Committee of Supply

Proceedings in Section C

ESTIMATES: MINISTRY OF
MENTAL HEALTH AND ADDICTIONS

(continued)

On Vote 36: ministry operations, $9,712,000 (continued).

The Chair: Good morning, Members. It’s very nice to see all of you on this lovely Friday morning.

I’d like to start by recognizing that I’m speaking to you today from the traditional territory of the Lək̓ʷəŋin̓əŋ-​speaking people, now known as the Songhees and Esquimalt Nations. I’m very honoured and privileged to do my work and to live on their traditional territories, as well, and to represent them at a provincial level.

We are meeting here today to continue consideration of the estimates of the Ministry of Mental Health and Addictions.

Hon. J. Darcy: I would also like to acknowledge that we are gathered here on the traditional territory of the Lək̓ʷəŋin̓əŋ-speaking people, the Esquimalt and Songhees First Nations. We gratefully acknowledge their traditional territory.

The Chair: Minister, do you have any opening remarks that you would like to share?

Hon. J. Darcy: I don’t think so. I made opening remarks yesterday, as we commenced estimates for our ministry this year. I think we can move straight to questions.

J. Thornthwaite: Thank you to the minister for letting me start off on my questions. For the Chair, I just wanted to let you know that I’ll be asking questions for an hour. Then I’ve got three of my colleagues coming in: the members for Prince George–Valemount, Vancouver–False Creek and Kootenay East. They’re going to be asking questions at 10:30. I very much appreciate that.

Just to begin, I’d like to provide a quote from Hannah Jarvis, who is the sister of Marni Jarvis, who died of an overdose on May 2 at age 28. “We’ve been naming the opioid crisis in Vancouver as a pandemic for the past four years. We have not seen that same response, and that makes me so mad.” This is about a comparison between the response of government from the COVID pandemic as well as the opioid crisis.

There’s very clearly a visible difference in this government’s reaction to the two public health crises. During COVID, we received daily briefing updates from the public health officer and Health Minister — six days a week, actually — at the height of the crisis. With the opioid crisis, we receive a monthly news release from the coroner’s office. Rarely, if ever, is there a press conference.

[9:35 a.m.]

I seldom recall the minister doing a conference similar to COVID, especially given that we’ve had the most deadly months in May and June with regards to overdose deaths. Why has the same emphasis not been put on the overdose deaths — the first public health emergency that was declared back in 2016 by our government? Why is there not the same emphasis on that public health crisis as there is on COVID? Why did the minister not hold a press conference announcing the record deaths, yesterday, when there was a release?

This has been brought to my attention a couple of times: why are there not daily updates on those who have died of overdoses like there are with COVID-19 and, more importantly, daily updates on those who have recovered from addiction? We see Dr. Bonnie Henry mentioning those that have recovered from COVID, but we do not see the same celebration of those that have recovered from addictions and from the overdose crisis.

[9:40 a.m.]

Hon. J. Darcy: I think the member should be aware of this. In case she isn’t…. I think it’s important for everyone to recognize that it’s the coroner that determines the cause of death. The coroner makes that announcement once a month. That’s because the coroner doesn’t….

There has to be an investigation done of every death in order to do the toxicology and to really determine the cause of death, what kinds of drugs are found in the bloodstream, for instance, and in what combination. We’re talking…. It certainly takes days. It sometimes takes weeks. In some cases, it takes months, and that’s why we sometimes get updates a few months later about what the death toll has actually been.

It’s a very different situation than COVID, where someone has been infected with COVID-19. They’re already diagnosed. They’re already in the health care system. They’re being treated for it. Again, the determination of death is much more straightforward in that case.

As far as our government’s response to the overdose crisis, we’ve been at this non-stop from day one. We’ve been tackling this from many, many different places and in many different ways simultaneously. We know that there are many different pathways that get people to a place of addiction, and there are, very importantly, very many pathways to recovery and to hope.

We have been working on every conceivable front, as the member knows very well, from harm reduction to treatment and recovery, to prevention, to access to safe prescription alternatives. We have been making announcements at breakneck speed, frankly.

As we now cope with a dual public health emergency…. The entire province has been challenged like we’ve never been before, coping with two public health emergencies. That didn’t stop us from acting very, very quickly to roll out new supports, responding to new situations, like the risk mitigation guidelines, in order to separate people from the illicit drug supply, which is what is killing people, and like the announcements I’ve made just in the last week about new treatment beds and new substance use integrated teams.

I speak to the media constantly. I think I’ve done 11 media interviews in the last week alone. I’ve held press conferences. I’ve made announcements. I get grilled by the media on every aspect of what we’re doing. I will continue to do so and to take questions in question period, from people across the province and from the media as well.

J. Thornthwaite: I’d like to move on, then, to the announcement. The government announced, on July 10, $13.5 million over three years for, the announcement said, 50 to 70 publicly funded treatment beds. I will note, on the record, that that’s about a third of the amount of people who died from an overdose last month.

[9:45 a.m.]

Doing the math on it…. I did do the math. If we were to be generous and go with the 70 — let’s assume the government does deliver on the 70 — that’s roughly $64,000 a year. Does the minister think that this is an adequate amount of funding for a facility, for a year, for all expenses to help someone recovering from addiction?

Hon. J. Darcy: As the member, I believe, knows and recognizes, there is no set price for a recovery bed. When we do the granting process — we have indicated that we will be announcing the opening up of that process next month — the amount that would be allocated per bed would really be relative to the level of service that’s provided.

I do want to clarify that the particular types of beds that we’ve made announcements for are residential treatment beds and supportive recovery beds. Again, even within those, there is a range of costs. Operators are going to need some flexibility, because they provide a range of services. They don’t all provide the same services, so some operators might well be receiving more than that and some less than that. It really does depend on the level of care they provide, the types of services they provide and the level of complexity of their clients.

J. Thornthwaite: If the level of services is variable, then how does the minister know it’s going to be exactly $13.5 million? How are there going to be choices made on where that money is going if the level of services is so variable?

[9:50 a.m.]

Hon. J. Darcy: As I’ve indicated already, this $13.5 million commitment that we announced is to add more capacity — to add more residential treatment beds and supportive recovery beds. Within those two categories, of course, between supportive recovery and residential treatment, there are varying levels of service. Even within residential treatment and within supportive recovery, there are varying levels of service. That’s why we give a range.

Until we actually see the proposals from operators that submit proposals, we aren’t going to know exactly how many beds we’re going to be able to provide. Of course, our goal is to provide as many new treatment beds as we can, to fund as many new treatment beds as we can. We also want to ensure that we are meeting high-quality standards and that we’re meeting the needs of clients.

J. Thornthwaite: Okay. Well, getting on, on that, then. We know that there are currently 30 PHSA specialized addiction treatment beds that are funded by the province. That cost is about $350 a day. I might be off, but it’s in and around that area.

Again, doing the math, that would be close to $128,000 a year. Again, it’s 70 beds a year over three years. That would equal $27 million, which is actually double what the minister has announced. So the money that is being provided in this announcement is actually half of what is needed for these specialized addiction treatment beds.

I guess what my question is…. I worry, with the answer that I got, that we’re probably going to get either less beds or less services in the beds, depending on where that money is going to. That’s just a comment. Perhaps the minister wants to comment on that.

The other question I did have is: is this new money, or is it year-end?

[9:55 a.m.]

Hon. J. Darcy: Let me emphasize, again, that the announcement that we made of $13.5 million is targeted specifically to residential treatment beds and supportive recovery beds. There is, as I’ve already indicated, a range of services provided in there and a range of costs, of course, to meet the needs of different clients, who have varying needs, as we know.

The numbers and the costs that the member opposite referenced are what we refer to as tier 4 and 5 beds provided by PHSA. Those are really the highest-cost beds in the system, serving clients with the highest level of complexity.

In answer to her second question, this $13.5 million is year-end money.

J. Thornthwaite: Okay. That’s interesting. If it’s year-end money, then why announce it in July?

My other question on this announcement is about the Canadian Mental Health Association. The minister has designated the Canadian Mental Health Association to distribute these funds. Will the Canadian Mental Health Association be doing the RFPs?

I wanted to get an answer from the minister on their commitment to recovery. I draw the minister’s attention to an article that was published in the North Shore News about the Canadian Mental Health Association’s presentation to the three North Shore councils on the lack of housing that was occurring on the North Shore. The executive director of the North Shore, Julia Kaisla, says: “The housing we lack, more than any other, is supported, low-barrier, harm-reduction-based housing.” Of course, that’s the North Shore she was referring to.

I guess what my question is…. I just wanted to get an assurance from the minister that the funding that the Canadian Mental Health Association will be distributing is going to be designated to residential recovery facilities, not to harm reduction or low-barrier supported housing.

[10:00 a.m.]

Hon. J. Darcy: I know that I was crystal-clear in the announcement I made about the $13.5 million, and in a whole array of media interviews since that time, that these beds are residential treatment beds for addiction — residential addiction treatment beds and supportive recovery beds. I don’t think I could have been any more clear.

I am a strong supporter of our recovery community, work very, very closely with them and absolutely believe that supportive recovery works and that residential treatment works. People become addicted in different ways. People have different pathways to hope. Supportive recovery and residential treatment is one very, very important piece of that.

The questions about the Canadian Mental Health Association. It’s the CMHA, in partnership with the Community Action Initiative, that will be overseeing the granting process. These are both highly, highly reputable organizations that the previous government worked in close partnership with and that our government is working in close partnership with. I have every confidence in how they will handle this. The parameters have been very clearly established by our government — what this funding is meant for.

I want to just read a quote from someone who spoke to this. In fact, it was in the news release the day that we made the announcement. “The B.C. Addiction Recovery Association, BCARA, applauds the Ministry of Mental Health and Addictions for this significant announcement…. It’s imperative that a range of interventions, including treatment and recovery, be available to those suffering from addiction.”

[10:05 a.m.]

She goes on to say: “The financial supports for the providers that have continued to operate during the pandemic will ensure that these essential services can continue uninterrupted. Increasing the number of recovery beds in B.C. will help our most vulnerable citizens access treatment and recovery more quickly, reduce wait times and, ultimately, save lives.”

That’s a quote from Brenda Plant, the chair of the B.C. Addiction and Recovery Association and the executive director of Turning Point Recovery, with which, I think, the member is very familiar.

J. Thornthwaite: With regard to the year-end funding, is this going to be in ongoing funding, in operations, as well? Does it go past the three years? If that’s so, whose budget has been increased to account for it?

Hon. J. Darcy: This is a year-end funding commitment, and it’s a commitment over three years.

As the member knows, any government’s fiscal plan — the previous government’s, our government’s — only runs for three years. So future years, the needs of the future years, whether that’s next year or the year after, would be the subject, the topic of future budgets and future estimates.

I do want to say to the member, though — I’m sure she’s aware of this, as I’ve already spoken about it — that the announcement is being delayed. We will be opening more youth treatment beds very, very soon. We know very well that the fentanyl poisoning crisis has affected people right across the province, from all walks of life and from all backgrounds, but it has had a particularly devastating effect on Indigenous people.

We know from the report from the First Nations Health Authority, which came out a few weeks ago, that Indigenous people are dying at a rate of 5.6 times the population at large. That’s why the numbers were very high, disproportionately high, before COVID-19, and even higher now since COVID-19 hit.

From early on, we’ve been working in very, very close partnership. In fact, some of the biggest investments we’ve made through our ministry have been in the partnerships with Indigenous peoples, specifically with the First Nations Health Authority, and a number of different commitments that are directly about mental health and wellness, about addiction.

One of the most significant ones is a commitment — and funding has already being allocated for this — for rebuilding and renovating six rural Indigenous treatment centres and building two new urban Indigenous treatment centres. There’s a combined commitment from our government and First Nations Health Authority of $40 million for those Indigenous treatment centres. That’s in addition to a number of other initiatives that I’m happy to speak further about, which really are about ensuring that First Nations are in the driver’s seat in developing programs that are about mental health and wellness.

[10:10 a.m.]

We’re making significant financial commitments in order to be able to do that, because we know these programs need to be culturally safe. We know that means that First Nations need to be in the driver’s seat in shaping them and delivering them.

We’ve rolled out significant investments in other areas that are also about starting early, starting with our youth, building programs that are culturally safe, programs that connect youth with Elders and reconnect them with land, culture, community and traditional healing.

It’s a partnership that’s founded in our government’s commitment to reconciliation. It speaks to the really, really high level of need amongst Indigenous people, which, as the member knows, is a direct result of our dark legacy in this province and this country of colonization, of racism, of residential schools — and the multigenerational trauma that continues as a result of that dark legacy and racism that continues in the health care system.

J. Thornthwaite: This spring we saw a return to triple-digit monthly overdose deaths. In March, there were 113, 118 in April, 170 in May and 175 in June. There was a 97 percent increase from May 2019 to May 2020. We know that both May and June have the highest recorded deaths ever.

I did a random phone call to nine residential recovery facilities to see how many beds they had empty. I’ve done this every year during estimates. It’s usually in the area of 110, 115. On this particular one day, with nine providers we called — obviously, it’s not everybody — there were 125 empty beds sitting there, not getting used, not funded.

My question to the minister is: does she know, actually, today how many beds are sitting empty that could be funded in British Columbia? Given the fact that I just did a random phone call to nine facilities, obviously it’s going to be more. Does the minister have an idea of how many beds are sitting empty, unfunded in the province of British Columbia today?

[10:15 a.m.]

Hon. J. Darcy: I have, actually, from as soon as the pandemic was declared, had multiple round tables — virtually, of course — with operators of residential treatment facilities as well as supportive recovery. I started, really, as soon as the pandemic was declared.

I did that in order to, as I do…. Throughout everything we do — my role as minister, the role of staff in my ministry — we want to have a direct sense of what’s happening on the ground across the province in this sector. We wanted in this case, with COVID-19 having hit, to have a direct understanding of the impact of COVID-19 on the recovery sector. They let me know very, very clearly about the challenges they were facing.

I want to give a shout-out. I hope some of them are listening. If not, I want to get the message to them. I’ve already conveyed it to all of them, personally, but I want to give a shout-out to all of the operators of residential treatment facilities and supportive recovery homes because they have been so committed and so diligent and so professional from day one in ensuring their clients were safe, doing everything they could to continue providing the services and the care to people in recovery.

[10:20 a.m.]

I can’t tell you how many moving stories they shared with me in those round tables about what they were doing to ensure that group work continues to happen virtually, rather than in a physical circle, and to maintain levels of physical activity. They couldn’t go to a gym anymore, but activities that clients could do physically distanced, in parks and so on. They made sure that they had access to counselling — virtually, of course, not in person.

I really want to give a shout-out to them. They have been absolutely diligent in respecting the directives and the advice of Dr. Bonnie Henry and her team. As a result of that, to my knowledge, unless they’ve happened very recently…. Well, there certainly have been no outbreaks, at all, in residential treatment facilities or in supportive recovery homes. That’s an enormous tribute to the operators and the staff on the front lines in the addiction treatment and recovery sector.

They certainly conveyed to me very clearly the huge financial impact and the impact on the capacity of service that they were able to provide because they were respecting the physical distancing guidelines. In that case, what that meant was that instead of someone being admitted directly from the community, from their home, into a residential treatment centre or a supportive recovery home, they would require that people needed to be isolated for two weeks.

In some cases, they provided the space on the premises — a separate room, a separate building — for people to be able to isolate for two weeks before being admitted. That, of course, has an impact on whether they’re able to work to capacity. In so many of these facilities, people share a room — sometimes two to a room, sometimes more than that. That is part of the supportive recovery process. It’s about buddy systems. It’s about people being there for each other on their recovery journey.

Some operators reported to me that they were only able to function at 50 percent capacity, some at 40 percent capacity, some at 60 percent. It varied. It really depended on what their existing configuration is, how many beds they have, how many people per room, and so on. They did everything in their power to keep their clients safe while continuing to provide high-quality services and care. I really congratulate them for doing it.

Because of that significant impact on them financially, the announcement that we made…. I think it was on July 10. Together with the new beds that we announced, there was also $2.5 million in direct COVID relief to these operators. We want them to continue doing the great work that they’re doing. We don’t want them having to close their doors or go out of business. So that was direct support that they requested and that we delivered on.

Do we know we need more publicly funded beds? Absolutely, we do. That’s why we made the announcement on July 10.

J. Thornthwaite: This will be my last question before the member for Prince George–Valemount steps in.

My question is: given the support that the minister has said for those that work in recovery facilities, will she ensure that they receive the temporary front-line pandemic pay increase? Will she also work with her colleague in Social Development and Poverty Reduction to bump the per diem for recovery facilities, which is currently at $45 a day?

[10:25 a.m.]

Hon. J. Darcy: Thank you to the member for the question. We actually have worked very, very hard as a government and in our ministry to ensure that the sector itself and people who work in this sector get the protections that they need.

The member asked specifically about wage top-up. We ensured, when government was defining what essential workers are, that those working in recovery were declared essential workers, which was very critical. The wage top-up that was provided for essential workers does include publicly funded recovery workers — people who work in residential treatment and supportive recovery in the publicly funded facilities.

In addition to that, we brought in job-protected leave for people who were unable to work because of COVID-19. We know that there are operators that, in some cases, couldn’t afford to pay people, and there were people who were worried about coming in to work because of the risks of COVID-19. So we brought in job-protected leave for people unable to work because of COVID-19.

We finally, finally — the Premier’s been pressing on this for months — got the federal government to commit to providing two weeks’ paid sick leave. Again, that’s a discussion I had with a number of operators. If people got sick, they couldn’t afford to pay sick leave.

[10:30 a.m.]

These are small operators, often, and we felt very strongly that just like small businesses, these operators shouldn’t have to bear the responsibility of sick pay if someone became sick because of COVID-19. So now the federal government has finally committed to that.

We also ensured that people who work in supportive recovery have letters…. They were having difficulty accessing, in some cases, personal protective equipment. They were having challenges when they went to grocery stores, being able to be there when health care workers were allowed to come at separate times of day, because they weren’t officially designated. We provided letters for them so that when the recovery operators or staff would go to grocery stores, for instance, they could show that they were essential service workers and that they were there in order to buy supplies for their sector.

As I’ve also mentioned, there was $2.5 million that we provided in order to help to ensure the financial sustainability of the sector. Another thing, I think, that was really important, in terms of key supports during recovery that the recovery sector has really benefited from.

First of all, last September we provided $10 million in grants to community agencies that provide addiction and mental health counselling. Some of the beneficiaries actually were residential treatment facilities, but mainly, they were community agencies across the province serving vulnerable populations who couldn’t afford access to the $150, $250 that you might have to pay to get access to addiction and mental health counselling.

These are services that some recovery operators are able to provide, also at cost. Those services are certainly available to them and to clients of theirs across the province. We stood those services up virtually, within a couple of weeks of the pandemic being declared, in the existing 29 community agencies that provide counselling. Then we added another 20 so that people could access virtual counselling.

As far as the per diem, I think the member will know that the previous government ignored the supportive recovery sector for many, many years. It’s been characterized — I think appropriately — as the wild, wild west in our system for mental health and addictions, so to speak, because there was virtually no regulation, no standards.

Most of our operators do a great job. Most of them are totally committed to ensuring the well-being of their clients, and many of the people who operate or who work in supportive recovery are themselves people with lived experience, and they’re totally passionate and dedicated. But we also know that there were a bunch of bad apples, and we’ve heard horror stories about what was occurring in some of those so-called supportive recovery homes.

We brought in regulations that would ensure far greater safety for clients, that would ensure that when a client approaches a supportive recovery home, they would be very clear before they enter that home about what their approach is, what their policy is, what services are provided. They would be involved in developing their own care plan, and very importantly, they’d be involved in developing a discharge plan so that people don’t leave supportive recovery and go out into the community or onto the street at a time when they are very, very vulnerable.

We also provided funding for training for supportive recovery operators in order to ensure that their staff were better able to meet those new regulations. Very importantly, on the issue of per diems, our government raised the per diem, for the first time in ten years.

The Chair: I recognize the member for Prince George–​Valemount.

S. Bond: Good morning, hon. Chair. Thank you for the opportunity to ask some questions. I very much appreciate that our critic does an exceptional job working on this file, and I appreciate her allowing us to have some time.

Yesterday, I think, all of us were heartbroken when we heard from the B.C. Coroners Service that our province experienced the highest single death-toll month in the history of the opioid crisis. The minister knows that this is the fourth consecutive month with over 100 overdose deaths — staggering numbers.

[10:35 a.m.]

As a side note — I’m sure the minister has been handed a note by now, by her very capable staff — it was very difficult to hear the Premier refer to addiction as a choice. I hope the minister took some time to look at what people who have struggled through their lives…. They were prescribed an opioid and managed to work their way through that. I hope she read some of their stories.

I’m sure that the minister now knows that the Premier said that he regretted his words and the choice of his words yesterday. Yesterday the minister refused, dozens of times, to admit that those words were hurtful and inappropriate. I’m hopeful that at some point during the answers that she’s providing today, she’ll take the opportunity to express her regret. It would have been a simple thing to do yesterday. The minister knows that those words are not correct, and she chose not to yesterday. I’m hopeful that we will see her follow the lead of the Premier, certainly, as the minister responsible for this file.

The questions I want to ask relate to the fact that the addiction crisis is experienced all across the province. In fact, the region that I represent, the Northern Health Authority, is currently second in the province, if you look in terms of deaths per 100,000.

I’m wondering if the minister can address the concerns of many northern residents about the need that we have for additional supports in our region of the province. We’ve had some fantastic round tables with people talking about what the needs are. We need services and supports for women. We need additional detox services, recovery beds, sobering centres. The list goes on.

Could the minister outline for me…? I would ask, in respect to the time that has been allocated for these estimates, that the minister focus on the additional supports that are being considered. I don’t need to know…. I already am well aware of the services that exist and the gaps that exist. Recognizing that time is short, would the minister please focus on what additional resources and supports are planned for northern British Columbia?

Hon. J. Darcy: Madam Chair, we moved very quickly to this member for questions, and I was not quick enough in asking if we could take a five-minute break. So I’m asking you now.

The Chair: Members, we will take a five-minute break. We’ll return at 10:43.

The committee recessed from 10:38 a.m. to 10:43 a.m.

[M. Dean in the chair.]

Hon. J. Darcy: I’m happy to speak directly to the member’s question about new services and programs in the north.

[10:45 a.m.]

The member will know that we just announced this granting application process for new publicly funded residential treatment and supportive recovery homes. We certainly want to see those across the province, so we look forward to receiving the grant applications in that process. The details of that will be announced in August.

I want to let the member know, if she isn’t already aware, that one of the new programs that will be coming to the north that we’re really excited about are child and youth mental health teams that work with school districts. We have initial funding for five of those. We’ve announced two of them, but one is still to be announced. The community is still being identified, but there will be a school district in the north that will also have a robust child and youth mental health team.

This is really about prevention. It’s about starting early. It’s about starting with our kids, which I know is something that the member opposite feels very strongly about and has spoken about passionately in the House. These would be substance use workers, mental health workers, Indigenous support workers and others as required working very closely with educators, school counsellors, and so on, to provide wraparound supports for children and families.

The counselling grants that we announced just a few months ago. Of the 29 that were announced, four of them were in the north. Carrier-Sekani Family Services, Central Interior Native Health Society, Dze Ḻ K’ant Friendship Centre Society and Quesnel Women’s Resource Centre all received grants for counselling for mental health and addictions.

Counselling, as we know, is an important part of helping people and supporting people on their recovery journey. Then, once COVID-19 hit, we knew that in order for people to be able to access those counselling services, we were going to need to support them to stand up their services virtually. All of those existing counselling agencies were provided financial support in order to stand up their services provincially, and we funded two new organizations to be able to stand up their services virtually: the Prince George Native Friendship Centre and the CMHA in Prince George.

Another piece that I think is really important is the substance use integrated teams that I announced, I think, on Monday of this week. The reason these are really important is that we’ve learned from the coroner that four out of five people who die of overdose had some connection with the health care system in the year prior to their death. Four out of five.

It’s critically important that we stay connected to those people, that we connect with those people. Once they connect in the emergency room, through primary care, through a Rapid Access Addiction Clinic — wherever they connect — we need to stay connected with them. That’s exactly what these substance use integrated teams will do.

There will be four of the substance use integrated teams in the Northern Health area: the northeast health service delivery area, which includes the north Peace, where we will be adding new resources to strengthen an existing substance use team; the northwest health service delivery areas of Smithers and Houston, again adding resources to bolster the team; the northwest health service delivery area, Prince Rupert, including Haida Gwaii and coastal communities, again bolstering those teams so that they can reach even more people; and northern Interior health service delivery for Prince George and surrounding rural communities, again, adding more resources to boost those teams.

Foundry. I know the member was there, and I was happy to be there for the official opening of the Prince George Foundry. I know the member was there, and I certainly acknowledge the work that she did to get us to the place where we could open a Foundry in Prince George. We have already announced, a number of months ago — lots of things have been delayed, of course, because of COVID — that there will be a new Foundry youth centre in Terrace, a community that has very high needs. And we just recently announced that one of the new ones, one of the eight additional that we announced, will be in Burns Lake.

[10:50 a.m.]

In addition to that, we have community action teams in five different communities that bring together all of the key players in order to identify what needs to be done in that community. How do we combat stigma? How do we close the gaps in service? What are the needs that are unmet? Those five community action teams in the north will, of course, continue to receive funding this coming fall.

S. Bond: Thank you to the minister for the answer.

I will move on to my other two, and I know that we’ll have more time in the future to discuss some of those issues. I just want to make sure — and her answer was clear — that there are gaps, and we need to work to continue to close them. I thanked the minister for her recognition at Foundry, when she came initially. That was very much appreciated.

I want to make sure that the minister…. I know she works across ministries on issues related to mental health, and she’s talked about a partnership with the school district. An initiative that was started with our government was the Car 60 program. As I’m sure she’s aware, it’s designed to make sure that people with a mental health issue receive the most appropriate and most focused care. It partners police officers with mental health professionals, and by all accounts, it’s been a success.

Just recently one of our city councillors, Kyle Sampson, raised the issue of an expansion of this program in our community. Our city council is discussing this and will be discussing it in the weeks ahead.

Certainly, no need for a long answer, just a quick touch-base. Is the minister aware of the program? Is she supportive of the program? After our city council looks at this initiative and looks at a potential expansion, would she be prepared to consider providing resources for a possible expansion of the Car 60 program?

[10:55 a.m.]

Hon. J. Darcy: Thank you to the member for the question.

I’m certainly acutely aware that police, over the last many years, have been dealing with a significant number of mental health issues. I know that, certainly, from talking to and working closely with the police in my community. There is a broad range of issues related to this topic of mental health and policing. Communities have taken different approaches to dealing with them.

We’re undertaking a review of the Police Act, as the member knows. That will include one of the issues the Premier has been clear about and the Solicitor General has been clear about: that this will include the issue of how police respond to mental health issues. I know that they will be hearing from a wide variety of people like the members opposite and also from communities across the province, about people’s ideas: what’s the best way to go here?

I know that we want to see police focusing on the issues that police need to focus on, and we need to involve mental health professionals and even nurses, social workers and others to a far greater extent in responding to these. There are communities, like Prince George, which I know have an excellent program already, Car 60. In other communities, it’s called something else. In Kamloops, I think it’s called Car 40. Different communities have developed different responses.

One that’s been developed in Abbotsford, called Project Angel, is also a really, really valuable program that’s shown very good results. That’s where the Abbotsford police department — they’ve really been leaders in this — are partnering with a peer support program and Fraser Health. So when people are struggling with addiction, instead of bringing them to jail, they connect them with peer support workers and try and connect them, in turn, through the peer support workers, to health care programs, to treatment programs, to recovery, to harm reduction — wherever people are at in their journey and whatever help or support they’re prepared to take at that point.

I think it’s a good program in the part of this discussion about where we need to go around policing and mental health and addictions. I know we’ll be having those discussions with health authorities, and then we’ll be making decisions in the future about where we need to increase supports at a community level.

S. Bond: Thank you to the minister. I appreciate her awareness of the importance of these programs. They are unique in some communities.

I know that in Kelowna, for example, the mayor there has also expressed interested in expanding resources. That’s been shared with me by my colleagues. I look forward to our city council discussing the issue and then, obviously, having further discussion with the minister and the government about appropriate resourcing.

A last quick question. I know there’s a lineup of anxious MLAs. Also, our critic needs to get back to her role here; I know she’s anxious to do that. I want to also ask the minister if she’s aware of the Vanderhoof MenShed program. It has served as a model to provide support for men — many who experience isolation, may be on disability or face depression. It’s a unique program, and it’s a relatively inexpensive way to provide support for men, especially in small and rural communities.

I know that in the riding I represent, there is interest. Looking at other smaller communities — like Valemount, for example…. The mayor and I have had a conversation about this.

I’m wondering if the minister has looked at the program. Would she consider it? These are the kinds of things that make a difference on the ground in small, rural communities, and we do have service gaps. I want to congratulate the Vanderhoof MenShed, but I’d love to see a Valemount MenShed and a whole bunch of other ones.

I just wanted to put that on the minister’s radar screen. I thank her for her time this morning. I’ll wait for a response to that and then move on to our other colleagues. Hopefully, she’s aware of it. These are the kinds of programs that I think, with a relatively small investment, can have some excellent outcomes as we support men with their situations. Thank you to the minister for the time today.

[11:00 a.m.]

Hon. J. Darcy: I am familiar with it. I understand that there are some similar programs elsewhere. We know of at least one other. I think it’s in Coquitlam. I’d be very appreciative if the member could send me more information. I’ve had it mentioned to me in conversations when I have visited Prince George or visited the north, but I would love to have more information about it.

I do want to really underline what the member said — that it’s innovation and creativity at the community level that often has the biggest impact. That’s why we’ve, for instance, funded community action teams. It’s why we have these community innovation grants available. It’s why, for community counselling….

The day that we announced the community counselling grants, one of the recipients said to me: “You could have announced some shiny, new government program” — and we know that governments like to announce shiny, new government programs — “but what you did instead was help to build capacity on the ground, right across the province.” That’s exactly what we want to do.

I welcome the member’s question, and I look forward to hearing more information about that specific program.

S. Sullivan: To the minister: three years ago you visited the Crosstown Clinic. It serves 200 of the most hard-core addicts, with an average of 15 years’ addiction, 11 times in treatment-recovery programs. Most were using illegal drugs daily and were stealing once every two days. And 80 percent were homeless.

Crosstown uses a combination of substitution drugs and nurse-led wraparound services. Clients see a health care provider every day, and social workers assist with housing and other needs.

Thanks to the clinic, homelessness in that population has dropped more than 90 percent. Stealing, and other criminal behaviour, has dropped more than 90 percent. For example, one of the clients had been in jail 200 times. Since then, he hasn’t been in jail once.

Use of emergency medical services is over 90 percent less than similar people with addictions. Overworked first responders do not spend any time trying to save the lives of Crosstown Clinic clients. In fact, none of these people, with the most serious of all addictions, have died of an overdose. Most have switched from needles to oral medications. Many have weaned themselves off drugs altogether. Many are now employed.

Since your visit to Crosstown Clinic, about 4,000, mostly men, average age 40, have died of completely preventable overdose deaths. Addiction-related crime and street disorder have spread to almost every community in this province. Our first responders and emergency rooms are at maximum capacity, trying to keep people alive.

The question to the minister. In light of these overwhelming statistics, why have you not added a single client to the Crosstown Clinic?

[11:05 a.m.]

Hon. J. Darcy: Thank you to the member for his question. I certainly remember our time together on the Select Standing Committee on Health, where we had extensive discussions on these issues and where he and I certainly were very much in agreement on some of these issues. Some of his other colleagues, not so much, but that’s a discussion for another day.

[11:10 a.m.]

I’m glad to see that the member continues to advocate and continues to recognize, as our government does, that there is no one pathway to hope. We need to be providing…. People have very, very different journeys to the place of addiction that they’re in now. We need to provide a range of different options. It’s critically important not to stigmatize things like harm reduction, things like the kind of treatment that is offered at Crosstown and elsewhere.

I think the member appreciates that there isn’t one model that works for everyone. So we really have been trying to meet people where they’re at with a variety of different options.

Having said that, we have actually expanded short-term iOAT, injectable opioid agonist therapy, which is what is provided at Crosstown. We have actually expanded that by 40 percent. The physical space at Crosstown, I understand, is not capable of having more clients there, but we’ve expanded from 304 people accessing injectable opioid agonist therapy across six sites to 440 across eight sites. That includes increasing the spots for clients who are using injectable medication in Vancouver outside of the Crosstown Clinic.

There are some people for whom that works, and there are some people for whom we need other options. So there’s a tablet, TiOAT, the experts and the clinicians call it — tablet injectable opioid agonist therapy. That has increased from 100 to 335 spots.

Also, the member for Vancouver–False Creek will be aware that within a couple of weeks of the pandemic being declared, we saw that the population as a whole was self-isolating, as they were asked to by Bonnie Henry, in order to keep safe. We know that meant that the numbers of people visiting overdose prevention sites and safe consumption sites, people visiting family doctors, people going to addiction clinics, people going to emergency rooms…. People were not accessing the health services that do exist.

We knew that people who were struggling with addiction were at dual risk of COVID-19 and of overdose. So we moved very quickly and were the only province in the country — I think, probably, the only jurisdiction in North America — that moved to put in place risk mitigation guidelines that were really about reducing the barriers and providing more flexible options. We’re very pleased that the federal government, on our urging, made exemptions to the Controlled Drugs and Substances Act that helped to enable this.

We have been working flat out, I assure the member for Vancouver–False Creek, to try and get more people connected to safe prescription medications as an alternative to the poisoned drug supply. The iOAT he refers to is part of it. TiOAT is part of it. Risk mitigations are a critically important part.

We’ve had an increase of about 1,300 people now who are on prescription hydromorphone since those guidelines came into effect, which is about a 190 percent increase. So that’s significant.

We join with the coroner’s statement yesterday, when the coroner made crystal clear that the principle reason why we’ve seen a spike is because of the toxic drug supply. She called on doctors and health care providers across the province to work to expand access to risk mitigation guidelines. The Crosstown model can work in some communities, but we need to make sure that, through their health care provider, people have access to a variety of options.

We’re working flat out on that, and I certainly appreciate the member’s support on that. Again, the coroner has made the call. The provincial health officer has made that call. So have I.

Also, I think that the member opposite, I’m sure, will be pleased to hear that our government has called for the decriminalization of people who have small amounts of drugs in their possession for personal use, not for decriminalizing the big drug dealers, the importers, the criminal gangs, the people who import and manufacture these lethal substances, more lethal than ever before.

[11:15 a.m.]

I know that the member opposite has been a strong advocate for decriminalization before. I appreciate his support on that, and I would certainly encourage him to encourage his caucus to come out clearly in support of our government’s position on this issue.

T. Shypitka: Thanks to the minister for the opportunity, and thanks to the member for North Vancouver–Seymour for slipping me in here.

Three quick questions. I’ll jump right to it. The last question might be a good segue into what my first question is, and that’s about the lack of family physicians. They’re creating barriers to best outcomes for people with mental health challenges. Right now we have people that have no physician. They go to nurse practitioners, perhaps. Mental health consultation is out of their scope of practice, to a large degree.

Local doctor virtual clinics are very informal, and, quite frankly, a lot of people in rural communities can’t connect or don’t have the ability to connect or navigate through those types of mediums. The First Nations Health Authority virtual doctors are somewhat a flavour of the day. Each day there’s a different physician on there, so there’s no real connectivity for mental health problems. What eventually happens is emergency room visits, and of course, that’s very impersonal and not effective at all.

We’ve heard the minister talk about how important it is to have that connectivity between our health authorities and our health services and her ministry. What is the minister prepared to do to ensure that connectivity is there?

Now, I understand that the minister made mention that a Foundry is coming to Cranbrook, which is a great thing. It’s well received. We’re very excited about it, and that’s very welcome. But I’m talking about a constituent, for example, I have who’s 50 years old. She has not had a physician for over five years, and her state of mental health is deteriorating rapidly.

I know the minister understands the seriousness of this. It’s heartbreaking. I just want to ask the minister: how is she prepared to bridge these gaps?

[11:20 a.m.]

Hon. J. Darcy: Thank you to the member for Kootenay East for his question. I certainly recognize the challenge that he raises about access to primary care. It is a challenge. It is a long-standing challenge in our province but one where our government, and the Ministry of Health in particular, have been working very, very hard at filling those gaps.

I want to assure the member that from day one, when our ministry was created, which actually was three years ago today…. Right from the outset, right from the get-go we were working with the Ministry of Health and, certainly, being crystal-clear we believed — as our major investments and our major rollout of improvements to primary care, increasing access to primary care as it happened across the province — that mental health and substance use services needed to be integrated.

That’s very much because we need to treat mental health and substance use issues as part of health care — to destigmatize it, to eliminate the hoops that people often have to jump through in order to get access to care and get referred here, get referred there, and so on.

I’m confident the member is familiar with this. If not, I’m letting him know now that there is some very good work happening right now, as we speak, between the Ministry of Health and Interior Health, as it affects East Kootenay and Kootenay-Boundary, about improving access to primary care in his region. I think he understands that work is underway. I’m not in a position to say exactly this moment where it’s at, but I think he’s aware that work is happening very actively right now with Interior Health in his constituency.

I’m glad that the member opposite acknowledged how much he welcomes Foundry, because that is about youth, ages 12 to 24, being able to walk in a door. Well, for a while, it’s walking in a door virtually. Hopefully, by the time the door is open, they’ll physically be able to walk in a door, we hope — if not, virtually. They can walk in the door, no questions asked, no stigma, access to a range of health care providers, from primary care to…. Foundry is known for mental health and substance use issues, but it’s also about primary care.

It’s about bringing together partnerships in the community, as the member knows. In some communities, there are 25, 35 community partners that come together to create the Foundry — with a lead organization, of course, and a physical space but also working closely with the school district, working with the health authority, working with counselling agencies, working with Indigenous People and First Nations. It really is about providing that seamless care. Again, youth ages 12 to 24, but it’s critically important that we catch small problems before they become big.

We’ve talked a lot about the overdose crisis. The more we can do to support children and youth early on to address issues related to trauma, to address mental health issues — anxiety, depression, whatever — the less we’re going to see our young people turning to substance use issues and carrying this burden of addiction through their lives.

[11:25 a.m.]

T. Shypitka: Thanks to the minister for the response. Yes, of course, as mentioned, the minister is preaching to the choir on the Foundry. I want to thank her and her government for following up the great work the former government did to initiate this program. It will be well received, and it is an awesome program.

The second question is an issue on an abstinence-based facility that I was part of a council on that was to see full wraparound services — mental health, substance issues, a full wraparound. The former government was ready to give the green light on this project right at election time. We were all excited that when the current government came in, they also followed up on former government’s recommendations and were going to give it the green light.

However, several months later there was a bit of a disclaimer involved in the progress of that facility, and that was to have safe injection or harm reduction on site. This facility is abstinence-based. It does not have policy that accepts safe infection or drug use on site, so that project was squashed. That was, I believe, 30 units, wraparound services.

Is it the view of this government to have these folks, who provide a great service, left out when it comes to caring for people in our communities with the full wraparound services that they provide?

Hon. J. Darcy: Thank you to the member for his question. The member didn’t indicate, actually, which facility he was referring to. Perhaps he could pass that on to us.

Let me just say that in terms of the approach of government…. I’ve said this from day one. The very first speech I ever gave was at a recovery conference, actually, with 500 or 600 people there — people from the recovery community across the province, across the country, even some from elsewhere. Our message has always been that there are many pathways to hope.

[11:30 a.m.]

In fact, that’s what we entitled our ten-year plan to build a better system for mental health and addictions care that we set out a year ago, together with several areas of urgent priority for action.

That’s absolutely the perspective of our government — that we need to meet people where they’re at. People are at different places. They got to their addiction because of different reasons, and their pathways to hope look different. For some people, that begins with harm reduction. For some people, that’s abstinence-based recovery.

There are also different definitions for people about what “abstinence” means. In some cases, that means no substances at all. In other cases, people can be on opioid agonist therapy, which is a form of treatment that allows people to stabilize their lives and start to rebuild their health.

The work that we’ve been doing is really spanning the range of options for people, because people need a variety of options. Even if they’re on, say, prescription medications, some work for some people, and others don’t. All of those options, we think, need to be available for people.

For Indigenous people, they’ve said it to us from day one. The work that our government has been doing, in partnership with First Nations and the First Nations Health Authority, is to ensure that we are supporting and investing significant resources in services, supports and programs for Indigenous people that are culturally safe and that are nation-based and community-driven.

It’s not up to us to decide what it is that First Nations need as far as mental health and wellness programs. They need to be designed and delivered by First Nations. We’ve made significant investments that I could speak about further. I already have, but I’m happy to go into it further.

The decisions about treatment are not made by government. Decisions about treatment are made between a physician and a patient. That’s where those decisions ought to be made, not by elected politicians. They need to be made between a physician and a client, a physician and a patient. That’s where those decisions belong. That’s where those decisions are made.

T. Shypitka: Thanks to the minister for that answer. It’s very encouraging to hear. The project, from what I recall, had the land and had the capital. Everything was ready to go. It just needed a rubber stamp from the government, and for the reasons I outlined, it was squashed. But I’m encouraged by the minister’s response.

I’ll ask two questions, and she can respond to both of them on the next one because I know we’re tight for time. Would the minister be willing, then, to revisit this project? In good faith, I can take part in the discussions — I know it fairly well — or the minister can do it on her own. It’s up to her. Would the minister revisit that project? I think it’d be well worth everybody’s time to do so.

My final question is just an interesting one. I know the minister understands the value in proper reporting and statistics on mental health and addictions. Whether it is use, fatalities or overdoses, those statistics are vital in addressing, specifically, what the concerns are and how we remediate the problem. I’m sure the minister will agree with that.

It has come to my attention that a lot of reporting — on fatalities, in particular — is perhaps misreported. For example, a first responder — a lot of this information I get is right from the boots-on-the-ground first responders — will go to a site where it’s very apparent that there has been an overdose. When the coroner’s report comes out, the cause of death is sometimes not an overdose. It is either a heart failure or a heart attack. I think it would be proper if we identified it for what it was.

Has the minister heard of this, and is she concerned with this to any degree?

[11:35 a.m.]

Hon. J. Darcy: Thank you to the member for his question.

Let me just say, off the top, that I have the greatest of respect for first responders, ambulance paramedics, firefighters and everyone who’s working on the front lines. I mean, they are dedicated beyond belief. They have just done yeoman’s duty in this, in the overdose emergency as well as in the COVID-19 pandemic.

It’s the coroner’s role to determine the cause of death. That is the agency charged by government — by previous governments, by our government — in determining the cause of death. That’s their area of expertise. It’s the expertise that the government relies on. There are many people who play a role in responding to the overdose crisis, in helping to save lives, in connecting people to treatment and recovery, to harm reduction, to the wide array of options. But it is the role of the coroner, because of their expertise, to determine the cause of death.

J. Thornthwaite: During last year’s budget estimates, the minister highlighted the referral coordination service in Fraser Health for referrals for addiction beds: “…it was just a few months ago — November 1, 2018 — that Fraser Health mental health and substance use services started up this new residential coordination service for all the Fraser Health–funded substance use residential treatment facilities. It is addiction specialists, clinicians, that make the assessment. They screen and they match referrals centrally….”

She goes on to talk about who is part of it. However, I have heard from providers that the new service has created extra barriers in requiring clients, even though they might have an existing relationship with a provider….

Has the minister actually reviewed and monitored the potential barriers, these delays of this procedure that was implemented last year?

The Chair: Minister, did you have something to add before answering this question?

Hon. J. Darcy: I did. My apologies to the member for Kootenay East. There was a second part of his question, or a first part, which I neglected to answer.

[11:40 a.m.]

The member still hasn’t shared with me what that facility is. It may be that he doesn’t want to do it on the record. If he does want to, he could do it now. If not, if he could please communicate that information to me in my ministry so that we’re in a position to look into it. I’m not in a position to say anything on it, obviously, without knowing what we’re talking about and without looking into it.

The Chair: Member for Kootenay East, did you want to respond?

T. Shypitka: Sure. Thanks, Madam Chair.

I will respond to the minister offline on the location.

Hon. J. Darcy: Thank you to the member for her question.

I am familiar with the fact that Fraser Health put in place a coordinated system. I know that Fraser Health put this in place with a couple of objectives. The primary ones are to match needs of clients with providers. As we’re aware, different providers provide different types of services, have different kinds of programs, have different policies. We’ve spoken about that earlier.

It was both to match needs to providers but also to accelerate referrals so that if people were looking for a treatment bed, they needed to have access to places where there were beds available. Those were the primary objectives that Fraser Health had in putting this system in place.

I know that there are some providers who believe it’s not working very well for them. There are other providers who think that it’s a step forward. There’s actually sort of mixed reviews on this.

[11:45 a.m.]

I know that Fraser Health is continuing to evaluate whether or not this program is meeting the objectives that they set out for it, which is to match clients more effectively with appropriate providers and to accelerate referrals.

J. Thornthwaite: The Alberta government was elected just over a year ago, in April of 2019. They have made the following funding commitments: a $100 million increase for mental health and addictions, $40 million to combat the opioid crisis, $25 million to fund mental health and addiction infrastructure and an additional $53 million for COVID-related mental health recovery.

They committed to fully fund or create 4,000 addiction recovery treatment spaces and expect to reach that goal very soon. They are also just now piloting recovery coaches in emergency rooms and on Wednesday an­nounced $25 million for the infrastructure to build five therapeutic communities along with operating funding.

This is all with Alberta, with nearly half the deaths between January and March as British Columbia, 142 versus our 266. In addition, we know that calls to the suicide lines were up 76 percent here. We know that calls to 310-Mental Health support are up. We know that calls to the Canadian Mental Health Association are up. We know that people with existing mental illness have a…. The number of suicide ideation has gone up 18 percent, 16 percent for Indigenous peoples and 15 percent for those with disabilities.

My question to the minister is: given the fact that Alberta has given, for the COVID response, $53 million — the province, $2.5 million — and the fact that they’ve committed so many more, a 4,000-bed commitment, for residential services, and they have half of the amount of overdose deaths, why isn’t this government in British Columbia placing the same or better emphasis on addiction and recovery treatment as our neighbouring province?

[11:50 a.m.]

Hon. J. Darcy: Thank you to the member opposite for the question. I’m certainly very happy to speak about our government’s record on this. I’m very proud of it.

We really have been responding to the overdose crisis and building across the continuum of care. I think the member knows very well…. I certainly acknowledge that she has been a passionate advocate in this field. I think the member will acknowledge — I hope she will — that when we took over government, we inherited a system that some people have even said you couldn’t call a system of care because of the lack of coordination, because of the huge gaps, because of the underfunding.

We have been working flat out, both in response to this public health emergency — the overdose crisis — and building that continuum of care, building across the spectrum. Really, that’s all set out very clearly in our Pathway to Hope that we announced last year, including some of the most urgent actions.

Let me summarize some of it. We’ve committed $746 million to the overdose response. A whole variety of things fall in that envelope. We have also expanded access to mental health supports, through Bounce Back, through Confident Parents, Thriving Kids, which are all about prevention and support for families. We’ve significantly expanded our support for Foundry, and we have financial commitments for 19 Foundry centres, right across the province, in urban and rural communities.

As the member knows, within a couple of weeks of the pandemic being declared, we had provided support for expanding the capacity of community agencies to deliver addiction counselling and mental health counselling. That was 29 agencies across the province, serving populations most at need in urban and rural B.C.

[11:55 a.m.]

We made a major commitment to no-cost or low-cost counselling, because we believe that access to care shouldn’t depend on the size of your bank account. The member knows that too often, historically, it has. We want to change that. Improving access on the ground to counselling is certainly part of that. As soon as the pandemic hit, we gave financial support to those first 29 community counselling agencies, and 20 more, to stand up their services virtually so that we could reach more people and that it didn’t depend on living in an urban community. It was really to extend the reach across the province.

We have announced, just recently, 50 to 70 new beds. Prior to that, we had made a commitment of $4.7 million to the Our Place Therapeutic Recovery Centre for new beds in a therapeutic recovery centre. Another 70 beds in various places in the province — residential treatment beds and new youth treatment beds — are coming very soon. That announcement was delayed initially because of issues related to land and so on and then because of COVID, but there are new youth treatment beds coming very soon.

The member never seems to mention or acknowledge, when she speaks about our government’s record on this, a really critical piece of our government’s response. It’s a critical omission, I would say. One of our top priorities as a government and as a ministry has been to work in partnership with First Nations in order to ensure that they have access to culturally safe services and programs that are nation-based and community-driven. Those have been some of the most significant investments that our government has made.

Let me recap them for the member. Six Indigenous treatment centres in rural communities will be rebuilt or renovated — some of them really not effectively in use anymore — as well as two new urban Indigenous treatment centres. This will be the first new investment by any level of government in Indigenous treatment centres in a very, very long time, according to First Nations. That’s an investment in partnership with First Nations Health Authority for a total of $40 million.

We’re investing and have committed $23 million for land-based healing initiatives. In answer to the member for Kootenay East’s questions earlier, we support many different pathways to hope. For Indigenous people, they’ve been very clear that for them, we need to integrate traditional healing — reconnecting to land, culture, family and tradition as part of healing. So a $23 million commitment to land-based healing initiatives is absolutely about supporting people who are struggling with addiction and is about responding to the overdose crisis.

There’s $30 million for programs for mental health and wellness, including addiction, in First Nations communities that are community-driven and nation-based. Again, First Nations have really welcomed this initiative.

Unlike some previous programs that have been an­nounced where there are set, inflexible criteria, these ones really allow nations themselves, based on engagement with their members and with their communities, to design and then deliver the mental health and wellness programs that their communities need and deserve. Ones that address what the social determinants of mental health and wellness are for Indigenous communities, which, as we know, have everything to do with racism, residential schools and colonization.

Finally, there’s harm reduction, in partnership with the First Nations Health Authority, $44 million.

Noting the hour, I move that the committee rise and report progress on the estimates of the Ministry of Mental Health and Addictions.

Motion approved.

The Chair: This committee now stands adjourned.

The committee adjourned at 12 noon.