Thank you, Minister Abernethy. Committee, we’re on general comments. Next I have Mr. Moses.
Debates of Oct. 7th, 2015
This is page numbers 6757 – 6826 of the Hansard for the 17th Assembly, 5th Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.
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Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Alfred Moses Inuvik Boot Lake
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Glen Abernethy Great Slave
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Consideration in Committee of the Whole of Bills and Other Matters
Delancey
Thank you, Mr. Chair. The Member raised a really important point about people suffering depression and Post Traumatic Stress Disorder, and we know that trauma in early childhood really is the root cause of the majority of addictions problems and many mental health issues. So, over the last year, the department has put a lot of effort into exploring the need for what is called Trauma Informed Practice. We have had workshops and training sessions for front-line practitioners. Just over the next couple of weeks, we are rolling out training from an expert group who actually run a trauma centre in Ontario, for our community counsellors. Our senior management team met with the lead on that this morning and it emphasizes what we are starting to recognize more and more, that the more you can deal with people at the earliest stages of Post Traumatic Stress Disorder, deal with childhood traumas, the more we can intervene and prevent some of those later-in-life onset addictions and mental health issues. This is an emerging area of practice. It is one that we are really emphasizing and it will become increasingly important. Thank you.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Consideration in Committee of the Whole of Bills and Other Matters
Glen Abernethy Great Slave
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.
Consideration in Committee of the Whole of Bills and Other Matters
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Robert Hawkins Yellowknife Centre
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Glen Abernethy Great Slave
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Michael Nadli Deh Cho
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
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Glen Abernethy Great Slave
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Michael Nadli Deh Cho
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Glen Abernethy Great Slave
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.
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The Chair Robert Bouchard
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.
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters
Some Hon. Members
Agreed.
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Some Hon. Members
Agreed.
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The Chair Robert Bouchard
Well defer the title until consideration of clauses. Clauses 1 to 20.
---Clauses 1 through 110 inclusive approved
Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters