm shift in treatment is integrating the treatment of both mental health and addiction as being treated together. A lot of the studies coming out now that have some of the best outcomes when we treat mental health and addictions as one. Now, where this puts the residents of the Northwest Territories in a bit of a predicament is that our addictions treatment facilities are down south and that’s going be causing a problem and you heard time and time again and even some of the recommendations is the fact that we strongly encourage addictions treatment programs need to come back to home row.

I know the Minister is very adamant that through cost efficiencies and trying to save money, economies of scale, that it’s not possible. But the health care system is saying we need to work together with addictions, we have to find ways to find solutions. There are many studies here. There are a number of studies I can provide to the Minister and the department later to back up the information that I’m talking about, but as the Minister always says, these are silos and there are silos now with mental health and addiction service across Canada.

Many organizations, many jurisdictions, many provinces have seen that and, again, this act is silent on that. The growing trend right now in the provinces is integrated diagnosis and treatment initiatives. These are going hand in hand, and again, many of the new paradigms in terms of treatment are showing that these integrated diagnosis treatment programs are starting to roll out across the provinces and even at a provincial level – I’ll pick Alberta, for example – addiction counsellors are being cross-trained to do mental health work and mental health counsellors are being cross-trained to do addiction work. So it’s happening in other provinces. In fact, it’s gone even further that even a province like Ontario, that Minister of Health made an integrating mental health and addictions services as one of his four goals in the strategic 10-year plan. So they’ve noticed the fact that this is important to them as well. I know we’re not Ontario, but we need to look at what’s leading the charge across Canada when it comes to the flexibility of treatment options and integrated services.

So I’ll leave it at that particular point, Mr. Chair, and again, because this act is relatively silent on addictions, I just wanted to point out some of the recent trends that we’re seeing across Canada and some of the silence that we have pursuant to this act.

One of the last things I want to talk about is the fact that, yes, there is a triggering mechanism of a five-year review of this act, and I’m very thankful that it is. I think it was well received across the communities and I applaud the government for including it. Not every legislation has a triggering clause and I’m glad we have one in this one. So, kudos to the department for allowing that to happen. However, as I’ve said before in committee, in public settings, I don’t think we need to wait for that five-year review before we initiate that trigger. I think we’re going to slowly find out, once this act and if this act comes online, that we’re going to probably have to do some massaging of this act sooner than later and we all know how the speed of government happens sometimes and I don’t want to fall victim to that trend. We waited over 30 years for this to happen, so let’s not become victims of our own demise.

Let’s make sure that we are proactive by design and I strongly encourage the department to look at it early on in the life of the 18th once this thing comes online. I would include even up to a year, up to two years after we go live with this that it comes up for formal review and a full public consultation process. Hopefully by then the stuff I talked about earlier with integration of addictions might be able to be incorporated with mental health within the paradigms of one act.

I will conclude saying thank you very much for allowing me to speak and I do want to thank my colleagues. This was the last act that we had the pleasure of travelling together. You get to know your fellow counterparts quite intimately, I guess, sometimes when you’re doing road community travel. But this is a great group from the Social Programs committee. They’re enriched with plenty of rigor and I just want to say, for the record, it was a pleasure working with them and we’ve got a great chair that leads us down that path. Thank you.

Thank you, Mr. Dolynny. Minister Abernethy.

Thank you, Mr. Chair. To the Member’s points about this bill being resource poor. During committee and other discussions, we were pretty clear that we know this bill is going to take some money to make a reality and we’re talking about just a specific bill, not any additional plans that we have outside of that.

At this time we feel it’s going to take an additional three positions to help us make some of this work, plus training, plus we have to have costs for the review board. That’s just a starting point and we will be going through the business planning process, rather, the department will be going through the business planning in the 18th Assembly, at which point they’ll be coming forth for a financial ask to help cover the costs of implementing the Mental Health Act.

On top of that, the department will continue to monitor and determine demand of some of the programs or opportunities that are outlined in here, like the review boards help us determine ongoing costs so that they can make some evidence-based decisions based on what the resources are going to be.

With respect to the five-year review, I agree with the Member. I think it is a good thing that we have a five-year review in here. The department is currently developing an evaluation framework for the implementation of this particular bill that will help us determine what aspects are working and what aspects are not working. I anticipate, as with any new legislation – and this is new legislation – that there will be some massaging, and I committed to that and indicated that when we were reviewing this bill in committee.

As far as requiring a two-year review, at this point I would say that that is something we should leave in the hands of the 18th Assembly, who can decide whether they want to conduct a formal review. I would suggest that two years might not be enough time for us to actually see some of this stuff working quite the way we want it. It is going to take a little bit of time to write the regulations. I will point out that we are not planning to go live with this legislation probably for a year. So, two years might be a little soon.

With respect to addictions, I think everybody gets this. This bill is a mental health piece of legislation; it is not an addictions piece of legislation. But in the Department of Health and Social Services, as throughout the system, the professionals clearly understand the co-morbidity of addictions and mental health. In fact, the Department of Health and Social Services has a mental health and addictions division which is focussed on collaboration, integrating services, working together around mental health and addictions. We have mental health and addictions counsellors throughout the Northwest Territories in many of our communities recognizing the co-morbidity of this, so I believe the department clearly understands.

With respect to addictions, the recommendations indicate developing a treatment facility here in the Northwest Territories, and I have heard people indicate that they would like to see a treatment facility, but we know that we have had four different treatment facilities in the Northwest Territories, and for utilization, staffing and a multitude of other issues, all four of those facilities have failed. We also know that the facilities that we have had here in the Northwest Territories, because of those issues like low utilization and other things, we weren’t able to provide the types of programming that we currently have access to in our four southern facilities, which are very, very specific. We have psychologists and psychiatrists who are working one on one with patients in those facilities who are also working with our professionals on plans of care for when those individuals are returning.

When we did the mental health and addictions round table, we heard clearly from residents throughout the Northwest Territories that what people wanted when it comes to mental health and addictions is options. Treatment facilities are but one option. We heard clearly that people wanted options at the community level, at the regional level. We also heard that people wanted on-the-land options. Since two and a half or two years ago when Nats'ejee K'eh, our last treatment facility, failed, a report that they conducted, or conducted themselves, demonstrated their clients and staff were at risk. There was underutilization, high expenses, $420 per day compared to $145 a day that we are getting in our southern treatment where the range of programming far exceeds anything we have been able to deliver here.

We have clearly made significant changes in the way we are dealing and supporting people’s addictions. We have community counsellors, mental health and addictions counsellors in every region of the Northwest Territories in most communities. We have Matrix programs that are available in almost all of the regions at this point providing outpatient community-based treatment options for our residents. I have had an opportunity to talk to some of the people who have participated or taken Matrix who have indicated that they are getting positive results and they appreciate the program being available.

We also have on-the-land programming in partnership with different Aboriginal governments and organizations throughout the Northwest Territories offering a wide range of services that two years ago weren’t available. Two years ago we had one treatment facility that was putting people at risk, and some community counselling. We have improved some of the protocols and standards for our community counsellors and our addictions counsellors. We have on-the-land programs. We have Matrix programming. We have ASIST in many communities. We are pushing really hard to get Mental Health First Aid out there. We are doing an awful lot. Is it enough, Mr. Chair? No. We continue to need to evolve our programs and services to meet the needs of our residents.

To that end, recognizing the co-morbidity but also recognizing that we do have a challenge around mental health here in the Northwest Territories, and building upon this act, I have already directed the department to begin the preliminary work on the development of a comprehensive mental health or youth mental health strategy that can help guide us in the future.

The Member talks about money. As we move forward with the strategy, that is going to change the direction on how we respond to youth. There will likely be some costs and the future Assembly is going to be faced with some hard decisions about how to pay for these particular services and these changes and enhancements that we need to put in place to provide our youth and adults who are suffering with mental health, a full spectrum of services and programs that will help them through their needs.

I have heard a lot of people, once again, say we need a treatment facility in the North, and given what I have seen with the treatment facilities in the North, I don’t agree with that. What I think we need here in the Northwest Territories, and I have seen it recommended in other places, is something more akin to a mental health transitional facility or mental health transitional housing facility much like the one described in the Members’ report. I believe something like that will give us far better results for our residents as opposed to building yet another facility that may or can fail here in the Northwest Territories.

Thanks to the Member for his questions. Thanks to the Member for his support of this bill. If anyone else has any comments, I am happy to answer them. Thank you.

Thank you, Mr. Abernethy. Next I have Ms. Bisaro.

Thank you, Mr. Chair. I don’t have any questions, but I do want to make a few comments to this bill.

It is a long time coming, both the amount of time it took to get from department to committee and then the time committee spent on it, although it was compressed. I know we had a lot of hours in a short period of time.

This bill, as I stated earlier today, is very much an improvement over the current bill. I look forward to seeing how it is going to work. In terms of the concerns that we heard in our public hearings and in our travels, I think most of them have been addressed by committee. We didn’t agree with all of the concerns that we were presented with, but certainly in our deliberations we took a great deal of time. If we were going to sort of put aside somebody’s concern, we took a great deal of time to understand why we were doing that and whether or not it was the right decision and if that concern could be addressed elsewhere. I feel quite comfortable with the changes that we have made to the bill, based on the concerns that we were presented with and I don’t think that the ones that we did not accept, I don’t think they have had a huge impact on the success of the bill, on the future success.

One of the things – and Mr. Dolynny mentioned it already – that I am really quite concerned about is the assisted community treatment program and the provisions in the act for that. I support the principle, absolutely, but I am extremely concerned that without the programs and services at a local level and, as I think we stated in the report, without increases in those local programs and services, it is basically going to be assisted community treatment in Yellowknife and maybe in a couple of the regional centres.

The Minister has referenced, and I think it was referenced elsewhere, that there is going to be an addition of three PYs. Those PYs are all going to be at headquarters. Maybe that is okay for the first year, while you are developing regulations and while the act is not in force, but if there is not a significant change in the provision of programs and services at the local level, assisted community treatment won’t work, in my estimation. I echo Mr. Dolynny’s comments. You are going to have to find more money somewhere or else, and money for people somewhere in order for it to work.

One of the major concerns that committee had, and many people who made submissions also had, right from the start, it was really interesting. It was a huge topic at the very first public hearing, and that was the lack of reference to any sort of culture in the act. We have added enough provisions in the act that I feel quite comfortable that those who made submissions about culture would read the act, or would understand it now, that the act does allow for a cultural component. It is so much of the way that people live in the Northwest Territories is based on their culture or their spirituality or their religion, whatever it happens to be. We have allowed for that to come to how the act is going to operate.

I am extremely pleased that the Minister has publically now stated that there will be a development of a strategy for youth and adolescents. It was something that at committee we felt strongly was required and there was a period of time that we were not sure whether or not that was going to be happening, and I’m really pleased that is going to be developed because I think it’s also going to add to the success of the act.

My last comment has to do with the recommendations that are in the report. They aren’t recommendations specifically to the bill, but they are recommendations, as I see it, to the way the bill is going to operate, to the way the programs and services are going to operate. I would ask, we’ve had a couple of reports in the last couple of years where the response from government to a report has not responded publicly to recommendations that don’t affect the act specifically. So I would ask the Minister to inform his future Minister that any response to this standing committee report should include, publicly, a response to the recommendations that are in this report because they are key to making the act work from an operational perspective. So that’s all I have. Thank you, Mr. Chair.

Thank you, Madam Bisaro. I’ll call on the Minister for a brief response, then I think you said there was a statement, but I think the Minister wants to make a statement. Thank you. Mr. Abernethy.

Thank you, Mr. Chair. I thought I heard a couple of questions in there. The assisted community treatment, we do hear what the Member is saying and what the other Members have said and there will be many assisted community treatments ordered in the community at a Yellowknife and regional level. We also believe, with our current resources, and it will all be on a case-by-case basis, depending on the individual’s condition. If an individual is relatively stable, or stable and requiring meds, and wants to go back to their home community, we can actually set that up today with a community health nurse, where that person would have to report to the community health nurse on any given day in order to receive their meds. Those types of things we can do and we should be able to do right away. We also have community counsellors who will be able to work on the individuals based on a plan of care that may have been established with a psychiatrist or psychologist at Stanton. So today we could provide some level of act. But we do hear you and acknowledge that as we roll this out, we may find that it’s taken up more time or resources than anticipated, which is why I’ve previously indicated we’re going to monitor, and continually monitor, to determine demand and usage so that we can seek resources where appropriate in the future. But we do hear you loud and clear and it will be something that is going to be monitored.

With respect to lack of culture, I have concurred with all the motions that I feel, and I believe committee feels, will help improve this bill and bring back some of the culture components that may have inadvertently been removed or excluded as a result of the drafting, and I think we have a better bill as a result of that.

The Member mentions a youth mental health strategy and I’d like to just take this opportunity really quickly to indicate that I’m pleased to announce that I have received the final report of the Mental Health Quality Assurance Case Review on October 1st. As Members will recall, I directed this case review back in the late spring in the wake of the death of a young Yellowknifer who had been a patient in our mental health system.

The work of the review committee got underway in June 2015 and has been carried through to completion with the original timeline I committed. I’m pleased to share that it is a very comprehensive report and I believe it will serve to guide to move the health and social services system forward in ensuring improved care for our residents and families impacted by mental health. To be really clear, so we get it out there, the report contains five major recommendations and 11 supporting recommendations for a total of 16, all of which will be addressed in the form of an action plan which I have committed to the Members and to the public previously. This action plan will be done in January. Originally I was hoping we would have it done sooner, but given the magnitude of the recommendations, we want to make sure that we get it right and the department has indicated they need until January to prepare that action plan. That action plan, all the recommendations within the committee report, all the research that has been done over the last couple of years plus future public consultations and discussions will inform the youth mental health strategy that will be developed in the 18th Assembly, that I assume will be developed in the 18th Assembly. I’ve already directed the department to begin the preliminary work so that they’re ready to move forward with that strategy, if it is the wish of the 18th Assembly and I anticipate that it will, given the amount of interest that exists throughout the Northwest Territories in this particular area. It will also inform the development of a more generic or sort of adult- based strategy as well.

So, we are moving forward. We will, absolutely, take into consideration the recommendations of the report and input from future committees of this House.

Thank you, Minister Abernethy. Next I have Mr. Bromley.

Thank you, Mr. Chair. I’ve heard my colleagues and I’ve heard the Minister and I appreciate all that I’m hearing. Mental health and this legislation and the policies associated really are of deeply personal concerns to many people across the Northwest Territories, and I’ve heard, through the committee, that they were able to put their finger on that pulse of their community hearings. I know that we’ve heard from many individuals and families, organizations, institutions, First Nations. I think this is a very strong cross-section of our society and it’s a common issue that I think there’s a high degree of interest in doing a better job of addressing. In particular I would like to single out a family, some individuals, Connie and James Boraski and Ian Henderson, who delved into their personal experience, which involved some pain, but they had considerable perseverance and commitment and dedication to drawing the best results for everybody that they could from that experience and were very willing to share it. So I learned a lot through communications with those families.

I just want to back up the calls for the recognition of the need and the intentions to act and, in fact, there’s some work going on already on a youth adolescent strategy towards mental health. I see there’s a preventative element, which I always like to see, as well as progressive early intervention. This is very important. I see the intent to develop assisted community treatment for outpatients where sufficient resources exist, and we’ve heard some comments on the need for resources.

I’d also like to recognize, really, the hard work and the excellent work by committee and staff and the response to that work and interaction with the committee from the Minister and his staff and legal professionals, and that includes, of course, Glen Rutland, who was legal counsel for the Standing Committee on Social Programs. I was able to see them in action a number of times.

One specific thing I would like to mention is clause 9.(1) and I’ll just mention it here, Mr. Chair, rather than interrupt our review later, which is a response to some specific situations and in particular, for me, allows a patient who feels unsafe being on his or her own but is being released from hospital care and who wishes to remain admitted in the hospital may now, with this new legislation, seek a thorough review of his or her situation through a second opinion before being released from hospital care.

I think we’ve had some specific incidences and situations where that option was not available to a patient, with perhaps dire consequences. So, I really appreciate the committee going after that and the Minister and staff stepping in to address it in the most effective way. I would note that other clauses were developed or amended to support this clause, including, I highlight, the requirement to ensure that the patient understands their right to seek a second opinion before leaving hospital care. I think that’s obviously a requirement that if we have good legislation, it needs to be known about and understood and transparent. So there’s a commitment in the legislation to make that happen. Of course, the Minister did mention in his comments a recent report on the specific case study that he commissioned. He mentioned the five major recommendations and 11 supported recommendations. He also mentioned that some were very substantive requiring more time to deal with. So I guess if I had a question at this moment in time it would be should we anticipate any of those recommendations require a legislative response.

Is the Minister prepared at this time? Has the analysis been advanced to that degree that he can respond to that question? Thank you.

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. I requested the mental health case review under the Evidence Act and I have to comply with the terms and conditions of the Evidence Act. So I need to be careful as to what I say and what I don’t say, but upon my initial review, recognizing that I am not a lawyer, I don’t believe that any of those recommendations require legislative change, but I’m seeking advice from the legal counsel right now on how I can legally get this into the department so that they can begin drafting an action plan based on the recommendations and they may determine that maybe some legislative requirements or amendments may be required. But in my review, recognizing I’m not a lawyer, I did not see any that jumped out to me that might require legislative changes.

Thanks to the Minister for that, and I recognize in some ways it’s a delicate situation in timing and we need a little time for the job to be done. I recognize that we’re talking about a future Assembly, but I hope if it is required that we can have some alacrity to deal with that legislative change despite having just done these amendments.

Thank you. That’s all I have.

Thank you. I think Mr. Bromley’s comment goes directly to Mr. Dolynny’s comment about the requirement for a review of the legislation, and as we are rolling out to developing regulations and recognizing future strategies and action plans, there is a possibility that we may have to do some legislative reviews. I believe the department, the government would be open to that. Mind you, it will be a new government, but I anticipate, given the interest in this particular area, that reasonable responses will be provided.

Thank you, Minister Abernethy. Committee, we’re on general comments. Next I have Mr. Moses.

Thank you, Mr. Chair. I just want to thank my colleagues and members of the Standing Committee on Social Programs for their insight and their comments this evening. I think they’ve hit it right on the head about the issues that were of concern to committee as we moved through the process with Bill 55.

I just want to say, when I started with the 17th Legislative Assembly and we went through all the department discussions and briefings as new Members, even before we went into the TLC, one of the biggest things that I remember and I recall, and I bring it up on many occasions, is that mental health and addictions are the biggest cost-driver for our government and to be able to be where we are today and address part of that issue with mental health and, as Mr. Dolynny said, mental health and addictions go hand in hand, and even though we’re passing the Mental Health Act, we’ve got to make sure that we’re also keeping in mind that a lot of the mental health issues are stemming from underlying issues such as addiction, housing, suicide and that this act should reflect and be that first step moving forward into addressing our addictions issues as well. On June 2nd when the bill was referred to committee, a lot of work has been put into this bill both in the department as well as standing committee and staff, and I thank Mr. Bromley for recognizing our hard-working staff. He’s come to some of those meetings and we appreciate that.

A lot of work in the last four months on this bill and part of it didn’t even get started until towards the end of August. So from the end of August to where we are now is a significant amount of time and work gone into this.

I won’t go into some of the details, as Members have mentioned them earlier. One thing I’m glad that we did get back in there was the principle section of the bill and added that in, mainly because it does touch on some of the cultures and religions and some of the areas that weren’t represented throughout the bill. That’s great to see.

Also, as mentioned in the report earlier, the 27 amendments to a bill. I know in my short time, my first term, that’s the most. I was happy when we got four amendments and then the Child and Family Services Act. So 27 amendments in committee, and working with the department, they broke that down from just over 30. As Ms. Bisaro said, you didn’t get everything in there, but I feel quite confident about the work that committee has done, that the department has done, the staff has done. It really reflects how it’s going to affect our residents of the Northwest Territories.

Two things that I would really like to focus on here that have been mentioned was our mental health strategy for children and youth. Every jurisdiction in Canada has one, every province except for the Northwest Territories, and by modernizing and updating this bill, I think, as the Minister stated earlier with the review that was taking place, we’re going to see some good recommendations coming out of that, the 16 recommendations to move forward. I look forward, whether I’m still in this House or even just as someone that’s concerned about the mental health and care and treatment of our residents, that I’ll be looking to see that report if it should become public or working with other Members to see that through.

Every community we went to, a treatment centre was brought forward. It was one of our goals of the 17th Legislative Assembly to use existing infrastructure, which there are plenty out there. We know they’re out there and we’ve got to find a way that we can utilize it. We’ve brought suggestions forward for a pan-territorial treatment centre and I know the Minister did allude to earlier that this is a Mental Health Act, but it goes hand in hand with addictions and that’s something that we need to address.

A lot of other good concerns were brought from the communities, such as Post Traumatic Stress Disorder, grief, loss, residential schools is a big one and those need to be addressed. If there was one question that I had, it is I know we do send a lot of people out for addictions issues, but we do have a lot of people out there who aren’t battling addictions but are suffering from PTSD, from grief, depression, trauma, from residential school. We’ve got to find a place where we can offer them the services equal to those who are battling addictions.

A couple other things as mentioned earlier. I guess we can do our part creating law, creating legislation, putting in the programs and services, Mental Health First Aid, ASIST, other screening tools, those kinds of things, but we need to get support from the communities, and that’s what we heard in the communities, as well, is government can only do so much, but as residents, as families, as leaders in the communities, they need to step up and be part of the team, as well, and work together, Aboriginal governments, NGOs, past survivors of addictions or mental health disorders. I just want to say that I really wish that residents and Members of the House, interested parties, stakeholders, could have seen the meetings that committee had, not only with the department but also within themselves working together, late nights in the communities, on the weekends, trying to get together whenever we could, e-mails and the work that our staff did to get those amendments, motions, providing reports all together within this short time frame was a lot of work and I know it had an effect, exhaustion, fatigue on not only our staff, but Members as well as we were dealing with other issues.

So I want to thank them for all their hard work, even right down to terminology within the clauses. When we did pass some of those amendments on Monday night in the public hearing, the Minister said on occasion that even though they were just small changes, it did strengthen the bill. So when Members do the questions and we asked and you try to change one word here and one word there, it does have significance behind it and that has strengthened the bill for residents.

I know this is just the first part in addressing our mental health and addictions issues, but it is a big step and I am really glad to be part of it. Everybody who assisted, family members who have experienced it, community members who have helped out other community members going through issues and not being able to find the services or the help that they needed, and I guess that when we put this into some of our other action plans, mental health and addictions action plans, anti-poverty strategies, early childhood development, economic opportunities strategies, when all those action plans come together, I think we are going to see a healthier Northwest Territories that is going to be a little bit better.

As Members have said earlier, it is quite fitting that the standing committee finish off their four-year term with such a significant piece of legislation that is going to have a strong impact on residents of the Northwest Territories. I think they have done a lot of good work. Members working with the departments, whether it be Justice, Education, Housing or Health and Social Services, moving forward I think there was a lot of good work done by committee. I was very happy to be part of it and it made me stronger as a Member, building off the energy and the hard work and commitment from Members and the staff that I worked with.

I know that on this particular bill, we had various staff members coming on trips and working in committee and I just want to thank everyone who had a part in this.

Really just the one question in terms of where do we send people who are dealing with mental disorders that don’t have addictions problems and are still seeking help. I guess that is the only thing. I am really glad that the department was able to work collaboratively with the Members and be open to making these changes. I think moving forward in the 18th Assembly, mental health and addictions is going to start to see some progress and see some really good things moving within our jurisdiction and can be a leader to our other northern jurisdictions and hopefully they will see what we are doing and can do the same for their people as well. Thank you.

Thank you, Mr. Moses. Minister Abernethy.

Thank you, Mr. Chair. I do want to take this opportunity to thank the standing committee and their staff and all the residents across the Northwest Territories who contributed to the public hearings and contributed by different means to ensure we got this bill to be the best bill that we can. I do know that committee worked awfully hard and I appreciate their willingness to work with myself and the department in order to make amendments to the bill, that I believe, and I believe committee believes, to make this a stronger bill at the end of the day. I really appreciate the work and the time that they put into this.

To Mr. Moses’ point, also to Mr. Dolynny’s point, we do keep in mind addictions. If you look at the way the department is structured, we have a big division of mental health and addictions. We have the Mental Health and Addictions Action Plan. We understand the co-morbidity. We understand the requirement to collaborate and work together. I do remember when Caucus got together and talked about treatment options in the Northwest Territories utilizing existing facilities and following up on the Mental Health and Addictions Forum where we heard very clearly that people want options, they want a range of programming. We have followed through on that and we do have treatment facilities available for our residents. We also have on-the-land programs. We have enhanced or better trained community mental health and addictions counsellors at the community level who are ready to work with individuals who are struggling.

As I said to Mr. Dolynny, we are not perfect. We need to continue to find ways to strengthen our response to mental health and addictions, in particular addictions. One area that we haven’t brought across the finish line that would go to local or regional treatment facilities would be the mobile treatment option, where we can really utilize existing facilities on a rotational basis to provide community-based treatment in facilities that can move around so we can get different catchment areas, different groups of individuals who may not be willing to go to southern treatment.

I have already attempted to utilize, maybe, on-the-land programming or maybe community-based programming to look for something different. The key is to create as many options as are reasonable, affordable and functional, that actually are helping people.

I still don’t believe that developing another treatment facility in the Northwest Territories at this point, given our resources, given our realities, that we will ever be able to provide the incredible range of programs and specific programs that our four southern facilities are.

Another point is, and we heard this during the Mental Health and Addictions Forum, it is great if you build a treatment centre in Yellowknife. Fifty percent of the population is still going to have to travel and what cultural components are going to be built into it? If you put it into Hay River, like the last one, 85 to 90 percent of the population are still going to have to travel. If you are going to have to travel, are we not better off having high-quality programs that have the capacity to provide psychologists, psychiatrists, withdrawal management, medication management, constant counselling and, as Mr. Yakeleya often points out, dietary programming? They have the capacity to deliver these because they have clienteles of 90 to 100 people. We have 12. At any given time, we have 12 people in treatment. When we had a facility in the Northwest Territories, we had 12 people in treatment. When we have facilities in the South, we have 12 people in treatment on any given day. We have a utilization issue and a demand issue, but we are moving forward to provide a wide range of programs.

I would like the deputy to talk briefly about some of the work we are doing around trauma, to talk to Mr. Moses point about PTSD and trauma, so if we can go to Ms. DeLancey, that would be great.

Thank you, Mr. Abernethy. Ms. DeLancey.

Thank you, Ms. DeLancey. Minister Abernethy.

Thank you, Mr. Chair. Just one final point on facilities. I had the opportunity to travel to Iqaluit in April when I had an opportunity to visit a mental health transition housing facility providing transitional housing and support for individuals who are struggling from mental health issues.

In talking to their Minister over there, they have such incredible success with it just helping with the homelessness problem, but also helping people to prepare to be ready to go out for treatment if that was their choice. Also, helping people with mental health transition back into the community. It was a great facility with a huge opportunity.

If we are talking about needs of those types of things, I think something like that would be a far more valuable asset than building another treatment facility which, if as predicts future, will fail. I think that is something that we should think about more than we should be thinking about building another facility to have it fail too. Thank you.

Thank you, Minister Abernethy. Next I have Mr. Hawkins.

Thank you, Mr. Chair. I certainly think today is a fantastic day that we are now at this stage that we are talking about the bill becoming a reality. It wasn’t that long ago that the Mental Health Act was being looked at as strong, maybe, but we’re not sure, and possibly, maybe next term. So a lot of things had to come to bear to bring an introduction into this ring and certainly an amazing amount of work has brought it forth here.

I certainly want to begin by stressing how appreciative I am of the department to bring this forward and for the Minister to bring this forward and certainly for the committee to do the work that was required to go through this in order to have a bill here today. You can tell how important the bill was. I have heard people speak about the Mental Health Act for years and I know, from my own experience of dealing with headaches created with the old act, I can tell you first hand I have seen it as a frustrating piece of legislation and I certainly look forward to the implementation of the new act.

You can also tell how serious the standing committee took it. As I understand it, there is, and I’m going to use the very specific terminology of a whack. There is a whack of amendments, and they put a lot of heart and soul and passion into their work that they’ve done. I want to thank them for that. It’s not easy work sitting on a committee, just like the saying it’s not easy being green. But committee work is very important. Many hours of briefings, details, you go through it over and over again, and that work, it needs to be stressed how important it is, and again, I give committee a pat on the back.

The issues I want to raise very quickly are that I’ve sat with constituents in meetings with their psychiatrist talking about their loved ones. I’ve been to discussions at families’ houses about the strain and stress about mental health problems in the Northwest Territories, and I honestly find it heart wrenching. I mean there is no humor in this. To me it seems almost like one of the most complicated issues, and in my experience there are certain issues you get in this House you just want to stay away from because you just know it’s going to be, you know, it’s not a 10 minute sit and listen; it’s not here’s an hour of your time all wrapped up. I’m serious. These are tough issues to deal with and there’s no way of sort of just saying do you want to hurry up? I want to go a movie tonight or something. No, you have to sit and listen and understand and appreciate from the people’s perspective.

Hearing people talk about either their children or their spouses or their parents, I mean, it is absolutely a very deeply emotional experience, especially even when they’re talking about themselves and how challenging it is.

One of the things I’ve found, not just with the act, and I’m going to stray only for a moment here, is the fact that so much work still needs to be done on the public education aspect of mental health and for those who want to seek it feel paralyzed, parents are paralyzed, loved ones are paralyzed because of either the stigma that is created by them or the challenge and fear of getting involved or feeling that the system itself can’t help them or won’t help them. Sitting at people’s houses, a family’s house, or sitting even at the hospital talking to the folks who have been going through these challenges, I can’t say it enough, and I’ll probably say it a few more times as I go on, but it is a very emotional experience and sometimes just watching people feel helpless is just such a terrible feeling.

I want to point out, and a couple of my colleagues have mentioned it. I heard Mr. Dolynny mention it, and I think Mr. Moses mentioned it, and probably others have mentioned about how mental health seems to go hand in hand with addictions and the literature supports that. I’ve watched people who have mental health problems also lean into the addictions world. Let us not assume that that’s an easy experience for those who watch.

The big thing about this one, of course, like anything, is we can create the best piece of legislation, we could have a million pages of clauses talking about this and certainly about that. So, it doesn’t matter if it’s one page or a million pages, it really comes down to how it’s going to be implemented and certainly how it’s going to be supported.

The implementation and support is certainly, if I’d say, just as important as the time it took to draft the concepts. Of course, you get drafting from speaking to the professionals and their experience in and around the system, so I certainly look forward to how it’s going to be implemented and see where the supports are going to be there. It’s funny, sometimes we talk about supports as brick and mortar and sometimes it’s just a phone call, so it’s going to be an array of things to see this come to life.

My last experience in helping a family was watching someone who had a loved one who self-medicated. They would seek help. They would get help. They would be fine. Then they would not medicate because, well, heck, they didn’t need it they said, and the family struggled knowing that there was no power for the psychiatrist to implement an order to say if you don’t take your medication, we’re going to make you. The destructive behaviour that they had done when they’d get off their medication was terrible. People were fearful. When they were back on their meds, they knew that it was a problem. But like I said, mental health goes hand in hand with addictions and they’d get into other trouble and not just addiction, they get into other types of criminal behaviour. I think really what we see is good people who just needed help and support.

I just don’t know what to say enough in the sense of how excited I am that we are here to this day and I can honestly say I never ever remember getting a phone call when someone had a mental health problem and I thought, goodness, I can’t wait to hear what’s going to happen, where this conversation’s going. I can tell you, every single time I’ve had a call on this, I know it’s going to be a struggle.

I know I’m not telling anyone anything new here and I can just say that I certainly know that I hope this prepares us for the challenge ahead. I mean, it is a new act. It’s like preparing for the knowns, in other words the known problem, but sometimes that’s easier than preparing for the unknowns. What are we going to be prepared for? What is the act going to facilitate and be flexible enough to address things that come along? That’s the problem. You try to predict where this challenge, the mental health issue, is going and how to be prepared for it. So, I don’t have a particular question. My last statement wasn’t necessarily a question, more an anecdote about making sure we’re ready.

I am just going to wrap up by saying that, you know, I’m so happy we’re here. I fully support this, support the implementation of this. I’ve witnessed it firsthand. I definitely believe education needs to be done. I know this is a department that represents health, not the Department of Education which is another Minister, another department, another budget. But you know, we have to ask ourselves, what can we do? I mean, if I may liken it in the way that we’ve had other problems in the world and social sort of understanding and realization has caused us to rise up and meet the occasion as required. But will the government eventually find a way to engage its citizenry in a way that we all rise up and all say that no one should ever be ashamed of having a mental health challenge and we should see so many hands up that say we’re going to help you through this challenge. I look forward to that day. I know this act isn’t going to do that and I’m under no foolish sort of delusion that it’s going to be easy to get there some day, but I just know that as we, as a society, have risen up and said certain behaviours are not correct on other areas, let us find a way to rise up on this one and be there to help when you need help. Thank you.

Thank you, Mr. Hawkins. Mr. Abernethy.

Thank you, Mr. Chair. I appreciate the Member’s comments and I would just like to speak to a couple of his thoughts and observations. I think we’ve all probably, as MLAs, had somebody approach us who had the same type of issue that Mr. Hawkins’ constituent had about trying to keep a family member on their meds, someone who has a mental health illness, and the assisted community treatment is designed to do just that. That is giving the tools to the psychologist and psychiatrist that they haven’t had before. When I talked to some psychologists and psychiatrists here in the Northwest Territories, this was the exact model that they were referring that would give them the tools. So, we’re thrilled to have the act in there, recognizing some of the concerns that have been raised over properly resourcing.

I’d also like to talk a little bit about rolling this out. We know it’s going to take us up to a year before this legislation goes live and in that time we have to do a number of regs, a significant amount of training, because business is going to be done in a different way and it also must include public awareness. We must make sure people understand their rights and obligations under this legislation but also the rights and obligations of professionals throughout the system. I believe that was actually one of the recommendations in the committee’s report, making sure that we help people become aware of what all this means and how it affects them and how they can utilize it. So there will be a public awareness piece to the whole rollout.

The Member, at the close, talked about our need to rise up, the need of everybody to rise up, and I agree 100 percent. In the Mental Health and Addictions Action Plan one of the action items, including creating a conversation in helping to destroy the stigma that exists around mental health, and I think everybody in this room has an obligation to help destroy and break down that stigma. In the department we’ve done a couple of things. We released a Mind and Spirit magazine, which we got some pretty positive feedback on, intending to begin the dialogue and help inform people about the stigma around mental health and start attempting to break down. We also released a video, “You’re Not Alone,” and I would strongly encourage every Member of this House to tweet, share, put it on your Facebook, get the information out there so people know they’re not alone and that there are places they can call or go to when they’re struggling.

Lastly, with respect to all of us rising up, I would strongly encourage all Members to encourage all their constituents and everybody they know to take the Mental Health First Aid training program. I’ve made that challenge in the House. I’ve personally taken the Mental Health First Aid training. If you break your arm, chances are that someone in this room will be able to stand up and stabilize that until you can get to a proper medical practitioner, but not everyone can stand up and help somebody who is struggling with a mental health disorder. So, please take Mental Health First Aid. Encourage everybody you know to take Mental Health First Aid. It’s delivered two times every year per region. Every region is funded to deliver Mental Health First Aid twice. It’s a phenomenal course. It helps you identify, but also it’s customized for the North and it can help direct you to resources that exist within your community or region to support people who are struggling with a mental health disorder. So, please, you know we all need to work together to break down the stigma, please, whether you’re planning to come back or not, take Mental Health First Aid. Thank you, Mr. Chair.

Thank you, Minister Abernethy. Next I have Mr. Nadli

Thank you, Mr. Chair. I, too, wanted to make some general comments in support of the initiatives and the efforts that have been made by my colleagues and the committee in leading the work with the department, as well, and all the staff that contributed to this and all the public who spoke out locally in terms of at least laying out the framework of how we deal with mental health issues across the North.

A question that I wanted to ask the Minister and, of course, being from a small community, sometimes you experience people who pose a danger to themselves or others because of their circumstances of mental illness. As it sits currently in terms of how all the legislative framework would work and operate, I wanted to understand how it is that if a person is posing a danger to themselves or others, how the community would deal with that in the context of the current legislation. Mahsi.

Thank you, Mr. Nadli. Mr. Abernethy.

Thank you, Mr. Chair. The legislation actually provides, with support from committee, that we made an amendment that if somebody at a community level is having difficulty, the recommendation would be, get them to the health centre and the health centre can do an assessment, and based on their current status, whether or not they’re a harm to themselves, whether – and thanks to the committee for this – they have recently harmed themselves or others. The community health nurse can then make a referral, have that individual go on an involuntary basis to Stanton or the closest location that is providing some psychiatric services – currently that’s Stanton – for a full psychiatric assessment. So they do need to go into the health centre. We do need to get them into the health centre, but there’s a whole range of options now available under this legislation to the health practitioner so that they can refer them on.

Thank you for kind of outlining how it is that maybe if another term could be used for community protocol in terms of trying to utilize what exists currently in the community.

The community has strengths, and one of the strengths is that we have caretakers, we have leaders that work sometimes with the front-line workers, mental health workers, the nurses. Sometimes you’re left with all that you have and so it’s really critical that at least an understanding of how communities would deal with circumstances like this is very critical at this moment in time in the NWT.

The other element that I wanted to understand is how it is that perhaps local persons might be involved when there’s been mention of culture being an element of the proposed legislation. Would there be a link in terms of perhaps elders or chiefs or priests who perhaps could play a role in dealing with matters and persons that perhaps could pose a danger to themselves or to others? Mahsi.

Within the legislation, going back to his first point before I go to the second point, it is going to require a significant amount of training and development of our staff to make sure that they understand their roles, and that’s going to be the community counsellors, the mental health and addictions counsellors, all the social services side, but also the health side is going to require a significant amount of development and training as we move forward with these new regulations, protocols and this new legislation that gives our people more options.

As far as culture, committee brought forward a number of recommendations on this bill to make sure that the bill recognized the nature of the Northwest Territories and the fact that we are a territory of indigenous, Aboriginal people. One of the things that is very specific is the requirement for an elder or a cultural advisor to be included on the review boards when individuals wish to have their release or whatnot challenged. So it’s designed to require cultural advisors, which could be an elder, will likely be an elder.

No further questions, Mr. Chair.

Thank you, Mr. Nadli. Committee, we’re on general comments for Bill 65. If committee is agreed there are no further comments, we’ll go clause-by-clause review of the bill.

Does committee also agree that we’ll take it in groups of 20?

Well defer the title until consideration of clauses. Clauses 1 to 20.

---Clauses 1 through 110 inclusive approved

To the bill as a whole

Does committee agree that Bill 55, Mental Health Act, is now ready for third reading?

Does committee agree that this concludes consideration of Bill 55?

Thank you, committee. Committee Report 25-17(5) is concluded. What is the wish of committee, Mr. Hawkins?

Thank you, Mr. Chairman. I move that we report progress.

---Carried

I will now rise and report progress.