The committee met at 1:05 p.m.

[N. Simons in the chair.]

N. Simons (Chair): From the virtual Douglas Fir Room, from homes across British Columbia, welcome to the committee meeting. We have some important issues to discuss.

I want to just start by wishing everyone good health and wishing everyone good peace of mind and hoping that we’re all doing what we need to do and encouraging others to do the same. I just want to say that I’m grateful for the opportunity to talk about issues that are important to us as British Columbians because of our care for one another and for the children of the province.

Without much further ado, let me just ask, Jennifer, if you would like to introduce the people who have come with you and then, perhaps, provide us with a statement regarding the impact of the COVID-19 pandemic on the child- and youth-serving system. Welcome to all of your colleagues.

Statement by
Representative for Children and Youth

IMPACT OF COVID-19 PANDEMIC
ON SERVICES FOR CHILDREN AND YOUTH

J. Charlesworth: Thank you very much, Nicholas.

Jennifer, if you wouldn’t mind, maybe we can just queue up the first slide with the information on COVID-19.

Before we launch into that, I just want to begin in a good way and acknowledge that I’m doing my work today from the traditional unceded territories of the W̱SÁNEĆ people, who have got close familial and cultural ties to the Lək̓ʷəŋin̓əŋ-speaking peoples, on whose land our main office and the Legislature are located.

This morning I referred, when we were speaking with the Finance and Government Services Committee, to the stories of the great flood that took place in these areas and that engulfed these territories many generations ago. These stories have been shared in various ways by knowledge-keepers up and down the Island. I think they have particular significance in this time.

One aspect of this story is how the people had to…. They had lost their way, and they had to find ways of helping one another. It was a cedar rope here or a canoe there, access to a mountaintop to wait out the flood. I think that is a really telling story for these times in terms of how we need to work with one another.

The other thing that is particularly pertinent is that the name W̱SÁNEĆ is translated as “the emerging people.” It’s the people they became when the floodwaters receded and they had to find a new state of being and harmony. I think we’re certainly in that space now, wondering who we are going to be as we move through this.

I’d like to thank you for this opportunity today. I will, first of all, introduce my colleagues. I’m being supported today by the deputy representative, Alan Markwart, whom you have met before; the acting deputy representative and the head of advocacy, Blair Mitchell, whom you also know; chief investigator Carly Hyman; and acting executive director of monitoring Alix Little.

Also joining us today are Chelsea Turpin, who is heading up our COVID-19 response team and is also a manager with our First Nations, Métis and Inuit relations team; and Shannon Clarke, who is a research officer in monitoring who has led and provided the leadership on our substance use report.

That’s who you are being greeted by today.

N. Simons (Chair): I want to say to anybody participating: feel free to turn off your video if you don’t feel that you want to stay in that little box for so long. And you can look at the slides. I just wanted to say that. We don’t consider that rude or anything.

J. Charlesworth: Thank you for clarifying.

Our presentation will consist of two parts. In the first, I’ll talk about the impact of the pandemic on the child- and youth-serving systems in B.C. and what we’re seeing and hearing about through our work, as well as how we have pivoted to adapt our work to these unprecedented times.

In the second part today, we’ll talk about the report Youth Substance Use Services in B.C. — An Update, which was released in March.

[1:10 p.m.]

As a way of beginning to talk about how we’ve adapted, I wanted to acknowledge and hold my hands up in respect for the extraordinary work being done by front-line workers in the health and the social care sectors as well as other essential service workers and, also, to the leadership throughout government, to the Legislative Assembly members and, of course, to our much beloved Dr. Bonnie Henry and her team.

It’s been an extraordinary time and a privilege, I have to say, to observe the ways in which people have come together in unique and extraordinary ways across party lines and across different perspectives. We have borne witness to some extraordinary areas of practice and some responsiveness that is truly unprecedented. There’s a tremendous amount that we can learn from this.

As you can expect, COVID-19 is having a significant effect on the child- and youth-serving systems in B.C. and on the work of our office, just as it is on nearly every facet of our daily lives. In many cases, the pandemic and the resultant physical distancing requirements have heightened the issues that we typically see through our advocacy and oversight work. In some cases, COVID-19 has created new issues for children, youth, young adults, families, caregivers and social workers.

What was obvious from the early stages of the pandemic is that we had to make some adjustments to how we do our work in RCY, beginning with a quick transition in mid-March to having almost all of our staff working remotely from home, and fortunately, we were able to do that. We also redeployed the equivalent of 3.25 FTEs to form our RCY COVID response team.

I would like to recognize the work of this team: Chelsea Turpin, who I mentioned is here with us in this meeting and has led the team, which includes staff members Paige Thombs, Tracey Eyles, Jennifer Williams and Jenn Morgan. Again, it’s extraordinary work they are doing.

The key functions of the COVID response team are really threefold. One is they review, analyze and summarize the impact of COVID-19 on the child-serving system by looking at changes to MCFD and CLBC policy and practice, reports from service providers and stakeholders. This is critically important, because we need to ensure that our advocates are well informed about what is going on.

As you can imagine, when they get calls, they’re getting calls from young people and caregivers and service providers that are frightened. They’re scared, they’re confused, and they’re stressed. We need to make sure that we’re guiding people in the best way possible, so ensuring that we are well up to speed on all those changes is critically important.

The other role of the team is to analyze and summarize COVID-19-related advocacy reports and court reports of critical injuries and deaths received by RCY — I want to go into those in a little more detail shortly — and collate and archive federal and provincial information resources so that we can take a look at the kinds of things that are going on, see what kinds of responses are in place and then influence and inform as need be.

The issues and themes that emerge out of the work and through our various other connections are then brought forward by myself and other RCY executives to leadership at MCFD, other ministries and public bodies through regular meetings and discussions to assist them in being informed as they make decisions about the matters and identifying the matters that require attention and action.

I can say that we’ve had an extraordinary response from our ministry and authority colleagues and from the PHO itself. We have regular briefings, a tremendous exchange of information, and it does feel like we are all hands on deck and pulling together in a good way.

As an example of how we have used the data and our research and these relationships, one of the biggest concerns we heard at the beginning of the pandemic was what was going to happen for young people who were going to be aging out of services during this uncertain time. We began discussions with MCFD leadership immediately, and I believe that the advice and information we provided and the advocacy, and also the data that you are getting through our advocacy and CID, enabled government to make quick changes to ensure that vulnerable youth in B.C. would not lose their placements and supports during the pandemic. As the deputy minister said, there was a pause in time so that they have the opportunity to get the full range of supports and transitional supports that they are entitled to.

We have also regularly advised other bodies — including the Ministry of Education, the Ministry of Health, the Ministry of Mental Health and Addictions, the provincial health officer — about various issues and concerns during COVID-19.

[1:15 p.m.]

We have relayed concerns about gaps in services from community organizations, parents, caregivers, and children and youth themselves. Sometimes our advice, which comes from the strong relationships we’ve built with the community and the child- and youth-serving sector helps us to shine light on potential or realized unintended consequences of government plans and, we hope, helps shift that planning to be more effective.

Relaying that accurate information and quick assessments that might not otherwise reach decision-makers is one of the most significant ways our work at RCY has changed during the pandemic. Our independent oversight role is still being fulfilled, albeit in a slightly different manner. As communicated to the members of the committee last month, we believe that our work during this time should not distract government and public bodies from their highest priority of delivering services and keeping young people safe and healthy.

So we have suspended the issuing of any RCY reports that include recommendations and are instead offering information, data and advice during regular briefings with leadership, especially at MCFD, as well as other ministries and public bodies. While we remain actively engaged in the work on all of those reports, we’re recognizing that we have to get the timing right, and we have to make sure that job number one is taken care of.

Moving to advocacy, we remain actively engaged in advocacy work, as you can appreciate, during these times, but the advocates are not able to provide some of the in-person advocacy and youth and community engagement activities that we used to provide. These have been postponed for good reason.

But our advocates have continued to work with children and youth, young adults, the caregivers and the community service providers via telephone, text and video messages and are actively exploring tools such as Facebook, Skype and Zoom to directly communicate with young people. We also expect to be up and running, in several weeks, with a chat and text function that will allow us to connect more immediately with youth. This is particularly important because of the lack of face-to-face meetings and how young people communicate most frequently.

Although our normal outreach work hasn’t been able to continue during this time — that’s been a significant part of our work, obviously — we’ve tried to figure out other ways of staying engaged and connected, with proactive outreach through our teams and with the implementation of a social media campaign. I should acknowledge the significant help of dozens of community partners who have collaborated with us and ensured that our media campaign has broad reach into the lives of young people and also that we are able to amplify the voices of those who are out in the community doing the work as well. The COVID response team is proactively reaching out to various organizations, community bodies, etc., in Indigenous communities so that they can get perspectives from those service providers on the ground.

The other thing I’ll mention before moving into what we’re seeing as a result of COVID is that we’ve taken steps in the short term to modify our RCY website and materials to make them more accessible to youth and to those for whom English is not a first language. This has come before the committee before, and Teresa, thanks to you for continuing to raise it. We’ve begun the process of translating our key informational materials into the ten languages most commonly spoken in the province as well as a number of Indigenous languages. We’re also adding the Google Translate function to our website. That will come on in very short order. We’ve been working on that for a while now.

Those are a few things that we’ve tried to figure out. How do we increase our accessibility? How do we provide the best information possible? How do we enhance our advocacy services so that people get the information that they need? How is it that we monitor and fulfil our responsibilities at a time that is unprecedented and uncertain?

[1:20 p.m.]

I’ll just pivot now to tell you a little bit more about what we are learning — what we’re seeing and hearing. We have two consistent sources of information. It’s unlike anything that any other body has. One is through our advocacy cases and the work with community partners that we do through advocacy outreach. Then the other is what we see through the reportables of deaths and critical injuries that are received by our critical injury and death review investigations unit, fondly known as CID.

Here’s how COVID-19 is playing out. We’ve opened 87 COVID-related advocacy cases as of last Friday. They deal with a wide variety of issues — and we’ll talk about this some more — ranging from concerns about children with special needs and their families feeling undersupported to family members being unable to visit their children who are in care, and concerns about lack of mental health and substance use services and supports, etc. We are tracking all of those as well as, of course, providing the services in the here and now.

In terms of our CID, these figures are actually between March 1 and April 17. We’re somewhat behind or trying to catch up on the unprecedented volume of reportables. The actual number that we have received is well over 100. But what we’ll represent here are the ones that we’ve done the deeper analysis on.

Of those, we see social distancing as a concern in 49 cases. That’s largely where young people are struggling to maintain the expectations around social distancing, which is actually putting their placements at risk — and I’ll come back to that — or caregivers are concerned about what’s going on with respect to social distancing and following the protocols set out by the provincial health office.

The exposure to COVID-19 was a concern in 21 cases. Access to services or important people in a child’s life was a concern in 19 cases. You can appreciate that there’s definitely some severing of some really important relationships to young people that they rely on in person.

Placement was affected by COVID-19 in 11 cases. I can say that in this period since April 17, and current, we’re seeing that ramp up more. That’s actually increasing as placements are somewhat in jeopardy. Then COVID-19 is impacting court availability in three cases.

Those are a broad brush, some of the data behind it, and then within that, the COVID-related concerns that we have been seeing. I’m going to go through them. There are a lot, but I’ll try and do my best to illustrate them in a good way for you.

The first one that I want to bring your attention to is children and youth with special needs and their families and caregivers. This is an issue that is, no doubt, near and dear to your heart, because you’ve done some extraordinary work in this area, and you know well the fragility of the CYSN system. You know that we’ve spoken about that before when we brought forward Alone and Afraid and that the ministry is working on it.

I have to say, and the ministry would agree, that COVID-19 has illuminated the fragility of that system and the difficulty that it has in meeting the needs of children and youth with special needs — and all children and youth with special needs, across diagnoses, functional status, complexity, etc.

MCFD has provided some flexibility to caregivers around the way their funding is used. The ministry is creating an emergency fund of $225 a month for some families, but the consensus we’re hearing across families, across service providers and across the advocacy organization is that more help is required.

Let’s put this in context. The children and their caregivers are being hit on multiple fronts. Schools are not in regular operation. For many children, school has provided a tremendous amount of support for families. Day programs are being cancelled, assessments are being postponed or cancelled, and therapies, such as speech and language or occupational therapy, are unavailable.

Respite is not available in many cases. Some therapies, such as counselling or behavioural therapy, can be done virtually to some extent, but this does not work for all children, as you can appreciate, as many of these young people benefit from touch or need to be physically guided through some therapies.

Parents and caregivers are reporting a lack of clarity around planning and responsibility for children with special needs grievance. Many companies that sell educational and therapeutic resources are experiencing a backlog due to high demand. This is challenging for families who are relying on these extra or alternative resources while schools and other supports are not available.

[1:25 p.m.]

It’s wonderful that there’s more flexibility in how some of their funding might be used, but then they’re not able to access some of the services and resources that would be helpful.

In general, many, if not all, children and youth with special needs are not getting the services or social contact they need. Parents and caregivers are reaching out or exceeding the burnout stage. Without adequate respite available and the schools not operating in the usual way, we’re very concerned about the stress that families are under. I do remain concerned that these parents and caregivers will reach the point of breaking and might not be able to care for these children. We are tracking this, and we’re hoping that MCFD is tracking and paying attention to this as well.

The final thing I’ll mention, because it has been highlighted in the last few days, is that the impact of physical distancing on children and their families, particularly those who are in agreements and are palliative, is significant. We’ve become aware of some practices in other jurisdictions that we’re sharing with the ministry that speak to how best to support children when their medical needs are such that they need an additional level of support than what is currently available in the time of social distancing. That’s a huge area of concern for us — children and youth with special needs.

This next area is youth aging out of care and their placements and supports. What we’re very worried about is young people losing access to support. MCFD reacted quickly and appropriately in this area. However, we’re still hearing from young people who have not received the message that they will not age out or lose their placements and support during COVID-19. Communications is a huge issue that we’re all well aware of, and it is something that we have to continue to learn. What’s the best way to reach those who are most vulnerable and most marginalized and aren’t connected?

Our advocates are hearing that there’s unclear messaging from some social workers around extension of funding in the agreements with young adults programming, leaving some youth feeling like they will lose funding due to the pandemic. Youth and caregivers are concerned about transition planning during the pandemic and that they might not be properly prepared to leave after the outbreak is concluded. Youth due to age out into Community Living B.C. in the coming months, and their caregivers, are worried about service continuity and bridging supports.

Those are just a few areas — the communication, the anxiety and the transitional supports. As I say, MCFD responded in a quick and appropriate way, despite the challenges around the legislative provisions. But, of course, we need to make sure that the good intentions are realized for the young people and their experience.

The third area is lack of access to technology, which leaves youth and families feeling cut off. We are obviously relying a tremendous amount on technology ourselves. It’s critically important that that technology be made available to children and youth and their family members to facilitate the virtual connection — and being mindful that there are many families that are living in areas with limited Internet or cellular coverage or simply, by virtue of poverty, don’t have the means to engage.

While some youth in care have access to technology, many youth living in poverty and not in care don’t have access to equipment. That might be young people on youth agreements or independent living or living in a marginal circumstance. They don’t have access to equipment that would enable them to access the support services, information, etc.

The other thing that we often don’t think of is that in pre-COVID times, young people could go to a Tim Hortons, or they could hang out in front of a café, and they would have Wi-Fi access, or they could go to a library or a mall. But all of those points of access are not available. Libraries are closed, and cafés are closed, etc.

This is contributing to young people’s difficulties in accessing their social worker, their guardianship worker, having virtual family visits, reaching out and asking for help and connecting with people that are meaningful to them. It’s interesting how important technology has become in these times.

[1:30 p.m.]

The fourth area is, of course, children and youth being exposed to violence and victimized. As you can appreciate, when we don’t have school, when we don’t have community-based programs, when friendship centres aren’t doing their cultural supports, all of those kinds of things, we have fewer eyes on…. When kids aren’t out in their neighbourhood or in amongst their extended family, we lose the eyes on children that are so important when they’re vulnerable. It’s further exacerbated by the risks we know of family violence when families are under significant stress, when they’re isolated and sheltering in place, when economic circumstances have increased the stress within the families, etc.

Community service providers in the anti-violence movement have reported that there are increasing numbers of family members, particularly women and youth, that are reporting that they are not safe, yet there are limited options for them. So we really need to think about the best way of making sure that people know about services that are available. Unfortunately, one of the assumptions is that when the storefronts are closed, it means that no services are being offered. Of course, that’s not true.

The Office of the Human Rights Commissioner and myself issued a news release about the concerns over an increase in family violence. We’ve worked with the provincial health officer. We’ve done a social media campaign. We’ve tried to raise awareness around family violence and what that might mean for children and youth as well as women.

It was encouraging, and it speaks to how important communication is, that the ministry reported that while their calls to their centralized services had decreased over the concentrated time in which we tried to raise information and awareness, the numbers went back up to a similar amount to what they were a year ago. It’s so important that we continue to make people aware not only of the risks but also of the availability of services and supports.

The next group that we’re concerned about is homeless youth and youth at risk of homelessness. Youth fleeing violence and those whose placements have broken down are showing up in homeless camps in B.C. We’ve got some notable examples. Of course, action is being taken in some of the camps, but the children and youth are also present in other areas. What we’re seeing is an increased risk and experience of violence and sexual exploitation.

Some youth are having difficulty finding housing during the pandemic. Those who used to couch-surf or cobble together something or were living in unstable housing situations but making a go of it, so to speak, are at a greater risk of homelessness. Some shelters have reduced services — their capacity is reduced — or they’ve closed altogether. And going into an adult shelter is not a safe thing for many, many youth, of course.

Those are some of the considerations we’re worried about there, and they definitely are showing up in our CID numbers.

Now, hotels will be used to temporarily house some homeless youth. As you know, our office has had some pretty strong views on the use of hotels with young people. We have been in consultation with the ministry, and of course, this is an unprecedented time. Hotels that have youth wraparound services, that are separated from adults and that are working towards youth-specific housing going forward are all in the discussion. We are also monitoring the use of any hotel. In fact, it’s a requirement that we hear about the use of any hotel for a young person that exceeds three days.

We’re monitoring to make sure that there are appropriate services and supports and trying to find more permanent measures. But as you can appreciate, the ministry is hampered in doing recruitment of new homes or in facilitating transitions. Interesting complexity there.

Mental health of children and youth during the pandemic. This is something that has received a lot of coverage in the media and elsewhere — the concerns about mental health for all of us and the deterioration of the mental health of young people during the pandemic.

Of course, that’s a combined effect. Young people are afraid of their situations and what that’s going to mean. They don’t have access to their typical supports. They don’t have access to their friends and some of the other coping practices that they might draw upon.

[1:35 p.m.]

We will draw attention to a few situations. We did see…. There are fewer supports, including for the most at risk. We did have a report of a death of a young person who was discharged from a facility because of a closure of the unit and shortly thereafter committed suicide. These are things that give us pause, and we wonder what it is that needs to happen at this time.

We have been in consultation with the ministry around CYMH services, child and youth mental health services, and the kinds of things that they’re doing. We’ve also agreed to do some what we call rapid research to try and identify interventions or ways of providing services, including in the more rural and remote areas where there are very few options. So that’s underway right now as well.

Substance use. You’re going to hear a little bit more in the second part of our presentation today. Youth substance use services are patchy, at best. This has been exacerbated during the pandemic.

Again, sadly, we see the report of a child who passed who had significant substance use issues. There’s a lot more that we need to understand about that, but in general, we are seeing young people who use substances and are leaving their placements because they have to access their substances. In this case, that also happened, and there were some alternative therapies that were not available, for a variety of reasons, for this child. Those are concerning to us.

The other thing is that a significant resource in the province, Ashnola at the Crossing, closed due to a limited workforce and unique challenges with service continuity in their remote location. Clients have been transitioned into their home communities, but this raises concerns about what the capacity is of those receiving communities when so many other services are not available and how this is being managed and supported. So we’re working with and monitoring that as well.

I want to spend a little bit on the well-being of First Nations, Métis, Inuit and urban Indigenous children and youth. I preface that by saying that the traumatizing history associated with epidemics and emergencies for First Nations, Métis, Inuit and urban peoples is something that I think we all need to be mindful of. This is a deeply felt history, and it’s critically important that as we move forward, we’re also thinking about how to ensure that cultural safety and the cultural appropriateness of services are upheld in these times and that we understand the injuring impact of trauma and historical trauma.

There are four big concerns that have come forward. One is a concern about food security and access for children who previously had regular meals at school. The second is access to culturally appropriate mental health services and supports. The third is a concern about family violence and responsiveness. The fourth is the inequitable access to funds.

I’m going to particularly note that the friendship centres…. The funding that was provided by the federal government will only be about $35,000 per friendship centre. It seemed like a big number when it was announced, but it’s only about $35,000 per centre. Our research has shown that the friendship centres are doing an extraordinary amount of outreach, including in the food security area and the mental health supports and cultural supports, and they’re having to look to all sorts of other sources that are not particularly reliable. So I want to raise that — the importance of equitable access to resources — at this time.

Those are the four big issues that have come up from our partners. We also have concerns about access to cultural connections. We know that’s a protective factor for Indigenous children and youth, and it’s even more difficult when we’re in a virtual environment. While agencies are trying all sorts of creative things, they can’t replace that in-person connection.

One of the things we identified early on as an advocacy was…. A youth was going to be going back to their nation, had the trip cancelled due to the pandemic but then was told: “Well, by the time you’d be through this, you would have aged out. So you’re not going to be able to go home.” We acted on that. That was not the intention. That was not the spirit that the ministry wanted to convey.

[1:40 p.m.]

We’ve had to raise things like that. It’s all in the operationalization of these intentions that we want to support young people, recognizing that some of the things that they were entitled to and that we should facilitate we’ll have to facilitate at a different time.

We’ll go to the next one. We’re almost there, folks.

Safety concerns regarding foster and residential resource placements. Of course, it’s interesting that…. Workers are employed, often, in many placements, so it’s similar to what we see in the health sector. But in the residential care sector, staff are moving between different agencies and placements. Fortunately, we have not seen too much…. I believe there are five caregivers, at last count, in residential care, and two foster caregivers that have been positive for the virus. Nonetheless, it’s a challenging area.

The biggest thing that we’re seeing is children and youth refusing to physical distance. That leaves foster parents, many of whom are older, and other residents in the home in potential danger. It’s a difficult thing. When we understand the psyche of young people, being connected to others…. They’re hard-wired to do that.

It’s a difficult ask of young people, and that’s had some consequences for them, either in terms of how they’re being treated or in terms of the stability of their placements, access to certain parts of their home, all of those kinds of things. We did try, through a social media campaign, to raise awareness for young people about what it is they need to be mindful of going forward.

We have also noted that some of the planned moves of children and youth have been cancelled or postponed due to COVID-19, either returns home or returns to more appropriate placements — for example, transitions into adult resources at CLBC.

There are a number of things that we are monitoring and are concerned about there. Of course, we are seeing placement breakdowns. When that happens, there’s a lack of other alternatives. We’ve also heard that foster homes are unwilling to take children and youth until the pandemic is over.

Just a few more here. Frustration over the suspension of visits. Now, this is one of those very difficult things. Of course, the suspension of in-person visits was necessary. It was the best decision that was possible at that time, given what we were dealing with. The ministry did try and facilitate access through other means.

They did create an exceptions policy, and we did see that there were very few exceptions applied for. They had concerns. We had concerns and questions about that. Although the extension of the suspension will be going on for another 30 days, they are taking a look at seeing, as things relax, whether there can be more exceptions made. That is a challenge, especially for parents’ access to infants for bonding and breastfeeding purposes.

Child protection. We’ve reports that children who might otherwise have been returned to family are remaining in care due to the pandemic. We’ve also heard concerns that children have been sent back to live with family, even though it might not be a safe situation, because the appropriate resources and supports aren’t around. There are a few areas that we’re mindful of there.

Of course, the big thing is how many reports are coming in and how the ministry is responding to that. The ministry is saying very clearly they are fulfilling their duties under the legislation. They are investigating reports. They are going out to meet children and things like that. That’s great. However, there is the challenge with the courts. How do you proceed with that? We’re seeing issues in which custody suits or legal disagreements between the parents over the safety of the children are playing out as well.

Now, in terms of…. Some of the things that are happening with day-to-day services. We have heard quite a bit that the responsiveness from service providers is limited in some cases. It seems to vary. Then there are delays in planning.

[1:45 p.m.]

Children and youth have expressed feelings of not being heard or acknowledged — and family members as well — feeling that they’re being excluded. We have had some concerns about service denial of things, basically saying: “Well, we can’t serve you until we’re through this.”

I want to say that this is not…. To share all of this is for the purposes of saying: “Here are the things to be mindful of.” We recognize, and as I said at the beginning, there is an extraordinary amount of work being done. People are trying to figure out how best to do it. We raise these with our counterparts in the spirit of saying: “Let’s be mindful of what’s happening for children and youth so that we can respond in the most appropriate way and make sure that we are attending to those things.”

In some cases — we call them the canaries in the coal mine — there are things that start to bubble up. For example, inequities or different ways or a lack of understanding about how policies are being interpreted. We can get those onto the radar early so that the risks can be mitigated. In other things, we’re starting to see the themes and trends that will let us know how we need to respond now and when things shift. Many people talk about what will happen afterwards.

You’ve been very patient — just a couple of other office updates for you. We’ve initiated a new process for the development and monitoring of the recommendations in our public reports. The key change with regard to the development of recommendations is direct engagement of affected ministries and public bodies as we’re contemplating recommendations that will affect them. That’s to ensure that we have eyes wide open on what the unintended impacts might be of our recommendations and the sustainability of our recommendations. We still own those recommendations and do what we think is right, but it’s very helpful to have that consultation early on.

The key change with respect to monitoring responses has been that we publish annual assessments now of the progress made by ministries and public bodies in implementing recommendations from our recent reports. The first set of annual assessments were published on the RCY website this week. We’re very happy about that — to be so transparent. We’re going to talk about our latest report, the substance use one, in a couple minutes, but because you’re familiar with the other work that we’re doing, I just wanted to give you some updates.

We’re very close to finishing our investigative report on the effects of intergenerational trauma in the areas of permanency — legal, physical, cultural, relational identity — on the life of an Indigenous person. We are very close on two statistical reports that cover three years of data on critical injuries and deaths, which will really illuminate the different experiences for First Nations children, Métis children and non-Indigenous children.

We’re working on the aggregate report of deliberate self-harm. We’ve got special reports on child participation, one on mental health detentions and the other on child protection and family law. A number of these have recommendations, so we will be suspending those, bringing forward to you that there are others that don’t have recommendations that we think are informative, particularly the one pertaining to the statistical findings.

Monitoring carries on with their FASD report, the care review, reviewing the transitional and post-majority services and supports and, of course, continuing to think about things like early years and contracted residential services. Across all teams, we’re aware of how important this time is — to not only respond and try and be helpful and relevant, but also to learn through the tracking and monitoring of what’s happening to children and youth in this province in these times.

You’ve been patient. I will be quiet now before we move on to the substance use report.

N. Simons (Chair): Thanks a lot, Jennifer. I appreciate that rundown.

L. Throness: Thank you, Jennifer. I appreciate your presentation.

Do you regard a COVID infection as a critical injury, and if so, how many critical injuries have there been?

[1:50 p.m.]

J. Charlesworth: Yes, we do. I’m going to refer to you, Carly, if you wouldn’t mind responding to the way in which your team addresses and codes COVID.

C. Hyman: Sure. We are including COVID infection as a critical injury. In addition to that, we’re currently monitoring, as part of the COVID response, any critical injury that makes reference to COVID. So where there’s an injury that’s unrelated to COVID — the injury itself might be unrelated to COVID or isn’t because the child has COVID — but their services are affected in one way or another as a result of the pandemic, we’re including those cases in our weekly COVID response summaries.

L. Throness: How many critical injuries have there been with regard to COVID effects?

C. Hyman: I don’t know the number offhand, but if you don’t mind, I could send a note and see if I could confirm that in the next couple of minutes.

L. Throness: Can I ask another question, Chair?

You mentioned court availability as being an issue. I’ve found it to be an issue in my riding, as well, where a person was denied access for a family law issue. Are you able to intervene with the courts or somehow get things moving if there is an issue that we encounter here?

J. Charlesworth: Good question. We don’t have jurisdiction over the courts, so we would not be able to compel or intervene in any way. Having said that, our advocates try and assist callers to point them in the right direction.

I’m going to ask you, Blair, if you wouldn’t mind, because that is coming up primarily in the advocacy world that we’re seeing access to courts being an issue.

B. Mitchell: Thanks, Laurie. Where we have some involvement where a family could be involved with court, we would have the involvement by way of MCFD being involved. If it’s just a strict family law matter, we wouldn’t be able to intervene because we have no jurisdiction in family law.

Where it intersects with MCFD, then we would be still pursuing advocacy on behalf of the children or child with regard to services and supports that they might require, especially at a time…. If there are some unresolved court issues and, perhaps, heightened conflict and tension, then we would certainly, like in any other time, be bringing that forward to the social worker to see what creative ways they can find to try and support the child, whether it’s through counselling or some sort of therapy that could help them.

That, of course, again right now is being exacerbated by the situation we find ourselves in. But we’d be looking for MCFD to try and find some of those solutions to support young people.

L. Throness: Thank you. Just one more question, if I could?

N. Simons (Chair): Sure. Go ahead, Laurie.

L. Throness: MCFD has provided supports for daycare providers and also children with special needs and their parents. Can you comment on the efficacy and the adequacy of these supports that the government has provided in this time?

J. Charlesworth: With respect to child care or with respect to children and youth with special needs, Laurie?

L. Throness: With respect to daycare providers and with respect to children with special needs — both those categories.

J. Charlesworth: Okay. Hmm. The area of child care, or daycare, has not come up for us very much. We’ve been monitoring what’s happening, but it has not come up in our advocacy cases. It’s not come up…. I’m looking to Chelsea here.

You’re monitoring so closely, so please, if there are things you want to add. It’s not something that’s on our radar.

The children and youth with special needs, however, is very much on our radar, and I would say there are a number of areas that have come up. One of them, and it may relate to the child care too, is that it’s not evenly distributed across the province. There are inequities region by region in terms of what’s available.

There are situations in which their communication is not very good, either because families don’t know what they can tap into or how to tap into it or assumptions are made about their ability to access technology and those kinds of things. So the ability to even find out what’s available is difficult for many families, and then to access it is as disparate across. And it’s simply not enough.

[1:55 p.m.]

I will say that the cracks in the child and youth with special needs system that you know about are exacerbated in this time. So no, I don’t think that there’s enough being provided for children and youth and their families right now.

But I’m just going to look to you, Chelsea. Is there anything around child care that we should be mindful of that would help?

C. Turpin: We haven’t had any cases that have been at all related to child care come through. I would say that there has been a lot on respite specifically, but nothing really specifically to child care that’s come across our desk as of yet, although I will say that each week the tide changes in terms of what kind of recurring theme is related to what’s coming up for children and families. So it’s possible that it will come up, especially with some more recent announcements related to the supports that they’re going to be providing to daycare service workers.

We’ve certainly noticed that week to week. The common denominator of what the issues are is fairly dynamic, but there’s a theme in each week. For instance, CYSN has come up two weeks in a row, and the numbers have been high in those areas, whereas young adult services was high for two weeks both across CID and with advocacy. So not to say that it won’t come up, but it hasn’t yet.

J. Charlesworth: If I may, I’d be remiss if I didn’t say this. There has been a lot of focus on autism support services, and I think it’s really important that we remember that every child with special needs in this province is being impacted in these times. It’s really important that we take that broad view of families that are under stress as they deal with children with a whole variety of neurocognitive developmental needs. So I appreciate your question.

C. Hyman: Can I provide a clarification to Laurie’s earlier question?

N. Simons (Chair): Sure.

C. Hyman: Thanks. I was just informed by the team that we’ve received two reports where a child was diagnosed with COVID. Both of those reports were coded as not critical injuries because, thankfully, the children recovered in less than a week. To be coded as critical injuries, it requires long-term impairment.

N. Simons (Chair): Thank you for that clarification.

I have a question, and I don’t see anyone on the list right now. My question, Jennifer: has there been anything that’s surprised you as you’ve heard the anecdotes or seen the statistics or read the accounts since this crisis began?

J. Charlesworth: I guess one of the things…. Maybe it’s showing my age, but I think one of the things that surprised me — and I’m going to turn to the other members of the team because we’ve all got different vantage points in this — is how critically important technology is. I should have known that, but I didn’t really get it.

One of the things that has come up is a recognition that for many young people, this is where the intersection…. You’ve got young people who have multiple needs. They’ve got complex needs. They also have a history of poverty or are living in poverty, unstable housing and whatnot, and they simply don’t have access to technology. Right now this can be a lifeline for young people.

It’s one of those things. Some of the youth advocates themselves have said, historically, that the kind of technology a young person might get would be simply sort of a burner phone or a kind of old technology recycled and whatnot, but it doesn’t allow them to actually stay connected or access the kind of information that they need. So the importance of technology has been really critically important and recognizing that it’s not ubiquitous. Not all families, especially families living in poverty or in rural and remote, have access to it, yet right now it can be a significant lifeline. That was one thing that really stuck out for me that I was surprised about.

I do have to say, too, that I’m not entirely surprised, but I’ve been inspired by the creativity and how quickly people have pivoted. This kind of gets to that I have been surprised at how quickly government has moved on a number of things. You know, it’s like we’ve been acting in unique ways.

[2:00 p.m.]

As many of us know, sometimes we get frustrated because it seems to take forever for policy changes and shifts to happen, yet it’s like sometimes it can happen in a week. It really teaches us that we can we can do a tremendous amount, and we can iterate and can hold space for it not working very well and getting it better the next week. I think that’s been the lightbulb observation.

Those are just a couple things, but I’m going to look to other members of the team because we’ve all been immersed in COVID. We think COVID 24-7.

Alan or Blair, Carly, Alix, Chelsea, do you want to add — yes, no?

N. Simons (Chair): I’ll just say that I got to participate in a family case conference via Zoom regarding a couple of young kids who were going to be in a youth agreement. The ministry workers were adjusting to the new situation quite well, from what I saw.

Did anyone else want to ask? I’ve got two people on the speakers list, and that starts with Rachna.

R. Singh: Thank you, Jennifer, great information.

On the technology part, we know that COVID has made us realize the importance of technology. We all are learning something new every day. I just want to…. Do you have any information about the youth obviously having no access to technology, which I’m sure the government is providing them with? But also, with the skills, is some kind of effort being made to make them technically savvy as well? What efforts are there? I would really like to know.

J. Charlesworth: Mm-hmm. That’s a good question. I don’t know. I’m going to look to you, Chelsea, because you might have your finger on the pulse. I haven’t heard of anything that says: “Here is some technology, and here is some coaching on how to use that.” I do understand that that has happened somewhat for families where they’re trying to use technology for virtual family visitations, for example, between children who are in care and their family members, and there’s been a bit of coaching there. But not for young people.

I should say that I’m not sure that young people are getting the technology that they need right now, let alone the coaching once they get the technology. It is one of the things that actually not only ourselves but the First Nations Leadership Council has specifically identified. They want to make sure that technology is distributed, made available and supported in terms of access to minutes or Internet, etc. and that it actually gets monitored — how the intentions are actually realized in the spread of this material. So that’s really important. I would say that we’ve got some work to do.

Chelsea, was there anything else that you’ve heard with respect to technology?

C. Turpin: I would just add that I think young people, for the most part, are really adaptable, related to technology, and are often the ones to show us how to use technology. Our biggest concern right now would be that communication isn’t being funnelled through technology directly to young people.

Like Jennifer was saying when she mentioned different advocacy reports and concerns related to policy changes and access to services, that information isn’t getting to young people and, therefore, the technology isn’t being leveraged. So young people aren’t getting the message.

N. Simons (Chair): Thank you, Chelsea.

Thanks for that question, Rachna.

Ronna-Rae.

R. Leonard: I, too, appreciate all of the in-depth reporting that we’re hearing today.

The question that I have also relates to technology. If we’re going to talk about COVID, it seems that’s where we always have to go to. I actually have started to get a couple of constituent calls, or emails — technology, virtual connections — saying that their kids are being bullied on line. As much as we’re pushing people into the technology piece of it…. What’s the role of your office in terms of having some impact on trying to limit the spread of bullying that can happen on line?

J. Charlesworth: What a great question. We haven’t…. You raise a good question that I don’t have an answer for. It’s an important one for us to consider.

[2:05 p.m.]

Our social media campaigns have actually been quite successful. We’ve had more reach than we’ve ever had. So it is an area that we can leverage through social media. We actually have a social media youth team. Young people, including young people with lived expertise, who are assisting us have actually designed the latest campaign that’s going out. It’s a harm reduction campaign for youth who use substances. So we can certainly bring it back to them. I think that would be….

That’s Chelsea’s great suggestion. Thank you very much, Chelsea.

I think that’s a really good point. You know, it’s interesting, because I think…. Forgive me for a moment. We talk about sort of three phases in this journey that we’re on. The first was resolve. It’s like, okay, got to roll up the sleeves. Got to get the job done. Pivot. Get people into using technology, doing things virtually. Figure out how we’re going to do our services differently and all that kind of stuff. There was that intensive effort.

We’re in that kind of middle stage, where there’s tremendous uncertainty. We call it the resilience stage. It’s hard. We have to find our resilience to keep going and to figure out what it is we need to do differently and to kind of keep it together.

Then the third stage, by the way, is the reimagining, because we aren’t ever going to go back to the way things were. So we have to reimagine how we do our work and what our office looks like as well as how all services are provided to children and youth.

But I think your point about the bullying reflects what we are seeing, generally, which is that the fatigue, the stress, the fear is showing up in ways that are not particularly helpful to families or to young people. There is more of that kind of nastiness that’s showing up. Unfortunately, south of the border, that nastiness gets almost lauded.

It’s a little bit of a digression, Ronna-Rae, but I think you’re raising a good point. It’s probably something we may see more of, given where we’re at in this really difficult time.

We’ve done some anti-bullying work through the social media youth team, so we can definitely bring that back to them and ask for their wise counsel, along with Chelsea’s team.

R. Leonard: The other piece of it, apart from bullying, is the predatory aspect.

J. Charlesworth: Oh yes.

R. Leonard: I just don’t want to lose…. All of those nasty things that come along with the good stuff.

J. Charlesworth: Yes. You raise, in terms of the predatory nature and sexual exploitation…. It’s something we are seeing in our critical injury and death reports.

Chelsea or Carly, if you’d like to add anything on that.

It is of huge concern to us, because we know that more time on line means that we are going to see more of that kind of predatory behaviour. Unfortunately, those folks are very sophisticated and know how to do their dreadful business in vicious and terrible ways.

We’re also seeing that kind of predatory behaviour happen in places like the camps or when people are feeling lost and the substances are there or they’re otherwise marginalized. On the streets, you see those folks move in. They’ve got, like, beacons. They hone in on those young people, and the exploitation is very worrying to us.

With respect to the predatory behaviour, that was another thing that’s on our list of things to start to raise awareness on and to monitor. So thank you for that.

Carly, is there anything you wanted to add around the sexual exploitation, predatory behaviour that we’re seeing?

C. Hyman: I think you captured it well, Jennifer. As you said, actually, these are both conversations that we’ve had recently around bullying and encouraging young people not to be bystanders to bullying, and what messaging the RCY might be able to spread in that respect.

Just also concerning the increase, I would say the number of injuries that are reported around young women, in particular, being sexually exploited on line continues to be a concerning trend that we’re seeing.

[2:10 p.m.]

J. Charlesworth: Jeff, who is listening on line, just sent me a little note that there was a report in 2015 on cyberbullying that was done with the Office of the Information and Privacy Commissioner. It talked about empowering children and youth to be safe on line. So it’s a good time to dust that off and see what we need to pay attention to right now as we are facing an unprecedented situation.

N. Simons (Chair): Thanks, Jennifer. Let us know if we can amplify any of the messages that you want us to.

J. Charlesworth: Excellent.

N. Simons (Chair): Okay. I don’t see any more hands anywhere. Maybe we can move on. We’re a little bit behind schedule, but no one is going anywhere.

The second item on our agenda is the consideration of the Office of the Representative’s report, Youth Substance Use Services in B.C. It’s an update.

Go ahead, Jennifer. You have the floor.

Consideration of Representative
for Children and Youth Reports

Youth Substance Use Services in B.C.
– An Update

J. Charlesworth: I want to reintroduce you again to two members of our team, Alix Little and Shannon Clarke, who have been very actively involved in this. Shannon provided leadership in getting this report out.

This report was released in March, and it’s actually a follow-up to an RCY report entitled A Review of Youth Substance Use Services in B.C., which came out in 2016. It provided an overview of the types of substance use services available to youth and highlighted gaps in service. But it didn’t do the inventory that this report does.

And then, of course, as you know, we released Time to Listen: Youth Voices on Substance Use, sharing the voices of youth with lived experience of substance use and reviewing the substance use–related critical injury and death data.

One of the things that these reports recommended was the development and funding of a comprehensive system of substance use services capable of consistently meeting the needs of youth. The reports also highlighted the need for more youth-friendly substance use services and supports, particularly those that engage the young people in planning and meet them where they’re at.

Our latest report provides an update to the 2016 youth substance use service inventory. It also went further and shared the perspectives of service providers and highlighted service gaps and proposing opportunities for future research.

This is a new baseline of substance use services for youth, which will not only allow us to measure and publicly report on progress made by the Ministry of Mental Health and Addictions, the Ministry of Health and health authorities to improve access to information about youth substance use services, but I think, importantly, it also provides the Ministry of Mental Health and Addictions and the Ministry of Health with a baseline. They didn’t have this before.

We can tell you that this was a very difficult report to pull together because it was very hard to get the information. In fact, Shannon and her team did over 400 calls, as I recall, to gather information in person, over the phone.

The report assesses the availability and accessibility of publicly funded youth substance use services in B.C. available to youth under the age of 19 and for young adults. We should say that it doesn’t capture an assessment of the quality or the efficacy or the outcomes of these. It’s basically an inventory.

To give you a sense of how we did this, we developed and validated it using existing service inventories, so that’s bc211, 811, Kids Help Phone and our previous inventory. No one group had fulsome understanding, so it was a matter of kind of cobbling together these various pieces and then, as I said, reaching out individually to every service provider.

In total, 406 services are included in the inventory, representing 84 unique organizations. And the contacts were made between July and November of 2019. We confirmed the details with them, and we also made sure that the public bodies that are responsible, the health authorities and the Ministry of Health, also had an opportunity to go through. So just to be mindful that things have changed since November 2019 as well, but this was a point in time.

To identify the trends in substance use by the geographic region and within specific populations, we also took a look at RCY substance use–related injury in death reports as well as substance-related hospitalization data from Health, and then we compared that with the service inventory to identify potential service gaps in different geographic areas and for specific populations of young people.

[2:15 p.m.]

We not only have the inventory, but through this, we were able to make a number of overall findings about youth substance use services in the province.

This is where we get to the key findings. It’s a complicated system. There’s no centralized point for access to information. It had been a recommendation we put forward previously, but there is no centralized point. Service types vary tremendously by region, and the process to access each service is different for most service organizations. Ages served are also in the grey zone.

Then to further complicate the service landscape, service providers reported that youth are getting caught between two streams of funding — youth mental health services funded by MCFD and youth substance use services that are funded by Health. As you know well, many of the young people we are serving are facing complex needs and have a mental health and addiction and substance use issues happening simultaneously.

What this means is that youth with concurrent mental health and substance use concerns are unable to access either service due to eligibility criteria or a lack of staff training in concurrent disorders. The message is, “Oh, you’ve got a mental health concern and a substance use concern. Well, we’re actually a substance use organization; we can’t handle mental health concerns,” or conversely: “You have mental health concerns, substance use, but we’re a mental health service provider, and we don’t have the capacity to address your substance use issues.” That’s a significant concern. So it’s complicated.

The second finding was that opioid use is not the only concern. We’ve got a lot of focus on opioids, but it’s not the only substance of concern when we take a look at the substance-related hospitalization data. For youth up to age 23, the substances resulting in the most hospitalizations were coded as “other,” followed by alcohol, multiple substances, cannabinoids and, lastly, opioids. Also of note is that youth 19 to 23 are more than twice as likely as youth 18 and under to be hospitalized for substance use.

Some service providers reported that most of these they see are using alcohol and express that concern around media attention on the opioid crisis masks the need for alcohol-related services in B.C. I know that’s something that is coming up within the adult service area as well — that alcohol use is the most abused substance, and it’s getting masked in some cases. Service providers also reported that the majority of youth accessing services are actually poly-substance users, so they’re using multiple substances — alcohol, and, and, and. That’s an important thing for us, because we need to make sure that we’re addressing the kinds of issues that are before kids.

The third thing was that information about services is hard to come by. No surprise. We raised that before in Time to Listen. An important indicator of a youth-friendly service is the ability to get a voice on the phone the first time a call is made. However, our staff, when making calls to validate the inventory of services for their supports, found it very difficult to get someone on the phone. This was especially true for services provided directly by health authorities, which often direct callers to a switchboard or a voice mail system. We know that youth are not going to persevere, if they even have access to a phone and the minutes.

Our researchers themselves had to make several follow-up phone calls to both health authorities and contracted agencies before they were able to speak to someone who could give them information. So that was interesting.

The fourth finding was that the pathway within and between services isn’t linear, and many service providers spoke about the need for both harm reduction and recovery-oriented approaches to care and wanted to make sure that we didn’t lose sight. Overfocusing on one area and one type of substance can preclude focus on other areas, so really looking for that balance of harm reduction and recovery and seeing them as part of a continuum of possibilities.

Service providers spoke about the journey within and between services that needs to look different. Mainly, it needs to look different for individuals. It’s simply not a linear process.

[2:20 p.m.]

We need to understand that there needs to be a considerable amount of flexibility, allowing youth to move across or around the circle of support options and not requiring them to move lockstep along a predetermined continuum. The same goes for adults, actually.

The next finding was that youth-specific substance use services are limited. Most of these services are concentrated in the Lower Mainland, with very few available in northern B.C. or in smaller, more remote rural communities across the province. Even on Vancouver Island, there are no publicly funded residential substance use treatment beds. Some service types, such as the youth-specific supervised consumption sites, do not exist in B.C.

Service providers spoke about the need for a range of youth-specific supportive housing options for youth leaving treatment as well. We do see that — that it’s actually a critical time when a young person is leaving treatment and doesn’t have a stable placement to go to. That’s when they’re at huge risk, and oftentimes, they do not have good supportive housing options available.

These findings are concerning, because substance-related hospitalization rates in B.C. are higher for youth living in lower-income and rural and remote areas. When there is a lack of services and supports that are specific to substance use, then you end up seeing the increase in hospitalization, because what else is there. To add to that, for remote regions, substance-related hospitalizations for youth 18 and younger and for youth 19 to 23 are almost four times the rate for those age groups B.C.-wide. That does say that more reliance is on the hospital system.

The final one is that cultural safety training doesn’t necessarily mean culturally safe service. Most service providers reported they do have a policy around cultural safety training or say they’ve got policies and they put priority on diversity. However, some service providers said there is…. They expressed concerns about racism, stating that non-Indigenous services, particularly in northern B.C., are not culturally safe for First Nations, Métis, Inuit and urban Indigenous youth.

We see that in our own organization. It’s one thing to say that we’re moving towards cultural safety, but it’s always about how it is landing on the people for whom we should be trying to provide those services. When there are very few services in the first place, then there are concerns about it being able to adapt and be culturally safe.

A similar concern about racism was raised in relation to certain mainstream services in the interior of B.C. While some sites provided a one-stop-shop to access multiple services that are youth specific, they may not be culturally safe or appropriate for First Nations, Métis, Inuit and racialized young people. In fact, of the 408 services, only 11 are Indigenous-only service.

Service providers are doing what they can….

I should say that available service doesn’t mean accessible service. What we realized was that there are a number of services where they operate Monday to Friday, standard business hours, and that doesn’t necessarily meet the needs of children and youth. Wait times vary significantly. In fact, it was difficult for service providers to even tell us about the wait time because it varied so significantly.

I just want to end with: service providers are doing what they can. We were very impressed and appreciate the engagement of service providers. They’re trying to do the very best they can, and the limitations in their own services weren’t lost on them. They expressed frustration themselves about limited funding or narrow mandates or the divide between mental health and substance use services. Despite these frustrations, they were doing the best they could but also pointed out that that takes its toll over time and that staff burnout was an issue.

[2:25 p.m.]

A number of service providers are trying to move towards an “every door is an open door” model and meeting young people where they are at, but then that clashed with some situations in which referrals are being gate-kept, and it’s more difficult to access.

The next one, please. This illustrates the complexity. There’s a lot of different things going on. There’s a lot of different services, but then, how is it that they’re working together?

Just a couple things about findings by service type, the next slide. Counselling services — distributed around the province but limited capacity, including in small communities. They’re available, but oftentimes the counsellor is a 0.4 or a 0.2. Practitioners sometimes need to triage, and they turn young people away.

The next area is around intensive case management. There are six youth intensive case management services in the province, none in northern B.C. or the Fraser Valley and only one on southern Vancouver Island. There are three sites in the Interior and two in Vancouver, so some difficulties there in terms of access.

In terms of in-patient, there is…. We didn’t capture the hospital-based services, but there is one in-patient treatment centre that supports youth with concurrent disorders, and that’s Carlile Youth Concurrent Disorder Centre. It’s the only facility of its type, and it’s in North Vancouver.

For withdrawal management, there are nine sites in the province — one in Metro Vancouver, two in the north, one in the Fraser Valley, two in the Interior and three on the Island. Two of these are not live-in. They offer withdrawal management in an office, which is not necessarily the best modality.

Residential services — there are eight residential treatment facilities across the province. One of the eight sites is in the north, two are in the Interior, three in Metro Vancouver. The only site on Vancouver Island is a treatment program for families struggling with substance use, and it’s not available to youth to access treatment on their own.

One of these facilities is for male youth; another facility has two residences, one for male and one for female; and the other six are open to all gender identities. Further, three of the eight sites, including the family treatment program, are specifically for First Nations, Métis, Inuit and urban Indigenous children and youth.

Moving to the next slide, supportive recovery. Four sites in the province offer live-in supportive recovery — one in the Fraser Valley, two on Vancouver Island, one in Metro Vancouver. The four sites are available for youth either 13 to 19 or 16 to 24. There’s nothing in the north.

Harm reduction services are widespread, but they aren’t comprehensive. That’s another one that we found. We have called for consideration of very youth-specific services. We only have one example of a service provider having a safe injection room in its facility that could be used by youth. All others are primarily serving adults and are not youth-friendly or youth-safe spaces.

I’m just going to conclude here that one of the things we found of concern is the lack of youth-specific substance use services in northern B.C. as well as in rural and remote places across the province. Worth considering is the high potential for resource extraction and development in many of these same communities and the associated social costs. We definitely see an escalation of substance use, as you know.

Resource extraction, as you know, has had family stress, domestic violence and substance use amongst the industry workers, and it’s inevitable that it will ripple out into young people, either through expectation and then the attachment to substance use. We think this is an important consideration for future work.

[2:30 p.m.]

The other areas that we are interested in going forward is how effective these services are, and it’s important that we take a look at what the efficacy of these services is and if they’re actually meeting the needs of children and youth. We also didn’t take a look at the complex interplay of substance use services and all the other social determinants. That can either hinder or support a young person’s access.

So there are some areas for further research, but at this point, what this enables us to do is to track the progress that the Ministry of Mental Health and Addictions is making, and the Ministry of Health, to improve access both to the information but also on services.

I will conclude my presentation, and we’re open to questions. I will be tapping into Shannon and Alix for support there.

N. Simons (Chair): Thank you very much, Jennifer, for that report.

I have a speakers list. I’ll start with Laurie, then followed by Adam.

L. Throness: Thank you for your report. I think this is really good work. Just to have a list of available services is really powerful, and that will really help parents. So I thank you for doing that.

In a future iteration, I would hope that you might include private services as well, because many parents can afford to pay and would love to pay if they could find services for their children. I would just put that as a suggestion.

I have a question about it, and then I have one other question. My question is about the number of beds. The number of residential treatment beds or, say, day treatment spots was not included in the report. Did you record that?

J. Charlesworth: Yes, definitely.

Shannon or Alix, would you like to…?

S. Clarke: Yes, we do have a full list of the number of beds at each of the sites that do offer live-in treatment. We just didn’t include those details as part of the inventory that was released publicly. But we did send the full list of all of the extra data we collected to health authorities and the ministry so that they can use that information for their planning purposes.

L. Throness: Great. Perhaps, Jennifer, this could be sent around to the committee, just so that we know the scale that there is.

The second question that I had. A few years ago several of us MLAs who were concerned about addictions met with Evan Wood, who was, at the time, the head of addictions treatment services in Coastal Health. He said that the landscape is changing — that harm reduction has been emphasized heavily in the past, but the landscape is changing so there’s an acknowledgement that there needs to be more of an emphasis on recovery. I don’t see that emphasis in this report. I see the opposite.

When I see things like, on page 6, “recovery as an option,” or on page 7, in the text boxes there, that “abstinence may not always be the end goal,” or that “for some, this includes recovery or abstinence,” I feel quite discouraged by that. I think: is there ever a situation in which a child would remain an alcoholic and that would be considered an acceptable outcome? I just can’t see that. I wonder if you would comment on that.

J. Charlesworth: Mm-hmm. Okay. Well, thank you for that question.

I think one of the things that…. When we talk about harm reduction, we’re mindful that the most important thing is that we stay connected to young people and that we’re providing the services and supports. Sometimes if we move too quickly or if we set out a timeline or a journey and impose that on young people, that’s not going to work. So we need to figure out what is going on in their lives right now and where is it that we meet them.

Of course we don’t want somebody to be growing up doing harmful things to their body. But we also don’t want to lose them. We want to stay connected with them so that we can support them as they are learning about themselves, growing up, figuring their lives out and then beginning to access some of the services and supports that might move them towards a healthier outcome.

I think the emphasis on harm reduction has been necessary because we have to, first, connect with young people. We have to meet where they’re at, and we have to recognize that sometimes people use substances, youth use substances, because there’s a whole bunch of other stuff going on in their lives.

As we learned from the Time to Listen report, most youth use because they’re numbing emotional pain. They’ve experienced trauma. They’ve experienced violence in their lives, abuse — all those kinds of things that roll up into trauma. And they’re using substances for a reason.

[2:35 p.m.]

So until we can address some of the other underlying concerns, how can we expect that they’re going to give up their crutch, if you will, or their coping mechanism? We have to help them and engage and then move towards having more enhanced coping mechanisms that perhaps don’t include substances.

I think one of the things that we’ve tried to speak about here is that it is important to recognize we need the array of services. Harm reduction is part of it, recovery, abstinence. There’s a whole range of things, and what we need to do is have that robust array, meet kids where they’re at and kind of help them move along their journey.

I don’t know if that answers your question — or if you wanted to add some more, Alix or Shannon. It certainly came up in the feedback that you got from service providers.

L. Throness: I do appreciate what you said, and I agree with you to an extent. I think part of it is the short-term view versus the long-term view. So in the short term, yes, we have to engage young people and that may require harm reduction. But in the long view…. What do we take as a long view for children?

We are dealing with addictions more and more as a disease. If you are in the hospital for any disease, even a chronic disease like diabetes or Crohn’s or something like that, you may have to live with it, but the idea is that someday you would be freed from that. So it would be my hope that in the future the RCY would emphasize freedom from addiction and maximum potential for youth in the long term, for their whole lives, which I think is the healthiest option for children.

I would just leave you with that comment.

N. Simons (Chair): Thank you, Laurie. I appreciate that.

I don’t see any other questions.

I have a question, Jennifer, if I may, about incarcerated youth. I’m just wondering if you’ve had an opportunity to scan the situation that young people who are in custody might be facing.

J. Charlesworth: Well, there’s no greater expert in this than Alan. So you’re on, Alan.

A. Markwart: Actually, the level of…. Well, number one, the prevalence of addictions issues among incarcerated youth is very, very high, and therefore, the needs are very high. In terms of access to treatment, there’s actually far greater access to counselling and treatment services in the youth justice system than there is in the non–youth justice public system. There are, for example, addictions counsellors in the youth custody centres. There are, I believe, five community residential addictions treatment programs around the province where youth attend as a condition of probation or conditional release.

It’s actually something of a sad comment that you can get better access to not only addictions treatment but also to mental health treatment if you commit a serious criminal offence, rather than otherwise.

I hope that answers your question.

N. Simons (Chair): It does, actually. I just remember that when I was in the field, some parents would say, “Well, I want them charged this time so I can get them into whatever treatment” — and what have you. It was a pretty tough situation for parents to be put in when they can’t access the services in a non–custodial way or a non–criminal justice way. Thank you for pointing that out.

My other question, Jennifer, is: have ministries looked at your update? Is there any indication of potential direction there?

J. Charlesworth: Well, I wanted to pick up on what Shannon said earlier — that, in fact, the public report has just got a fraction of the information that was collected.

Shannon, you’ll have to remind me how many other data points and fields we collected — but a lot.

What we did was packaged that up so that all of the ministries that have a stake in this received a very comprehensive package with….

Again, Shannon, please let me know how many additional fields there were.

[2:40 p.m.]

We specifically said that this was being provided to them to inform their planning and their decision-making going forward, and the feedback from the ministries was that this was extremely helpful to them.

So 32 additional fields of information — everything from the number of beds that you asked a question about, Laurie, to all the different ways that you access the services, etc., the kinds of treatment modalities. One of the reasons we released it was that we felt it was important that they have the information. We actually consulted with the ministries to find out, in this time of a pandemic, if this is important. Basically, the message was: “We have two public health crises — on COVID and substance use, the toxic drug supply. So yes, please, send it on, and we will work with it.”

We haven’t asked them for an action plan, or anything like that. We actually have those with respect to the Time to Listen report, but we will certainly follow up. And I’ll point you to, on our website that we released this week, the annual review of progress towards the recommendations in the Time to Listen report. We rated the work they were doing and how they were moving forward, and that included things like the array of services, access to information, centralized access, that kind of thing. So we have recently evaluated their performance and will continue to do so.

Just so you know, we will prepare the package with the more robust array of information for you and get that out through Jennifer.

N. Simons (Chair): Thank you very much, Jennifer.

A. Olsen: Thank you for the report, and thank you for the update.

I did want to respond to Laurie’s comments. The overall desire to see the best outcomes for our children I think is really, really critically important. The gap that I see here is all over the province in the lack of access to the supports. I mean, what this report clearly shows is that the overall lack of access to supportive treatment options for youth is very, very lacking and that there are gaps in most places across the province, I’ll just say.

I wanted to emphasize that one of the ways we can support the overall well-being of our youth is by being strong advocates from this committee, going forward, that government invest in more supportive networks for youth to access treatment programs and programs that they need. Their doctors will determine…. At that point, people that are working with them will determine what the best course of a treatment plan is for them, and it will be different for each and every individual that goes through that process. I think our work here is to ensure there isn’t a child that needs it that doesn’t have it, in terms of access to a treatment program.

I just had one question with respect to some of the recent announcements from the COVID-19 investments that are being made in programs around the province. I recognize that this report has been drafted, and it’s now being presented to us, and then a lot has changed in just the last couple weeks. I’m wondering if you’ve seen any of the current programs…. I can’t think of any off the top of my head, but I wanted to ask if any of them start to address this and perhaps some work that might be done in order to get more resources to this area.

J. Charlesworth: Thank you for the question. Well, first of all, thank you. You’re absolutely right that what we need to focus in on is helping our young people have the best possible life outcome, and problematic substance use does not support that.

With respect to your question around the implications of COVID-19, I’m going to look to…. There are any number of us here. Advocacy will have a perspective.

Chelsea, you’ll have a perspective.

But one the things we are concerned about is that, for example, one of the main programs available, Ashnola at the Crossing — it’s up in Keremeos — has closed down. It was struggling before to get staff, but it’s been exacerbated.

[2:45 p.m.]

When we see that and then we see the young people being discharged back into their home communities where there’s very little available to deal with…. You know, if you have to go into a residential program, then your needs are pretty significant. The capacity of the community, especially smaller communities, to respond, especially smaller Indigenous communities…. They’re saying: “My goodness, if you come back, that is problematic for us.”

We are concerned about the lack of services for substance-using young people, and we’re very concerned about…. In fact, the deputy provincial health officer said that we need to remind young people that the most important thing right now, if they’re using substances, is to not use alone. We have to make sure they understand that they cannot be isolated at this time, and there are very few places to connect them to. I think we do have a significant concern right now, and it does show up in our critical injuries.

I’m going to turn to Chelsea, Blair, Carly, because you may have some perspectives from children and youth particularly.

B. Mitchell: Just to say that people are being as creative and flexible, I think, as they possibly can, Adam. I think one of the things that we can learn from this process is where we are finding innovation through service delivery, and is this happening curbside to people connecting in different ways, like we’re doing today. I do think there’s innovation that hopefully we can learn about how we support people with substance use.

Certainly, the impact is, as Jennifer has pointed out, that we’re seeing some services not being offered.

J. Charlesworth: Shannon, you just wanted to let them know about the First Nations Health Authority.

S. Clarke: Oh, just a note that the First Nations Health Authority was interested in the full range of data we collected so that they could reach out to service providers themselves to find out how they’re dealing with COVID-19 and whether or not they’re able to maintain their level of service.

Of course, we released this inventory, and then things are rapidly changing. It’s great that FNHA is hoping to follow up. I’m not sure about the other health authorities, but FNHA for sure.

N. Simons (Chair): Okay, I don’t have anyone else on the speakers list.

I think it’s time to say thank you very much to all of you for being here. It’s nice to see your faces. I look forward to seeing you face to face in the real world again. Thanks for all you do, and we’ll see you next time.

Maybe the committee wants to take a minute?

J. Charlesworth: Thank you for the work you’re doing too. This is a really difficult times, so I appreciate the work. Take care.

N. Simons (Chair): All right. Let’s take a one-minute recess or something, or is that worth it?

Yeah, we can do that. Okay. We’re going to take a recess for four minutes, please.

The committee recessed from 2:48 p.m. to 2:52 p.m.

[N. Simons in the chair.]

Deliberations

N. Simons (Chair): Welcome back, committee members. Thank you for all the questions you had for our presenters today. They were good questions. I think it went a little longer than I expected, but we’ll work on the timing issue.

For now, I believe it’s…. We have some deliberations to undertake, and it’s best that we go in camera. I seek a motion to do so.

M. Stilwell (Deputy Chair): I’d like to make that mo­tion to go in camera, Chair.

N. Simons (Chair): Thank you, Deputy. We are in camera, almost.

The committee continued in camera from 2:52 p.m. to 3:02 p.m.

[N. Simons in the chair.]

Committee Report to the House

ANNUAL REPORT 2019-20

N. Simons (Chair): Welcome back to the public portion of our deliberations. I ask Michelle, our Deputy, to move a motion to accept our report.

M. Stilwell (Deputy Chair): Thank you, Chair.

I move:

[That the Select Standing Committee on Children and Youth approve and adopt the report entitled Annual Report 2019-20 as amended today, and further, that the Committee authorize the Chair and Deputy Chair to work with Committee staff to finalize any further editorial changes to complete the supporting text.]

N. Simons (Chair): All those in favour of this motion, please indicate by checking on the “yes” mark next to your name.

All those indicating no, please check on the X mark next to your name.

The vote is seven yes, zero no. Let the record show. Thank you very much.

Motion approved.

N. Simons (Chair): We have a second motion to be presented by Ronna-Rae.

R. Leonard: I move:

[That the Chair of the Select Standing Committee on Children and Youth deposit a copy of the report entitled Annual Report 2019-20 with the Clerk of the Legislative Assembly; and further, that upon resumption of the sittings of the House, or at the next following session, the Chair present the report to the Legislative Assembly at the earliest available opportunity.]

N. Simons (Chair): Thank you, Ronna-Rae.

Could all those voting yes please indicate the “yes” next to their name, and those indicating “no,” the X mark next to their name.

It looks like the “yes” have it again.

Motion approved.

N. Simons (Chair): We have two motions that have been passed.

Jennifer, I look to you to see if there are further discussions to have today.

I look at my colleagues. I miss seeing you. Seriously, I look forward to it, and it’s nice to talk to you today. Be well. Stay healthy.

Thanks, Katey. Thanks, Jennifer. Thanks everybody at the Clerk’s office and in Hansard. Until the next time.

We need a motion to adjourn.

Another unanimous vote. Thanks, everybody.

The committee adjourned at 3:05 p.m.