I will now call Committee of the Whole back to order. Committee, we have agreed to consider Committee Report 4-18(3), Standing Committee on Social Development Report on Adult Residential Addictions Treatment Facilities Tour 2017. I will turn to the chair of the Standing Committee on Social Development for any opening comments. Mr. Thompson.

Thank you, Mr. Chair. Mr. Chair, we have read in the report in Committee of the Whole. A number of Members have made Members' statements about the tour. I think it is pretty straightforward. We have four motions we wish to read in. Thank you, Mr. Chair.

Thank you, Mr. Thompson. I will open the floor to general comments. Minister Abernethy.

Thank you, Mr. Chair. I just want to thank the committee for their report and the hard work they put into it. I was, I think, honoured and privileged to join them in their tour of the treatment facilities. I really appreciated that opportunity.

Overall, I just want to be clear that we are very supportive of the recommendations provided by committee. The department is in favour of them and is planning to include three of the four recommendations in the addictions recovery action plan. We are not planning to include the section on the 120-day report, but all the other three recommendations, we are planning to incorporate. I would just really like to thank the committee for their hard work. Thank you.

Thank you, Minister. Mr. Testart.

Thank you, Mr. Chair. I just was wondering if a Member of the committee could just share. I know what is in the report. It is a very good report. I am glad the committee undertook this. Mental health and the southern treatment model that we are using can be controversial among some of my constituents, at least, who still believe very strongly on a personal level that a local treatment option is a better option. Did the tour change their opinions on that perspective, that local treatment options are better? Thank you.

Thank you. First, I will turn to the chair. Mr. Thompson.

Thank you, Mr. Chair. In regard to the question, what we did was we had an opportunity to visit the four facilities that have contracts with the Government of the Northwest Territories. We believe that, yes, a treatment centre in the Northwest Territories at some time in the future would be a good opportunity.

The biggest challenges that we found were, one, the ability to provide the selection that the government has with the four treatment centres out there. It gives us some variety. It gives us some options that seem to be well versed for our residents. The other thing is that we lack capacity presently, not just facility-wise but capacity-wise. Thanks to the Minister and the department for coming with us so we actually got the opportunity to hear facilities present to us and the patients who were attending it. The people who were trying to work on their treatment, they presented stuff to us. It was very informative.

We don't have the capacity right now in the Northwest Territories. We miss the capacity right now to fulfill our requirements for doctors and specialists. Right now, we are saying that this is the best option available for our residents, to attend these four treatment centres. It doesn't eliminate people from going to other facilities, but that there is a cost that people or their insurance company or the company would have to bear. Right now, the four facilities meet the needs of the residents of the Northwest Territories on the most part. Thank you, Mr. Chair.

Thank you. Ms. Green would also like to comment. Ms. Green.

Thank you, Mr. Chair. I will just build on the point that the chair of the standing committee made. Other immediate advantages to southern treatment include privacy where people are not among a group of people who they may live in the same community as or be related to, closely or not. They are able to have a certain amount of anonymity in these facilities. That seems to be something that they desire.

Secondly, the facilities have large capacities, so it is possible to get a bed for treatment almost immediately. There is no need to go on a waiting list and to wait months for a treatment option. The treatment is available in very short order.

Another point is that there are gender-specific choices in the options the GNWT has contracted. Women can seek treatment among women only. Men can seek treatment among men only. Then there are the co-ed facilities. That is important to some people, that their trauma is related to the opposite sex and they are happy to have the healing opportunity where they are in a gender-specific facility.

Fourthly, the different facilities have professional staff. They have linkages to other professionals in those larger communities, such as Edmonton, Calgary, and Nanaimo. That means that, if the person has a medical condition that is complicating their addiction or their mental health, that there is a resource available right in the community where the treatment facility is based, so there's no need for them to be flown out on medical travel, and of course, the waiting times would be less.

I also want to mention that the programs have follow-up options for people. They are able to continue their treatment in a transitional setting, and some of the people who we met found that very useful, that they really wanted to cement their sobriety before returning to their homes.

Also, there was the option for family counselling. Often people have family members who are addicts or have issues of their own, not necessarily with addictions but with the trauma that the addiction of their family member has caused, and they have trouble with boundaries, with appropriate communication, and so on. These treatment facilities all have some level of interaction with family members, who can both heal for themselves and support their family member in healing.

It's my firm belief that offering a suite of options to the residents of the Northwest Territories is going to, first of all, meet their needs and give them maximum choice in how they want those choices met to obtain and retain their sobriety. Thank you.

Thank you, Ms. Green. Another Member of the committee would like to speak. Mr. Blake.

Thank you, Mr. Chair. Mr. Chair, this tour really opened my eyes as a Regular Member who represents small communities. I know the last two years I have been supportive of having a treatment facility in the Northwest Territories, but after this tour, I do support sending our people south because of the specialists who are available on-hand and, you know, especially the treatment that is needed. In this day and age we are having more people that are being hooked on powerful drugs like crack cocaine. We just don't have the capacity here in the Northwest Territories to deal with that. You know, it's very important that those people who have identified the need to get treatment have the best care available. After going on this trip, I have seen firsthand that help is there and needed, if needed.

Also, Poundmaker's, I didn't even know this, that they have a mobile treatment facility that comes to Fort Smith here in the Northwest Territories. You know, it gives people a chance to go there and, if they feel comfortable enough, they make arrangements to go to Poundmaker's. You know, that facility is more than willing to come to other communities, as well. At the moment, we are actually working on that in some of the communities, to try to set that up. So, yes, this trip was much needed.

Before, when we had questions about these facilities, we didn't know what to explain to our constituents because we didn't know firsthand what is actually being treated at these facilities. Seeing things firsthand is the way to go, Mr. Chair. You know, now when my constituents come to me asking why we don't have facilities here in the Northwest Territories, it's very clear that we don't have the capacity. We do have a long way to go to build that capacity, but having those specialists come here in the Northwest Territories, we do have to have more to offer for those specialists to come here. Right now, it seems Yellowknife, maybe Hay River, has the capacity to draw those specialists in, but you know, for them to come to, say, Inuvik, it's very challenging because we just don't have the facilities that would draw in those specialists. That's one thing we have learned. I would just like to share that. Thank you, Mr. Chair.

Thank you, Mr. Blake. Mr. Testart, I hope that answered your answer, as it used up the bulk of your time. The Minister would also like to comment. Minister Abernethy.

Thank you, Mr. Chair. I know that I'm not committee, and once again I really appreciate the work they did. It was a pleasure and honour to travel with them to these facilities to see firsthand some of the things that are going on, and I really appreciate the comments I heard.

To the Member from Kam Lake's comment, the Member talked about local options and the lack of a treatment facility. We may get to the point sometime in the Northwest Territories where there is a treatment facility. We don't know where that will be necessarily, but what we heard clearly from people during the Ministers' Forum on Mental Health and Addictions is that people wanted options. People wanted more than just one program or one possibility for the treatment of mental health and addictions. They wanted on-the-land programming. They wanted better programs. They wanted programs that met a variety of their needs. The facilities that we have had in the past have been basically one program. We didn't have the uptake necessary to support them and continue to support them and provide high-quality services to our residents.

We have local options, Mr. Chair. In Yellowknife, we have community counsellors. We have mental health and addictions counsellors. We have NGOs that are doing incredible work. We have the ability to do detox at Stanton, medical detox at Stanton. We have the ability to do medical detox in Inuvik. We can do social detox in our communities with assistance from community mental health and addictions workers.

We are trying to bring more options. We have supported on-the-land programming, which we heard during the Mental Health and Addictions Forum was the thing that people wanted the most in the Northwest Territories, particularly people outside Yellowknife. We fund on-the-land programming. We actually have worked with other partners to create an on-the-land collaborative that creates even more options for people who are seeking a healing journey.

We have also put in a program called Matrix. It's a really interesting program. It's an out-patient program that can be done at a community level, so people can receive the supports they need, but they will stay in their homes in the evenings, and those types of things.

Fort Smith, the Salt River First Nation did an amazing job of piloting a mobile treatment option. We have been working with them to see if we can encourage other Indigenous partners to pursue the same type of program to create more options. At the end of the day, when it comes to treatment facilities, on average we have about 18 people in the Northwest Territories who are identifying as ready to go to treatment facilities, 18 people on average. That has gone up, and I think it's good that it's gone up. It means that more people are ready and more people are getting the support they need to go to facilities. When we move to the program we have in place now, we were averaging about 12, so I think it's great that the numbers are going up. It means that people are ready. We have put in an expedited referral process to get people into these treatment facilities as quickly as possible, because sometimes now is the right time.

I hear people when they talk about a treatment facility. We need a treatment facility. Bricks and mortar aren't going to solve the problem. High-quality programs that meet the needs of our residents and provide options are going to help us solve the problem, but it's going to take more than that. It's going to take us addressing poverty. It's going to take us addressing, you know, creating opportunities, meaningful work for people to do. It's about getting housing in place to make sure people have appropriate housing. Addictions is going to take work on all of our fronts, every one of our fronts, and a treatment facility of bricks and mortar isn't going to give us the solutions by itself.

I have heard people say to me, "If you build it, they will come." If past predicts future, we know that isn't true when it comes to a treatment facility. We have done four treatment facilities, and the enrolment and the number of people going to them was low. We are providing more support to people today than we did yesterday. Now, I say that with a qualifier. Absolutely we need to do more. We have the recommendations from committee. We are moving forward with an addictions recovery action plan to help us build upon the things we are learning and also acknowledge and recognize that there is new science there and there are new concepts, new theories, new ideas. There is harm reduction. There are things like managed alcohol. There are all sorts of things that we could do better on.

In Yellowknife, we have also put in a sobering centre. This is a huge opportunity to help get people who need support and the information they need and help build them up, at least in the first step so that they are ready to pursue other treatment options.

I hear the Member. I hear the people. We never say never, but right now, our best choice is to do what the Ministers' Forum on Addiction and the people of the Northwest Territories have told us to do, which is to create the best options and the best programming possible. More options don't limit us to one model, and that is what we're trying to do. Thank you, Mr. Chair.

Thank you, Minister. I will give the Member for Kam Lake an opportunity to speak again if he wishes. Mr. Testart.

Thank you, Mr. Chair. I appreciate that the format of our proceedings might not accommodate the same kind of back and forth we have in other reviews, but I do appreciate all of the Members who spoke to this, the time that they have put in, and of course, the Minister's comments as well.

I am certainly not saying that we need, with definite certainty, a brick and mortar facility today, but there are a lot of people who feel that way, and I think the work that the standing committee has done has given new information to consider about the effectiveness of our addictions strategy.

Aftercare continues to be a prime concern. A lot of people who I talk to, my constituents who are concerned -- one of them has started a petition, in actual fact -- a lot of what their concerns are relate to aftercare.

I note that the committee has two recommendations here directly applicable to aftercare, but what does the current model of aftercare look like in the Northwest Territories, for one, and how can we improve upon it?

Granted, I am happy if committee wants to speak to the recommendations, but if we can just have that conversation here so that people understand that that is part of the work that committee has undertaken. That will be my final question, but I think it is an important question that needs to be raised, and I would appreciate hearing from committee members on their thoughts on aftercare and how we can make it better. Thank you.

Thank you. Do any committee members wish to comment? Mr. Thompson.

Thank you, Mr. Chair. Aftercare was one of the big things that we were looking at. It was one of the challenges that we saw there. Basically, though, what we found is that aftercare has to be individualized. It has to be respective to that individual. Each facility, like Ms. Green talked about, had the opportunity to have aftercare available from each facility, that there were some 30 days, 60 days, 90 days of aftercare. There was the opportunity for people to come back to the facility for further treatment there. There was the opportunity to make phone calls. There is that option available.

The department has some good aftercare processes with their staff, and I don't want to speak on that, because we didn't look into that aftercare so much. When we talked to the Minister, he did provide some good, clear direction, good ideas, and good information that we needed to hear, and I think the Minister could probably elaborate further on that.

Again, we thought it was an issue, and we needed to work on it. We, as the government, need to make it better. We need to make it individualized, but we need to also train family and get family prepared. When I say "family," we are talking extended family and friends, when the person comes back. If we put them in the same environment, then we are going to see failure again.

When we talked to the people, that was one of the things there. One of the things with aftercare, they have actually stayed back. They stayed down in the city where this program is being done, because they realized the aftercare was not available for them presently in the Northwest Territories in their community.

We talk about peer support groups and that opportunity to help them. The aftercare is individualized, the department has some stuff, and I would rather have the Minister speak on that, as well, on what they are doing.

I guess the biggest challenge that we found was the communication of the programs that are being offered, and we are trying to, you know, work with the department on coming up with a plan. I will turn it over to any of my colleagues or the Minister who wishes to talk on this further. Thank you, Mr. Chair.

Thank you. Ms. Green, you wish to comment? Ms. Green.

Thank you, Mr. Chair. Mr. Chair, all four of the treatment centres that we visited operated on the 12-step model, and as you may know, peer support is critical to the success of the 12-step program.

What I have heard since I came back is that, in even the regional centres, let alone the small communities, people are reluctant to create AA groups, which would be the natural follow-up, because of privacy concerns, which I stated earlier. There really isn't a level of anonymity in a place that has 1,000 people, and not everyone is comfortable sharing the details of their addiction and recovery in that format.

That means that aftercare, as my colleague from Nahendeh said, really needs to take place on an individual basis. How this would work within privacy concerns, I am not sure, but it may be possible to link people who have been in recovery to one another so that they can provide peer support one-on-one. That was one thought I had.

Otherwise, as my colleague said, really, it is individual. The centres offer online support. They offer telephone support. If you are in the place where the treatment facility is located, you can drop in and talk to them. Other than that, the peer support piece, it is not really clear that it would be easy to get that going. It is not really a matter of money and resources. It is a matter of privacy, which is a more difficult issue to address.

Having said that, of course, that is not the only way to support people in their sobriety, and I will leave the Minister to fill in the blanks. Thank you.

Thank you. Mr. Testart, would you care for the Minister to respond as well? It is your 10 minutes.

Thank you, Mr. Chair. I am content if the Minister would like to. I am sure that people would appreciate hearing about the supports we currently have towards aftercare. Thank you, Mr. Chair.

Thank you. Minister Abernethy, three minutes.

Thank you, Mr. Chair. I was hoping to have a response to each of the recommendations as we are going through the motion, so I won't go into too much detail here, other than to sort of articulate as best I can what the process is today, not necessarily where we need to go.

If an individual in the Northwest Territories is seeking support through a facility-based treatment centre, we go through a referral process and expedite it. We get the person in there. Before they even go down, they are required to have a follow-up appointment booked in their community or wherever their referral came from. If the person is from X community, they have to have an appointment booked in their community as part of their aftercare.

Then, the person goes down, they go through their treatment process, they get the tools they need, and then their facilitator, their lead person, their clinical advisor, if you will, down there will then work with them on the development of a self-directed aftercare plan. That involves getting in touch with the local provider, following up on those appointments, and getting in contact with local resources that exist and other programs that might be appropriate.

In principle, on paper that sounds good, but what we know is it's not necessarily happening. People aren't following up when they come back to the communities. Some of these aftercare programs, as the Member for Yellowknife Centre described, aren't necessarily working because of the size of some of these communities and the size of some of these groups. Clearly, without question, we need to do better on aftercare.

It's not just about some of these counselling things. When we were on the trip, the Member for Yellowknife Centre said something that stuck with me, and I think she nailed it right on the head: we can't be releasing people to poverty or to homelessness, and sometimes that is the case. Some people who are in treatment have come from a couch-surfing lifestyle, and they have nowhere to go to when they return. There isn't really a defined plan on how to help those people come back to the communities and avoid going into that homelessness situation, the poverty situation, again. We have work to do.

I would like to speak to those when we are going through the recommendations, but I think we are on the right track. I think we are working together to find solutions. We have aftercare, but it needs to be strengthened, without question. Thank you, Mr. Chair.