The committee met at 9 a.m.

[N. Sharma in the chair.]

N. Sharma (Chair): Welcome, everybody, to day 3 of this week of our hearings for the Health Committee.

I want to start by acknowledging that we’re all gathered today on the traditional territory of the Musqueam, Squamish and Tsleil-Waututh people.

We have some members on the phone, so I’ll just invite them to reflect on the territory that they’re on — that we guide our work and think about that as we proceed.

This morning we have Jasmine Bradley, executive director of communications and public affairs at E-Comm 9-1-1.

I just want to welcome you, on behalf of the committee. We’re looking forward to learning from you. You have about 20 minutes, and then we’ll have 40 minutes of questions and answers after that.

Briefings on
Drug Toxicity and Overdoses

E-COMM 9-1-1

J. Bradley: Thank you for the opportunity to present to the Select Standing Committee on Health, as you examine the urgent and ongoing illicit drug toxicity and overdose crisis. On behalf of E-Comm 9-1-1, I’m pleased to be here and look forward to our time together.

I’ll briefly offer some background, first, on our organization — how the system currently works and deals with emergency calls, including overdoses — and provide some insight into opportunities that E-Comm believes will strongly help to improve the service, moving forward into the future. Let me begin with some background information on E-Comm.

Municipalities and public safety agencies in the Lower Mainland established E-Comm in 1997 under the provincial Emergency Communications Corporations Act. It was formed in response to the 1994 Stanley Cup riots in Vancouver, when police, fire and ambulance first responders were unable to communicate as a result of incompatible radio systems. How appropriate: a hockey game, a very Canadian story, and the start to E-Comm.

Initially, after being formed, we had three primary lines of business: operating an integrated regional radio system used by police, fire and ambulance agencies throughout the Lower Mainland; providing dispatch centre services for several Lower Mainland police and fire departments; as well as answering 911 calls, originally just for the Metro Vancouver regional district. Since 1994, E-Comm has grown significantly, and we’re now the first point of contact for 99 percent of 911 callers in British Columbia.

If you dial 911 in the areas that we serve, your call will first come to an E-Comm 9-1-1 call taker. We will triage those calls to the requested police, fire or ambulance agency that’s asked for. Out of the 911 calls that we answer, 65 percent are to police, 5 percent are to fire, and 30 percent are to ambulance.

I think it’s important to emphasize at this point that in terms of dispatch services, E-Comm doesn’t dispatch for the B.C. Ambulance Service. That’s done by B.C. emergency health services. Therefore, we don’t have a significant role and/or impact on how these calls, in particular, are handled. When a caller dials 911, we’ll ask if they need police, fire or ambulance. In the case of overdose calls, these will likely go to B.C. emergency health services. At that point, we disconnect from the call and go on to answer other incoming emergency calls.

In particular, while we obtain detailed data of our overall call volumes and response times, we don’t track the type of health emergency for calls that are transferred to BCEHS — such as, for example, overdose calls. Instead, data on overdose calls is maintained by BCEHS. We understand that this committee will be hearing from their organization, so we’ll allow them to provide specific data on overdose calls.

Given that, what I can speak to is the overall increase in demand and strain on emergency services in general, in terms of those initial 911 calls that are coming through our centre, which does include overdose calls. We know, from BCEHS’s public reporting, that the opioid crisis is significantly adding to their 911 call volumes. Indeed, it’s just one of many factors that we’re facing at E-Comm and that are significantly increasing our overall call volumes and impacting the service.

[9:05 a.m.]

I’m sure all of you have heard in the news of the challenges with B.C.’s 911 system over the past year. I’d like to take some time to explain some of those challenges and then offer insight into how we can improve this system and offer British Columbians the level of service that they deserve.

E-Comm provides 911 services. We answer 99 percent of 911 calls in B.C. That breaks down to us providing service to 25 out of the 27 regional districts in the province.

Nearly a quarter of the province’s land does not have 911 service. This includes the Stikine region; much of the North Coast regional district outside of Prince Rupert, including Haida Gwaii; the entire Central Coast regional district, including Bella Coola; parts of the Northern Rockies regional municipality; and parts of the otherwise served regional districts, particularly Indigenous communities. This means that if someone is overdosing in these unserviced regions, they have no access to emergency services.

In addition, even where 911 is available, the lack of cellular coverage in many parts of B.C. due to our geography continues to limit access to 911 services. Further, it is our opinion that the lack of consistent, provincewide standards for 911 in B.C. increases the risk of service disparities.

The governance structure is based on E-Comm’s original Lower Mainland radio systems shareholders and is not reflective of our subsequent expanded provincial footprint. For example, nearly all of E-Comm’s municipal and public safety agency shareholders and board of directors are based in the Lower Mainland, despite the fact that our organization serves the broader province.

We work with more than 100 different public safety organizations and agencies, each with varying needs, resources and requirements. Finding agreement can be challenging and has resulted in differing processes, procedures and service level agreements between regional districts and individual police and fire departments. This makes it very resource-intense and slow to evolve 911 emergency communications in B.C. and is a major roadblock to improvements in the face of all challenges.

A further challenge facing the system is the fact that B.C.’s 911 emergency communications system is more than 30 years old and increasingly at risk of failure. Calls to 911 are directed through special infrastructure dedicated to emergency communications and are not part of the regular telephony network. Because this infrastructure has not been updated anywhere in Canada, it has, in particular, not yet been migrated over to the new Internet protocol or digital system in terms of the infrastructure itself.

These infrastructure improvements will be addressed as part of a project that is called next generation 911. I’ll go into detail in a moment on that project. The changed management for this is challenging, and it’s costly to implement and operate.

Finally, in terms of pressure on the system, 911 call volumes have been significantly increasing over the past few years, placing added pressure on call takers and first responders alike. This has been compounded in B.C. by a growing population, climate-related events, three states of emergency, the ongoing COVID-19 global pandemic and, of course, the opioid crisis, along with other complex mental health and social issues.

Last summer, during the June 2021 heat dome and subsequent wildfires and flooding…. The combination of these forces resulted in emergency services being strained to the breaking point. The busiest days in E-Comm’s 23 years of service occurred last year, at one point dropping to 81 percent of 911 calls being answered in five seconds or less. This is well below E-Comm’s nationally leading service standard of answering 95 percent of 911 calls within five seconds or less, although call response subsequently did improve to 91 percent by the end of 2021.

As elsewhere, the rise of cell phones has contributed to higher call volumes in B.C., as has significant population growth. Metro Vancouver alone is planning for a further one million new residents by 2050. As a result, call volumes will increase.

In the last quarter of 2021 alone, call volumes were 22 percent higher compared to the year prior, and we are projecting a further increase of 13 percent in 2022. In fact, heading into what traditionally is always the busiest time of year for E-Comm and emergency services….

[9:10 a.m.]

We’re very concerned about the number of emergency calls we might see this summer as our province moves towards a summer where COVID restrictions are no longer in place. Major gatherings can happen. The potential for other extreme weather events as well.

Simply put, demand and strain on the emergency services system has turned the extraordinary into the ordinary, and the challenges that we face and the need to strengthen the system are not going away. As we move forward and consider how E-Comm can work with other service providers, first responders in particular, there is an opportunity to improve the system. There is a little bit of light at the end of the tunnel. And this is next generation 911.

This is a federally mandated modernization of 911 networks and infrastructure across Canada. This will essentially allow our systems to adapt to new and emerging voice technology and messaging services by moving to a digital platform.

For example, if 88 percent of B.C. households have at least one cell phone and 80 percent of 911 calls come via cell phone, texting options will make 911 even more accessible. NG911 will significantly enhance 911 service in Canada by changing to IP-based networks that support modern, new features while ensuring that this lifesaving system remains effective, secure and resilient.

This shift will enhance accessibility by allowing greater access to the deaf, deafblind, hard of hearing and speech-impaired community, enabling people to text directly to 911. It also has the potential to expand and enhance the level of service provided to people in mental health crisis by more directly connecting community-based resources into the 911 system itself. This change will also help Indigenous communities and rural B.C. communities access the service the same way those in urban areas do already. This is a critically important shift that will ultimately help more British Columbians.

The CRTC has set a 2024 deadline to deliver NG911 services across Canada. To ensure a smooth and effective transition to NG911 here in B.C., E-Comm believes that there are two key actions required. One, the province needs to establish a provincial-level 911 authority and funding model for policy and standards of service. Two, we need to elevate police dispatch authority from the municipal to the provincial level, which will support a single, integrated provincial police call-taking and dispatch service.

These proposed changes are significant but are also needed to ensure a smooth transition to a better, more equitable and accessible service that will meet the needs of British Columbians and, hopefully, help save more lives that are unnecessarily lost to the opioid crisis every day.

NG911 will also evolve existing emergency services in ways that can and will help the toxic drug supply and opioid crisis, such as more precise information on location for callers, information that’s essential for effective and swift emergency response. The option to text 911 in addition to calling and sending images and video to 911 from the ground. Direct incident information transfer to first responders on the road so they are better prepared upon arrival for an overdose situation. Health condition–specific responses for complex social issues like mental health and addiction that removes the stigma of 911 for some vulnerable populations. New ways to triage and direct calls to services other than police, fire and ambulance.

Right now those are our three options. With next generation 911, it does provide the opportunity to look at a possible fourth option for more community-based supports.

Call transfer capabilities across the province and country is also going to be possible with next generation 911. I’m sure some of you have heard in the news of recent 911 network disruptions. With next generation 911, were that to happen, we would have more capabilities to ask other dispatch centres potentially — Calgary 911, as one example — to take incoming 911 calls for B.C. while that disruption occurs.

Different alerts based on incident that can trigger ultimate resource responses for different situations. And call trulySafe emergency service options, such as for Indigenous communities and other racialized and marginalized people.

These are just some examples of the benefits of NG911 that will improve how emergency service responds to opioid overdose and mental health and addiction–related calls to better address these types of incidents.

[9:15 a.m.]

What is the path forward? We believe that for B.C. to fully embrace the opportunity NG911 presents, it needs a provincial mandate. Eight provinces in Canada now have some form of provincial legislation governing 911 service delivery and standards. B.C. and Ontario are the only two that do not. In the past few months, Newfoundland and Labrador became the latest provinces to move to bringing responsibility for 911 service delivery under the provincial government, while Ontario announced significant new provincial investments of $208 million in 911 emergency response, including to help implement NG911.

From a standardization perspective, we believe calls such as those related to an overdose need a consistent approach and response. Currently, the system is fragmented across B.C., and if not remedied, this gap and divide between different communities across the province will only continue to grow. For example, we have separate health authorities, separate police departments and, in some regions, separate emergency communication centres that may all have different ways of responding to an overdose call.

E-Comm believes a new way of responding, one that is consistent and standardized, is key, moving forward. It is our view that this would include the consolidation of 911 and police call-taking and dispatch. For example, if you look at the two largest centres for opioid overdoses, Vancouver and Surrey, they illustrate the challenges I was just speaking to about the fragmented system in B.C.

For what is an invisible line for a person overdosing in these two cities, the response is quite different, because we have two different police structures — RCMP and municipal — two different dispatch centres and two different sets of standards and protocols around 911 call response. So even within Metro Vancouver and the examples I just provided of Vancouver and Surrey, we have inconsistencies that really should not exist.

In closing, the demands on 911 in B.C. are growing. The deadlines for NG911 improvements are quickly approaching, and we continue to see far too many deaths as a result of the toxic drug supply and the opioid crisis. I commend this committee for taking on this important work, and as you work toward identifying possible solutions from every aspect of the crisis, E-Comm is committed to working with you and doing all we can to support your efforts.

Our team cares deeply for the people we help every day. We are eager to be part of a solution, moving forward. E-Comm is grateful for the support and leadership of this important priority by all parties of the Legislature. I’m now happy to take any questions.

N. Sharma (Chair): Thank you so much, Jasmine.

All right. Committee members, any questions for Jasmine?

Go ahead, Pam.

P. Alexis: You talked about growth. Does the new system, next generation 911, have the ability to take on more clients? Obviously, we’re growing at a very rapid pace. Is there that capacity, and what is the plan for population growth, as far as E-Comm goes?

J. Bradley: The increased capacity with next gen 911 is significant. I think what’s most important about that potential, with the growth, is the ability to be able to extend that service across areas of province that currently don’t have access to 911. Because it is moving to a digital system, that ability to be able to expand the service into those areas is greatly enhanced. That’s where we see the biggest opportunity, in terms of that growth piece.

P. Alexis: So that’s one kind of growth.

Sorry, a follow-up, if I could.

Certainly, we’re looking at Surrey with over 1,000 people a month moving in. Is that system, just in those two centres that you spoke of initially, able to handle additional call volume, and what are your plans for that additional call volume? Are you looking at increasing your staff? Tell me about that.

J. Bradley: It’s a great question. From a technical perspective, NG911 will offer that increased capacity for growth that is going to be required. It doesn’t take away from the challenges that we are already having, in terms of staffing, in terms of the people power behind that.

What comes with that is the need for E-Comm to really look, closely with our partners, at different ways of doing the work that we do. How can we leverage technology in new ways so that we’re able to resource, from a people perspective, the call-takers and dispatchers we need? Perhaps technology plays a greater role in that, in terms of triaging some of the calls before they even get to a call-taker.

[9:20 a.m.]

For example, if I take the non-police, non-emergency line service that we provide to our police partners…. We estimate that about 40 percent of those calls coming through the non-emergency lines aren’t actually police matters and need to be redirected. It we take technology and put it into that picture and can get rid of that 40 percent, that will reduce the call line demand that is hitting our people.

That’s just one example, and it’s obviously not a 911 example. But looking at different ways we can automate more and triage calls differently…. It will never take away from the fact that we will need more people in order to meet the increasing demand. We don’t have enough people now to meet the demand that we’re seeing, let alone increasing demand over the years.

D. Davies: Thank you. Very informative. I’ve got a few little points here. Hopefully, I’ll try and squish them in all at once.

We’ve brought this up…. I sat on the other committee, to reform the Police Act. I know we had a couple of presentations by E-Comm. One of the big concerns…. I’ll start with a bit of a preamble, and then I’ll move to a couple of questions, if I might.

Of course, I represent one of those areas that has massive land that’s not covered by any 911, which is a big challenge. It’s a fact that there is no cell phone service. Often, there is no phone. There’s no Internet. So we have a lot of work to do, I think, before we even get to the point of expanding those services.

My question, I guess, around this new, next gen 911…. It sounds like we’re just kind of in the pre-stages — here in B.C., anyway — of getting this organized. You talked a little bit about federal mandate and funding. My first question is: what does the funding look like? Do you need mass amounts of provincial money? I believe E-Comm is a private company that provides the service. Is this being done, and the fees will go up? What does that funding look like, or how do you get — I imagine it’ll be quite expensive — that money piece sorted out?

J. Bradley: Great question. Currently E-Comm’s 911 call answer service is contracted to each of the 25 regional districts that we serve. Last year, the cost for that service across the board for our regional district partners was around the $7 million mark, but with next generation 911, this is going to go up significantly — in terms of tens of millions of dollars. It’s going to be a significant cost.

It’s our opinion that local government just simply does not have the ability to fund what we know is going to be a hefty price tag for this transition to next gen. That’s where our belief in a provincial mandate in terms of oversight for policy, for standardization purposes, but also for funding….

Right now local government doesn’t have the ability to leverage a wireless call answer levy in terms of funding 911 services. I mentioned that we answered more than two million 911 calls last year, and 80 percent of those came from cell phones. Currently, local government has the ability to fund 911 services through property taxes and land line clients or levies. But the significant users of the system are not funding that.

If I take my home, alone, between my work phone, my cell phone, my teenage kids’ phones, my husband’s, there are six cell phones that are all capable of calling 911 and using the system, but that’s not contributing towards the funding.

D. Davies: This is one of the things that I noticed. Our regional district went to E-Comm eight, nine, ten years ago or something like that. I know there were a lot of discussions and such, and I know this is one of the issues that I had with the system at the time. Our regional district paid for the service that they got, right? That’s why you got these different levels of service all across the province.

You identified the challenge. Municipalities, coming from a municipal background…. You know, you’re already talking tens of millions of dollars more. There is no way that the municipalities are going to be able to afford it.

[9:25 a.m.]

I’ll just follow up quickly. I have some others, but I’ll just let it go. Has there been some dialogue already with local governments, regional districts, to say that this is coming, and we’re working on getting this, moving forward? If so, and I assume so, what have those discussions been like?

J. Bradley: Yes, absolutely. E-Comm executive and board have been actively engaging with our regional district and municipal partners in terms of our advocacy around a provincial mandate for 911. There is a resounding support for moving in that direction.

I want to reference the fact that this idea of provincial oversight in terms of 911, specifically through a call answer levy for wireless, is something that has been brought forward numerous times. I know that you mentioned you were a part of those discussions. It’s been brought forward to UBCM as a resolution, and it has not passed.

E-Comm believes that now is the time that this should pass and will pass in terms of the support that’s needed, specifically because next generation 911 is coming. It’s federally mandated. This is not an option. It needs to happen in terms of moving to this new system, and the costs of that need to be covered.

We do have a UBCM resolution that will be put forward in September. Vancouver city council has supported that, and we will be moving that forward to the UBCM September convention, where we hope that, this time around, it will pass.

R. Leonard: Thank you very much for your presentation. I appreciate it. I could see that we could go really broad here and start talking about 911 generally. But because we’re talking about overdose deaths, I wanted to focus on a couple of things that you said that I’d just like you to respond to.

In the old days, I was in local government. I remember the decision-making process that we had to move to E-Comm 911, because it was going to be more expensive to stay local. Going back to that is not going to work. Whatever. The place that we’re concerned about now — and you’ve mentioned it — is the lack of that digital platform, at homes, for people to access 911.

It’s kind of a chicken-and-egg question I have. How can we go to a digital platform if it’s not going to serve certain parts of the community until we get…? We’re working hard to increase that capacity throughout the province, but how can we get there? I guess that’s the chicken-and-egg question.

The second question. You mentioned about the capacity of it to provide culturally safe services. I’m wondering why you can’t do that now. Or if you can, what is it that will be enhancing that service?

J. Bradley: Yes. I think I understand your chicken-and-egg question, but let me know if I’m not answering it directly.

The move to an IP-based digital system for next generation 911 can happen within our current service footprint. Where the opportunity with next generation exists is when the province is in a position and able to expand services in those areas that currently don’t have it. That system would be able to seamlessly move to provide 911 access in those areas, whereas with the current analog system, that is a lot more difficult and challenging.

When we roll out next generation 911, the two systems will exist simultaneously for a period of time. Then there will come a point where Telus will shut off the current system, and then we will operate fully on the IP-based next generation system. It would just be in the same footprint of where the services are available today. But we would be able to expand upon that service and offer it to other communities once the province is ready and Telus has built out that infrastructure to be able to allow that to happen.

Does that answer the chicken-and-egg question?

R. Leonard: Yeah. I have a little follow-up around the use of…. You’ve mentioned radio and land lines. I’m wondering if that’s the bridge piece. How much can we rely on old technology — which is what helped build communities in remote areas in the first place — to bridge that divide?

J. Bradley: Yeah. You brought up an interesting point about relying on the old technology. The system in B.C. is more than 30 years old. The technology is aging. It’s coming to its natural end of life. The recent service disruptions in terms of the 911 network that have been covered in the media lately….

[9:30 a.m.]

More of those situations are going to keep happening as the system continues to age. That’s where the reliance on the technology really does come into play, in terms of needing to move to that enhanced system, that digital system, for the redundancy, for the capacity, whether that is stabilizing the system itself or expanding that to offer it to other areas of the province.

In terms of the radio piece, it’s slightly different in terms of that it’s not operating on the same network or infrastructure or technology as the actual 911 network itself. Currently our radio system exists in Metro Vancouver and through to parts of the Fraser Valley, but that’s it.

I’m not aware of any discussions that have been happening in terms of expanding that further, but it is definitely part of our strategic plan in terms of our belief in having that interoperability and that capability for police, fire and ambulance, no matter where they are, to communicate seamlessly with each other. So it could go hand in hand there, but they’re not directly connected.

R. Leonard: And then the culturally safe services.

J. Bradley: Yes. That ties into more of the options that next gen 911 as a system would offer in terms of how we treat 911 calls when they’re coming in. Currently, they come in, and the only three options are: you send it to police, you send it to fire, or you send it to ambulance. We know that a vast majority of the mental health calls go to police. We know that a vast majority of the overdose calls go to ambulance.

Not to say that the three tri-services aren’t connected in responding together and supporting each other, but with next gen 911 and our ability to expand our model of response, it’s looking at: what could a fourth option be so that maybe not all of the mental health calls need to go to police? Notwithstanding the importance of making sure that police are involved in response where warranted, but looking at different, more community-based options for the mental health calls and for, potentially, those overdose calls as well and being able to offer that in a way that better supports the community.

Another piece around the culturally sensitive expansion of services could be opportunities like having a 911 centre established specifically for Indigenous communities that is staffed by Indigenous peoples as well, to offer more of that culturally sensitive response option for the people that are served in that area.

R. Leonard: And that requires this digital next-gen…?

J. Bradley: It makes that transition much easier to make happen, absolutely.

S. Chant: Thank you for your presentation. I appreciate it.

Two combined into one, I think. I’m hearing that right now — 25 areas, different ways of doing business…. Does that include the training of the dispatch folks as well?

J. Bradley: Yes, it does.

S. Chant: So each area is responsible for its own training, are they, or do they have standardized training?

They do not have a standardized training. Okay.

J. Bradley: That’s correct.

S. Chant: The other question around the culturally sensitive stuff is: do you have language options?

J. Bradley: We do have language options. We have a translation service that’s available 24-7 in more than 173 different languages. In situations requiring a translator to be on the line, it’s like a three-way calling scenario between the caller, our call taker and the translator.

S. Chant: Okay, very good. Thank you.

S. Bond (Deputy Chair): Thank you for being here. I think we recognize that the job of dispatch is not easy, and I think all of us need to recognize that during the very difficult times we face, particularly during the heat dome, I’m sure that people working to dispatch calls probably faced a lot of stress.

I appreciate your presentation. I’m wondering if…. I just have a couple of questions in sequence. Can you just articulate for us specifically what parts of the province E-Comm currently serves?

J. Bradley: Absolutely. First of all, thank you for your acknowledgement of the demand and strain that last year had on the call takers and dispatchers, E-Comm and others. Unprecedented is the way to describe that impact. It’s a demanding job on normal days. We still, at E-Comm, have staff who are on long-term leave because of the stress of last year.

[9:35 a.m.]

In fact, we currently have 34 percent fewer call takers than we did this time last year, partially due to the tight labour market and the challenges that, we know, many other organizations — including public safety organizations — are experiencing right now in recruiting and retaining staff, but also because of the number of staff we have on leave, which is of concern to our organization.

For the regional districts that we currently provide services to — I’m going by memory here — that includes the regional districts within Metro Vancouver. Our contract for the North is with Fraser–Fort George. There are four regional districts in that area. Our contract for the Interior is with the regional district of Central Okanagan. We also have the Fraser Valley.

Basically, of the areas in B.C. that have access to 911 services currently and that don’t fall under E-Comm’s service area, it’s Prince Rupert that has its own system and Nelson that has its own system. All other parts of British Columbia that have 911 service through Telus fall under E-Comm in terms of that provision of the service.

S. Bond (Deputy Chair): So expansion to a provincial system is not really overly substantive, because most of the province is covered. Is that accurate?

J. Bradley: There are some significant areas that do not. Let me just….

S. Bond (Deputy Chair): While you’re looking at that, I’m thinking about our circumstances. I believe, for example, that Prince George fire rescue still has dispatch. How does that fit with what you’re suggesting here?

J. Bradley: Currently, with the model, using Prince George as the example, E-Comm will answer that initial part of the 911 call. Our call taker will say, “911. Do you need police, fire or ambulance?” and will confirm their location. Then, for callers in Prince George, we will transfer those calls — similarly to how we handle requests for the ambulance service going to BCEHS — and disconnect once they’ve been accepted by a call taker.

S. Bond (Deputy Chair): So you’re not suggesting displacing fire rescue dispatch, for example, in a community like Prince George.

J. Bradley: No. E-Comm’s focus, at this point, is that we do see value — this aligns with the recommendations from the Special Committee on Reforming the Police Act — in terms of looking, in the future, to consolidating police emergency communications as well. Currently E-Comm does provide call-taking and dispatch service for 33 police agencies and 40 fire departments across B.C.

On the policing side, though — even using the Surrey and Vancouver overdose example that I was speaking to earlier — for Surrey, E-Comm will answer the 911 call, but then we transfer it to Surrey RCMP, or we transfer it to Surrey fire or to BCEHS. For Vancouver, we will transfer that 911 call to one of our police call takers and one of our fire call takers, because we dispatch for Vancouver police and fire.

S. Bond (Deputy Chair): But there’s always a secondary call, whether it’s to your dispatch or Surrey dispatch?

J. Bradley: Exactly.

S. Bond (Deputy Chair): I mean, I will just state my bias. I like having the local…. It is not unheard of to have people call, and people don’t know where we live. If you live in Dome Creek, British Columbia, there are people who don’t know where that is. I would rather have the hope that somebody who answers the phone actually knows what we’re talking about.

I guess my last question…. Chair, thanks for your indulgence here. Not in a partisan way, but what happened during the heat dome was absolutely devastating in this province — absolutely devastating. We are now heading into floods. I mean, we have people today who are facing floods. We’re probably going to face fire. Who knows whether we’ll face another heat dome? There was significant concern about the capability of E-Comm to respond at the time. We had two concurrent crises happening, basically, at that time.

I think it’s great that we’re talking about expansion. We need to make sure that the base works before we start adding other expectations. You say that there are 34 percent less call takers. Has enough change been made at E-Comm and elsewhere…?

I know that dispatchers were beside themselves with stress and worry. Maybe you can just speak to: are we ready? I, for one, think we need to have the base, making sure that it works effectively, before we contemplate taking on additional work. Maybe you could just speak to that.

[9:40 a.m.]

J. Bradley: Yeah. I’ll start answering your question by saying that the 911 system is designed for everyday emergencies. It’s not designed for extraordinary circumstances. But when the extraordinary becomes ordinary, that’s where the level of demand and strain that we saw last year, specifically with the heat dome, has an impact on the system.

I want to be clear that the entire emergency services system experienced that demand and strain. We are all in the same boat in terms of a tight labour market, in terms of recruitment and retention challenges, in terms of the fact that this is a demanding job, and it’s not for everybody. Looking to the summer, are we concerned? Yes, absolutely. I would say that all emergency services are concerned about what could potentially happen this summer in terms of extreme heat, in terms of increased call volumes.

Tourism is back. I remember hearing on the news that there was a cruise ship that needed to have aquabuses ferry back and forth because there just wasn’t any room at the docks. It’s busier here, and that means that 911 calls are going to be increasing. It means E-Comm is busier. It means our partners are busier.

What have we been able to do about that? We worked last year…. It’s very commonly known about the challenges on the system, the delays on 911, the delays that we experienced being able to transfer calls to the ambulance service who are experiencing the exact same challenges that E-Comm is in terms of staffing and resources. Together, B.C. EHS and E-Comm put into place a temporary call transfer procedure which allows us to disconnect from some of the calls that we would normally be waiting on the line for an ambulance call-taker to pick up — calls such as requests for an ETA on an ambulance, where there isn’t a need for an E-Comm 911 call-taker to stay on the line.

All of that, that temporary procedure, is helping to ensure that 911 calls are being answered as quickly as they can be. Currently we are answering 97 percent of the 911 calls this year so far in five seconds or less. Our target is 95 percent, so we are above that. But when volumes increase to the point that the number of incoming calls outnumber the number of staff that are available to answer those calls, that does become of concern.

S. Furstenau: Thank you so much. Just to echo Shirley’s words, I can’t even imagine what it has been like to be on the other end of those phone calls.

I’m interested about, again, coming back to the provincial role in trying to get the provincial standards, the provincial oversight. What I would say is equity of access, really, should be the goal. You identified that you’re bringing a resolution back to UBCM in the fall. There is currently a review and proposed overhaul of the legislation governing emergency management in B.C.

Are you engaged in conversations around that legislation. Is this where that would fall, in that legislation? Or would this be what the other eight provinces have that you identified having governing 911 standards? Is that separate legislation from emergency management, or can you be incorporated into what is happening in terms of that overhaul right now?

J. Bradley: That’s a very good question. I don’t have the answer. Those conversations are happening right now with government. I’m sorry. I don’t have that answer for you today.

S. Furstenau: Good for us to know.

D. Routley: Much of my question has already been asked. It reflects the concern over capacity. I wanted to say how pleased I am. We had Oliver Grüter-Andrew from E-Comm speak to us a few times on the police committee, as my friend Dan mentioned. I’m really, really pleased to hear so much of the report’s recommendations reflected in the kind of planning language that you’ve used here. It’s really reassuring to hear that. Thank you for that.

[9:45 a.m.]

That leads to my concern over the capacity and the load that’s being put on call-takers. We were told that it takes somewhere in the neighbourhood of 19 months to fully train a call-taker. At the same time, we’re asking for an expansion of the scope and a fourth option, as you referred to it. My concern is around recruitment and the ability to train and what steps are being taken to enhance recruitment, with the understanding that this is a problem in virtually every sector. Thank you very much for that.

J. Bradley: Thank you. It’s a good question.

In terms of recruitment, E-Comm has been aggressively recruiting for 911 call-takers and, at the same time, aggressively expanding our training capabilities as well. In terms of 911 call-takers, we do have a number of new hires who are coming through, also our summer student program, which is a great source of recruitment and talent for us, particularly over the summer months when this program is in place.

It does take close to a year for a police call-taker to really fully get up to speed, in terms of the job, and that is a separate role from the 911 call-taker. The staff will do both, but they will start as the 911 call-taker, and then they will move on and train to the police call-taker position. That does take close to a year, in terms of getting that person up to speed. It takes time. I think that that’s important. When we look at our recruitment, it does take time for those police call-takers to get up to speed there.

In terms of our provincial mandate, it’s really about…. Yes, expansion is part of the equation, in terms of the capability of expanding the system through next generation 911 expansion, based on our belief in the value of a consolidated model as part of E-Comm’s strategic plan.

Our provincial mandate really is applicable to the current service scope as well. It’s really meant to address the inconsistencies in terms of standardization, in terms of policy. I mentioned E-Comm has more than 100 different entities that it has to work with, in terms of those policies and standardizations, but having one overarching set of standards for the entire service area is where we believe there’s a need to move to.

Then also, in terms of the provincial mandate, the funding piece, in terms of…. As we talked about, local government just does not have the ability to be able to fund the service, particularly when we look at the costs that will come with next generation 911 — again, having that provincial funding oversight and looking at the models that the other provinces in Canada are using in terms of that, specifically being driven by the needs of next generation 911. That’s really driving a lot of the momentum behind our advocacy of this.

N. Sharma (Chair): Doug, you had a follow-up?

D. Routley: Yes, thank you.

Not a follow-up, but just a comment. I see reflected the language around, say, forestry, which I consider to be a really wonderful industry in so many ways, but sometimes the language around it can discourage people from choosing a career path. I think it can be true.

My friend Shirley mentioned, in a non-partisan way, reflecting on the challenges. Understanding that we do live in a competitive partisan environment, politically, I fully expect that she, as much as anyone, will be stern in her review and critical as the opposition should be.

I also hope that this opportunity for NG911 is something that will excite the imagination of young people who really will appreciate the progressive technical advancement of all that, and hopefully, you’ll be able to recruit people who have that kind of interest. I know that all of us will be doing our best to support that.

N. Sharma (Chair): I have a question for you. I wanted to dig a little bit deeper into the opioid crisis and the response — the role that you play and what that is.

[9:50 a.m.]

From what I understand from your presentation, if you receive a call of somebody that’s experiencing an overdose, you would pick up the phone but then transfer it to whatever the appropriate service is. Is that correct? Is that how it works?

J. Bradley: Yes, that’s correct.

N. Sharma (Chair): Okay. I wonder if you have any insight for this committee, particularly about responding to the opioid crisis, of what you think might be a better way to respond or adjust or something that would feed into what we think we would be recommending to the government when it comes to our response to this. Anything particular there?

J. Bradley: I’m a little limited in terms of what I can say around that simply because we don’t handle the overdose calls, specifically. Those do get transferred to B.C. emergency health services. On the fire dispatch side, the agencies, fire departments, that E-Comm dispatches for are often called out to those calls for assists.

Where the impact really does fall on E-Comm is just in terms of…. With overdose calls and the increase in overdose calls that we’re seeing, that means 911 call volumes are higher. So in 2021, when we know volumes reached historic highs, we know that within that, the Ambulance Service saw extraordinary increases in terms of their call volumes. Before that gets to Ambulance, it hits us. That’s the broader 911 piece there in terms of the impact.

Where we do see opportunities is really around looking at what alternative response measures could look like for those calls. I would have to defer to my friends at the Ambulance Service in terms of more specifics around what that might be and what that might look like. But it is connected into the capabilities with next generation 911 to offer something that goes beyond just the traditional police, fire and ambulance that could potentially help with the crisis in that regard.

N. Sharma (Chair): So the more flexible, what you were talking about, ways of looking at calls for really appropriate responses or community responses or engagements might come with the next generation technology in terms of response options.

J. Bradley: Exactly, yes. And the consistency of standards in terms of how those calls are responded to as well.

N. Sharma (Chair): Okay, thanks.

We have about eight minutes left and two more people that had questions. Let’s see if we can get them. We might want to have a little break in between our next speakers, but we’ll go….

Go ahead, Susie and Ronna-Rae.

S. Chant: Actually, I’m fine. Thank you.

R. Leonard: Just that last exchange brought up something for me. I don’t know about most people — I think it’s true — but you make a call, and you have to go through a menu to drill down to getting your needs met. When you dial 911, nobody expects that. The value of that human ability to respond is just so critical.

It makes me…. Since we’re on the record, and there’s an opportunity here, in terms of recruitment… It’s value. It’s such a valuable service and something that everybody in British Columbia values. There’s an opportunity here to just talk about that recruitment situation that Doug was referring to. What kinds of values and what kinds of talents and skills are you looking for when you’re seeking out your dispatch receivers?

J. Bradley: Great question. I wish a member of my people and culture team were here to answer it more eloquently than I can, but I’ll give it my best.

This is such critical work in terms of the services that are provided by 911 call-takers and dispatchers in terms of the importance of that role for public safety as a whole. It’s demanding work. It’s not for everybody. It’s fast-paced. It’s dynamic. It’s stressful. The ability to decompress after your shift, to not bring home with you what you’ve just gone through in a 12-hour period is challenging. It takes its impacts mentally and emotionally.

That’s why ensuring that we have the best mental health supports available to our staff, including trauma-informed counsellors and our critical incident stress debrief team, all of that, is critical to our organization and a priority for enhancing the current offerings that we have.

[9:55 a.m.]

This is purposeful work, so when I think about our staff and what drives them, it’s that purpose. It’s that being part of something bigger, and that’s important. It’s knowing that at the end of the day, after a 12-hour shift where you took some of the worst calls you’ve ever dealt with in your career — even on those hard days — what you’ve done has mattered and made a difference into the lives of people who have called for your help.

Our staff recognize that it might be the thousandth call that they have taken that comes in through the beep in their ear, but for that person, for that beep in their ear…. There’s a person at the other end of the line. For that person, this is potentially the worst day of their life. Having that empathy in order to really understand that, being able to take charge of the situation when it’s dynamic….

They’re not only looking out for the safety and well-being of the callers and the public; they’re looking out for the safety and well-being of our first-responder partners as well — wanting to make sure that when they arrive on scene, they know exactly what they’re walking into, for their own safety. It’s being able to multi-task and work quickly and really rising to the occasion. Even when I think about the challenges of last year, what continues to just amaze me is how our team really…. It sounds cliché, but it’s a family. We bonded together, and the staff were there to support each other.

Knowing E-Comm is understaffed and under-resourced and that our people are having to take on too much overtime…. They’re taking that overtime on because they know that it’s helping the public and our first responders, but it’s helping their colleagues as well. It’s important work, and that is really fully understood, and it shows up every day when I’m out on the floor and I see our people and how they’re doing. It’s incredible. It’s very fulfilling work, as well, at the end of the day.

N. Sharma (Chair): Thanks, Jasmine, on behalf of the committee.

I think you heard a lot of committee members just express how appreciative we are of the important work that the responders do for British Columbians across the province, as you said, at their time, when it could be the worst day of their life. I appreciate the toll that it’s taken on everybody. I just want to send that message to your crew — that you have a bunch of people that appreciate that work.

J. Bradley: Thank you very much. I’ll take that back.

N. Sharma (Chair): Thank you for coming and talking to us and helping us learn about the work that you’re doing.

We’ll start in about three minutes with the next round.

The committee recessed from 9:57 a.m. to 10:02 a.m.

[N. Sharma in the chair.]

N. Sharma (Chair): All right, friends. We’re going to get started now. Our next guest is Jonny Morris from the Canadian Mental Health Association, B.C. division.

Welcome, Jonny. We all have your presentation on our screens, through SharePoint, so we’ll be able to follow along that way. You have about 20 minutes to present, and then we’ll leave 40 minutes for questions and answers. We’ll pass it over to you.

CANADIAN MENTAL HEALTH
ASSOCIATION, B.C. DIVISION

J. Morris: Great. Thank you so much, Chair.

It’s an honour to be here and a pleasure to be here and a privilege to have been invited to present to a committee that’s undertaking such significant and important analysis, work, heavy lifting, in subsequent recommendations around a profound and devastating loss of life that we’re seeing across the province right now.

I do want to acknowledge that I’m joining you here today on the unceded, unsurrendered, ancestral Tsleil-Waututh, Musqueam and Squamish territories and am very privileged to be doing that this morning with you.

I’ve read the materials you’ve had presented to you as a committee in the lead-up to today. You’ve received a lot of data, a lot of data about lives lost, a profound loss across this province, across many, many communities. I think it’s just so important to preface my comments with an acknowledgment of those losses and the fact that currently there are hundreds, if not thousands, of people grieving across the province from multiple kinds of losses, not only drug poisoning–related losses but suicide-related losses, heat dome–related losses.

There is a profound time of loss right now. Sometimes statistics can desensitize us, I think, to the gravity of the undertaking that you have in front of you as a committee. I think, as part of the conversation…. My hope is that we can turn to some of the needs and the imperative around grief and bereavement support, which often is in short supply in the community mental health context.

I work for the Canadian Mental Health Association. I won’t linger here for too long. Sometimes we are confused with the Canadian Mortgage and Housing Corp., which is less than ideal right now, given mortgage rates.

I do work for CMHA. We’re one of the most established national charitable organizations in this country. We’ve been in operation here in B.C. since 1952. We really do hold a vision of mentally healthy people in a healthy society. We bring a strong social determinants lens to our work, and you’ll hear more about that as I move through the material.

I’m the CEO at the provincial office, and we have 14 branches serving over 100 communities, many of which are in your constituencies. Many of you know my executive director colleagues across your regions.

What I thought I would do, in the remarks I have for you this morning, is just very quickly get to our positioning around some of the issues that I think are at the heart of this. A significant amount of the important conversation and planning and action around the drug poisoning crisis in this province is around decriminalization and access to safe supply.

[10:05 a.m.]

You will hear — and you’ve heard — from many, many experts in this space. You’ve had many presentations with the health authorities and the ministry, for example.

I can absolutely comment on that, but I do want to start by saying that CMHA is very much in support of the decriminalization of substances and enhancing access to safe supply in this province. I think there’s a moral imperative to act there, when it comes to a poison drug supply, and our positioning is there. I’m happy to add more to that.

What I wanted to turn to today was kind of broader context around the crises, the multiple crises that we’re facing, and to posit some possible routes of action for this committee to consider.

On one of the slides, there are three bullet points and a fairly heavy title there around “Crises of Deaths of Despair.” I’m being deliberate here in framing…. In this province, you have other public health–related deaths that we need to grapple with, including suicide, including alcohol-related deaths and including the drug poisoning crisis.

The way I’m coming at this is…. As I mentioned, CMHA very much believes in tackling the social conditions in which people live. We really need to look at livability, the livability of lives. Do the conditions in which people live contribute to experiences of despair? What we do know form epidemiology and research is that when despair is present, we tend to see injuries. We tend to see fatalities. We tend to see very, very poor outcomes.

We recognize the absolute need for treatments and supports in this province. We absolutely need more appropriate, more accessible, more timely supports. But I think this table recognizes that, ultimately, we won’t treat our way out of all of these problems. We won’t problem solve our way out of this with treatment alone. We absolutely need to look at the social conditions and the material circumstances in which people are living.

Deaths of despair is a framework that was first provided by economist Anne Case Deaton out of the U.S. It may not be the right context here in Canada, though at the University of Alberta, there’s some interesting research around this, looking at the number of excess deaths that we see across this country. B.C. has seen significant — and if you’ve heard from Dr. Réka Gustafson, you’ll likely see this data very well laid out — excess deaths related to not only COVID but also opioids, alcohol-related deaths and suicides. Their framework very much thinks through the circumstances in which people are and how we can tackle inequity in those conditions in preventing loss of life.

You’ve had lots of data these past few weeks. So 9,400 lives lost since the declaration of the public health emergency for opioid-related deaths. There were many lives lost before the declaration of that emergency, which we need to remember.

Every day in this country, according to data from a few years ago, eight Canadians die in hospital from conditions entirely caused by alcohol. So 240 hospitalizations each day, across this country, caused by alcohol alone. As many as 16 children and youth a day hospitalized. B.C. is one of the poorer-performing provinces when it comes to hospitalization rates related to alcohol. Back in 2019, about 367 per 100,000 hospitalizations were entirely caused by alcohol, a very readily available and regulated substance.

What we know is that during this pandemic, the data we’ve collected…. We were one of the first organizations to collect multi-wave pandemic data — so trying to look at the impact of the pandemic on mental health. The data we have shows that substance use and alcohol use have all increased over that time. It’s critical we look at drug poisoning deaths. Alcohol-related deaths are a significant issue that we also need to grapple with.

Then finally…. This is an issue I’ve been around for 25 years. I know that there’s a Member of Parliament in Prince George who cares deeply about this issue, too, about suicide prevention. There are a number of folks across the province who really have been calling for change in this area.

In 2021, 582 lives lost to suicide. In 2020, 597. In 2019, 634. Island Health is the only health authority to have seen increases year after year since 2019. In the age group 30 to 39, we’ve seen increases since 2019.

There’s always a risk in relying on single years of suicide data. You want to look at things over time. The Coroners Service has reported a drop. What we do know about suicide, though, is that it’s a lagging indicator very much linked to people’s experience of livability and economic inequity. It’s not only mental illness. We really do need to keep an eye on those pieces.

[10:10 a.m.]

Between drug poisonings and suicides in B.C. alone, last year we lost 2,806 lives. That’s not including alcohol-related fatalities.

What I’m trying to do here, for the committee, is broaden the lens. If we look at three indicators around lives lost, deaths of despair…. Hopefully, that broadens the sites of action that you might consider in your recommendations going forward.

For this next part, I’m just going to talk about some of the roots of this. We’ve been at this for some time. You’ll see in your material a slide headed: “Drivers of adverse well-being and underlying pain.” When it comes to responding to complex phenomenon like lives lost due to suicides or drug poisonings, we need to think in a very multi-factoral way. We need to consider chronic pain. I think you’ve heard — or you will hear lots — about the relationship between physical pain and drug poisonings.

There are all sorts of kinds of pain that people experience, which can lead to substance use, which can lead to death, that we need to consider. They include adverse childhood experiences. If you haven’t heard of ACEs before, these are the ways that very early on in life, adverse events can stack up and really affect the trajectory of our lives — experiencing child abuse and neglect, violence in the home. A good way, long term, to prevent drug poisoning deaths is to implement provincial trauma prevention strategies, violence prevention strategies, systemically looking at reducing adverse childhood experiences.

You saw in your slides from the Ministry of Mental Health and Addictions…. There was a very important discussion around people living on income assistance or in poverty and the relationship there — a persistent and prolonged stress in childhood. Living as a child in poverty can create trajectories that lead to all sorts of outcomes that we want to prevent. Discrimination and racism, as well, you’ve heard throughout your testimony, and economic inequity. The more economic inequity that people experience, the poorer some of the outcomes can be.

What I’ve done here is I superimposed…. You had a great slide from the Ministry of Mental Health and Addictions earlier this week, and you saw these stats of 33 percent times more likely for people living in extreme poverty to die by a drug poisoning. Recent release from prison — First Nations disproportionality represented.

All of those factors there relate to things that we can intervene with much earlier on in people’s lives, from a prevention perspective but also from a settings perspective — communities, schools, educational settings, families, etc. I understand that that can feel very daunting when you’re faced with the death rates you’re grappling with here as a province. How do we think about prevention at the same time as stemming a devastating loss of life over here? It requires bold action at a provincial level, a doubled action — both prevention and also intervention with the loss of life later on.

Here on the prevention and despair slide, I’ve offered some ideas, from the perspective of our association. We’ve been in the space of some of this work for many, many years, modernizing pain treatment and management. There are lots of experts in this province that will help you with that. We have a long ways to go before we’ve truly, truly dealt with workplace-related injury, disability prevention and all those pieces.

Decreasing adverse childhood events — very, very key. There’s work underway, I think, in many areas. But how do we scale and deepen the advocacy? How do we avoid tinkering or incrementally making those changes, given the imperative that’s in front of you?

Systematically, we have not had a provincial suicide prevention strategy in this province — I don’t think ever. We don’t have one in this country. Systematic efforts to look at the prevention of suicide are a marked absence in our public health infrastructure. We’ve tried, but we could do so, so much more there. Systematically looking at how we can prevent suicide through a strategy, I think, is very, very important. You’ve heard lots about reducing stigma and enhancing school-based efforts focused on education and recovery.

This presentation isn’t about CMHA, and it’s not about showcasing our programs in any shape or way, but I do offer three things here that I think are just case studies of early intervention prevention work. There’s a slide labelled “Case Studies” in your PowerPoint deck.

We have a program that we’ve operated — and you’ve heard about it, I think, from colleagues at the Ministry of Mental Health and Addictions — called “Confident Parents, Thriving Kids.” We reach thousands of families each year with this particular program. We have a wait for service now, because we’ve seen demand absolutely skyrocket. Parents have more anxious kids. Parents have kids experiencing more distress. This program is profound in its impact. We provide people-powered support.

[10:15 a.m.]

I remember MLA Leonard’s comment earlier about human-powered care, the ability for a human to connect during a time of crisis. We do the same. We provide human-powered care to parents of young children who are experiencing behavioural problems related to attention, cooperation and conduct. Across all of those indicators, these kids move. They go from a red zone of high challenge around conduct or high challenge around agitation and behavioural problems to a green zone. We move — with the program and with the work of parents — kids from red to green.

Of that, what we see are kids, longer term — we’ve been at this since 2015, and we’re studying this actively — less likely to be excluded from school. If you’re excluded from school, your life chances start to shift significantly. There can be trajectories towards heightened use of substances, mental health problems, etc., because despair can start in many, many ways. This is a good example of getting to kids, aged three to 12, and actually mitigating some of those outcomes, longer term. I would say “Confident Parents” is a despair prevention program. It’s a suicide prevention program. It’s a positive parenting program, but underneath it, we’re trying to achieve those aims.

Links to employment. It’s a bit of an experiment of trying to bring employment support, psychotherapy — so access to counselling and to primary care. We’ve been doing this as a pilot for about 18 months, on behalf of the province. This program is for folks who are on PPMB. That’s persistent and multiple barriers. It’s an income assistance category. It’s often a classification of disability and income assistance where you kind of sit and languish for some time — and also persons with disability rates.

What we’ve seen…. When you have primary care — and there’s a shortage; I do get that — integrated with occupational therapy, counselling and employment supports, you see amazing outcomes. The people we serve meet all of the risk characteristics that you saw on that slide, at the MMHA. They’re on disability. They’re experiencing poverty. But when you put people-powered care around them, we’ve seen folks move…. We have a 57 percent rate of those folks moving from those disability income classes into employment. They’re actually in training.

Again, it’s despair prevention. We’re changing the material circumstance in which people live. It’s not the panacea, but what we do know is that when people can make their ends meet, when they’re not struggling to make ends meet, when they experience dignity, respect in work or volunteering or training, things can remarkably change. It’s just another example of despair prevention, in my view.

You’ve heard earlier that we’ve provided…. We’re an administrator. We don’t provide the direct service, but we’ve managed to establish 105 beds across the province, through a network of 14 providers, with a one-time-only grant. We converted a few private beds into public-pay, but the rest were public beds. I know there’s a challenge sometimes with the data in those treatment and recovery spaces. Because we’re the intervener, we’ve been able to kind of spend time with those operators and really see an 83 percent occupancy rate.

People stay in those beds. They are staying in those beds because there’s nowhere to discharge in community sometimes. That context of care is challenging, but the beds are not sitting empty. With 484 admissions last year, 199 came in on OAT. We really wanted providers, irrespective of their orientation to care, to make sure they weren’t creating harm by taking people off OAT — the opioid agonist therapy that you’ve heard lots about.

We’ve seen fairly good maintenance of OAT through those folks and about a 40 percent rate, last quarter, of folks self-identifying as First Nations, Inuit or Métis. The providers we’ve been able to work with have targeted their services to respond in culturally safer ways to those populations, which has been great. It’s a grant. We’re the administrator, but we’ve collected really important data about what’s needed to make sure that people bridge into better care. There’s a lot of work to do there in and around those community-based beds.

In the balance of my time…. It’s rare. I was at the Finance Committee the other day, and five minutes flies by in front of your colleagues at the Select Standing Committee on Finance. To have 20 is remarkable, and clearly I can take up 20 minutes with great adeptness.

Finally, in my recommendations to this committee, I admire the engagement of this committee, and I know you’re grappling with profound volumes of information and data. You’re sitting amidst folks at the forefront of a crisis, and you’re likely going to hear from lived experience, and you’re going to hear from substance users and service users.

[10:20 a.m.]

When it comes to recommendations, I’m sure you’re grappling with many already in your minds. I’ll do the last one here first — strengthen. I think you all know the imperative to act here. We need to strengthen the response to the profound and immediate risks of the poisoned drug supply.

That is absolutely where we need to see enhanced access to safe supply. We need to rigorously evaluate those thresholds under the decrim piece to make sure that there are no unintended consequences there. I think that work is under active debate in the House, at committee tables and inside government. We need to see sustained action there.

The top end…. I’ve said here: “To develop and adopt a provincial strategy.” I say that with some caveats, because I think there is strategy fatigue. We have a lot of strategies out there. But I do think there’s an opportunity to either update the existing strategies that are in force… I know we have Pathway to Hope. But really look at systemic ways that prevent and intervene with pain and despair that is responsive to the time we’re living in.

Two-thirds of the people who died during the heat dome were people living with chronic illnesses, including schizophrenia, depression and anxiety. Climate change impacts people with mental illness. It can cause a mental health problem; we’ve heard all about that. But these things that are happening around us do disproportionately impact people living with disability, living with mental health problems, much more than the general population. We need to attend to that, not in one-size-fits-all ways, but in very targeted ways aligned with the evidence.

You have a lot of work underway. There is work that is underway, and there’s novel work that needs to get started with investment and time and money. But to scale existing preventive and early intervention efforts that show strong outcomes in the prevention of despair, I think is a very important call to action.

There are hundreds of recommendations that have been made to government over the past five years — coroners, the Special Committee on Reforming the Police Act…. There are so many recommendations that even sitting with those lists of recommendations and consolidating them into the five that are going to make the biggest impact over the next few years might also be a prudent way to move forward.

With 19 seconds to go, I will stop there and hope….

R. Leonard: Well done.

J. Morris: Oh, thank you.

N. Sharma (Chair): Jonny, I think that’s a first. You came in just on time.

S. Chant: The red light didn’t come on.

J. Morris: Well, I was in red-light prevention. I really wanted to make sure…. That’s another 15 seconds you’ve got.

N. Sharma (Chair): Okay. We’ll move to the discussion portion.

S. Furstenau: Thank you so much, Jonny, for this presentation and what you bring to it.

I’m reflecting on what we heard from Guy Felicella last night and the role that trauma therapy has played in his recovery and how important that continues to be. He talked about jurisdictions where that therapy is accessible and covered.

You say: “Develop and adopt a provincial strategy.” I’m going to push you on this. But when our local CMHA is doing fundraising with silent auctions online, and you’re going to the Health Committee and saying, “Please, please keep us going,” to me, what is apparent is that we are not valuing the role of mental health care and preventative mental health care in addressing this and so many other crises.

I’m giving you an opportunity to be a little stronger about what you think is needed in terms of how to get access to mental health care for everybody. There’s a proposal from the B.C. Psychological Association to incorporate a minimum of six visits a year to a psychologist. We, I think, need regulation of counsellors and therapists in this province. But I’d like to hear from you on just what is needed to be able to counter the despair with accessible mental health care.

J. Morris: Legislative parity — so legislation. It starts…. This is the tricky part of federated health delivery. Mental health money is the softest money in the economy. It’s the first thing to be cut. It’s the hardest dollar to track, and we’re not where we need to be around parity.

We have these mental health transfers that are meant to be coming from the federal government. I think, through my federal colleagues, there’s some ambiguity around when those transfers will work. We do have a historic attempt from the federal health transfer to level up mental health resources, but it’s not legislated.

[10:25 a.m.]

We’ve called nationally — I’m not sure what we could do provincially — to legislate parity, because under the Canada Health Act, mental health money is restricted and protected around hospital-based mental health care, psychiatric hospitals. There’s no protection for community mental health dollars, really, in that transfer.

The U.K. legislated parity of esteem. A dear colleague of mine, the Rt. Hon. Sir Norman Lamb, was a health minister there for a while. Under his watch — he’s a brilliant person to spend time with — he managed to legislate what is called parity of esteem into the NHS, the National Health Service, framework in the U.K.

Now, they’re nowhere near where they need to be, but there’s an important kind of legislative assumption that funding is allocated in particular ways, and it’s not about creating a $27 billion Mental Health budget alongside the overall Health budget, but it is around legislating and protecting funding for access to things like community-based counselling.

Because mental health and substance use money is so vulnerable — it’s one-time-only; it’s grants — it’s easy to kind of obscure in that overall Health spend. We keep an eye on that $2.2 billion that’s allocated in the overall Health spend in this province, to make sure that it doesn’t start to shrink. The Mental Health Commission, and others, have recommended a 9 percent to 10 percent allocation.

I think, in thinking about legislation, the U.S. has its Parity Act to prevent insurance providers from discriminating against the provision of benefits related to mental illness and substance use. I do think legislating it is an important way forward. Where that happens — I’m not a legislator; I leave that to you — federally or provincially, there’s some thought there. We have to ring-fence mental health and substance use dollars. The fence currently has a few little gateposts and a very large open gate in and around those funds.

I think parity as a lens, MLA Furstenau, is also helpful, because it kind of predicates that when you go and experience a primary care visit, you should experience the same standard and level of care if you’re going in for a heart problem as if you’re going in because you’re hearing voices. Parity is a very helpful legislative and regulatory framework. The last thing I would say is on the quality of the regulation issue you raised. I was at a recent forum lately where there was a huge emphasis on quality in the physical health system.

There’s an expectation, if you go for surgery, that you don’t leave with sepsis or additional injury. We do not see the same quality frameworks as deeply in and around mental health care. You could just see how parity could really ring fences, and I think that would be the starting point to start looking at how you allocate MSP to pay for it. I appreciate the nudge, and feel free to nudge away. I’m happy to be nudged. We really do have to protect and ring-fence where we can. Was that helpful?

S. Furstenau: Yes.

D. Davies: Thanks, Jonny. Good to see you again.

Kind of along the nudging line of Sonia, but more specifically around children, we’ve been hearing lots…. Children’s mental health issues have obviously increased, especially during COVID, which is really concerning.

You talk of the one program you have — Confident Parents, Thriving Kids — as one piece. Let’s say that money were not an issue. What is the best path forward to do what we need, right now? This isn’t something that we need to study and look at and, three or four years down the road, come up with a solution, because it would be too late for a large group of young people right now.

What can we do right now to work with the education system, to work within the Ministry of Mental Health and Addictions, Health and other ministries that cross all over these pieces? What can we do right now that would have the biggest impact to benefit these young people that are struggling right now?

J. Morris: Do we have all day for that one? That’s a good question.

You’ve probably heard so much about the challenge across systems for them to work together, right? I do think often that there’s an inability to make the meaningful change, because you’ve got to get all these systems to play in the sandbox, share information and actually unite around this priority. That’s hard, but I think the moral imperative is that we have to get of our own way and find a way for that.

[10:30 a.m.]

I absolutely think there is evidence that some of that is underway — to kind of get in and around and share that unified vision, irrespective of which ministry service provider. We see it in the non-profit sector too. Getting to kids, young kids — we respond to kids aged three and up — is just so critical right now.

There are good examples around responding to the fact that kids are experiencing trauma. They’ve experienced trauma during the pandemic — pandemic-related trauma — and there are things that you can do really, really early on to prevent the worsening of that trauma. Clearly, you’ve heard from Guy, just around the value of trauma intervention. These are not a fait accompli. We can intervene in people’s lives and alongside people to shift those trajectories.

What can we do now? We can see that you can promote and support mental health and intervene with mental health in so many settings — schools, workplaces, communities, families — to really double-down on…. It doesn’t have to be the treatment room where you can provide care. There’s just so much that we can do in K to 12. There’s so much that we can do in universities and colleges, going forward.

As I sharpen my pencil a bit more here, MLA Davies, I think we absolutely have to not study how long it takes for people to get here but arrive at the conclusion that waiting 12 months for care…. If you have stage 3 cancer, you’re dead. In this case, if you’re waiting 12 months for mental health care, you might also be dead. The outcomes are different. So we have to get to a point of….

We have wait-lists, where I have zero tolerance, but we’re constrained. So how do we…? We’re in the same boat when it comes to wait-lists. But how do we draw a line to say: “This wait is grossly unacceptable. It’s not okay, and we’re going to do everything we can to make sure that there’s less wait or no wait”? The challenges across this country…. There are no, if any, jurisdictions that actually study the wait that we have for people — understanding that if you’re waiting for care and people are deteriorating, all of those opportunities are lost to intervene in those people’s lives.

I think that probably would be a good conclusion. We must stop allowing people to wait for care, and we have to get care to them somehow, some way.

Was that helpful to your question?

D. Davies: I’m sure you could probably go much deeper and very pointed but yes.

N. Sharma (Chair): Trevor.

T. Halford: Actually, the majority of it has been taken by Sonia and Dan. It is around affordability.

To Sonia’s comments yesterday, Guy gave the example that if he didn’t have trauma therapy, he’d be, in his view, dead. That trauma therapy is obviously very, very expensive, and he was public about it yesterday — that he is now on a sliding scale in order for him to attend. He said that at the beginning, you really have to go heavy in the beginning to deal with everything kind of up front, and then you’d go from there.

I think everybody agrees, from a humanistic point of view, that we have to find a better way. This has been a problem that’s been going on for decades. We have to find a better way to get people access to mental health supports.

Have you ever come across things from an economic point of view that would show you the impact of getting people that access to those supports and how that benefits us overall in terms of not having them have to rely on additional supports later on?

I know that from a humanistic point of view, we understand what the right thing to do is, and we’re not there yet. We haven’t been there for a long, long time. But from an economic point of view, have you guys at the association ever looked at that?

J. Morris: Yeah. I mean, I’ll have to fact-check this and maybe correspond back with the committee in case I’m wrong, because it’s been awhile since I’ve been in the data, but there are very rigorous economic evaluations that underpin, MLA Halford, your comment.

Currently you’re paying for it in the most expensive ways possible — every police visit to someone in crisis, every RCMP officer that sits in the ER for six hours, every jail bed. The vast proportion of people in provincial jails right now are identified to live…. I think the percentage, the latest research — 70 percent. We closed Riverview, and we’ve just re-institutionalized folks in prisons. That’s trans-institutionalization.

I think we all just need to conclude…. You’re actually paying for it in the most profoundly expensive ways possible right now. For every kid we divert, with Confident Parents, Thriving Kids, from social exclusion and contact with the justice system, it’s an over-a-lifetime cost saving of about $250,000 saved, diverted per child, diverted from the system, who might have been on a trajectory for exclusion.

[10:35 a.m.]

I can find that research and send it in to the committee.

Every loss…. Without boiling it down to crude economic terms, every one of those deaths of despair is a life lost of contributing lives — not just economically, of course, humanistically and socially. If you can get to someone early on in a trajectory and you’re not sending first responders to a crisis situation and then they’re hospitalized for 30 days, those are profound, profound cost savings.

There’s been a lot of work to demonstrate the return on investment of preventive, early interventive supports. We actually did analysis five, six years ago that tried to compare…. We were using the language of before stage 4. If you think of stage 4 cancer care, very expensive, very invasive, very challenging options. You can apply the same logic to mental health. It’s crisis. You’ve got hospitals, acute care, in-patient visits. You’re already paying for those in profound ways. What’s a jail bed per year in this province? A lot of money.

The challenge, I think — and I’ve heard this before — is the way government is set up. So your appropriations are set up…. You’ve got MCFD. You’ve got Health. So those appropriations are challenging to say: “Well, I’m going to save the justice system.” Say we have ten kids we divert over ten years, and we’ve saved, what’s that, $3 million. To say to another ministry, “I’ve saved you that money. I’d like that money,” is hard in the current set up of your appropriations. Your estimates structure — you’re all investigating estimates against dedicated, appropriated lines.

Other jurisdictions have looked at health in all budgets, really looking at the common treasury in a different light, in a different way, so that you can say, across the cabinet table: “I’ve saved you half a billion dollars during the course of this administration. For budget whatever, let’s add that in currently.”

I think just arriving at that conclusion: you’re already paying for it, but you could pay for it in different ways. I think it’s an excellent comment, MLA Halford.

N. Sharma (Chair): Okay. We have lots of hands up. Let’s try to get through as many as we can while we have you.

I’m going to go to Susie. Go ahead.

S. Chant: When you look at Canada, are there provinces…? How would you put B.C. relative to the work that’s happening in other provinces, in terms of the mental health support and in terms of your outline of the deaths of despair? Specifically, let’s look at opioids, since that’s….

J. Morris: It’s a great question, MLA Chant. I do have to say…. I know there’s often lots of conversation, but to actually have — it’s good to see the feds do this — a dedicated point of cabinet accountability around the mental health, to actually have a Mental Health Ministry, is very important on the outside.

Full disclosure. I worked there for a little while.

To have that access point makes it easier, I think, to start to peel out…. There’s a different level of accountability and transparency now around some of these things. You’re not sitting in front of someone who’s also accountable for hips, hearts, eyes, hospitals. You can actually allocate that. There are lots of recommendations we could have around emboldening that in the province, and that likely has to happen.

I think, in the province, on the spend, B.C. is favourable in some areas in trying things out. There was one of the largest investments — we administer it — around community counselling. That’s made a profound difference for thousands of lives in this province. There’s money that’s gone into community agencies, including CMHA, to provide low-cost or free counselling. I’m not sure of how across-the-board that is. There are good opportunities around Foundry and integrations there and what have you.

I think we’re in a particular space, when you look at B.C…. So we’re the worst performer on alcohol-related hospitalizations. There’s a lot there. On the suicide rates, I mean, we lose 500 lives a year. That’s one 737 or 747 crashing every year in B.C. I think we stack fairly equivalently across the country.

I know I’m deviating from opioids, but I think we do have a serious issue around involuntary hospitalization — 20,000 people involuntarily detained in this province two years ago, which is a very significant increase when you compare it to ten years ago. I think it’s a 40 percent increase, something like that. I think the challenge we have in B.C. is that more and more people are getting to a point of crisis and needing involuntary care options.

[10:40 a.m.]

I’d have to pull more data to do…. We used to do more of that cross-jurisdictional analysis. I think B.C., on the opioid deaths, is one of the hardest hit most recently, MLA Chant.

S. Chant: I’m hearing from you, I think, that having a Minister of Mental Health is a big step forward, relative to other places. It allows a better focus, and it allows a wider gate.

J. Morris: Yeah, it started a global trend, right? There are Ministers of Mental Health and Addictions popping up everywhere.

Again, involving that ministry with the legislative authority, the spending authority and the mandate to make meaningful change is likely the way it needs to go. It’s back to my response to MLA Furstenau’s comment earlier around parity. Do you have equal clout at the cabinet table when it comes to making the changes going forward around these very complex issues?

S. Bond (Deputy Chair): Thank you for your presentation. You’re right. You have incredible teams across the province — Maureen in Prince George. I’m looking forward to attending an event with them, I think, next week. That’s going to be fantastic. It’s Ride Don’t Hide month as well, so I’m happy to participate in that.

I just want to thank you for the emphasis in your recommendations related to prevention, early intervention. I think that as we look at a full spectrum of recommendations, there does need to be the full spectrum included, which includes early intervention, education and recovery at the other end.

You talked about scaling up existing preventative and early interventive efforts and also expanding school programs. I thought that was important too — enhanced school-based efforts. I thought supporting positive parenting was also really important. Ironically, that’s what Guy Felicella talked about last night — positive parenting and how we support that.

Could you just expand a little bit on that? You’re right. We hear all the data, and we hear about all the horrific deaths. What we don’t hear about is the front end that says: “Maybe we should think about how we talk about this differently or create those front-end programs — and also recovery.” It is possible. I certainly understand the challenges when it comes to opioid addiction, but it is possible. So I want to make sure we’re talking about the full spectrum.

I just want to say how much I appreciated your specific comments about intervention and early education.

J. Morris: I think, MLA Bond, your comments really serve as an opportunity to kind of zoom out a little bit from a profound focus on death data. We have to focus on death data because that’s where loss of life…. But for each one of those deaths, there’s an inquiry into how many doors that person knocked on, how many adverse experiences. Kind of a myopia on the death incident — I’ve seen this over 25 years in suicide. There’s just so much that leads up to that. And I think interrogating and challenging the terminality of these things….

People are literally written off, right? You have an addiction. Nothing’s going to…. You live with schizophrenia. It’s terminal. We forget that people can live with illness like schizophrenia and substance use problems and flourish and thrive in community when the right conditions are in place. We have lost our collective imagination, I think, around what we can put into place in community so people can thrive.

We live and breathe prevention and early intervention work. If you were to have any of the families that we’ve served over the past number of years — and we’re grateful for the support we get from government to do this, across multiple administrations — they feel walked alongside. They feel human-powered care. It’s not a robot delivering care. It’s a human who’s trained to help parents and caregivers in the context of confident parents and thriving kids with challenges and problems where people can often feel very isolated and alone.

They can talk with their GP about it. Actually, GPs are our referring agent. We have thousands of doctors referring to us each year.

To sit with a parent who says, “I’m no longer putting my kid in time-out” or “My temptation to spank my kid or physically discipline has dissipated because I’ve learned practical skills around positive parenting….” It’s quite profound to listen to that, MLA Bond, because it is life-altering in the most positive of ways.

[10:45 a.m.]

I think thinking of those journeys in your inquiry as a committee is really important, and thinking about the multiple opportunities we have to get to people before all that’s left is an ambulance — that’s the only response you’ve got left — or a police car. There are so many more things we can do.

Did that help, MLA Bond, with your question?

S. Bond (Deputy Chair): Yeah. Thank you.

R. Leonard: Thank you for coming and speaking with us today and bringing your expertise. My question is kind of similar to, or builds on, what Shirley Bond just asked you about.

You’ve spoken to the Finance Committee in the past. One of the tools that they use is: how would you spend your tax dollar?

I’m going to talk about this continuum. You hit the nail on the head, of course, about the social determinants of health. That’s where we’ve got to start from, building a society that’s equitable, inclusive, where everybody is thriving, so that we don’t even get to a place where we need mental health supports. You move into prevention, and then you move into early intervention. That is, of course, the beginning of the reactive stuff, rather than the building, until you get to the urgent situation and the crisis that we’re facing right now, which is what brought us to this.

If you had a dollar, 100 percent of the money, to spend, on where we spend your money…. As government, we do try to address all of these things. How would you distribute that dollar, from the beginning to the end, from birth to the ambulance or police?

J. Morris: I think it’s a beautiful and important question, MLA Leonard.

I think there’s a reality, likely in the beginning, which is a tricky piece…. Given the reality of treasury right now, likely, it’s double-funding. I do think we’re in a situation where there needs to be a sustained emphasis on improving the treatment and care that people get right now. We need to allocate as much of that dollar over there as possible, while simultaneously ramping up that prevention dollar.

I would say, if you were to think of it as a pyramid, that most of the spend is on the treatment side. It’s expensive to have people in hospitals and those kinds of things. So we do need to start inverting that pyramid, gradually, over time. Instead of 80 percent of the dollar going to treatment and 20 percent going to prevention, we move towards a 50-50 split. We move towards a 40-60 split, with a greater emphasis on prevention and early intervention.

Those are cheaper things. They’re much cheaper things. We serve 1,500 people on $2.75 million a year. It’s not like millions and millions of dollars to do the prevention side of things.

I think there is that reality. It would be impossible to take all of that money on the treatment side and reallocate it to prevention. You’ll have lots of problems over here. But that gradual inversion of a pyramid over subsequent administrations. You’ve got to think four, eight, 12, 16 year cycles in this kind of work, which is tricky in government. I understand and respect. But thinking of that long-term inversion of that pyramid would be great.

There are very good evidence-based recommendations on where prevention spending should be. We should be looking at a distinct, at least 10…. I would say, in the current climate, probably even higher. A 10 percent allocation of your overall health spend should be going towards mental health and substance use care. If you’ve got a $25 billion health spend, you want to be as close to 10 percent but, also, the right spend within that. Understanding what’s in that spend is really important.

P. Alexis: This is very similar to the questions that have been asked.

I call tell you, Trevor. Years ago, when I was a school trustee, we were certainly advocating. We had results from the…. I forget what the acronym was, but it was the readiness program for kindergartners coming into the system. At the time, there was a problem with readiness in our community, where we had a third of our children not prepared at all. There were some issues with respect to poverty and the conditions and all that.

Anyways, in the end, it was, I think, $1 invested was $7 saved down the road. That was in the early 2000s. I’m sure that that’s shifted, but that was the formula that we were advocating for and investments at that time.

[10:50 a.m.]

I come from a community that has a very high ratio of mental health issues. So we have been working at this for quite a while.

I have done the ACEs questionnaire. I was in an audience setting where we were all asked to do it. Afterwards, when I got the results, I was shocked at how many people were impacted as children, through this exercise. That was really an eye-opener.

If there is a question, it’s: do we have evidence of that investment, which has been made over time, with respect to early childhood…? Now we know…. The middle years are going through the same kind of rigorous testing. We’re seeing the same sorts of results, with about a third of those kids that are really having issues in school…. What we heard yesterday was all about the impacts of trauma early on. If we just had trauma therapy for everyone, would that be enough?

We know so much stuff. We know about investment. We know about the causes, the root causes. But how do we figure out all the stuff that we know and say: “Okay. This is what we need to do”? It’s not like we need to study it all, all over again.

J. Morris: No. No more studying.

P. Alexis: We’ve all had information for years about the investments and the importance of success for school-age children.

What’s missing? Is it a stigma thing?

J. Morris: I think it’s what surfaces when it comes to decision-making and kind of unobscuring some of the things that have worked.

I would invite you, as a committee, to have Dr. Charlotte Waddell come and speak with you. Dr. Charlotte Waddell is one of the most eminent child and adolescent psychiatrists in this country and is doing profound work in partnership with Indigenous communities. She’s been a fierce advocate for closing the gap between evidence-based care and people. There’s a huge gap to get…. There isn’t much of a gap to get evidence-based care of other kinds, but in mental health, we’ve often had a significant gap.

There are great examples in this province. The nurse-family partnership sends a nursing person to a recent mom to really deal with some of those very early-on stressors, postpartum. There are lots of things, but I don’t know if we’ve subsequently kind of added it all up and juxtaposed it against the death side of things and put those things….

We can only focus on a number of things at any one given time. I think that’s the work that sits before you. It has been studied and studied and studied. We know what to do. So reconciling that with the public and the family and the imperative to do more on the intervening at the very pointy end of things, around death prevention. It’s a lot to reconcile.

Stigma is a huge part of this, absolutely.

N. Sharma (Chair): Thanks. I have a question for you, in the last few minutes.

J. Morris: Of course, Chair.

N. Sharma (Chair): I thank you for bringing the perspective that you offer today, which is about building a system of care, across a continuum, that values mental health, really, as people experience all of the challenges that they do in their lives.

What really struck me when you were talking about…. We spoke to Guy yesterday about this idea of early childhood trauma and that pain that people are using substances to fill and that spectrum of supports you can build up when you are in that situation to intervene.

There are a couple of things that struck me about that. Having learned about zero to five, that brain development that happens, which is so key to being part of…. All of the studies show that it’s so key. And the building of a system for that period — for parents, for caregivers, for early childhood educators — where we can actually intervene at a very young age.

[10:55 a.m.]

As we build out child care…. I really want to know what you feel like your role is, as an association for mental health, and how to get to the kids even before they enter school, in terms of the challenges they face, and then that period where they’re kind of undiagnosed but maybe having some kinds of challenges. It seems to be a pretty crucial intervention point.

I’m just curious about that interface of early years and where you see that. Maybe speak to that a little bit. I’m curious.

J. Morris: Well, even backing it up further, just even the notion — I’m not an expert in epigenetics by any means — around maternal health and the trajectory that maternal health sets up and the structural things we can put in place around moms to flourish through pregnancy and through postpartum, etc.

The provisioning of child care access is absolutely despair prevention. I mean, you’re tackling an economic piece. You’re tackling all sorts of things within the provisioning of child care. Then seeing child care provisioning as a site of intervention with evidenced-based things. Like seeing these all as sites, right? There’s lots that you can do in that zero-to-five age group around programming, the role of child care providers in understanding mental health, mental health literacy, from a young age, being able to identify how you’re doing.

I used to do this in violence prevention. Supporting kids who have witnessed trauma with the vocabularies to make meaning of their experiences is so important, right?

Child care is a setting. I haven’t heard much about…. I appreciate your question, Chair. How you might overlay a mental health promotion lens into those child care spaces is actually quite an interesting trajectory too. Then recognizing that you can intervene with trauma with kids with evidence-based programs, kids who have experienced trauma in profound ways early on in life.

I would agree with you wholeheartedly. Child care is a site for prevention and early intervention and intervention, absolutely.

N. Sharma (Chair): Okay. Thank you. We have about three minutes to spare with time.

On behalf of the committee, I just want to thank you for not only the work you do for the province and the people that need it but also for coming here today and really showing your passion for helping people go through mental health challenges that they experience. I know that’s a big issue that we need to do a lot of work on. So thanks for your time.

J. Morris: Well, thank you, Chair. I’ve been at many of these committees over the past 12 years. A lot has shifted just around the discourse at these tables, and I applaud all of you for leaning in on really, really tough issues. We didn’t have these conversations as much 15 years ago.

To be at a table for an hour with you is a privilege. Thank you, Chair.

N. Sharma (Chair): Thank you.

We will be starting in a few minutes.

The committee recessed from 10:57 a.m. to 11:06 a.m.

[N. Sharma in the chair.]

N. Sharma (Chair): On behalf of the committee, I just want to welcome our next two presenters. We have Tom Littlewood, from Dan’s Legacy, and Jason Lesser, from Pacific Community Resources Society. We also have here Barbara Coates, from Dan’s Legacy.

We want to welcome you, and we really look forward to learning from you, from your experiences. Each of you, I think, is set to have 15 minutes, and then we’ll have about 30 minutes for discussion afterwards. If you’ve provided us with slides, we have them on our various screens, but if not, no worries.

Go ahead. I’ll pass it over.

Briefings on
Drug Toxicity and Overdoses
Panel 1 – Youth Experts

DAN’S LEGACY

T. Littlewood: Dan’s Legacy is growing quickly, but we’re quite a small and new organization. About 11 years ago, Dan lost his life to a drug overdose. He went through two really expensive 12-step abstinence programs. They thought they did everything they could for him, but he still lost his life.

They got hold of me, the family. It was just edging off, and I felt I had enough gas in my tank to do something. I’m 71. You take on new challenges at 65. So I said: “Okay, I’ll help you, but I’m not going to fundraise for you. I’ll develop some programs that are necessary, which, if they’d existed, Dan might still be here. That’ll be his legacy — that these programs exist for other kids that are in the same situation.”

I went off. We did a pilot — I’ll do this really quickly to get to the meat — with three programs: a recovery program, an alternative high school for little gangsters and Aunt Leah’s in New West, the program that helps kids out of foster care. We saw, within a couple of years, a 50 percent increase in graduation in the high school. It doubled. The recovery rate doubled. At Aunt Leah’s now, we have a therapist there every day of the week in New West, as well as downtown, and we’re seeing about 150 of their young people on a regular basis.

What we found is that trauma-informed practice is what we’re talking about. It’s really a term that has become so overused. I used to joke with the kids I talk to, because they’ve all heard “trauma-informed.” I said: “Well, you know, there’s trauma-informed toilet paper out there now,” and they’d laugh. They’re 15, 16, 18 years old, and they see the humour in it. There’s a little bit more than humour in it.

It’s kind of got to the place now where we’re working with the Doctors of B.C., and they’re asking us to give them a definition of what trauma-informed practice is, because they’re all doing their ACE scores. The ACE thing — they’re really getting into it. But what do you do with that information once you have it, especially if you’re going to be prescribing an opiate?

Anyway, we got to a place with these three programs where we felt we really had something here. We were really seeing some changes, and the kids were getting involved. We brought it to the provincial government, and the provincial government, through the new Ministry of Mental Health and Addictions, funded us the first year and then the second year. We always kind of hear on the 31st, at 3 p.m. in the afternoon, “You’re funded for the year,” and you breathe again.

It would be nice to have multi-year funding. It’s really hard to get high-calibre therapists if it seems like piecework. You know, we’ve got a year a time, and they’re looking at careers. They have families. Anyway, we got that funding. We got the next funding. Then, two years ago, we got a major fund.

[11:10 a.m.]

It was great, because we really wanted to grow. But it was really hard to grow that fast, because we were a small organization. We went from a team of four therapists to 12 therapists and an outreach team of five — two social workers, three outreach workers. Along the way, we have a fitness program, a food security program. We have a training program in food, and we have cultural workshops for the Indigenous youth.

We just got back from a cultural camp at Camp Potlatch. Our Elder…. We had about 50 people over there. We were going to canoe, but you’d have to….

Interjection.

T. Littlewood: Yeah. It would be a pretty wild canoe ride with kids.

We took the launch over, and they canoed when they were over there. But the big thing was getting them into the rituals of sweats and the bathing and all the different cultural medicines and stuff that these kids need to be able to identify with.

Many of these kids we work with are lost. They don’t even know who they are, if they’re Indigenous or not. Some­times their parents, when they adopted them, wouldn’t tell them because they felt that would be a hindrance if the kids knew. But kids really need to know this stuff.

We got to this place now where we have this team, and we’re just setting up now a partnership with Children’s Hospital, Burnaby General, Royal Columbian and Surrey Memorial. We’ve done a pilot with them, but COVID kind of interfered with the pilot. Not much can happen in hospitals right now, especially if you’re not a doctor. So we’re just firing this up again. It’s an on-call system where, in an emergency, they can call us, because a lot of these kids, as soon as they’re conscious after their overdose or self-harm or whatever, want to get out of there, and they would like at least to be able to connect them to a therapist rather than….

Before, the social worker would call us from the hospital and say: “Jimmy’s on the loose somewhere in Strathcona Park. Can you go find him?” And we’re walking around Strathcona Park going: “Jimmy. Jimmy.” You know, a good way to get mugged. So this is a much more efficient system.

About 50 percent of the kids tell us to take a hike, but at least they’ve got someone to tell that to. Before we leave, I give them my card, and I say: “If you need shoes or a phone or housing or a great big sandwich, just let me know that kind of thing, and then get back here. I’ll make good on the sandwich, and we’ll talk.” So that’s how it starts sometimes, that connection.

We know that 58 percent of the kids that age out of care will end up in entrenched addictions and homelessness within three to five years. That’s a statistic that Aunt Leah’s and SFU put together, and it’s a pretty reliable statistic. But what’s sad is it doesn’t take into account how many kids walked out of care. You know, they’re the ones that are really at risk. Most of the kids I work with…. You know, at 16 or 17 they were a nightmare for their social worker. They were full…. Trauma goes a long way with these kids. It happens in utero — FASD, ADHD, Scattered Minds, Dr. Gabor Maté, you know, that kind of background.

We’re starting to understand that it’s not even at birth. It happens when these kids are in utero. And then what happens in their first few years of life…. Even if it’s a divorce, it’s trauma. These kids don’t understand. It’s all about them. They did something wrong — why daddy left. But some of them — there’s extreme trauma. I’ve got a client that was actually taught by his father to dismember other gang members on the kitchen floor — you know, with tarps and stuff. This kid couldn’t even talk. He didn’t have a voice. He was so in there. He just phoned me about two weeks ago, and he’s dancing all over the place. You could hear him yelling and screaming. He’d got into UBC creative writing. And this is a kid that couldn’t even look up.

Trauma-informed therapy really…. The first thing we have to do is recognize their pain. This is the big problem we’ve had. Now the Doctors of B.C. and us are talking the same language. If they couldn’t X-ray it, if they couldn’t scan it, if they couldn’t see it on an MRI, it didn’t exist. And asking a doctor to provide safe supply while the kid is in therapy so that they are not triggered and use and die, and then taper them down with Suboxone at the end of the four months of treatment — or five months, whatever it takes…. We see about a 50 percent success rate with that.

We’re just kind of experimenting with it because it hasn’t really been legal for too long. We may have been experimenting for a little longer than we were allowed, but these kids’ lives are at stake. I’m perfectly willing to take that risk with a kid, and if the doctor is willing…. But now the doctors are more than willing. They’re understanding that they need to be part of the solution because we can’t solve it, and they can’t solve it. We have to be able to do this together.

[11:15 a.m.]

In our talks with the Doctors of B.C. and also with the ministry, federally and provincially, with mental health and addictions, we’ve all said: “Wouldn’t it be nice to have a centre of excellence for trauma and therapy and trauma-informed recovery so that we could actually teach it properly and guide people?”

We have a manual that we’ve just about finished that I produced in order to train my team, because even though they come with a master’s degree — the minimum that they have to have to work for us — a lot of them haven’t had a lot of trauma work, especially if they graduated a while ago. A lot of the trauma work that’s current is…. If you look at it from a therapeutic perspective, it is enabling. It’s not really empowering, and that’s what we really want to see happen.

When we have these kids in therapy, what we’re trying to do is get them to that place where they really are safe, first, through self-regulation. They don’t know…. I’ve had a psychiatrist that was prescribing Risperdal and Seroquel. The kid gained 100 pounds and started to lactate. This is a little hockey player. It’s pretty embarrassing to start lactating in your gym thing. And nobody even asked him.

The first thing I noticed is that he had a Monster drink and another one in his backpack. I said: “How many of those do you have a day?” He said: “Oh, four or five before lunch.” Well, I had half of one and almost went into psychosis. I mean, have you ever had a Red Bull? Well, you know, these things are this big, and the kids drink them. Nobody even asked.

He stopped that, and I had him off Risperdal — with his doctor, of course — right off all that stuff within a month. Within a year, he was back to almost normal again. But nobody had asked him. So how could that be considered trauma-informed? That’s trauma-inducing. They didn’t even ask him.

We have to have more care there. This is what we brought up with both the federal and provincial ministries — that when one of our therapists takes a kid into Royal Columbian, we sit there, while they’re in psychosis, for six hours, trying to keep them in that waiting room. That’s a pretty scary place not even in psychosis. If you’re in psychosis, it’s really a scary place. We sit there, and we finally get them through the doors. We get home. We pass out, because we’ve been up all night. And we get a phone call from the kid half an hour later saying they’re already out.

There are some things in the system that really need to be addressed. It’s not keeping them in too long. I know there was talk about having a bill that would keep them in, but the Mental Health Act is perfectly capable of doing that — and even more, as well, if it’s used properly. This is where the Doctors of B.C. and the college have to come in and back up the doctors that are afraid to use it or who are afraid to provide safe supply because of — they perceive — consequences.

I mean, some doctors are never going to do it. Their attitude is: “I’m not a dealer. I’m not a drug dealer. I’m not going to do it.” They miss the point entirely. What we’re trying to do is…. They wouldn’t hesitate if that kid came into the hospital with a broken shoulder. They’d give them a shot right away, and then they’d do the surgery, and then they’d give them the OxyContin. Then they’d have to be dealing with them a year later, when he’s down on Hastings Street because he couldn’t stop.

What we’re saying is that there are a lot of tools out there, but if they’re not being used, then why develop new ones? So this year we’ve got to this place with this team, and we’re expecting to see 600 youth in our therapy program. We had 24 youth go through our intro to cook program last year, and 20 of them are working. These were some of the kids that nobody thought would even be able to take the course.

Trauma-informed therapy is when we find that youth’s potential. They come in with a briefcase under their arm, a file folder with their problems. They’re experts in their own problems, but they don’t know what their own potential is. When we can find that with them and then say: “In five years, if you thought you could be a cook, where could you be in five years…?” When they can see that, then they begin to move away from the problems that are anchored in their current situation.

It’s really a logical approach. It’s not like magic at all. But it’s not as exciting as listening to them tell you about their abuse and stuff like that. Like, for a lot of therapists, it’s an entertainment thing, almost. The kids just go there and rent someone for an hour and just talk. We make them work. We want to see if they’re going to change: “We’ll provide the food; you change your diet. You can’t live at 7-Eleven or dine at 7-Eleven and think it’s going to be okay.”

[11:20 a.m.]

A million years of evolution never predicted 7-Eleven. Our pancreas would have never put up with it. But that’s what we’ve done. We’ve paved over Mother Nature, which self-regulated us. Now we’re expecting these kids to self-regulate, and nobody has ever taught them. They were raised by the state, in 15 foster homes. That’s the average — 15 placements — that we deal with.

Now, it’s not always like that. There are some great foster homes out there. I was a foster dad for a long time, and I think I provided really good service for some really haywire kids. But they’re still kids, right? I think that there are a lot of foster situations that are less than good and some that are criminal. When you go through 15 homes, you’ve probably had all of it.

The trauma wasn’t just at birth or in utero or when they were brought into care. It continues when they age out at 19. Thank God that’s changing.

My kids are 42, and they’re phoning me on a regular basis. “Dad, what do I do here?” I’m going: “I don’t know.” I can’t phone my dad. He’s gone. Nobody knows these problems, but these kids don’t know that nobody knows. They think it’s only them that doesn’t know. They’re lost in this…. They don’t get the social contract.

We’re there providing, almost, reparenting as well as therapy, life skills and work skills. If they can’t make it to that first rung on the ladder, they’re not going to make it. The first rung on the ladder is their first job, successful at recovery, going to college with the waiver program, all of these things.

They’re there for them. The tools are there, but we have to make sure the kids have access to them. A lot of what we do is just run interference. “First of all, you need to register with Fraser Health to get into Surrey Mental Health. Let’s take you to START, to start with. It gives you a bit of…. Some self-injury will do….”

Fraser Health isn’t communicating with itself. We have to basically get these kids from place to place. You get a kid sitting in front of you that doesn’t have income assistance. Couch-surfing. Doesn’t have a bank account. Lost his ID. He’s hungry. Where do you start? At the beginning.

Anyway, I see the red light is flashing. I don’t want to see what happens when that stops.

N. Sharma (Chair): Nothing, nothing. I assure you. Thanks, Tom.

We’ll pass it over to Jason.

Go ahead.

PACIFIC COMMUNITY RESOURCES SOCIETY

J. Lesser: I’m still curious. What exactly is the trauma-informed toilet paper made out of, and where do I get it?

T. Littlewood: Very special old-growth forests.

J. Lesser: Okay.

I wanted to start off with recognizing that we have the opportunity to live and provide service on the traditional and unceded territories of the Coast Salish and Nla­ka’pamux Nations. We’re very grateful to have that opportunity.

A big piece of what I’m going to be talking about is more to do with our substance use continuum, although…. PCRS is an agency that has provided more than 35 years of service throughout the Fraser Valley. I think we started out with residential programs, expanded into housing, expanded into some programs with WorkBC helping folks find employment.

We are predominantly youth-led. There’s a ton of different programs that we provide reaching out to people who are newly landed immigrants and helping them to connect to community, to a couple of different alternate schools. We have youth hubs where they can connect in and just have a safe space to be and also be able to connect with the services that are appropriate to them.

What I want to start with is…. We led a forum with Fraser Health where we were just asking some of the youth with lived or living experience about what they see as a good way forward in moving in recovery. Why we started with that was to gain the insight of the people who are going to adopt the service, because the only good solution would be the one that’s chosen, in my perspective.

Some of the key pieces that came out of that I’ve put into the slides. Some of them are barriers that they’ve experienced in accessing services.

This was a group of eight youth. This is still ongoing. This is a forum that started Monday and will be going until sometime next week.

Barriers to accessing services. One of the youth that was presenting at our forum had the experience where the individual that they were trying to connect with never had followed up with them. They made initial contact, and there was no follow-up contact from that.

[11:25 a.m.]

A lot of them identified with the stigma associated with mental health and substance use, and being able to walk through the door. For them, a big part of this was the accessibility and availability of information about what was even available to them without having to go to a door where they’re identified as somebody who has been at risk of substance use or demonstrated as having mental health concerns. By itself, walking through the door is a big enough thing, let alone if you’re also given a sticker or something like that that identifies you as a subset of the community in some way.

The choices around what’s suitable for them often weren’t available. They’d be assigned a counsellor after enduring some type of a wait-list. The choice, if that counsellor wasn’t a good fit, to choose a different counsellor just wasn’t made available to them.

The lack of understanding of professionals before offering different solutions. They would walk in the door, and without listening or fully hearing and comprehending — what they perceive the solution to be or what they perceive the problem to be — different resources were handed out, almost by rote. I think that Scott Miller, with the feedback-informed therapy, recognizes that the probability of success comes at meeting them where they’re at and with what they’re looking to change.

Conversely, what was helpful to them was access to a long-term service, somebody that they could stay with for a longer period of time. One of the stories with, again, a barrier was that they wouldn’t necessarily be notified if they were going to have somebody that would change over as staff. So their social worker or their counsellor might change jobs, and then they would be just assigned a new one, not necessarily having that prospect of closure but also not having that continuity of relationship.

Developing personal consistencies in routines and having people that meet you where you’re at. So if they’re not willing or ready to make a change to substances use, being able to identify what they would welcome. Finding hobbies or healthy activities. Support focusing on the whole person. So bringing their body, their mind, their spirit, not just treating substance use in a vacuum.

Developing long-term relationships with family, friends, just people who offer unconditional support. Those outside connections can often be lost because of substance use. A part of it, which I might speak to, with what I would see as being the ongoing repercussions of things like prohibition, from the past, carrying forward to mentalities where it’s treated as: “This person should be separated from community rather than connected.”

Having somebody who can either hold hope for them for the future or point them to a direction where they might have hope and opportunities to connect with oneself, one’s culture and the people that belong to that.

Along with this…. Part of what we were seeing coming out of the conversation, as a potential way forward, was a threefold task, all carrying some of the same elements.

Destigmatization. I’m going to borrow a little bit from Len Pierre. He’s an educator inside of Fraser Health. If you haven’t had the opportunity to either listen to him speak live or to some of his videos online, he does an excellent job of presenting a decolonizing perspective on substance use. He speaks to stigma as holding space because of four essential pieces: the lack of context, misinformation, discriminatory language and bad policy. While I’m not in a position necessarily to speak from the Indigenous perspective, I think that a lot of that holds true inside of anybody who is experiencing substance misuse.

The lack of context doesn’t take into account those early years that we were talking about, the ACEs that Tom mentioned or the developmental factors that even happen in utero that led them to a point where that was a viable choice.

The misinformation of what substance use actually entails, what causes it to continue.

Discriminatory language using non-person-first language, like calling somebody a user or an addict rather than a person who uses substances. He speaks to that as using the person-first language.

[11:30 a.m.]

Bad policy. In this, he was referencing the carryover that we experienced from prohibition or other policies that Indigenous people had endured that don’t put the person at the centre of the need or the service.

I can’t remember where I got the quote from, so I’m going to quote it uncited. “In a war on drugs, the drug can’t pick up a gun and start fighting.” We’re actually fighting against the people that are most affected by it.

Alongside of this, dealing with destigmatizing, moving towards upstream prevention, where the person has a viable alternative to move away from substance use before it starts and developing viable alternatives.

To this, from our perspective, with our programs in Traverse: our in-patient, bed-based program; our day, evening and weekend for youth day treatment program; our outreach counselling group, referred to as Astra — it’s an acronym. Don’t quote me on what it stands for right now; I probably won’t remember off the top of my head — and our prevention team, all of which operate within the Fraser Valley, anywhere from Surrey to Chilliwack…. In that, really carrying the focus on developing those viable alternatives and a sense of belonging, mastery, independence, generosity, because from the perspective that we hold, the opposite of addiction is connection.

A bit of what we’re doing. I already referenced this in part. Our Traverse program — we try and approach that connection to relationship as not just a relationship to other individuals in community but individuals connecting with family, connecting with nature, connecting with themselves, connecting with the things in life that make life more living. It’s commonly referred to as social capital in some sense, but relationship is a different way that we frame that.

Our DEWY program carries a similar focus. We combine recreational activities with core therapeutic programming. The recreation is built with the intention of them challenging themselves to step into something to re-explore the options to move forward in life. Recovery is seen as reclaiming some aspect of self that was lost.

Then I’ll reference our substance use prevention program, which is largely based on the model out of Iceland, where they saw a sustained period of ten years with steady reductions in problematic substance use in the youth in their community. When they cite that, they also cite that as opposed to…. Just because of some of the nature of the geography, what they would often see was that the way that most adolescents would use…. They would see problem consumption of alcohol as more something where they would drink in vast quantities to the point of blackout rather than drinking what we would see as recreational here.

I think I might be able to close with a couple of minutes extra so you can take that back from your lunch. What the youth were still hoping for was…. This is what I’ll close with. What didn’t seem to exist in the service continuum as they saw it was an atmosphere where they could walk into a home-like environment, where they could access the services as they saw fit. It not being a one-size-fits-all — we’re walking into this, and this is the structure of the program — I can enter at the level that I need to, and the care and support are presented in a non-judgmental, responsible way.

One of them specifically cited that in their experience, more often than not, they could hold their stuff together for the nine to five that most people are working. It’s those other hours of the night where the stuff creeps up on you, and you don’t have resources available to you to cope. So wanting somebody who could offer that level of responsibility and care at more of an expert level in the hours where they felt most vulnerable, which is often, for them, the wee hours of the evening.

[11:35 a.m.]

Access to culture, community, friends, rather than having to separate from their world. Being able to…. Treatment, as it’s traditionally offered, is something of an island from the rest of your life. For some, that is a valuable opportunity to be able to separate away. For some, the thought of having to leave home and community just represents something that they might not be willing to take.

The last piece was just a choice in how they can engage and the options that are available to engage. If I don’t like going to 12-step meetings, I don’t want to have to go to 12-step meetings in order to facilitate my recovery. Although they do present a very valuable option, having the alternative of SMART recovery or some other therapeutic means to be able to engage and choose as you’re walking through this type of resource were all something that they deemed as appropriate.

I’ll close by just saying thank you for the opportunity to speak and meet with all of you. I look forward to hearing what results come of all these meetings that you guys have got to sit in.

N. Sharma (Chair): Thank you, both. We’ll switch now to questions.

Go ahead, Susie.

S. Chant: Thank you to both of you for the work that you do for our kids at risk. I, too, was a foster parent for many years and got some of those kids that had already been through 15 other places. It’s a tough, tough role.

Your focus is really in some of our larger communities right now, but we all know that there are kids that need throughout the province. When you think of B.C. writ large, are you able to put it in sort of somewhere relative to the rest of Canada? Are we doing okay? Are we doing better? Are we doing worse? How are we doing in this area in terms of our platform to move forward from?

J. Lesser: I think that we have a lot of integral pieces that are necessary at the front of things of things. Things like opiate….

N. Sharma (Chair): You might have to speak up a little bit in your microphone. You remember, there are people listening to us. We want to be able to hear you.

J. Lesser: Inside of Fraser Health, I think that there are a lot of pieces. Well, inside of all the health authorities, I think that there are a lot of the necessary pieces that are available for moving forward — things like their new food program to do outreach to people who are experiencing some sort of an overdose. There are other continuums of care like the youth concurrent disorder therapy programs, the access to opioid agonist treatments.

I think, from what I gather, this…. From what they were saying, to also have what’s available in community, what they’re coming back to in community, to be a place of connection — something where they can perceive it as being a viable alternative. That’s where they seem to be commenting on what was missing.

T. Littlewood: Our focus is basically Metro Vancouver, at this point, although there has been some talk with the Ministry of Mental Health and Addictions to help with the module system that they’re thinking about. I know that there’s….

Especially when we talked to Doctors of B.C., we saw that some of them were quite concerned. They might only have one or two therapists in town, and they don’t think that they’re the right ones for the job. Or: “How do I know?”

That’s something we might be able to help with provincially. But at this time, we’re dealing with probably about 10 percent of the population that needs us, and we’re paddling as fast as we can.

We try not to have a waiting list. That’s the real thing with these kids. If you say four months….

S. Chant: They’re gone.

T. Littlewood: It’s another life, right?

We try and have it where we get to them within a couple of weeks, if it’s a normal kind of referral, or immediately if it’s an emergency.

S. Furstenau: Thank you both for the presentation. One of the themes that keeps coming up is the belonging piece and the need for connection to community.

Tom, when you say 58 percent of kids who age out of care end up in entrenched homelessness, to me that’s a measure of…. We have a systemic problem here.

T. Littlewood: Yes.

S. Furstenau: I think that we, as legislators, really need to sit with that figure and recognize there are provincially funded systems that are creating outcomes that really are not in the benefit of young people and children.

[11:40 a.m.]

In terms of the last slide here, whether you still hope to see developed…. I know that this is something that we have — a network, the Cowichan health network — advocating for a very similar thing: home-like, inclusive environments, a place for youth to be. That really seems to be lacking, certainly, in a lot of, I think, smaller communities.

Could you go into a little bit more detail about what would be needed to achieve meeting these needs that the young people are identifying?

J. Lesser: I think, from what I would hope, from my perspective, it could be approached from two different lenses.

One, an aspect of recovery. Something to the effect of social detox and stabilization that could allow for a youth to have a period of time — whether it be a month or months, a short period of time — to be able to step away from a certain community, engage in something that would be supportive of their recovery that they could connect back to, especially after they left that specific facility. It’s not something contingent on just being present in that space for them to be a participant of that thing that they perceived as being helpful.

The other side of things would be…. Our prevention program is widely aimed at developing social resources, so connecting them to supportive adults, connecting them to different levels of support that they’re needing to be able to maintain just being present at school and getting through that, let alone dealing with the different aspects of life.

Having something that is solely dedicated to building the social capital of the individual seems to be an important piece for a lot of these kids that we see moving forward. We have a camp that’s attached to it, and many of them will come back as peer leaders to give back as an opportunity to show how they’ve moved forward and how much they’ve appreciated having that connection.

T. Littlewood: I think, from my perspective, what I see missing is…. The waiver program to get kids from care into college and stuff is amazing. The AYA program to support them…. I think there still needs to be some alignment between the two things, because I’ve had kids that qualify for the waiver program, but they walked out of care, so they don’t qualify for the AYA program. If they want to try and go to university and look for a job at the same time as staying on welfare, the system needs to be aligned better that way.

A lot of these kids that we work with, the majority we see…. This is the average kid that’s aged out: trauma around three to five, identified as the trauma personally, took it into themselves, went through all these foster care situations — some of them good; some of them bad; some of them criminal — and then aging out and having grade 8 and no work experience, no life skills. They don’t know how to cook. They don’t know how to clean. They’re allowed $375 towards housing in the Lower Mainland. I know it’s been bumped up a little bit.

We’re seeing that the whole thing is inversed in their world, so it’s the psychology we’re trying to deal with. I know that in my family, they always wanted someone to graduate from university and get the degree. That would be the…. A lot of these families with generational poverty or colonial trauma all the way down the line look at a PWD. “Wouldn’t that be nice if someone from the family got a PWD?” It’s the ceiling; it’s not the safety net. It’s an amazing safety net, but it’s not the ceiling. These kids — that’s their view.

We’ve patched together things to try to make the runway, as we call it — the proverbial runway…. We have three months of training, four months of therapy. That’s a really short runway if you’ve had your whole 20 years of life messed around with.

We have a grant from the Ministry of Poverty Reduction, and it’s for a job-placement kind of thing. We can hire them at the end of the training program and add another four months to the runway and some more life skills and fire them a few more times. They have to come back the next day, of course, but they have to learn what firing is.

[11:45 a.m.]

They haven’t been raised in a family, so they don’t get the social contract, and they’ll do the darndest things. Right in class, we had a kid spark up a big joint, and he says: “I’m stressed. I have to. I’m stressed.” Well, that wouldn’t last very long at the White Spot. You probably would be tossed out the back door.

Recognizing their pain, that they’re desperately trying to self-regulate with a drug — not judging them for it but then moving them towards a functional way to self-regulate — that’s what trauma-informed therapy is. It’s not saying: “What’s wrong with you?”

That’s what they’re waiting for, and that’s why a lot of them don’t have a voice. If we could look at them and say…. What I see happening in the hospital: if you get your broken shoulder, you get all the treatment you need. But if your family and your placements in your life broke your spirit, you get nothing. They’re just as legitimately in pain as the person with a broken shoulder, and it’s totally healable if we look at it that way.

I mean, sometimes it isn’t, if we’ve got concurrent stuff going on — you know, FASD, ADHD that’s really extreme, or OCD. These are things that really can complicate the situation. But we’ve seen kids successfully get something out of therapy, even with the extreme difficulties. The work experience gets them the basic job, they’re perfectly happy with it, and they probably will be for life. “I don’t want to learn…. This is it. I love vegetables, and chopping them up is my world.”

That’s okay for that person. A lot of kids want to use that just as a launch pad to get into a regular life. They’ll probably be running for office in 20 years, right? I mean, they’re normal people. They just have had nobody there with them when they started out. So they need that now.

Provincially, most of these kids end up down here anyway. It’s the same as…. Do you want to spend the winter homeless in Winnipeg? Or would you rather come to the land of free rent, free food and free drugs? That’s not true, but that’s what they hear on the streets of Winnipeg where it’s 35 below.

We’re dealing with not just the 1,000 that age out of care every year and the 1,000 that end up on the streets. We’re also dealing with all these people from all across Canada that come here because they’re free and independent. I think a lot of the services federally have to be focused where they are so that we don’t end up with an overwhelming kind of problem here.

P. Alexis: A couple of things. What’s your relationship like with the schools? We spoke of alternate education and all of that. I know that the schools are overwhelmed with very high numbers of kids that are on the edge — there’s no question — and COVID only accentuated those numbers. If you could change something tomorrow with respect to the relationship with schools, what would it be?

T. Littlewood: I think it’s having a system where the school counsellors can kind of tap out and bring in a more specialized counsellor to deal with the situation. I don’t think they have the resources in their own community, or know about them and what they can draw on. So a lot of times they try and just do what they can do.

A school counsellor isn’t necessarily who you’d want to be doing trauma-informed therapy with a kid. Really, they’re looking at how to get them through school, and we have to look at the five-year plan to get them on a life course that is functional — that kind of a proper referral system. We’re just setting up this referral system with the hospitals. There’s the talk about a new number coming out, instead of 911, for mental health issues, and that kind of future that can be more focused.

A lot of these kids will ask for help between 15 and 25. Usually about 15 to 19 or 20, they’ll ask for help, because they realize they’re not doing well. They’re in a little wee box in a basement in Surrey. They have no money; they have no phone; they have no Wi-Fi; they have nothing. They have a microwave and a hotplate, maybe, and you’re expecting that kid to survive. It’s not going to be real.

It’s developing a system where not just the teachers can refer but the ambulance drivers, the fire people, the police. It’s so that there’s a consistent kind of approach to this, and that when you need a therapist, a properly trained therapist shows up and you’re not trying to find one for $150 an hour for your kid, on the Internet. You might do well; you might not.

[11:50 a.m.]

S. Bond (Deputy Chair): Thank you very much, both of you, for your presentations. We appreciate it.

I read Dan’s story, through his mother’s eyes. It was pretty hard to read, in terms of the painful journey that they were on.

One of the things we’re hearing is…. There don’t seem to be enough avenues for engagement and discussion with people with lived experience and on the front lines. We’ve heard that in the last three days, especially. Groups that have been here have said: “We’re so happy to be able to participate.” Yesterday VANDU was a really good example of that. They were more than happy to be here.

Maybe talk a little bit about…. How do we create a more inclusive way of creating policy and driving decision-making? I can tell you. I am no expert in this field at all. You are experts because of your lived experience, the work that you do every single day. I mean, we shouldn’t be sitting in isolation, creating policy and thinking about how we change the system for the better.

What are the barriers to your inclusion in those discussions? Are there…? What do we do to be more intentional about hearing from people with lived experience?

J. Lesser: With our experience in getting youth feedback….There are some programs, and going to your question as well….

Our prevention program is school-based. The receptivity is largely based on the administration as to how we can present materials and raise awareness. They do an excellent job of collecting youth, bringing them together to offer a voice. These are youth who are identified as either at risk or are aware of somebody who is at risk. They’re youth in school who just would be seen as benefiting from support.

Our Astra program or, sorry, our substance use continuum, I should say, is also seeking to develop a panel of youth that would be able to contribute their voices to different issues. Having that opportunity where they’re able to be present and able to give back, in my experience…. I was walking through a parking lot behind a building to get into one of the resources that we had. It’s close to Encompass in Langley. That’s often a space where there will be a large gathering of people who are homeless. In that space, I’ve had more than one person come up and offer me a piece of pizza.

The people that are out there are generous and looking for opportunities to give back. Creating a venue where they can have their voices heard seems to be the biggest piece.

T. Littlewood: We try and hire staff that have had life experience. I’ve had lived experience myself. I’m a residential school survivor, and I was an addict in the ’60s, way back there. I can’t even remember how long I’ve been clean. I’ve been clean since I was 20, and I’m 71. So a while.

I didn’t see any opportunities or any…. I mean, back then it was jail. There were no social workers that would help you. They’d send you home, and the problem at home was what got you on the street to start with.

A lot of the decisions we see being made…. I spoke at length with both the federal and provincial governments about a safe supply, not legalizing a toxic supply. What do we have right now? We have a legalized toxic supply. I mean, we’re moving towards a safe supply.

Nobody should be arrested. It’s a medical problem. I’m happy for all of it, but I think it should have happened at the same time so that people didn’t think that it’s now safe to use because it’s legal. The people that are really getting it now…. They may have had trauma in their life, but they were able to muscle themselves over it.

Now they’re that young guy on the construction site. He crushes his hand, and he goes to the doctor. The doctor doesn’t do the ACE score but says: “You look like a pretty reliable young guy. Here’s your whatever, your painkiller, your opiate.” Then, three months after the surgery, he’s gone the course, and he asks for another prescription. He’s refused. He buys everyone’s used prescription, who didn’t have trauma, that crushed their hands on the jobsite. Then, eventually, he’s on Hastings Street buying active supply.

[11:55 a.m.]

They’re the ones that are dying now. It’s not the hard-core addict in East Vancouver. They’ve got shooting galleries and nurses and guys on bikes and Narcan kits everywhere. It’s the kid that if he tells his boss or his family he’s using, he’s going to get fired or thrown out of the home. He’s the one that’s going to die, because there’s still shame and stigma involved there. That’s an issue that you can see. Not a lot of people with lived experience made that decision.

I mean, it’s important. It shouldn’t be illegal. It should be, like in Portugal, a medical problem rather than a police problem. The police have never been good at it. It’s a job they don’t want either, really. It’s like the whole end of it is…. We can deal with a kid for about $2,500, provide that four months of therapy and maybe a little bit of intervention in that. Once they’ve turned the corner, five years later, and they’re a hard-core addict in downtown, it’s millions of dollars. You’ve got fire trucks and ambulances and police and prisons and hospitals.

It’s just a complex problem that costs a fortune, and it’s almost impossible to turn someone around at that point because you’re not just dealing with the addiction; you’re dealing with all of the rituals that come along with the addiction. When we do the trauma work with someone and we help them get to the place where they’re ready to go on Suboxone and get off the drug completely, it’s the rituals that are going to trip them up. Those rituals can be there for the rest of your life if they’re not identified.

I mean, I go in for a blood test now. It’s about 51 years, right? I put my arm out, and the nurse pulls out the needle, and I’m sure my eyes go: “Ooh.” My brain: “Ooh.” Something happens, right? I know I’m going, through my brain, “You’re a trained therapist; settle down,” kind of a thing. You know, it’s body memory. There’s a whole bunch of stuff taking place there, and if you don’t identify those triggers, it’s like walking around with one round left in your revolver, and you don’t even know it, and you’re doing this. So it really is important to look at it holistically.

I’m glad that we have Crosstown Clinic. It’s one of the few places where you can work with an addictions doctor to get a prescription. There should be one of those in every community. They’re trying to do this, but it’s hard to. Asking them to go cold turkey and asking them for abstinence and to submit to a higher power and: “You’re an addict for the rest of your life….” They don’t buy it. The average young person thinks you’ve got the problem. Technically, we do, because we’ve got our blinders on and our prejudices in place. “Pull yourself up. I get it. Why can’t you do it?”

What I had to do to go through my trauma I don’t recommend for anyone — three years on top of a mountain, 17 miles from a road. I mean, you can rage all you want up there. No service. You can’t call your dealer. There’s nothing, right? That’s a pretty drastic way to do it.

We see most of the kids achieve a recovery they’re comfortable with, which is what we’re talking about, in four months to five months without in-treatment, in-care at all, if they know they’ve got a safe supply while they’re doing the work. It’s going to trigger them. The work will trigger them, because they have to face what got them there. That’s the way we need to go. Making it legal so they don’t get a criminal record and all that kind of stuff is important too.

I think we need to go way more upstream and deal with these kids from the first time they say: “I’ve got…” In school or in Aunt Leah’s…. We work in PCRS programs. We have three programs our therapists are in. We provide the service with 17 partners so that we’re right where the kids are when they first say: “Look, I’m having….” The youth worker there at Aunt Leah’s can say: “Why don’t you go see one of the Dan’s Legacy counsellors?”

What we’re doing is empowering each other as organizations. Rather than us becoming an expert on housing, these guys already are. We focus on the therapy and this other stuff. They focus on that, and we are able to meet the needs of these kids. That’s what’s really needed — everyone kind of working together rather than in silos. You’ve probably heard a lot of that in the last three days.

N. Sharma (Chair): I’m going to jump in with the final questions here.

First of all, thanks for what you’ve provided on the work you do.

[12:00 p.m.]

I was really intrigued by a couple of things. We’ve been learning a lot about the kind of treatment system that we have and the need for a more…. I don’t know if it’s regulated or standardized or something that has standards, when it comes to how we respond. You mentioned a centre for excellence for trauma-informed counselling…

T. Littlewood: And recovery.

N. Sharma (Chair): …and recovery, and that being something that we may be able to house through the work you’re doing.

I want to know a little bit more about that, and it’s tied to my second question. We were just learning how relentless the drug supply is now in terms of its increasing toxicity and that drive from the illegal market to get the most potency in the smallest amount. And how hard it is to get people through, the relapse rate and the fact that the retention on the OAT program — sometimes they don’t stay — and all the things associated with that….

I’m just really curious how you are both doing in terms of relapse and retention on OAT and the trauma-informed approach — whether that shows a sign of you being better than the average — or the things that we’re seeing with just the toxicity and addiction of the drug supply.

T. Littlewood: I can go.

J. Lesser: Do you want to start off with your centre?

T. Littlewood: Sure. I mean, this is a dream of mine. A lot of my dreams turn into nightmares, but I really believe this would be…. We really need to standardize an approach. The doctors feel that. The ministries feel that. Everyone feels that, because it doesn’t mean anything anymore to say “a trauma-informed approach” unless you’re backed up by what that really means.

Trauma-informed recovery…. There are not a lot of people talking about it, because up to about a year ago, until the Crosstown Clinic, a doctor would have to kind of write your prescription on the side. They’re risking an awful lot. And why should they? I wouldn’t…. I mean, I have, but I can see it from their perspective. They don’t want to risk everything on helping someone when they might lose their right to practice, right?

I think the government has to really focus on talking to the college and to the insurance companies that insure the doctors and to the doctors so that they are given permission to be doctors. I mean, they feel like their hands are tied right now.

A lot of the OAT thing and stuff that we’re talking about…. These kids are in agony, and you want to put them on Suboxone so they can’t deal with their pain, or methadone, which is the worst drug of all. It’s the hardest one to stop later on in life when you do want to stop.

If they want fentanyl, give them fentanyl. If they want heroin, give them synthetic heroin. This stuff is clean. They’re not going to die from it if it’s given out properly. You test them. You make sure, if they’re in this contract, that they’re not…. It’s not: “Here. Have some drugs.” It’s very tied to performance and doing the work in therapy. If they don’t do the work, you phone the doctor and say: “It’s done.” The therapist calls it off.

We’re not about to be manoeuvred by this. I mean, how do you know when an addict is lying? Their lips are moving, right? They have to be able to create this thing to get through life so that I will give them a gift card, and you’ll give them housing. I mean, they have to.

I did it. I was expert at it. I could walk into a place and just look at…. “Hmm. Gee, we’ve got sleeping bags, hiking boots over there.” And I’d walk out with that stuff. I’d say whatever was necessary: “Oh, yeah, I’m going to work tomorrow.” I mean, you’re an addict. You have to do that to survive. You can’t judge them for being…. You can say: “Wow. If you had some skill sets besides doing drugs, you’d be quite entrepreneurial. You could really have something going here.” Again — strength-oriented. Go towards their….

I mean, I was a basket case. They put me in Oakalla at 16 because it was the safest place for me and for the community. But I had no options, and I didn’t know what was wrong with me. Most of my memories had been…. I complained to the family doctor, and they sent me to Riverview and ACT and ice-water baths. Obviously, I was psychotic, because priests and brothers don’t do that in the 1950s.

[12:05 p.m.]

Not being believed, not being understood is the key thing. That’s the part where, when they believe that you get it, that you understand them…. Not that you’re an ex–drug addict and you get it. I hate to have to see all of these people have to go get addicted and off drugs again just so they’ve got lived experience. Anybody who cares can get it. It doesn’t take rocket science, but you have to care. If it’s just a contract, then it’s a whole different thing.

I know most of the workers that I meet with PCRS, with Aunt Leah’s and with our people, we’re all a little insane. We really care. We’re really trying to do it. Impossible odds, burnout super high, yet we’re doing it.

J. Lesser: I won’t speak to the centre, because that’s your dream. I can attest to just being a little bit insane.

I don’t want to say that we’re more successful than other community partners, because there are a lot of people doing a lot of really good work. The piece that we’re seeing, though, when we are successful is that the youth will engage for a longer period of time because they see this as a viable alternative to their use. That is with the pain of coping through trauma. That is with having other mental health diagnoses that prohibit them from thinking that they can function in the world as a part of the normal social contract.

I think that’s where we do most of our good work: when we can bend their perception of what they actually need to do in that social contract to be a part of things in a meaningful way, because oftentimes, it can be perceived as something that’s very narrow.

T. Littlewood: I think that what we can do is keep up this kind of dialogue so there are ways to talk to both sides. I mean, we’re not political. I’ll take money from anyone except the Hell’s Angels, and I’ve had them try. I actually got one of their daughters off the street. He comes in with a big roll of cash, and I’m like: “Woah. I know where that came from.” They don’t want their kids in this thing either.

There really needs to be more of a dialogue between the federal and provincial governments. We have a training program that was funded by the ITA, the Industry Training Authority. We were notified that the federal government didn’t transfer the money to the provincial government. The provincial government didn’t get it to the Ministry of Advanced Education. The Ministry of Advanced Education didn’t get the funds, and 19 programs like us got shut down around the province.

We just kept going. Let’s just keep…. It’s like running across a pond on the lily pads. It works, but you can’t stop.

We’re trying to find funding to put towards this program. So 24 kids that were basically considered level 3 — like, “Don’t worry about them; just entertain them” — are working and like their jobs. Out of 24, 20 are. We want to do that. That’s an intro to cook. We want to develop that into warehousing, commercial driving and bike mechanics, like we used to do at Sanctuary Foundation.

They’re things kids want. They’re quick and portable, a job where you got a diploma on the wall, not a degree but a diploma. You’re being hired because you’ve trained a little bit. So the kids feel like they’re empowered, rather than a program that gives them job skills where they practice getting a minimum wage job so they can keep the minimum wage job after they got it. That’s not going to hold them.

I’ve probably trained 1,000 bike mechanics in my career — not me but people who know about bike mechanics. They’re all now…. They’re not all bike mechanics, but that was the first job. The ones that are bike addicts are still bike mechanics, but the ones that used it to get their first job, they might be running an arena now where they started out doing that and sharpening skates and up through the…. There are many ways to get there, but there has to be a place to start.

What we see is that gap between where they are and where they can start, that first rung on the ladder. That has to be addressed. We don’t really see that. The programs out there, like PCRS and us — we see it, but not necessarily the funders, people who are writing the cheques.

N. Sharma (Chair): Thank you so much. On behalf of the committee, I just want to thank you. It was such an engaging hour to learn about not only your vision and dreams for what could be better but also the work that you do every day for people. So just want to thank you for that.

I think we all learned a lot. We’ll definitely be in touch if we have more questions. Thanks for your time.

P. Alexis: I also want to say that the Len Pierre…. Yes, it’s in your presentation.

J. Lesser: The Len Pierre…. I’ve referenced it directly, yeah.

P. Alexis: Right. There’s a link directly to the YouTube.

J. Lesser: There should be.

P. Alexis: Yeah. There is. Thank you.

N. Sharma (Chair): Okay. We’re going to recess until one.

Enjoy your lunch.

The committee recessed from 12:10 p.m. to 1:07 p.m.

[N. Sharma in the chair.]

N. Sharma (Chair): My name is Niki Sharma. I’m the MLA for Vancouver-Hastings. I just want to welcome you on behalf of the committee.

Maybe we’ll do a quick introduction of everybody that’s at the table. I’ll read out all of your names, or maybe you want to introduce yourselves. Then we’ll get going.

S. Bond (Deputy Chair): I’m Shirley Bond. I’m the MLA for Prince George–Valemount, and I’m the Deputy Chair.

T. Halford: I’m Trevor Halford, MLA for Surrey–White Rock.

D. Davies: Dan Davies. I’m the MLA for Peace River North, up in Fort St. John.

S. Furstenau: Sonia Furstenau, MLA for Cowichan Valley.

S. Chant: I’m Susie Chant. I’m the MLA for North Vancouver–Seymour.

R. Leonard: I’m Ronna-Rae Leonard. I’m from Vancouver Island, the beautiful Comox Valley, Courtenay-Comox.

P. Alexis: Pam Alexis, the MLA for Abbotsford-Mission.

N. Sharma (Chair): We’re so grateful that all of you joined us today, and we’re really looking forward to learning from you.

I’m going to read all of the names that I see here for the Hansard record. We have Caitlin Shane, from Pivot Legal Society; and Brian O’Donnell, Garth Mullins, Jeff Louden, Laura Shaver, Howard Calpas and Ryan Maddeaux — welcome — from the B.C. Association of People on Opioid Maintenance.

We will have…. It was 15 minutes for each presentation, but please tell us what you want us to hear, and then we’ll leave the rest of the time for questions and answers.

Briefings on
Drug Toxicity and Overdoses
Panel 2 – Legal Services
and Community Outreach

B.C. ASSOCIATION OF PEOPLE
ON OPIOID MAINTENANCE

G. Mullins: I’m Garth Mullins. I’m on the board of the British Columbia Association of People on Opioid Maintenance, which is who you see before you: Laura Shaver, Ryan Maddeaux, Jeff Louden, Brian O’Donnell, Howard Calpas. We’re elected by our membership to run the organization and come before you.

BCAPOM is what we are short for, and we were formed in 1999 or ’98. We’re still trying to figure out the exact year, but we’ve been at this for a long time. Our mandate has been the same. We’ve been fighting to reform the methadone system.

[1:10 p.m.]

I’ve been in this group for about ten years, and I’ve been on methadone myself for 20 years. The people who came before me opened up the system a little bit so that people like me could also get on methadone. It used to be even more restrictive.

Since we’ve been active, we’ve seen lots of other medications come online that are prescribed in British Columbia, like Suboxone, Dilaudid, hydromorphone….

Interjection.

G. Mullins: Kadian. That’s right, slow release oral morphine. And fentanyl. These are all trying to do the same thing. They are all trying to replace or reduce the amount of the deadly, illicit drug supply that we have to rely on.

Some of us are old enough to have lived through two overdose crises — two officially declared overdose crises, including the one in the 1990s. It’s amazing that the people here have survived. There are more people who are former, deceased members of our group than there are current members, so everywhere we go, we go with ghosts. Every place we sit, we have former board members, former treasurers, former presidents — like Chereece Keewatin — former sergeants-at-arms. All of these kinds of people are with us, and we stood on their shoulders.

As the overdose crisis was starting, before it was officially declared in Vancouver, we felt it. We felt it in 2011, 2012, 2013. We knew something was wrong. When the province went to change the formulation of methadone, we started raising our hands, saying: “Let’s be really careful with big policy moves. Moving to Methadose may not help.” We weren’t listened to. They did. It proved to be less effective. Lots of our members died because they were on something that was supposed to replace heroin, replace the opioids. It didn’t last as long anymore.

We kept trying to reform the methadone system, not by asking for the moon, not by asking for major changes in law or major apportions of funding or something like that. Just change the small things that act as barriers. Small things like: it’s very difficult for us to get take-home doses. Most of us have to go to a pharmacy every single day. When you go into the pharmacy, they pour your dose, and then a pharmacist watches you take it because we are not trusted. We get a message every morning: not trusted, not trusted.

When we go into a private — they’re mostly private, for-profit — methadone clinic, we often have to piss in a cup. We often have to get a urine screen to prove that we are actually taking our methadone. It’s so they can watch if we are taking other drugs as well — not trusted again. We’re stuck in this sort of privatized system which is a combination of health care but also criminalization. We feel the effects of that watchful eye over us at all times.

Not everywhere in the world does this. A lot of other place have more liberal policies towards methadone prescribing — and all of these other medications that I just mentioned — such that you get a way higher percentage of daily drug users on this stuff. Here in British Columbia, people who are on all of those medications might total 20,000 or 25,000 people. The government of British Columbia admits that there are 100,000 of us who are daily opioid users. So that’s a quarter, at best, and that’s very poor by other developed and European nation standards.

We come before you to say that our little group — part of VANDU — is begging for reforms to the methadone system so that we don’t have to suffer these humiliations. Also, these reforms keep lots of us away. They keep lots of us from even getting there. As we try and build out more and more prescribing of better medications, we can’t continue to bring these rigid, old ideas forward from decades past. We have to open the doors to all of this stuff because when you can’t get access to it, you’re 100 percent reliant on the contaminated street drugs, and you’re 100 percent more likely to die.

We’re suggesting that the province has the power to reform their prescribing system. Not only the power in regular times, but since now it’s an emergency — a declared public health emergency. We’ve seen the power of the Bonnie Henrys of the world, of the provincial health officer, to order things to happen.

L. Shaver: And court cases.

G. Mullins: That’s right. We have done….

We want to see the province use the maximum extent of its tools possible. Our comrades have come here from VANDU and other organizations to tell you how important a heroin co-op model is, how important safe supply is. We are part of those solutions as well. Every day, we are building them. But we also know that lots of people live in really remote places in British Columbia and need access to regular prescribing. We’ve got to modernize regular prescribing, so it is nimble enough to keep up with what’s happening in the contaminated drug supply.

We are going to go around the table and talk to a few of our members who have direct experience with this. I’ll just tell you: the private clinic fees that I’ve paid since I’ve been on methadone total $10,000. This is a Canadian public health care system. Half the people on methadone, like me, work. You don’t get it funded. You don’t get it subsidized from anywhere else. I have probably given a swimming pool worth of urine to be tested there and spent a lot of time in pharmacies.

[1:15 p.m.]

These things are barriers to us. We think the province could fix all of the things. We’re going to go around and tell you personal experiences with them. But not only that. We’ll help you fix it, because we don’t trust the province or any government to fix it properly on its own.

If there’s a table of decision-makers, a cabinet committee of the ministers responsible, we will sit down and go line by line through this and fix it. I’ll tell you, you can make up a massive amount of ground without having to change any laws, without having to spend millions of dollars. Even within what’s already set up, we can make a much more liberal and effective system.

Laura, do you want to start? Shall we go around?

L. Shaver: I sure do. The one thing I need to start with, of course, is that every program that we could use and that could be changed has already been designed from start to finish. No longer can guidelines….

Guidelines are not working. Unless these things that we have been invited to time and time and time again — not just oversight or to give our advice right — are changed into policy, they mean absolutely nothing. Every single clinic — and not even just every single clinic, but a doctor in those clinics — can each have their own decision on what policy or guideline in those that they want to use. So maybe this doctor in this same clinic that will be the doctor to use the fentanyl patch will not prescribe the next patient Metadol.

There’ll be a clinic on one part of the street that will prescribe the opiate that you asked for, not just for pain but for opiate replacement or safe supply — something that you have a discussion about, not just what you’re told.

My biggest thing today is we that have been working for many, many years with policy-makers, the people that are in the position to make these changes. During this time, we have lost…. This year already, we’re going to be topping 200 and, I don’t know, 600, 700…. We’re six years into a health crisis. We already know what could change this. There have been programs and policies implemented. The research numbers…. I hate to say “numbers” because we’re not numbers; we’re names — Laura, Brian, Garth.

The thing is that until these things are implemented, it’s not a maybe anymore that I might die; it’s I will. If I do not stop street fentanyl, I will die, not I might. I will die. The numbers show there are still six people a day dying in B.C. That’s a large amount of people to be dying in a group of people that are really not…. It’s larger than you would expect. It’s not just a…. Maybe it’s drug-seeking, but it’s health care. People have the right to put things into their bodies that make them have a better quality of life.

Since I started at the Vancouver Area Network of Drug Users in 2008, I have not been in jail. I have done no crime. I have obtained a full-time, part-time job with the hospital. I now pay taxes, and I’m about to move into a new place. And actually, VANDU wrote my last parole letter.

[1:20 p.m.]

What I used to do was…. I was a jewelry store robber. That was to support my opiate replacement therapy. Withdrawal petrifies me. Well, I no longer need to do that because we have these programs. But the thing is….

There are so many opiate replacement therapies available. It’s almost like a popularity contest, which one you’re allowed to have. We have a clinic that is prescribing powdered fentanyl in capsules but only if you can pay for it. We have people who are going in, asking for a fentanyl patch opiate replacement prescription and can’t receive it. They’re still needing to have a special exemption written for it.

On February 1, 2014, when we switched from methadone to Methadose…. If BCAPOM didn’t do the work that we did — and myself, with the BCAPOM board at that time — didn’t design the poster that we did, which was sent to every pharmacy and doctor in B.C., nobody would have known about that change until the day they picked up their prescription.

The thing is…. I had been clean for five years up until the sixth of February, 2014. I am now, to this day, still on my way back to that. That’s 550 mils of prescription fentanyl patch.

That was a decision made by the province with no conversation with us. With five, now, research papers between the States and here…. Between 75 and 80 percent of the people that were switched between those medications have either relapsed or went up in their methadone prescription, thinking that was going to make it better. During that time, now, do you know how many of those people are now dead?

Policy needs to be implemented. There are guidelines. I’m one of the second people ever to be hired as a person with lived and living experience as a drug user to write programs for drug users. Unless the policies that I’ve been hired to write and implement are made, then I feel like I’m just being tokenistic so that people can be told, “We have a drug user that’s hired that’s helping us,” while they’re still seeing thousands of people die a year.

G. Mullins: Ryan.

R. Maddeaux: Yeah. Thank you, Garth.

My name is Ryan Maddeaux. I am the secretary, currently, of the BCAPOM organization.

I don’t have a lot to say. I believe my fellow members have said quite a bit already. I will say…. I think it’s evident that we have the data. We have the evidence. We have the studies that show that we need to make changes in a certain direction, not just with the OAT area. It just goes in the whole…. The drug laws that we have on the books currently need to be changed. We have the evidence that shows that this needs to be changed.

I think it’s fair to say that the majority of…. Not just policy-makers or government officials or drug users today but the majority of the population knows that the drug war has failed. We hear this all the time. However, we still continue to operate with the same policies or to the same protocol. It doesn’t seem like we are in any major hurry to make these changes. You hear about it a lot more. It’s talked about a lot more these days, but it doesn’t seem that the required polices are changing.

You might say: “Well, we are doing…. We have decrim coming in. There are a lot of changes happening.” We’re not seeing any less overdose deaths. We’re still setting records. So the changes that need to be made are not being made.

However, getting back to methadone and trying to stay on topic here….

[1:25 p.m.]

I’m 43 now. I initially sought methadone as an avenue that I wanted to take to get off drugs or just something that I needed in my life at the time. It was roughly 20 years ago or 23 years ago now. I think I was around 20. I was living in Ontario when I first went to a methadone doctor. Things were quite a bit different back then. When I asked why I needed to give a urine sample on a daily…. No, sorry. I asked: “Why do I have to have my doses observed, and why can’t I bring my medicine home with me?” The doctor looked at me and said: “You’re an addict, and you can’t be trusted.”

You don’t hear that anymore these days. However, it’s only the reasons that we are told now that have changed. The methods that we still have to follow, or the protocol that we still have to follow, as Garth mentioned — giving our urine samples, having our doses observed when we take them…. None of these things have changed. The reasons why we do have to do these things have changed. It’s what we’re told, at least.

My experience, though, recently…. I was off of…. I wasn’t taking opiates. I wasn’t dependent on opiates for about eight or nine years, until about a year and half, two years ago. It kind of coincided with when COVID became an issue. I had a bad toothache, or tooth pain, a bad tooth. This happened right when all the dentists closed down, and I couldn’t get a dentist appointment. I called the hospital. I was told: “Don’t come to the hospital.” For whatever reasons. I made the decision to find some painkillers. At this time, I had never done fentanyl before, but this was all that was available now.

A long story short. I became dependent quickly again and needed to find a new methadone doctor. When I did…. I’m trying to summarize a bit. A lot of things opened my eyes to how things are done. I was able to…. I don’t know how I want to say this. I had a lot of anger when I came back. I’d moved from Calgary, where I initially got back on methadone, and I had been receiving carries. I’d reached my…. I think it’s six weeks of “clean” urine. I don’t like using the word “clean.” Negative urine samples for other drugs. So I was able to receive carries, where I could have take-home doses.

Then I moved to Vancouver. I’m doing my master’s at SFU now, so I needed to move back to Vancouver. When I got here, I expected to have my prescription just switched over and still receive my carries. However, that wasn’t the case. I was now told that basically I have to start over. My doctor wants to get to know me. More of the same issues. As I will get to, I started to realize that these are just made-up reasons.

To get to the point, I had a lot of anger with my doctor around this. I felt very degraded for having to be observed taking my medicine. It could be that this is my personality or where I was now at in my life and the education I’ve received. I just really started to see it as discrimination, having to have another person watch me take my medicine.

I don’t know if you can relate to that or think about how that would feel.

L. Shaver: Ninety-six percent of the people that are on methadone, Ryan, are all….

R. Maddeaux: That’s what I’m trying to….

You can think about it. If you were given some medicine and you were told that you have to take this in front of another person….

They thought they had a solution for me. They said: “Well, we can have it delivered for you.” They didn’t really get too much into it. Maybe I wrongly assumed that this would mean they delivered and dropped it off at my house. No. This now meant that another pharmacist delivers it. Basically, a pizza delivery man came to my door and asked me to take my medicine in front of him at my door, with my neighbour standing two feet away from me at their door. So yes, this didn’t…. After that day, I said: “No more of this.” Then I started to….

This is the point that I’m trying to get to. I started to have discussions with my doctor. I could see that she really did want to help, but it was evident how handcuffed she was, or how handcuffed she thought she was, how scared she was of having to explain herself to the College of Pharmacists. As we started talking more, I started to realize that these things that I’d been told over the years from multiple different methadone doctors….

[1:30 p.m.]

You have to have six weeks of clean urine tests or negative urine tests. There are multiple different rules that you have to…. If other drugs show up in your urine, you’ll be cut off. Your carries will be taken away. I’m sure you can all kind of agree with this.

Our doctors tell us that these are mandatory things that we have to do. We have to have six weeks of clean tests. We have to have no other drugs in our urine. We can’t miss a day. If we miss a day…. There are all these rules, and I started to find, talking with my doctor, that these aren’t mandatory rules that are set down from above. These are the doctors’ choices. The doctors can…. Yeah, it’s their discretion. They can give you your carries on the first day if they want.

The point I would like to make here is that there needs to be clarification. There shouldn’t be lies to the patients about what we are required to do, and there should be guidelines, not so much about when you should be taking urine tests. The guidelines should be that we are taking medicine, and we should be treated like anyone else who is taking medicine. The same as if I got into a car accident or if one of you got in a car accident and you hurt your back, and you needed to be on morphine or a powerful painkiller. You wouldn’t expect to have to take this medicine in front of another person. You’d expect to take it home with you and be treated as an adult that could be trusted.

I won’t be done fighting until that’s how methadone or Kadian or Suboxone is treated. It’s medicine just like any other medicine, and we’re patients just like any other patients, and our wants and desires and needs for what medicine we want and what we think works best for us should be implemented, and we need to be treated like any other patient taking medicine.

J. Louden: My name is Jeff Louden. I’ve been on the fentanyl patch for a couple of years, because I couldn’t do that methadone crap. It’s cough syrup, as far as I was concerned. It didn’t do anything for me.

The fentanyl patches…. I’m on a little bit more than Laura. It’s taken probably two-thirds of my pain away. I’m on it for chronic pain, and I guess I’m an addict. Because this won’t do anything with surgeries…. But there are a lot of people that would benefit if it was easier to get on these patches. It seems to be a clusterfuck to get on them. They run you around for a month with sob stories, and then you have to wait forever to get up to the dose that you require. They raise you up 15 micrograms or whatever it is a week.

L. Shaver: If you’re lucky.

J. Louden: Yeah. I’m on 1,000. You can figure out how long it took me to get there. And it still isn’t enough.

L. Shaver: That’s if they wrote to the government to ask if you could be on the fentanyl in the first place. It’s accepted.

R. Maddeaux: And there’s no evidence or studies behind that showing why they do that. I think they just pull it out of thin air, or it seems like it, anyway.

J. Louden: It’s going by good old Christy Sutherland there. She’s running the program. That’s self-explanatory, I think. Right on.

I don’t know. I think you should change the guidelines on that, especially the amount people start at. I don’t know what you started at, but I started at 400. And it still took forever to get where I’m at.

L. Shaver: I started at a higher level than normal because I ended up in the hospital, actually, with serotonin syndrome, because I had a reaction to the diacetylmorphine. If I would have started using it….

B. O’Donnell: Hi. Brian O’Donnell, current sergeant-at-arms with BCAPOM. I’m also on the board at VANDU as well. I’m the sergeant-at-arms at VANDU as well. Myself, I’m on 210 mils of Metadol-D. I wasn’t stabilized until about 180. I wasn’t on the original methadone, but a lot of my friends were, and they all relapsed. I’d say about 80 percent of them are now dead. It was like they were forced to use, right?

I’m sick of this, and I’m mostly sick of the stigma. You know, we are human beings, not human doings. Why are we judged for what we do? I mean, it’s ridiculous. If people want to divert their drugs, obviously, then, they’re not getting the right things. They’re not getting what they want. The doctors are in control of that, right? And they always say their hands are tied. “It’s up to you. You guys make the policies.”

[1:35 p.m.]

The doctors, I know, have the rights to be able to pick and choose what they want, because I know a lot of people who go right in and — bam — they get what they need from the doctors. So we want to end this stigma all the way up to the top with you folks. “Nothing about us without us” is very important, okay? If you’re going to make policy about drug users, drug users should be part of it — definitely.

Happy that we’re finally in the room, but it’s seven years too late, really — you know what I mean? — for the amount of people that I’ve lost. I’m just disgusted with the way the system has gone.

We still have this Methadose thing, and it definitely does not have any legs at all. It does not last long. It forces people to go out and use. The doctors tell them it’s the same thing. They’re still telling them that — that it’s the same — and it’s not. They should be telling them…. Once it doesn’t work for them, they should be encouraged to be on different medication. But they don’t.

They come to our meetings, and we tell them, and it’s all news to them. What’s Metadol-D? They’ve never heard of that. Why aren’t the doctors…? Sometimes the doctors are even saying, “That doesn’t exist. That’s just a pipedream,” or whatever. No. Why would the doctors lie about that?

Maybe the doctors are not being informed, to keep it a secret, because we’re just subhuman. We’re not a real part of the program, right? But we are. We’re all a part of society, every single one of us. I’m just sick of the way things are going, and things have to change. That’s really all I have to say. Thanks.

H. Calpas: Hello, everybody. I got some interesting things to tell you folks. I’m going to talk a little bit about money. First of all, I’m going to tell you a little bit about my story.

I came from Alberta, 2014-2015. I am a chronic pain victim. I’ve got spinal stenosis from C4 to C8. I’ve got a popped disc, where my vertebrae is, bone on bone, pushing into my spinal cord; herniated discs from the top to the bottom. I have a lot of pain. I had been on hydromorph for years. That was working very, very well for me. I was on just over 100 milligrams a day.

When I came here, I could not find a doctor that would touch me. They said: “No, we can’t give you that. That will kill you.” I said: “Well, I didn’t start on that dose. That’s where I’m at now, after years.” But they wouldn’t touch me. Instead, they forced me to take Methadose. I begged the doctor not to put me on it, because I had already done some research and found out that it was poison. The bottles actually say poison on them.

For a year, I was on that drug and sick every single day. They did not care. They forced me to walk to a pharmacist every day for three months to go and get my so-called pain medicine. There was no reason for that. They called it policy. Why would you force somebody with chronic pain to have to walk to go get their meds? That was absolutely bizarre, in my mind.

I joined BCAPOM because of the fact that they were actually doing something about this. I did some research, and I found out that in this area here, there is close to a quarter-million dollars a day that is taken out of the community to pharmacists because of the daily dispense and witnessing. Once you walk through that pharmacy door, that’s $10 right there. Then they get another $15 to witness you take your meds.

There’s only 4 percent of the people in this area that actually have carries. The rest have daily dispense. They say that it’s to stop diversion. Well that’s absolute nonsense.

B. O’Donnell: It doesn’t work.

H. Calpas: It does not work. Instead, we’re getting toxic drugs from all over the place. I could not tell you how many of my friends have died from this nonsense.

B. O’Donnell: Far too many.

[1:40 p.m.]

H. Calpas: There’s no reason why, as a province, we cannot actually grow our own poppies, make our own opium, process it and give it….

We could supply all of Canada very, very easily. You guys go out to Abbotsford. You take a look at all the greenhouses out there, all the fields. We can do this. We have enough smart people that we can do this. Instead of relying on toxic drug supplies, we can give safe supply. That’s just with the opium. I can’t say anything about cocaine or the other drugs, but with opium, we can do that. There’s no reason why we can’t.

There are some of these things I wanted to say…. What they’ve been doing, the Colleges of Pharmacists and of Physicians…. They’re guilty of crimes against humanity. When they switched from methadone to Methadose….

I worked in three different overdose rooms. I actually walked and talked with Thomas Kerr to get these rooms opened when we were doing the alley patrol. He told me straight out: “You know, in the ’90s, it was bad. It’s a lot worse now, and it’s terrible.”

We got the rooms opened. I worked in three different rooms. I’ve had guys come from all over the place — from Surrey and different places — and tell me that they had been on methadone for up to 20 years and never, ever chipped. When we did the stats, for 80 to 85 percent of the people, when they were switched form methadone to Methadose, in three days, they started chipping. They were looking for heroin on the streets. That’s when fentanyl was brought in.

I call it systemic genocide. They’re getting rid of a certain class of people that they don’t want. I believe that to be true because of the evidence that I’ve seen. I know that those are very strong words, but I believe that to be true because of what I’ve seen. When you look at 165 people every month that are dying from a toxic drug supply, it’s insane — family, friends, somebody’s kid, somebody’s father, somebody’s mother. You know, it’s not right. When we have the ability to stop this from happening, let’s do it.

A Voice: Do you want to say what “chipping” is?

H. Calpas: Oh, chipping is going to buy heroin off the street. That’s what chipping is.

R. Maddeaux: Howard’s comment just made me also think of one thing. It just goes to show that the reasons that they give us are just silly and made up. Howard mentioned that they want us to do observed doses because they don’t want us to sell our drugs on the street to other people. That’s one of the reasons that we’re given.

Another reason we’re given is that they don’t want us to overdose, which makes no sense, because methadone or the other substitute doesn’t kick in for about 45 minutes to an hour after you take it. So if you take it in as an observed dose, you’re already out of the harm reduction centre before it kicks in.

A Voice: It doesn’t make sense, right? You’re never going to be able to observe it.

R. Maddeaux: It just shows that the reasons they’re giving aren’t any logical reasons. They’re just making up something to have a reason.

B. O’Donnell: Thanks, everybody. If you guys have got questions, we can do questions.

N. Sharma (Chair): Yeah, maybe we’ll go to you, Caitlin. Then we’ll have our questions afterwards.

PIVOT LEGAL SOCIETY

C. Shane: I can assure you that my presentation is going to be far more boring than what you just heard, but I can, hopefully, get into some of the legal mechanisms that are at play here and some of the concrete actions that the province can actually take.

I want to situate my discussion today in the reminder that the power to legislate matters of public health within the province belongs to the province and that that authority is constitutionally sanctioned. That means that when municipalities, the police and the professional regulatory bodies like the Colleges of Physicians and Pharmacists, which we heard a lot about earlier…. When these entities take measures that actively interfere with public health, the province does have recourse.

The province has powers under the constitution, under the Community Charter, under the Public Health Act, under the Health Professions Act, under the Police Act. There are many powers that the province has access to, but these powers remain unused, at direct cost to the lives of people who use drugs.

[1:45 p.m.]

Most of you, I’m sure, are familiar that in 2016, B.C.’s Minister of Health issued an order requiring that overdose prevention services exist around the province. This order is nowhere near being fulfilled by the province or the health authorities. Instead, it is drug users and their allies that risk their lives and their liberties to establish sites and services to save lives. They do so under constant threat from local entities whose actions go virtually unchecked by the province.

Today Pivot is asking the province to grasp its legal and ethical responsibility to support what is really your greatest asset, which is drug user–led groups like BCAPOM and VANDU. I want to make recommendations that kind of go to three sites of power abuse. That’s at the municipal level, at the police level and at the level of the colleges.

Firstly, I want to talk about a recommendation that the province stop municipalities from undermining harm reduction efforts of people who use drugs and drug user–led groups. A reminder that municipalities are creatures of provincial statute: they do not have inherent or constitutional legislative powers. Their ability to create laws and policies and practices derives from the province, so it’s the province’s power and responsibility to step in when municipalities are undermining these critical health services, which they’re doing every day.

In the last year, I’ve worked with four separate drug user groups whose harm reduction sites have faced closure because of municipal zoning decisions and business licence denials. These sites are almost always operating in municipalities where there are no other harm reduction services. People are getting their sterile harm reduction services from a truck at the McDonald’s parking lot, yet when drug users are trying to organize to set up a concrete location where people can readily access consistent harm reduction supplies, they’re getting shut down.

We first called on the province to act on precisely this issue in 2014, to no avail. Cities are amending their zoning bylaws. This is kind of the mechanism that they’re using. So they’re amending their zoning bylaws to create new land uses — land uses like harm reduction services, supervised consumption sites. The effect is that existing harm reduction sites, overnight, are not in compliance with the bylaws, and they have to shut down. I’ve seen this happen over and over again over the years.

Amendments like these also prevent hopeful harm reduction sites from setting up, because suddenly they’re in a community where they have to have one of these zoning uses. Nowhere in town is zoned that way. The only way to do it is to apply for a rezoning process that can cost thousands of dollars. Drug user groups can’t afford that. They are busy saving lives. No one is out there helping them, and they’re just trying to set up harm reduction services when everyone in town is trying to get them shut down.

Clearly these zoning decisions are impacting public health, and under the Community Charter, municipalities have to obtain the approval of the Health Minister to pass any law that impacts public health. Municipalities aren’t taking that step. The province isn’t monitoring it, and it’s not intervening, either.

B.C. Court of Appeal has called out the absurdity of this exact practice. In 2019, it said that this provision of the Community Charter — the provision that requires provincial approval of public health–related decisions or decisions that otherwise infringe on provincial jurisdiction…. They said: “It’s very badly drafted, and this has led to municipalities sliding in health policy under the guise of zoning decisions, zoning legislation, all without provincial oversight.”

We’re asking the province to immediately begin monitoring and intervening when these types of bylaw decisions are happening. We’re also asking the province to amend the Community Charter to make it crystal clear that provincial approval is, in fact, required any time a health decision is being made by a municipality, including zoning bylaws and business licence denials.

We’re asking the province to engage in good faith with the 2016 ministerial order that requires overdose prevention sites to be established where there is need. At this time, there is no community in B.C. that isn’t in need of overdose prevention services, yet there are tons of communities that have no place where people can go and receive overdose response on a consistent basis.

[1:50 p.m.]

I’ve been told firsthand by various health authorities that sites are typically only being established upon request from municipalities. This is unsatisfactory, and it goes directly against the order, which says sites based on need, not politics. Whether or not a municipality agrees in principle with harm reduction should have no bearing on whether drug users have access to health and harm reduction services.

In addition to fulfilling this 2016 order, we also ask the province to invest in property for the use of drug user–led groups and realistic funding for their establishment and continuation.

I’m conscious of time.

N. Sharma (Chair): You have about eight minutes and 30 seconds left. You’ll see a yellow and a red light on that thing when you’re….

C. Shane: Okay. Cool.

Our second recommendation is that the province take a more active role where police are interfering with harm reduction in drug user spaces. We didn’t even have a chance to get into that today, but I feel like we could have a whole other three hours to talk about police interference.

A recent study by the BCCSU said that police frequently loiter outside of overdose prevention sites and drug user spaces. The study concluded that people will oftentimes not access an overdose prevention site because they fear police interaction or arrest.

A Voice: They were parked outside of VANDU as we left.

C. Shane: I was just going to say that I spoke to an overdose prevention site operator, service provider, in Vancouver yesterday. They said police had been standing outside, out front, all day. They were asking people for ID before they go in. The service provider said they witnessed numerous people turning around and leaving. People will not access these sites if they know police are out front.

B. O’Donnell: Police are corrupt. They’ve been stealing from us all the time. The Crown has been saying they don’t want to have any small crimes, so the police have been self-enterprising by stealing the drugs. Where are they? Where are all these drugs that they’ve been taking? They’ve been taking drugs and money from us. Where does it go? I want to be able to see it in a lockup somewhere. I want to be able to see it.

Sorry, Caitlin.

C. Shane: No, no. That’s fine. Actually, Brian, this is a recommendation that you came up with in one of our last meetings.

We have the province encouraging everyone to make use of supervised consumption sites, overdose prevention sites. At the same time, people have no legal means to leave from their house to a site with drug in hand. There’s no legal protection.

One of the things we had talked about in our last meeting was that we want the provincial government to legislate bubble zones, or safety zones, around drug user spaces. Under this policy, the police and other detractors would be prevented by law from entering and loitering in these zones except, of course, in cases of emergency or exigent circumstances.

The province did something similar in the context of abortion clinics. In 1996, the Access to Abortion Services Act said that because the presence of protestors was detracting people from accessing these health services, legislation needed to be passed. We’re in the same circumstances now. If we know that police presence outside of sites is preventing people from accessing a life-saving health service, we should be legislating accordingly.

L. Shaver: They are dying. They will not come in.

C. Shane: Absolutely.

B. O’Donnell: We’ve had zero deaths at VANDU, in our IR, our injection room.

L. Shaver: But not in our alleys.

B. O’Donnell: In the alleys and the streets…. When people are deterred because of police going into the places, they die. They end up going…. If police are going to concentrate on going after the big dealers, maybe they’re going to shut down the good drug dealers, the ones that have the clean drugs, right? Then they’re going to be turned to the poisonous drugs.

That’s what’s going on, and people are dying. People will go out and smoke a bit of crack, which shouldn’t kill them, and they’re dying of fentanyl overdose. What’s going on? Is it cross-contamination, or are there people out there murdering us? That’s what it seems like. It seems like there are murderers out there.

H. Calpas: Systemic genocide.

C. Shane: Another action that police are regularly taking — and this is quite shocking — is that they’re detaining and investigating people for carrying basic harm reduction supplies like crack pipes and syringes.

I speak with defence lawyers around B.C. every week who spend their days defending people who use drugs in the criminal justice system whose arrest stemmed from merely possessing basic harm reduction supplies. This practice has a clear chilling effect on people being able to carry the supplies they need, even as the province and the health authorities are encouraging them to carry these health supplies as a best practice.

[1:55 p.m.]

L. Shaver: Not only that. They are taking our marked pills that are our safe supply prescription and have our names on them. But because some of us do not carry ID, they do not know that they actually belong to us, so they’re obtained.

J. Louden: I had a pig say I had to pull my patches off because he said there were too many of them. Just couldn’t be from the doctor.

H. Calpas: I had a friend of mine…. He’s an outreach worker. He got shaken down by two cops. He was in the alley right behind the Carnegie….

A Voice: Doing outreach.

H. Calpas: Yeah. He’s got his bag over his shoulder. He was talking to two people. The next thing he knew, he was up against the wall with an arm across his throat and this cop whispering in his ear: “Give us your money and your dope, and things will go easy.”

They let him down. He took out his wallet. He had five bucks on him. He said: “This is all the money I have. As far as dope, all I have are harm reduction supplies.” He made them look like fools, but the fact was that they tried to shake down an outreach worker.

L. Shaver: In small, rural places, there are still bylaws if you have harm reduction supplies on you. I used to get $100 fines in Kelowna when they would find a piece of Brillo in my possession. The thing is that now…. You know, decrim is great. With decrim, legalization would make it work even better. But it feels to me almost….

It’s a win but almost a back win, because it almost feels like now it’s opened the door for them to stop any person that they think might have drugs on them to be able to check if they are carrying the amount that they are allotted. So now it is almost like they have probable cause for every person that walks a street on the Downtown Eastside.

R. Maddeaux: Decrim, just the broad term of it, sounds like it’s a step in the right direction. However, how we set up decrim can make it worse or better than we are doing right now. It seems like, the way it’s going right now, it could be worse.

C. Shane: This is really good context. It’s completely in line with the recommendation that we’re making, which is that….

Laura mentioned these bylaws that prevent carrying harm reduction supplies. That’s a clear example of a bylaw that should not have received enactment without provincial approval. That’s a bylaw passage that the province could be monitoring and intervening in to say: “These are health supplies that you’re carrying. You cannot pass a bylaw that says you can’t carry health supplies.”

R. Maddeaux: That have just been handed out by….

C. Shane: Exactly. Oftentimes these are supplies that are handed out by the health authority and then confiscated by police, and the person is arrested.

L. Shaver: I get mine back, just because I’m wearing a St. Paul’s tag. If that’s not showing, they take it away. Then I produce it, and I’ve gotten them back.

C. Shane: You can see how application does not look the same for everyone. Different people are targeted by the laws. The fact that this law has as its heart a prohibition on carrying health supplies should never have been passed in the first place.

There are powers that the province has in terms of reallocating or redirecting police resources away from things like simple possession and street-based drug trafficking. Street-based drug traffickers…. Oftentimes, drug users themselves are providing some of the only safe supplies right now that people have access to, given the total lack of state-sanctioned alternatives.

B.C. also has one of the highest sentencing ranges in Canada for people who traffic in substances that contain fentanyl. It’s an incarceration of one to three years. I believe it’s only B.C. and Ontario that have that sentencing range, and it’s the highest in the country.

An amendment to B.C.’s Police Act that diverts funding and police resources away from the enforcement of simple possession and street-based drug trafficking is possible. Something like this was recommended by Dr. Bonnie Henry in 2019. Even though the province has taken steps to decriminalize, the result we’ve gotten is 2.5 grams. That’s not going to protect anyone in this room.

C. Shane: The police wanted one gram. If the province is committed to full decriminalization, it can take this recommendation from Dr. Henry. I’ve reminded the province of this several times. I’ve been told that there is no legal avenue by which to do it.

[2:00 p.m.]

That’s absolutely not the case. The report itself contains a legal opinion that I myself wrote. I can say with certainty that it is absolutely legal and possible to do. It just requires political will.

There can also be a directive from the Minister of Health under the Public Health Act, which goes to police and the B.C. Provincial Court, to say that harm reduction supplies are health supplies. It’s not drug paraphernalia, and it shouldn’t be treated as a crime to carry them.

Am I almost out of time?

N. Sharma (Chair): Go ahead.

C. Shane: Okay. I’ll just say one more thing. This kind of dovetails with all of BCAPOM’s recommendations but from a legal perspective.

You’ve heard about many of the restrictions to safe supply, whether it is bans on carries, mandatory witness doses, urine tests, narrow prescription guidelines, doctors being unwilling to prescribe. Time and again I’ve heard people in this government claim that the chief barriers to safe supply lie at the level of the colleges. This is not the case. Sorry, it’s not that it’s not the case that it is the colleges, but it’s not the case that the province is powerless in front of the colleges.

In May 2020, this province amended a regulation under the Health Professions Act. It’s called the Health Professions General Regulation. Section 13 of this regulation says that the provincial health officer can make an order that effectively overrides the regulated health professions, the colleges, in the event of a public health emergency.

These restrictions that limit people’s access to medical safe supply, to the extent that the colleges are involved, can and should be overridden.

L. Shaver: There were things they changed. It was — what? — until 2022 at one point. Now they’ve changed some of them till 2026, which are some of the regulations to the College of Pharmacists. That happened within a three-day period.

It’s like giving…. Pharmacists now have the ability to “write” an emergency safe supply prescription for two days, if somebody misses a doctor’s appointment, so that they don’t go to an illicit street drug. This can happen within…. A pharmacist is given permission within…. They changed this within a three-day period of time.

A Voice: Yeah. So shows how easy it can be changed.

L. Shaver: Something that was to be stopped by September 26, 2022, is now till September 2026. It now gives pharmacists the opportunity to prescribe safe supply in an emergency, where somebody misses a doctor’s appointment.

This is what is saving lives. It’s changed. You can do it.

I’m leaving this meeting because I have somebody who needs me to help them to get on to a prescription that they’ve been denied. The thing is…. I left because…. I feel so defeated right now. My friends are dying, and I’m dying.

You people are the people that are the ones that can make this stop. That responsibility is…. It’s your responsibility. I have to say that it’s also your responsibility that it’s happened. It’s six years. It’s been six years. You can’t tell me that in six years not one person in this room, sitting at this table, hasn’t lost somebody in your family through an opiate overdose that didn’t need to happen. There are medications that are made to fix this.

In 1989, the Australian drug users union…. You need to read some of their information.

Some Voices: Thank you, Laura.

L. Shaver: I’m sorry. No disrespect.

Interjections.

N. Sharma (Chair): Is it okay if we switch to a little bit of questions and answers now? I think we should probably have about half an hour for that, if that’s okay with everybody. We’re a bit over.

A Voice: I actually have to leave in about 15. This is more important.

N. Sharma (Chair): Okay. If you have to leave, you have to leave.

[2:05 p.m.]

I just want to say, at the beginning, on behalf of the committee, thank you for coming. Thank you for speaking so openly with us. It’s really invaluable to hear all of your experiences and what you see needs to change. It’s really a good lesson for all of us to hear that.

I also just want to acknowledge the pain that was talked about, whether it’s physical pain or the pain of loss that you’ve all experienced. We certainly have all definitely been touched by some of that in some ways, as Laura said.

We’ll go to questions.

D. Davies: Thank you very much, all of you. Good to see a couple of faces from the reforming the Police Act, as well, when you guys presented.

I’m not sure the best way to ask for this, between that committee and what we’ve heard about here is that continuum. I mean, right now we’re dealing with: how do we stop the six deaths a day? That is critical. We look at the long-term piece, around the recovery and getting those supports; the prevention piece. They’re all important in this whole spectrum. Loud and clear on what we’re dealing with right now, on the people dying. Your message, very clear.

In light of time — and I know that we’re short of time; I wish that we had much more time — can one or two of you talk to us about what could have made a difference for you before you started using? If government needs to act on the prevention piece right now, what could have made a difference? I hope that’s a clear enough question.

G. Mullins: You guys are legislators. The government legislating to the full extent possible. The government instructing its deputy ministers to roll out the regulations to the full extent possible, like Caitlin was saying, so that when someone is getting wired, you could actually get on methadone.

We had a prescription heroin program here. It was frozen at that little sample study group. I just sometimes imagine. What if the province had boldly said, “We’re going to have prescription heroin here,” in 2003 or 2005 or 2010? We wouldn’t be sitting in this room. We wouldn’t have the fentanyl crisis.

To me, prevention is prevention of death. The question of preventing people from trying drugs to begin with, I don’t know about that. Everybody tries drugs. It just happens.

We could also make mental health care the same as regular health care: funded. The current government talks a lot about health care, but we don’t have funded health care, so most people don’t get access to it if that’s the source.

We’re here to tell you about prevention of death. Prevention of death is giving people as many pharmaceutical alternatives to the poisoned street supply — certainly a co-op model, but also within the province’s mandate of prescribing, within its area — that keep up with the contaminated drug supply too.

Methadone has been pretty good for a lot of us, especially if we had habits in the time of heroin. But as the drug supply has gotten stronger and stronger, it’s kind of like it feels like light beer now, and you might need something a little stronger than that to get across. That’s prevention of death.

H. Calpas: One of the big problems, too, is that we do not have proper detox or treatment centres in this province, unfortunately. I think that goes all the way across Canada.

I work for the BCCSU as a peer navigator. I was helping people get off the street dope onto prescription drugs, but when we tried to get people into detox, there were so many barriers. One fellow, he’s in a wheelchair, one of my clients. It took me a month to finally get him into a place where they could accommodate his needs. He was there all day, just happy as a clam that he could finally get there to get off the dope.

At the end of the evening, he asked them if he could go outside and have a cigarette, and they said: “No. It’s a non-smoking facility.” He said: “Well, you better call Howard, because I can’t do this. You know, I’m trying to get off of dope. I’m not trying to quit cigarettes.”

[2:10 p.m.]

They called me, and they said: “We have a problem.” I said: “I talked to you guys for a month. I begged you guys to bring this gentleman in, and not one of you said that it was a non-smoking facility.” If I would have known that, I would have looked somewhere else. To make a person quit absolutely everything at one time is bizarre, but that’s what they did.

Even Onsite, I guess it’s called — there it’s a disgrace. They told me that you have to go there every day for a minimum of two weeks to prove you really want to detox. I’m not kidding. This is what they told me face to face. You have to go there a minimum of two weeks to prove you want to detox, and then maybe they’ll let you in.

In two weeks, you can be dead. You’ve got no choice but to take the street dope or whatever you can get. When you’re trying to get off of it, they’re making people suffer needlessly, and it’s a disgrace. That really, truly is. We need more and better detoxes and places, too, that let cannabis be used as well.

Cannabis is proven. I started the CSP in Victoria. When I was over there, I worked in two different overdose rooms. I worked for SOLID.

You might know them. I believe we actually met before.

S. Chant: We have indeed.

H. Calpas: Dan, I believe we met before too.

We started the CSP over there. It’s going great. They’ve got thousands of members. People really, really appreciate it. Here, unfortunately…. There were four of us that went to city hall, and we talked to Rebecca. I can’t remember her last name. But we got support from the city. Neil, who runs the CSP, cannabis substitution project, here has been busted four times.

B. O’Donnell: The police keep taking his things.

H. Calpas: The last time was a couple weeks ago. They took his van. They took all his product, his money and everything else. I talked to the cops myself, and I said: “Why are you doing this? They’re saving lives. Why are you doing this?” “Sorry. It comes from higher up.”

J. Louden: Some of us were functioning junkies. I used to be a brick, block and stonemason until I went to St. Paul’s Hospital and got some bone-eating disease. Now I’ve got to be operated by the goddamn government, which is not something I want. That’s the way it goes, I guess.

R. Maddeaux: I have more, focused on your question of what could have been done differently before I started.

If legislation and our laws and the way we did things around drugs were in place before I started using drugs, I would have been in a much better place. My ideas around what that would be…. I initially started using drugs both for medication, self-medicating, and for recreational use. I started in my mid-teens, and I won’t get into the details of my life, but I’d gone through a lot. I started using drugs to fit in and to be somebody that was maybe looked up to, looked as cool in my group of friends but also to escape reality in that I didn’t like my life at that point.

However, I think if all these drugs that are available had been seen as the same as alcohol or other medications where I didn’t have to go onto the streets and deal with gang members and the black market, I could have gone to a doctor who’d work with me to prescribe me drugs, whether it be opiates or heroin or whatever.

For me, that’s what worked for me the best for depression and getting to the point where I was able to get better. If I write a book in the future, I want to title it “Heroin Saved My Life” because that’s how I see it. For about five to ten years, I was suicidal. I didn’t want to be alive. If I wasn’t high, if I wasn’t using something to escape the reality I was living in, I didn’t want to be alive.

[2:15 p.m.]

Heroin got me to that point where I could smile during the day. I could enjoy myself. I could have a life. It got me to the point where I was now ready to deal with my problems in a more beneficial way, I’d say — or a more productive way.

However, there are some people…. We are all different. Some people will use an antidepressant or a drug or something for the rest of their lives. If they need to do that, then I think they should have the support to deal with those drugs — get the cleanest drugs possible, the safest drugs — and do it in an educated and productive way, right?

That’s where I think…. If things were different before I started using drugs, that’s where it would have to be. It’s that we can use these drugs…. They serve a purpose. Basically, every drug we have out there serves a purpose in some way or another, and we’re not utilizing them in the most productive ways.

N. Sharma (Chair): I have a few more questions here. Let’s try to get to as many as we can.

Trevor and then Sonia, go ahead.

T. Halford: Throughout the presentations the last couple of days, there’s one thing that keeps coming up. It’s the benefit of trauma therapy. But for a long time now, there has been an access problem, a cost, an affordability problem.

In terms of what you guys are seeing every day, are you able to speak on the benefits of trauma therapy — what you are seeing, what would work better, if it’s more accessible, if it’s cost?

R. Maddeaux: I think it needs to be in a way that we can utilize everything that’s out there, whether it’s behavioural therapy, counselling, while also using the drugs that are out there — in speaking with the individual and what works best for them.

Yeah. I do fully believe that those of us who got to the point where we’re on the streets, working in the sex trade, committing crimes to obtain the drugs we need…. I think that we need to access all the available options out there. I think we do need a lot of improvements in what’s out there as well.

G. Mullins: I’ll tell you what. I’ve had PTSD treatment. It was really helpful for me. But we’re here to tell you how to stop people from dying. We’re looking for solutions for this afternoon — you know, for the next two hours. This is triage, right?

If you think about a roadside accident, and there are people lying on the side of the road. You don’t want some city engineer to come and say: “How would we put a traffic light in here to prevent this?” I mean, prevention is important, right? Or: “How would we put another airbag in the car?”

Those are great questions, and we can have committee meetings on that. But in the context of an emergency, it’s the death. That’s the problem for us. Not if people are using drugs. People are going to use drugs. That shit just happens. Trauma therapy is great for us who have been traumatized, but there’s lots of people who just do a bit of coke on the weekend. They shouldn’t die.

It’s calibrating what the problem is. In this committee, the terms of reference really focus on that toxic drug supply, right? So in my mind, I agree. Let’s give everybody access to really good PTSD treatment. Fucking A. But the main thing we have to do is end the toxic drug supply, and we come here asking the province to put its hands on every lever that’s possible, because so many of them have gone unpulled.

We see the Minister of Mental Health and Addictions get on TV, and she says: “Our hearts are heavy. We’re doing everything we can. Never before have so many people done so much.” I can’t even hear it anymore, and none of us can at the Vancouver Area Network of Drug Users. We’ve just had crocodile tears for years.

That’s why we’re looking for those immediate triage moments. One of our co-founders of BCAPOM, Ann Livingston, says that you’ve got drug user groups, and then you’ve got drug user groups with a lawyer. So this is our lawyer. This is Caitlin, and she rides shotgun on all of our shit.

That’s why, when we had a strategy meeting about this, we’re like: “Let’s really identify for the province, in as much detail as we have time for, the things that we can do that would save lives this afternoon.” Because this panel of people you see in here…. If we have this again next year, there’s a 50-50 chance that not all of the people will be here.

We go to meetings, and we prepared for this meeting. Look in your book. This handout that we gave you — if you look at the end here. Here is Greg. Here is our past president, Chereece Keewatin. They’ve come to rooms like this and talked to people like who are in this room, and they’re dead. They’re gone.

It’s just like…. I think to myself: “Next year is Laura going to be here with us? Is Jeff, my best friend for 30 years, going to be here with us? Is it going to be me?” We don’t know, right? So for us, prevention and trauma treatment are good things, but they’re just not urgent enough.

[2:20 p.m.]

H. Dempsey: Is it possible for me to add something? I’m Hannah Dempsey. I’ve worked with BCAPOM as their project coordinator since October. I think, in terms of trauma-informed therapy, as Garth says, that it could be helpful, but….

The way in which this committee was set about takes very little responsibility for the fact that government policy is responsible for this toxic drug supply. The war on drugs and prohibition have resulted in this crisis. We need governments to take that kind of responsibility up. These policies, these systems are causing trauma as we speak — all of these deaths. Forcing people to piss in a cup every week.

If I went to a BCAPOM member meeting, and I’m looking in the face of someone who missed an appointment for a week because he was ill and he is unhoused, and now he has to go to the pharmacy five times a day…. Anyone in this room who can go to the pharmacy five times a day and maintain any semblance of a life and not experience that as, in itself, traumatizing…. Telling that person that now they have to go to a trauma care therapy, and that’s going to save them….

This is why we are here with these directed recommendations that we need these punitive measures that are a part of the war on drugs…. These barriers in the OAT systems are full of stigma, and they are part of the war of drugs which the government is responsible for. You are an actor in this war.

A Voice: It is an open-air jail.

T. Halford: Just to be clear, though, I wasn’t talking [audio interrupted] trauma therapy.

H. Dempsey: No, I don’t mean mandating. I just….

T. Halford: Just hold on a second. What I was saying is that we’ve had people come in here in the last couple of days that have said trauma therapy is keeping them alive. That’s what I’m just trying…. I just want to make sure I put that….

H. Dempsey: Oh, totally. No, I’m not at all speaking against the life-saving capacity of trauma therapy and therapy in general and the real, dire need for actual services and real health care, real counselling and care for people who use drugs, and people in general. But I just think if we get caught up in that….

Again, like Garth said, we are in an emergency right now. We are six years into an emergency right now. VANDU has been feeling the effects. They’ve been feeling this as an emergency for longer than when it was publicly declared by a Health Minister.

R. Maddeaux: It doesn’t feel like we’re an emergency from the way the reactions are. We’re living in an emergency. It feels like that on the ground level. On the streets, it feels like an emergency. But it doesn’t feel like there’s an emergency going on when it comes to all the other actors or the sources that are involved.

I would also like to add that…. Hypothetical situation: somebody is receiving trauma care, and it’s really helping them out. There’s a good chance that they’re also still using drugs. So they could also be using this really beneficial care and still die, still overdose on drugs. That’s where….

For me, I believe…. You know, my way of thinking is that everyone that is responsible for making drug policies throughout the last 100 years is in some way responsible, holds a responsibility for creating the fentanyl overdose crisis and is in some way responsible for everyone who has died in that it’s completely unnecessary.

There’s no reason for heroin to be illegal and alcohol to be legal. You know what I mean. We’re functioning on ideology and an uneducated population. Their needs and wants seem to be much more important than the people who are actually dying and living this war.

N. Sharma (Chair): Sorry, I’m going to step in here. We have about five minutes left before we said…. I just wanted to see if I can get to the next two questions so people get a chance to engage a little more before.

Go ahead, Sonia.

S. Furstenau: Okay, thank you. I think it’s really valuable for us to feel the sense of emergency and urgency with you. I think this is essential.

When you say, “Pull the levers,” we’ve heard pretty consistently, from everybody who’s talked to this committee, about the need for regulated safe supply. I know about VANDU’s application to provide safe supply and the letter back from the federal government. Describe for us how that lever can be pulled quickly and what VANDU’s efforts have been to try to pull that lever on regulated safe supply — the co-op model, or the compassion….

[2:25 p.m.]

C. Shane: In which folks are purchasing from the web and then testing and selling?

S. Furstenau: Yeah. We heard about it yesterday, but if you could give some more description about what that could look like on the ground.

Garth, you said we need to triage. Tell us what the triage looks like on the ground.

G. Mullins: Sure. I mean, you’re talking about the Drug Users Liberation Front, I think, which is ourselves and other groups, DULF, that gives away to our membership tested heroin, coke and meth that’s sourced from the dark web but then run through a mass spectrometer to make sure of what it is. It’s an act of civil disobedience. It’s symbolic. It does not scale. We can’t get the amount of material, the amount of drugs to do it.

I think what we’re all asking is for the people who allow or don’t allow the importation or the prescription or the distribution or even the manufacture of those drugs in British Columbia to make way for it. We used to manufacture prescription opioids here in British Columbia. I mean, I know that on the North Shore, my girlfriend used to work in a factory. We can again, but it’s that source that’s definitely a limiting factor.

We need to get it out to people through every means necessary, every means possible, like through forming co-ops but also through the prescription possibilities of the province.

I think it’s really worth having DULF come before this committee and give the presentation. Eris and Jeremy, who are on DULF, have a presentation that you would probably find really helpful on this.

A Voice: You could listen to Crackdown.

N. Sharma (Chair): I just want to see if we can get the last question. I might have a little one, if I can sneak it in.

R. Maddeaux: Just real quick. I think we need to eliminate the process that it goes through to get an exemption. That needs to be streamlined, or just put a mass exemption out there because we’re in an emergency, or something. I think we would have more time if we came to this meeting with an actual presentation in mind around those ideas.

N. Sharma (Chair): Okay.

Go ahead, Susie.

S. Chant: Mine is really sort of clinical. Excuse my ignorance. What is the difference between methadone replacement and Methadose? I don’t know.

G. Mullins: The real quick version is methadone was generic; Methadose is a brand name prescribed by a pharmaceutical company. The province switched everybody over in 2014.

S. Chant: So it’s like going to a generic.

G. Mullins: But the Methadose doesn’t work, doesn’t hold people for very long. So we fought for a return to the old stuff. We failed in that fight. We fought for other alternatives. They’ve come on, but there has been no communication out, really. So most doctors, most drug users don’t know. Most are still on what Jeff calls crappy cough syrup, which is the Methadose.

S. Chant: Got it. Thank you.

H. Calpas: Methadone would last for 30 hours, whereas Methadose would last for 16.

N. Sharma (Chair): Can I ask, hopefully, a quick question?

We’ve been learning about the toxicity and the response of the drug supply. You’re all speaking about it in a very personal way. In your view, is it the fentanyl patches? Is it the powder? What is the match to that that would be the safe alternative? You already talked about methadone.

G. Mullins: The best substitute for street fentanyl is prescription-grade fentanyl in whatever formulation we can get it. So if people smoke it, smokeable. Injectable. On the patches, it’s the best we can be doing right now. The closest thing to the street supply is going to get the most people.

R. Maddeaux: I think that’s a good way to put it. Just the regulated, pharmaceutical level — you know, tested, safe supply.

It also needs to be whatever is the right method. Say the patient likes to smoke, then they need to have that option. I think Garth just said this. If they like to inject, then they need to have that option — what they want, not what the doctor tells them they should be doing.

N. Sharma (Chair): Thank you, all, for all that you’ve taught us today and the lived experience but also what you’re seeing. I think it was really impactful for everybody on this committee to hear your voices directly, so I just want to thank you for that.

Howard, go ahead.

H. Calpas: Do you think you folks could have any kind of influence on actually getting real detoxes out there into communities? There’s not just here, but everywhere. You’re all over the place, right? So if it’s possible to get real detoxes happening and real treatment centres too. Is that possible?

[2:30 p.m.]

N. Sharma (Chair): What you have before you is a cross-party committee. We’re representing basically every party that’s elected in B.C. Our job is to hear these real-life needs of what’s in community and give recommendations of what’s needed to respond.

We are covering everything — probably, likely — not only about what our terms of references are, with the direct response of what’s needed, but also we have been talking about things like hearing about detox, hearing about treatment centres. We had a presentation this morning about prevention and what that looks like, in terms of mental health services.

This is part of the work that we’ll have to do once we hear from as many people as possible.

We’re kind of in the education phase right now, so we’re all…. We have our ears open. We’re hearing from tons of different people what’s happening.

H. Calpas: What about growing our own poppies here?

N. Sharma (Chair): It will be part of the deliberation. I thank you for your thoughts on that. It’s been really….

G. Mullins: We have lots to say, and we’d like to invite you all, collectively or individually, to come to our meetings. We meet every Wednesday, except for cheque day, at two o’clock at VANDU. You would all be most welcome.

N. Sharma (Chair): Thank you. We really appreciate that.

A Voice: And you can listen to the podcast Crackdown.

G. Mullins: That’s right. Listen to Crackdown. Lots of people on the board here are on the Crackdown podcast if you want to hear more.

N. Sharma (Chair): Thank you. Thanks for coming in. It’s been a really great afternoon. Take care.

We’ll give ourselves a motion to adjourn. I need a motion.

Motion approved.

The committee adjourned at 2:31 p.m.