PROCEEDINGS IN THE
DOUGLAS FIR ROOM

Committee of Supply

ESTIMATES: MINISTRY OF
MENTAL HEALTH AND ADDICTIONS

(continued)

The House in Committee of Supply (Section A); R. Leonard in the chair.

The committee met at 2:46 p.m.

On Vote 37: ministry operations, $12,735,000 (continued).

Hon. S. Malcolmson: I’m going to take the opportunity to respond to the question that was on the floor at the time last night when we ran into technical difficulties and Hansard adjourned us early.

The member had made some comments about the lack of action on overdose response during the pandemic and then asked some questions about barriers to implementing safe supply. I understood that to be regulated safe supply, as opposed to prescribed safe supply. The member is nodding. I’m going to get some of those answers on the record and then look forward to further questions.

First, to say again how, with the immediate pressure of COVID-19, with the pandemic being declared and measures being brought into place in British Columbia in early March 2020, the provincial government here immediately stood up a broad range of additional responses, keeping in mind that at that time, four years into the declaration of a public health emergency, there was already established an overdose emergency response centre.

The ministry’s action team and our task force, in effect, on implementing the province’s response to the overdose crisis, the toxic drug poisonings — that was already in place.

The expansion scaled up almost immediately within weeks of the pandemic being declared. We added new overdose prevention sites — now 38 new and expanded overdose prevention sites. We expanded access to safe prescription alternatives, prescribed safe supply. Since then, there’s been a 400 percent increase in people receiving that safe prescribed alternative to toxic street drugs. Over 3,300 people are now safer and more stable.

We added more outreach teams, nurses and social workers to connect more people to treatment. We’ve added new adult treatment beds, 100 of them. We’ve made a commitment to doubling youth treatment beds. Some of them are in place. Some of them are still in the hand of the health authorities to be rolling out. We’ve implemented other tools — like the Lifeguard App, which is saving lives.

[2:50 p.m.]

The other question was impediments to implementing a safe supply that does not need a prescriber in British Columbia. The impediment is our federal versus provincial jurisdiction. Our solutions to the toxic drug crisis must operate within the bounds of federal legislation regarding illicit substances, so we’re focused on what we can do today in British Columbia within provincial jurisdiction, and that is prescribed safe supply. I’m going to talk, though…. I imagine that we’ll go on in this area. There’s certainly more that I can add.

To the member’s question about this budget allocation, it’s $22.6 million in funding to all five regional health authorities, so that they can expand programs or create new program settings where people can access prescribed safer supply, as a broadening of what is available already in British Columbia. We’re working now on determining allocations as we work with the health authorities to receive their plans to expand access to prescribed safer supply. The intention is that this be widely available — rural, remote, urban, suburban — across the province. That’s the commitment that we have.

A couple of innovative and interesting areas, where we are testing, particularly, new substances that can be prescribed, have been involved in some really interesting partnerships under Health Canada’s substance use and addictions program — something that British Columbia is a partner on — federal funding that we helped design and direct, in cooperation with the health authorities, our provincial delivery arm.

One of the programs is the Safer Alternative for Emergency Response initiative, done with Vancouver Coastal Health Authority. That’s $5 million, over four years, being provided to deliver a safer supply program that will prescribe from suitable-grade opioids to people most at risk of overdose. I can give more details on that, if that is interesting to the member.

Another one that has got some breaking news is here. This is through Island Health. It’s the Victoria Safer Alternative for Emergency Response initiative, with AIDS Vancouver Island — AVI Health and Community Services Society — which I think the member knows well. It’s a very active social service delivery organization on Vancouver Island. Approximately $4 million, over three years, is being provided to deliver a community-based, flexible, safer supply model, again intended to separate people from the toxic drug supply, which has been increasingly toxic during the COVID-19 outbreak.

This is particularly focused on people who have not responded to other types of treatment, as well as those who’ve been difficult to reach or engage through traditional public health and additional treatment measures. This program is particularly interested in taking up the use of fentanyl products. Yesterday Vic Safer announced that they’ve started their first participant on prescribed fentanyl. They’re just two examples of the work that is being done right now in cooperation with the health authorities, the federal government and the provincial government.

S. Furstenau: Just one clarification. I didn’t quite catch the number. There’s a 400 percent increase in people accessing a prescribed safe supply. What is that in actual numbers of people?

[2:55 p.m.]

Hon. S. Malcolmson: It was last March that 677 people were on prescribed safe supply. In February of this year, 3,329 people were on prescribed safe supply.

S. Furstenau: Thank you to the minister for those details. I guess it’s more of a question for the minister than any specifics. Given the trend that we’ve seen — in the last year, in particular, but certainly for several years now — does the minister consider this response to be sufficient for this health emergency?

Hon. S. Malcolmson: Clearly not. That we still have people dying from overdose is a clear indication that the prescribed safe supply has not yet reached enough people. That’s why we have enormously expanded our budget offering in this area. The $45 million that was announced just ahead of the budget was to give the communities and health care teams working on the front line the assurance that we’re going to continue to fund and to expand overdose response options and actions.

For example…. Well, all of the ways that we’ve been acting over the last five years as a province, particularly the last three years, to prevent overdose and to connect more people with prescribed supply as a way to separate them from the toxic supply. It’s the reason that we are working through the OERC, our overdose emergency response centre, to work with the medical community, with prescribers, to stand up new policy — as Dr. Bonnie Henry directed, both last March and in September — to expand prescriber options and expand the number of substances that are being prescribed.

As we have said repeatedly, that all has to be done within a framework of patient safety, and it has to be done in tandem with prescribers. That’s the very detailed work that the overdose emergency response centre has been leading — again, with patient safety at the forefront.

[3:00 p.m.]

As well, we’re continuing to do the work to educate and to support prescribers, so that they have got the knowledge and the expertise to be able…. When a patient comes to them seeking treatment or safer supply options to attend to their addiction, then we need to give them the support so that they know how to prescribe safely — what their options are for prescribing. That’s also part of the funding expansion that has happened over the last year but is also committed to in our unprecedented investment in mental health care and addictions in this budget.

Then I can also speak, maybe, in more detail, if the member is interested, about our assertive community treatment teams that have been unfolded, first of all, in Interior Health, where we’re using an innovative approach to go out and to meet people where they are at, not to have people necessarily walk into a doctor’s office or into a clinic. I think that it’s since February that we’ve had these teams moving out to be able to do that kind of outreach that connects people directly with addiction services that they, to this point, have been unable to receive.

All of these measures working on all of these fronts give us great confidence that we’ll be able to connect more people with the care that they need and deserve.

S. Furstenau: I appreciate that the minister recognizes that it’s not sufficient.

It’s not just the people who are in harm’s way because of the drug supply. It’s also the people trying to help them. Just specifically about the overdose prevention site in Duncan. The doctor who is running that site is, herself, completely burnt out and has been asking for additional resources, just basic resources — an electronic medical records system, a fax machine. She has been navigating what appears to be a complicated web of: which authority? Where does the funding come from? How does she get access to these supports? At the same time, she is trying to help some of the people that most need it right now.

On the ground, it appears to be not only not sufficient but, in many cases, nowhere near sufficient. When we compare that, again, to the health emergency of the pandemic, where no shortage of resources are put to solving that health emergency, this feels very different. There are nowhere near enough resources in community, on the ground. It doesn’t feel like this crisis is truly prioritized.

As I was saying yesterday, the number of people who are dying every day from COVID — we know that number. But we wait for the coroner’s report every month to find out that more and more people are dying every day from a toxic drug supply, but it doesn’t get the same attention publicly — anywhere near the same attention. Yet right now we are losing far more British Columbians to a toxic drug supply than we are to the pandemic.

So in terms of front-line service providers asking for resources and supports, what can the minister say to them in terms of, under this health emergency, what the avenues are for them getting the resources and supports that they need? How is it that there’s confusion about which avenue those go through? For example, even up in Prince George, in the Northern Health region, where we have a very high per-capita rate of loss of life, it’s the First Nations Health Authority funding the overdose prevention site, as I understand, as opposed to Northern Health.

Just in terms of…. What can the minister say to the people on the ground right now who are doing what they can to keep people alive, but doing it in a sense of true scarcity and under-resourcing? What are the solutions that can be immediately put on the table to stop these deaths happening at the rate that they are right now?

[3:05 p.m.]

Hon. S. Malcolmson: This sounds very hard from the practitioner’s point of view, and I recognize how much we’re asking of our public health authority and front-line health care providers, fighting two public emergencies at the same time. I haven’t heard about this particular example that the member cites, and I’d like to learn more if she wants to bring that to me.

I would say that this separation, even though there are two simultaneous public health emergencies happening…. We are fighting COVID on the foundation of a very long-established and robust public health care system in British Columbia. We’re fighting the overdose crisis without a system of care being previously established.

That’s what we have been working for the last 3½ years to build up. That is the foundation of the Pathway to Hope, our plan for mental health and addictions care that we have been acting on every day, working hard to try to build that system of care, to fund it, to train people up to work in it and to make sure that people do not fall through the cracks. But the work is not done. There’s no question.

So to fight the overdose — emergency response — while the same health care system is fighting COVID, and doing that while also building up that system of mental health care and addictions care, means that it is much harder, and much harder for people that are working on the front line. That’s why there is such a substantial increase in our budget commitment to these two areas, because there is absolutely more work to do.

S. Bond: Thank you to the critic for the opportunity to ask some questions this afternoon.

On May 14, I sent a letter on behalf of my caucus and on the heels of a letter that came from my colleague, the Leader of the Third Party. I’m wondering if the minister can tell me if she received that letter directly, regarding the work that could be done by the Select Standing Committee on Health related to the opioid crisis and other work in British Columbia.

Can she confirm that she received that letter personally? And can she describe what conversations she had with the Premier about the request that was made by two leaders, the Leader of the Opposition and the Leader of the Third Party?

[3:10 p.m.]

Hon. S. Malcolmson: We discussed this at some length yesterday in committee, so I will just say briefly in response to the Leader of the Official Opposition’s question that when I received the letter from the Leader of the Third Party directly — I believe I got a letter from the Official Opposition, also directly — my first instinct and my own response was that the solutions that we are working hard to implement are those arising from people with lived and living experience, the people working on the front line of the overdose response, gathered together by our overdose emergency response centre.

Those actions are reflected in the budget submissions that we gathered and successfully argued to Treasury Board and to the Finance Minister be included in this year’s budget. We’re particularly focused on the work with health authorities to implement this enormous expansion of spending on mental health and addictions.

I also, reading the opposition party’s very generous offer to work more closely and in support, was reminded of the very successful model that the Health Minister rolled out during the early days of the response to COVID-19 pandemic. I agreed that it was a very successful model. I was reminded of the benefits of working in that kind of model. I very much appreciate the offer of the opposition parties. I articulated that in my response to the letter.

Although we don’t have any budget allocation for doing that kind of work, it’s the sort of work that would happen within our ordinary part of the ministry budget, our base budget. I believe that my office has already reached out to the representatives of the two opposition parties to start those very first briefings and start that process of working together on this public health emergency, the same way that the Health Minister did with the opposition parties, very successfully, on COVID-19.

S. Bond: I’m well aware of the discussion that took place yesterday afternoon. In fact, it’s what sparked a number of my questions.

So to the minister, again, did the minister discuss the request specifically made to the Premier of British Columbia for the Standing Committee on Health to do joint work, in public, demonstrating to British Columbians that we can work together on one of the most tragic crises in British Columbia’s history?

The letter from the minister referenced briefings. That is not the request we made. This doesn’t seem to be a complex ask. It is simply to say that the opposition parties in the Legislature would like to see the standing committee reactivated to deal with a public health crisis.

Did the minister talk to the Premier directly? Was she asked to respond to the letter? This, by the way, is quite unusual — to have the Premier, when approached by the leaders of the two other parties, have that response from the minister.

Did she speak directly to the Premier about this, and could she specifically articulate why there is a stubborn unwillingness to activate the Health Committee to deal with a public health care crisis?

[3:15 p.m.]

Hon. S. Malcolmson: I believe I’ve already answered the substance of the question — that we are expanding our response to the overdose crisis. We are drawing on the lessons of people with lived and living experience and those working on the front line.

We very much appreciate the generous offer of opposition parties to work more closely. We believe that the model laid down by the Health Minister last year, working with opposition parties more closely on the public health emergency, is a good one and one that I intend to follow, with thanks for the offer to the opposition parties for extending it.

To be honest, when the letter came into my in-box, and it was about areas of my responsibility — I’m directly tasked as Ministry of Mental Health and Addictions with leading the response to the overdose crisis — it didn’t occur to me that anybody but me as minister would reply to that letter.

So that is the spirit within which the direction was chosen and the response letter was written. No disrespect meant to the parties opposite whatsoever, only a gratitude for their offer to work more closely together.

S. Bond: Well, thank you very much. It wouldn’t have occurred to me that anyone but the Premier of British Columbia would have responded to a letter directly written to him about a willingness of elected officials in the Legislature of British Columbia to work together under a system of parliamentary committees that has long been the practice in this Legislature.

The letter of response that came from the minister — let me quote a paragraph: “There is much to do. We recognize the urgency of the situation, as well as the value of working together as elected representatives to advance solutions that will save lives.” Will the minister, for the record, then, say that she is not prepared to activate, or request or advocate for the activation of, the Standing Committee on Health so that British Columbians can see all of the elected officials in this parliament working constructively in a transparent way?

The minister has offered to brief the opposition parties. We would actually like to be partners and cooperate in the work that is being done. So can the minister make it clear that she is not prepared to advocate for the activation of the Standing Committee on Health to deal with a public health emergency in British Columbia?

Hon. S. Malcolmson: I believe I’ve answered this question three times, at least, within budget estimates — more times, I believe, in question period.

I look forward to the member’s question on our budget submission.

The Chair: Leader of the Official Opposition, do you have another question?

S. Bond: I absolutely do, and I will end my remarks by simply saying this. I do have specific questions. It’s a disappointing day for British Columbians when, twice in the same day, the effort to work across party lines on issues that are not political in nature, require no additional budget allocation…. I don’t know what the minister was talking about when she talked about briefings and meetings that require budget allocations.

The fact of the matter is that British Columbians deserve to see elected officials working together to address a public health crisis. Certainly, this will not be the last time that the minister hears about this concern and others that have been raised today.

I’d like to raise with the minister the issue of Car 60. Car 60 is a very successful program in Prince George. Despite the minister’s comments that nothing happened prior to 2017, in fact, this program has been operational since April of 2015. Variations of this program exist across the province. There’s Car 60; there’s Car 67; there’s Car 40.

The point being made today is the fact that this program works and that communities across the province, including in Prince George, where members of city council — including Coun. Kyle Sampson and others; the superintendent of the RCMP and others — are calling for the expansion of this program.

[3:20 p.m.]

I’m certain you’ll hear from other members who may want to see the same set of circumstances in their communities. Will the minister today outline what plan she has to ensure that there’s sustainable funding and, in fact, to provide funding to expand this absolutely critical program?

Hon. S. Malcolmson: Thank you to the member for the question. This is the intersection between mental health supports and police resources. It’s a common theme in every part of the province, and I’m grateful to her for representing this in the north.

I would say that the top piece for me is the work that’s happening right now to reform the Police Act. We are hearing a lot of testimony from across the province, a lot of advice about that intersection of police resources. It’s not only the initiation of the review of the Police Act, which hasn’t been done for 45 years. I think that came up in the wake of reports and concerns about racism and policing last summer. But to me, the call for action related to mental health responses was just as important.

There are a number of ways that, as a province and as health authorities, we are working in that area, but I think that our biggest breakthrough or clarity is going to come in following the report of that special committee about actions.

In the meantime, the car programs — Car 40, Car 60 — are one type of crisis response. I have not met with all of the CEOs of the health authorities yet. But those that I have met with and have talked with about their actions or intentions in relation to these car programs, where mental health workers would ride along or be there in support of police on particularly sensitive calls….

[3:25 p.m.]

They are saying that they may have a role, but they are very much pursuing an evidence-based and experience-based approach around whether they expand these car programs. Those that I have met with so far have identified that in many situations, a person in crisis may be better served with a direct mental health response or a social service–led response. So it may be that in some cases, it’s police and mental health, but that might not always be the way.

Where there has been at least a slowing of expansion of some of these programs or an expansion of hours, as is the ask in Kamloops…. I think that is the sort of separation or the extra evidence that I think the health authorities, as the deliverers of these services, are looking at.

A couple of other areas, though…. My mandate letter does speak specifically to what we can do to add mental health supports that would take the load off policing, to have police be able to focus more on serious crime, to free them up to do that work. I’ve been specifically asked to find ways to add more on-the-street or front-line or outreach mental health supports, which would, again, take the load off police.

One tool is our expansion of situation tables in the communities. I think that there are nine or maybe 11 already that have situation tables. In those cases where police files have had people that have been in active addictions or mental health crises or are frequent flyers with a number of different social service agencies, for lack of a better word….

In those cases, the experience to date has been that 45 percent of those police files have transferred those individuals to a social service agency that is more appropriate and that can actually attend to their underlying issues — whether it’s lack of housing, lack of income supports, a brain injury, need for more intensive mental health supports — thereby freeing up police to do their work focusing on true crime. That is one example.

We do have, as well, a toolkit that we created as a government in 2018 to support police agencies and health authorities on working together to attend to these individuals that have both a criminal or a public disturbance element as well as a mental health crisis. We’ve also launched pilot projects with police in Abbotsford, Vernon and Vancouver, again to that same aim. I look forward…. Once the results and evidence of some of those investigations and programs come out, then I will be building that into my response to the Premier’s mandate letter instruction to me.

S. Bond: Well, thank you. That answer has led to so many more questions, and I’m very respectful of the fact that I have colleagues galore that are lined up to talk about this, including the critic.

I will simply say this. I don’t know what a situation table is, but I do know that Car 60 in Prince George and, I’m sure, the car programs in other communities have been exceptionally successful. It’s not just about offloading work from the RCMP or from police services. It is about finding the appropriate match of service for the person who is struggling. These programs — the evidence already exists that they work.

We are asking the minister to be proactive — at a time when we set a record-shattering number of deaths in April — to expand the programs as requested by communities across British Columbia. Why? Because they work. So while I fully respect that the minister is looking at all kinds of other things, I would think that it is pretty straightforward. When a program works and we are in a crisis, one would assume that we could find additional resources.

My last question. Thank you to my colleagues for their patience this afternoon. I want to have…. If the minister would please confirm for me how many net new beds will be provided in the Northern Health region, related to her announcement of 195 beds over the fiscal plan. My math suggests that that’s 65 beds a year. I would like to know how many of those will be in the Northern Health region and how the allocation process for beds across health authorities was determined.

[3:30 p.m.]

We are desperately in need of resources in the northern parts of British Columbia. I appreciate the Leader of the Third Party referencing the statistics for opioid overdose numbers in northern B.C. They are beyond tragic. I would like to know how the resources are being lined up, for example, to the per-capita numbers that we are seeing.

I thank the critic for allowing me the time this afternoon. I will wait to hear the minister’s answer. I will cede the floor to my colleagues.

Hon. S. Malcolmson: Thank you to the Leader of the Official Opposition for the question.

I’ll just start by saying that the situation table was a tool that was identified by the blue ribbon panel that Darryl Plecas led as MLA when her party was still in government. It’s a tool that was not taken up at that time, I understand, but one that we started to implement when we took government in 2017. It really is a successful model, and I’d be very happy to share what we’ve learned about that with the opposition members. It’s quite encouraging.

The need in the north for more beds absolutely is something that we hear both from people on the ground and from the First Nations Health Authority. I absolutely agree with the member on that. That’s one of the pieces that we are working to build up.

Some of the challenges in accessing service will be partly attended to by the work that we’re doing with the First Nations Health Authority. The rebuilds of some of the First Nations treatment centres and the new builds that we are funding, in conjunction with the First Nations Health Authority, are underway. That is something that we are putting a lot of hope in.

To the member’s question about the 195 beds, it’s the same as the 100 adult beds that we funded and announced at the beginning of this calendar year. For the 195 beds announced in last month’s budget, the allocation is being worked on right now between the health authorities. The need is identified by the health authorities, based on priority needs.

That’s what we did with the 100 beds that we’ve already funded. That’s the same process that we will use for the 195 and, absolutely, for the needs of people in the north. Particularly in light of the tragically high per-capita overdose deaths in the north, it is something that we have very much front of mind.

[3:35 p.m.]

T. Stone: I want to thank the critic for Mental Health and Addictions for the time today. I am going to merge a couple of questions into one question, and I’ll look forward to the minister’s response.

I think we can all agree on the need for increased access to integrated health and wellness services for young people, particularly in that 12-to-24 age group. I think that we can also agree that Foundry centres are an exceptional support with very good results, providing access to a wide range of services for youth, all under one roof. They provide access to primary care, youth and family peer supports, walk-in counselling, mental health and substance use services, and so forth.

Also very well aware of the Foundry B.C. virtual app and understand that it has a role and a place, but it is no replacement for an actual Foundry centre. The current Foundry locations are Abbotsford, Campbell River, Kel­owna, North and West Vancouver, Penticton, Prince George, Richmond, Ridge Meadows, Terrace, Vancouver, Victoria. There are eight additional new Foundry centres that were announced on June 15, 2020, that are coming in Burns Lake, Cariboo-Chilcotin, Comox Valley, Cranbrook, East Kootenay, Langley, Port Hardy, Squamish and Surrey.

Very, very happy for all of those communities, recognizing again the tremendous value of these Foundry centres. But there is no Foundry in Kamloops. It’s one of the largest cities and, certainly, the largest city in the Interior and the north that has no Foundry. It’s very disappointing, especially with the reality that a very strong service provider had stepped up in this last call for proposals. Interior Community Services in Kamloops had an outstanding proposal with very strong and broad partnerships, broad buy-in from the community and a lot of depth of experience with youth.

The partners in the Interior Community Services’ proposal included Secwépemc Child and Family Services, Lii Michif Otipemisiwak Family and Community Services, the Kamloops Aboriginal Friendship Society, the United Way, the Royal Inland Hospital Foundation, the Phoenix Centre, the Boys and Girls Club, the city of Kamloops, SD 73, the Kamloops community YMCA, the Children’s Therapy and Family Resource Centre, Community Living B.C., Thompson Rivers University. On and on the list goes.

There was a tremendous package of testimonials and references that were provided as part of the Interior Community Services’ proposal. I’m going to just read into the record a couple of sentences from a couple of them.

Secwépemc Child and Family Services had this to say:

“Secwépemc Child and Family Services offers this letter of support for the Interior Community Services’ Foundry application.

“Increased access to services and supports for Indigenous youth in the Kamloops area would benefit many of the youth served by Secwépemc Child and Family Services. The development of this multiservice location would ideally provide easily accessed services in a youth-friendly environment that is culturally respectful and a positive addition to services currently being offered through SCFS.

“Secwépemc Child and Family Services and Interior Community Services have had a positive working relationship over the years. The approval of a Foundry project will provide further opportunities to best meet the needs of the youth and their families in the Kamloops area. We look forward to further collaboration, discussions and considerations with the Foundry project.”

That’s from Yvonne Hare, the executive director, again, of Secwépemc Child and Family services.

Lii Michif Otipemisiwak had this to say:

“As the executive director of Lii Michif Otipemisiwak Family and Community Services, a fully delegated Métis child and family services agency serving the Métis population in Kamloops and the surrounding area, I am pleased to offer our agency’s support to Interior Community Services for their proposal for the establishment of a Foundry centre in Kamloops.

“I’m impressed with the extensive efforts that have been made to engage the community, particularly youth, in the developmental process. It is abundantly evident that there is a significant need for such services in Kamloops. The tremendous community support that this proposal has received is a testament to this need.”

That last one was signed by Colleen Lucier, the executive director.

The Kamloops Aboriginal Friendship Society had this to say:

“I am writing this letter to express our support for the Interior Community Services’ Foundry application. This program will provide integrated supports and services for all youth and their families. Having a central access point could possibly eliminate barriers for youth.

“The Kamloops Aboriginal Friendship Society and Interior Community Services have worked in collaboration for years. It is our hope that Foundry central will support this much-needed project within our community of Kamloops. The KFS would like to collaborate with the creation of a holistic, culturally sensitive, welcoming and respectful Foundry project.”

[3:40 p.m.]

That’s signed by Vicki Michaud of the Kamloops Aboriginal Friendship Society.

When Interior Community Services was notified this last round of the bad news that the Foundry selection committee was not going to move forward with a project in Kamloops, the Foundry selection committee advised Interior Community Services that their submission was strong — they were impressed with the thoughtfulness and the commitment to youth and families that was demonstrated — and made the very strong statement that: “Your organization demonstrated strong partnerships, clear examples of how important doing this is and a deep understanding of systemic barriers.”

I would add that Interior Community Services is a CARF-accredited social service organization providing support or intervention in crisis intervention programs, counselling, and subsidized housing for children, youth, families and seniors. They’ve been operating in Kamloops since 1967 and currently have offices in Kamloops and Merritt and programming in Barriere, Gold Trail, the Cariboo and the Kootenays.

With that background, obviously, we are very, very eager to see a Foundry centre located in Kamloops and have been very disappointed several times to this point that that hasn’t taken place. So the question to the minister, and I look forward to her response on this, would be: why has Kamloops consistently been passed over for a Foundry to date? Will the minister commit to making an investment in a Foundry centre in Kamloops in the near future? When can the people of Kamloops expect a Foundry centre to be located in our city?

Again, thank you to the minister and thank you to the critic for the time today.

Hon. S. Malcolmson: Thank you to the member for the advocacy and the very strong picture of how deep the need and how strong the support is for Foundry. I was similarly disappointed when Nanaimo’s also very strong application didn’t make it through with the last expansion of Foundry. I understand that the program was deeply oversubscribed.

[3:45 p.m.]

The Pathway to Hope commitment was to expand Foundry by an additional eight centres. The member has listed the communities that host them now.

The member’s question is in relation to the expansion in 2019-2020, when Foundry led a selection process that identified which would be the new eight communities. That was an independent process. There wasn’t a ministerial hand on the decision-making. The panel, as I understand it, was made up of two independent panels of young people, families, caregivers and subject-matter experts. They’re the ones that made the determination of which successful applicants would make it through the last time. In addition, that Budget 2019 included stable funding for the existing 11 Foundry centres.

Our budget just tabled, Budget 2021, provides additional funding for four more centres starting in 2023. That will make a total of 23 Foundry centres provincewide. What I have heard from Foundry directly in relation to this budget announcement is that communities like Kamloops and Nanaimo should dust off their applications and be ready to resubmit.

For the benefit of the public…. I know that the member understands the program well, but I will just flag, for the communities that don’t have a Foundry in them, what a resource it is. Young people can access health care, mental health and substance use supports, social services. It’s designed very much by and for youth. This is young people aged 12 to 24. There’s also a lot of peer support, group counselling, primary care and support for families as well. We’re particularly aware of the benefit of this in relation to mental health and substance use challenges.

As I think the member also has described, through the pandemic, when people couldn’t necessarily walk into centres so easily, the transition to a Foundry virtual was a really great success. Foundry has identified through their own stats that, in fact, different ages, different types of young people were accessing Foundry virtual who hadn’t necessarily felt comfortable to walk in or hadn’t chosen, for whatever reason, to walk in the doors of a physical Foundry centre. Then just last month we launched the Foundry app, at least five years in the making, that was funded, just under $2 million, by our ministry budget as well — again, a new tool for young people.

If anybody’s listening out there, they can download the Foundry app. It is free, and it can connect them right away with mental health, addictions, primary care counselling. If they have a physical Foundry in their community, then that’s available for them also.

Thanks to the member for his advocacy, and watch for announcements on when the next opening comes, inviting new communities to apply.

P. Milobar: With respect to the minister, this seems to be a constant refrain of: it’s hands off. It’s ministerial hands off. It’s ministerial hands off on how Foundries are located around the province or not. It’s ministerial hands off on health authorities and what they are doing or not doing. It’s ministerial hands off, it seems, on everything — or go talk to the Health Minister.

You know, we’re here trying to figure out what, exactly, powers the minister is invoking within her budgetary framework to provide services and support to people in the middle of a health crisis. The repeated answer seems to be: well, it’s been ministerially hands off. It’s simply not good enough.

In the case of Kamloops, we’ve heard about Foundry from the member for Kamloops–South Thompson. There’s another issue that’s been percolating away since 2017 in Kamloops, with repeated asks from mayor and council, around expanded Car 40 services in Kamloops.

Now, I was the mayor in 2012 when Car 40 started. It got renewed in 2014. As the success started to build, as we started to realize over time that we needed an expansion of Car 40, that led us to 2017. From 2017 forward, the only answer we’ve been able to get out of this minister and the previous minister was that it’s up to the health authority.

[3:50 p.m.]

At a certain point, the public expects the Health Minister or the Mental Health and Addictions Minister to actually show some guidance and some leadership towards the health authority to actually provide services that are desperately needed in the community.

All agencies in Kamloops that deal with people in crisis want to see Car 40 expanded. The mayor and council want to see Car 40 expanded. This has been asked since 2017, and it has been ignored since 2017 by this provincial government, by simply them saying: “Go talk to the health authority.” Somebody needs to actually to be in charge. It’s not good enough to hear: “It’s hands-off.”

So the question to the minister I have is: will the minister intercede with Interior Health and direct them to find money in their budget, or provide the extra money for them, to provide the much-needed, much-asked-for expanded Car 40 services that everyone in the community of Kamloops agrees are needed?

Hon. S. Malcolmson: Thank you to the member for the question. I believe that he would agree that health care delivery on-the-ground questions are best left to the people in the region and the health delivery teams. Same as the Health Minister. He does not get into the small, operational details. I assure the member that this is not a shirking of responsibility. This is referring, always, to the people with the most direct experience and to the health care practitioners.

[3:55 p.m.]

In this case, it is the health authorities that deliver health, mental health and addiction support services. The member could refer to my response to the Leader of the Official Opposition when I spoke to her question about the mental health supports for police in Prince George. I really was more informed about the Kamloops situation because those are the more detailed conversations that I’ve had with Interior Health. So the answer that I gave to the opposition leader applies to this member’s question as well.

But while we’re talking about Kamloops, I’m extremely encouraged that the health authority did identify the needs and tapped into the funding that our ministry provided to add ten new youth treatment beds, substance use and recovery beds. This is an unprecedented expansion in British Columbia, to add 123 beds. It’s a doubling across the province. Ten of them are in Kamloops, and we’re very grateful to the front-line service organization that is operating that. Those beds opened this month.

Also, Kamloops is one of the places that’s hosting one of the new integrated treatment teams that I referenced in an earlier answer, where we have practitioners fanning out throughout the region, delivering addiction support services to people that have, to that point, been unable to access treatment and recovery or a safer supply or medication-assisted treatment because, say, they are shift workers or they are not conventionally housed or maybe they have daycare or child care or parental care responsibilities.

So those are two places where Kamloops has received new and expanded addictions and mental health treatment that was identified and implemented in partnership with Interior Health, which is the lead in these cases.

R. Merrifield: I thank the minister for all of this great information. I do celebrate all that’s happening in my riding of the Kelowna-Mission area.

I recently toured the Foundry Wellness on Wheels, and after hearing my colleagues from Kamloops, I almost feel somewhat guilty celebrating just the program and this more modular and mobile application that’s going to create a further reach into West Kelowna, Westbank First Nation and Lake Country. So very excited about some of those expanded mental health aspects.

Obviously, resources for mental health are needed in all communities. I’m going to focus just on my riding of Kelowna-Mission today. Recently there was funding announced for the campus-of-care prototype. As Kelowna has been chosen as one of these sites, could you give more details about this program, as well as the funding and funding commitments over time? Is this a one-year funding application? Or is this a prototype that will then be funded in perpetuity?

Hon. S. Malcolmson: Could you clarify? Did you say “campus of care”? We may have a transmission problem here.

R. Merrifield: Sorry. I apologize to the minister. My understanding is that it was a wraparound mental health and wellness prototype. I might have misused the word in terms of “campus,” but definitely wraparound services and a prototype where all of that would be offered in one place.

[4:00 p.m.]

Hon. S. Malcolmson: I’d like to undertake to get the details, and maybe we can just deliver after a break. This is a press release that I am partly remembering, but I want to get the information right. The member is quite correct. This is an innovative and new approach. We’ve got Health working on it already, and we’ll get the details to the member as soon as we can. I imagine that will be this afternoon.

Interjection.

Hon. S. Malcolmson: No. I’m just going to undertake to get it on the record as soon as the information comes in, if that’s all right with my critic opposite. We can just interrupt our proceedings, and I’ll read it into the record at that time.

The Chair: Does the member have a further question?

R. Merrifield: Yes. The minister indicated that the number of youth treatment beds in the Okanagan has doubled. Ten of those, I understand, have gone to Kamloops, ten in the city of Kelowna. I understand that the total number that are funded is 123, I believe, from what I’ve heard today.

Have we ascertained what the total need is of the community? My second question, and I’ll conclude with this, is: how has the Keremeos loss of 22 beds been calculated in the total beds or net new in the Okanagan?

[4:05 p.m.]

Hon. S. Malcolmson: Thank you to the member for the question. Prior to expansion, there were four youth substance use treatment beds in Kelowna. We’ve added another ten, which were announced, I believe, this calendar year.

Again, Interior Health is the health authority that was ahead of the other health authorities about implementing our 123 new youth treatment beds, so ten in Kamloops and ten in Kelowna, which are new this year. There are more to come. We continue to work with all the health authorities, including Interior Health, so we will have more news on that in the time ahead.

The Keremeos youth treatment facility is in transition. It has been operated under the umbrella of the Provincial Health Services Authority, and I understand that there have been some challenges around the extent to which it is being utilized and the patient mix there. We have some conversations underway right now between Interior Health and PHSA about how to better use those beds, and I would be very happy to brief the member and keep her connected about those evolving conversations. I think we’re going to be able to find a really good solution.

Again, that Keremeos facility has really been underused, which has been a source of real concern. But I’m optimistic that we’re going to be able to find a good solution. That is separate from these announcements that we’ve been making for Kelowna already.

The Chair: Members, we’ll now take a ten-minute recess and reconvene at 4:18.

The committee recessed from 4:08 p.m. to 4:19 p.m.

[J. Sims in the chair.]

D. Davies: I appreciate my colleague for allowing me the opportunity to ask a couple of questions of the minister.

[4:20 p.m.]

Just recently we heard of the death rate regarding overdose deaths in the northeast. We, of course, have been following this number quite a bit over the past number of months. I’m just wondering if the minister could possibly go a little deeper. From what we’re hearing, the numbers, it isn’t seeming to match what I hear from our first responders in our communities. It seems like the number is being reported lower than what it actually is.

I’m wondering if there is something, a disconnect maybe, with how the numbers are reported by the coroner’s office, if they’re looking at…. For instance, I understand that if someone possibly died of heart failure or of asphyxiation which was caused by the overdose, it doesn’t in fact get recorded as an overdose death. It gets recorded as the final outcome. I’m just wondering if the minister can clarify that and let us know how these numbers are gathered, and specifically in the northeast.

[4:25 p.m.]

The Chair: Minister.

Hon. S. Malcolmson: Thank you, Madam Chair, and welcome to the chair.

Thank you to the member for the question. I haven’t heard this particular criticism, but I absolutely know in my own community how much I rely on first responders. They often are the ones that see overdose events up front — and particularly with increased incidents of people, sadly, using drugs alone, partly because of the stigma and shame associated with addiction. Often by the time they are called to 911 calls, the person has already passed.

The coroner has her own methodology that is not something that is controlled or dictated by our ministry, but I’d be very happy to work, through my office, to connect the member with the coroner’s office so that we can try to find out whether there is more granular data that might respond to the pattern that he’s seeing from first responders.

It may also be because…. This kind of goes back to some of the questions that one of the other opposition members was asking earlier in this session. Overdose deaths are reported and then sometimes take some time — weeks or sometimes even months, I understand — to have confirmed. It may be that there is a lag in reporting, where a suspected overdose death becomes confirmed as an overdose death, but it may not show up in the monthly reports.

I’d be happy to pursue this question alongside the member, and we can find the answer together.

D. Davies: Thank you, Minister. I look forward to hearing from your office there. I would certainly appreciate further information on that and to dive a little deeper.

My final question for the minister — it’s something that I’ve brought up over the past couple of years in estimates — is around supports. For folks in rural British Columbia — I know in my community, Fort St. John, Taylor, Fort Nelson, for that matter — there are incredible challenges accessing supports. Often people, when they need help and they walk in and say, “I need help now,” it’s not a couple days from now; it is immediately now. It’s sad when I hear these examples of people in my communities that go in to get help, and they can’t access it right away.

You know, they have to catch the…. Of course, money is often the issue. They don’t have the opportunity to pay their way, so they have to get on the Northern Health bus or some other means. They’re sent to Prince George, where they can’t get the support. They have to leave their family supports that are better in their communities, whether it’s Fort St. John or Fort Nelson.

We need more support in these smaller rural communities. There are so many people that are falling through the cracks. I’m just wondering if the minister can share ways that she is working or ways that the ministry is working to improve support services in our smaller northern and remote communities where they’re just not there. They are absolutely not available, and people have to leave the community, if they can even do that on their own,

If the minister can explain some of the things that she’s working on.

[4:30 p.m.]

Hon. S. Malcolmson: Thank you to the member. This is a long-standing challenge in British Columbia — all parts of the health care system — but particularly one of the gaps. The Pathway to Hope, our plan for building that continuum of care for mental health and addictions support that is intended to repair, absolutely, access in rural and remote communities is something that we are focused on.

We do see examples, but they are all in the southwest of the province — where there are services stood up and where it may be that someone comes to access the supervised consumption site or harm reduction materials. They have the ability to be connected with care — that might be detox — and then they can walk across the hall and get connected with treatment and recovery beds. That doesn’t happen often enough. That is exactly the kind of system of care that we are working hard to build. But it is not in place across British Columbia, and certainly not in rural and remote areas, as the member identifies.

With the Chair’s indulgence, I’m going to read quite a list that would be helpful, I think, for all of us to get on the record, because these are programs that are intending to fill the gap that the member, quite rightly, identifies. The province provides mental health and substance use services to rural and remote communities through mobile clinical teams, e–mental health, telehealth and travel assistance programs for both patients and physicians. Other mental health services include Bounce Back and Confident Parents, Thriving Kids. Those are all programs that have virtual care options.

Next, to ensure that everyone in B.C. has access to virtual mental health supports during COVID, we expanded existing virtual mental health programs and services and launched new services to support British Columbians, especially Indigenous communities and those living in rural and remote areas. Again, expanding the Bounce Back program, expanding access to no- and low-cost community counselling and supporting front-line workers.

[4:35 p.m.]

Also, as has been mentioned in response to earlier questions, we’re supporting an accelerated launch of Foundry Virtual, in response to the pandemic. It remains available for young people and families who do not have a physical Foundry centre in their community, or those that were not able to access it because of physical distancing rules. Foundry Virtual, as the other Foundry centres, offers virtual counselling, peer support. Many of them will soon offer virtual primary care services.

Next, we’ve also increased access to community-based adult mental health and substance use counselling through the province, through the community counselling grant program.

Also, as part of the Pathway to Hope, the Ministry of Advanced Education and Skills Training launched a 24-7 counselling and referral line for all post-secondary students.

Also, community action teams have been established in 35 priority communities as part of the response to the overdose emergency.

Also, substance use integrated teams have been established and expanded throughout the province, including in the North Peace, Smithers-Houston, Prince Rupert and coastal communities and also the northern Interior, specifically Prince George. There are two clinics in Fort St. John that are prescribing medication-assisted treatment to treat opioid use disorder.

Through the Rural, Remote and Indigenous Framework, the province and First Nations Health Authority have stood up the virtual doctor of the day service that connects First Nation clients and their care providers to a physician or a nurse practitioner through video conference.

This service was recently expanded to include psychiatry and substance use supports. The Premier, in a recent cross-Canada challenge that all the Premiers did together to highlight innovations in substance use and mental health deliveries, highlighted this virtual doctor of the day program as a tool that he challenged other Premiers to support and adopt in their own communities.

So Budget 2021 supporting rural and remote communities, through my ministry, includes $4.8 million to the Canadian Mental Health Association to support community counselling grants, bringing the total investment to $14.8 million since 2018-19. Also added in this budget — $1 million to increase access to the Bounce Back program, $1.6 million in support of Foundry Virtual, $1.8 million to increase access to mental health supports for front-line workers.

We are also continuing the existing Pathway to Hope investments, including $16.56 million to support implementation and expansion of substance use integrated teams; $6 million to support the community crisis innovation fund, which provides support for community action teams throughout the province; $66.84 million to continue investments in child, youth and young adults mental health initiatives, including $1.5 million to support post-secondary counselling and the referral line earlier referenced.

Then finally, again in this area, Budget 2021 commits an additional $500 million over the next three years to continue to build that comprehensive, safe, seamless system of mental health and substance use care for everyone, including Foundry Virtual and expanding Foundry centres, both of which will benefit rural and remote areas.

Maybe the final one, just because I didn’t include it in my list earlier, is the fact that registered nurses and psychiatric nurses have stepped up to become prescribers of medication-assisted treatment for people suffering addictions, in particular opioid use disorder. This is a first in Canada. There isn’t anywhere else that nurses are able to prescribe medications like this. We’ve had the first wave of nurses trained and out in the field in every health authority, including in the north.

This is, I think, particularly going to be a benefit to rural and remote communities where it’s hard to get an addictions medicine doctor there, let alone a primary care doctor. Nurse practitioners already can prescribe, but to now have registered nurses and psychiatric nurses able to do this prescription for medication-assisted treatment is going to be a particular benefit to rural and remote.

Thanks for indulging that long list.

D. Davies: Just a final comment in regards to…. I know that was an exhaustive list. I just want to draw to the attention…. I just received a letter and had the opportunity to read it while she was reading that list off. It’s from a local constituent. He actually cc’d me and just sent it to the minister.

[4:40 p.m.]

I do hope that the minister’s staff will forward that letter to her, because it really is the reality of what people are living in, in rural and remote communities. Specifically, this is Fort St. John. The letter is from Thomas Whitton, a concerned father, spouse and friend. He wrote to you here just now, and he really lays out some of the incredible challenges. I just wanted to leave that with you here.

Again, I want to thank my colleague for Surrey–White Rock, and I’ll turn it back over to him. I thank the minister for her time.

The Chair: Minister, did you want to respond?

Hon. S. Malcolmson: I’ll say thank you to the member for giving me the opportunity to clarify. That list that I just read notwithstanding, absolutely there are gaps in care for people. That is why we are continuing to fund expanded services. There is absolutely more to do and that’s why…. The province is behind, was behind when we formed government in 2017, as has been alluded to by a number of independent officers. We are working hard to build up that system of care.

Our work is not complete. I look forward to seeing the member’s constituent’s letter. I do hear heartbreaking stories from families, children, youth, adults who have tried to access care and have experienced gaps in service. That is just why we’re so determined to build up a continuum of care so that people get the help that they need when and where they need it.

B. Stewart: The Westbank First Nation in my community has a concern about the fact that there’s currently grant funding for positions on 12-month terms to do funding for the work needed in mental health in their community. The dynamics of that community are that the First Nation population is just under 1,000 and growing rapidly, but the overall population on the Westbank First Nations lands is over 10,000.

Anyways, they have asked the question about permanent funding of these positions to being able to work in mental health so that it works for the employee, works for the employer and the community. I’m just wondering if this is going to change with the new funding that is being put in place for your ministry.

Hon. S. Malcolmson: Thank you to the member. I would appreciate getting the details about the program that he’s referencing. It might be that this is a service delivered through the First Nations Health Authority. We’d be really happy to get the information that he seeks.

Absolutely, we want health care workers to have continuity of employment. We count on them working on the front line. We want them to have that continuity of employment. We certainly want to draw on their expertise.

Without knowing the specifics of the contract, I can’t give a helpful answer. It’s not something that my team is familiar with either. So let’s get the information, and I would be very happy to pursue it.

B. Stewart: Minister, I have a question just in terms of the wraparound supports. You actually allude to the problem that…. I think the complexity in dealing with mental health is spread between health authorities and different agencies. I think that one of the things that I’m seeing and I hear from many, many communities — and I’m sure that you all have your own examples in your own communities, and being that you’re from Nanaimo, Minister — about what is perceived to be the lack of wraparound supports for mental health and for addictions.

[4:45 p.m.]

I say that I recently have visited several shelters. They have the 24-7 people on the ground, but they’re really lacking in the care and the people. I’ll give you an example. Just a week or so ago on Russell Street, here in Victoria, we had a person that was just recently moved in that started a neighbourhood house on fire, was removed from the shelter. I’m not really certain where they fall into, but it’s obvious that there are gaps.

That’s the biggest question that I get from mayors, councils and people around the B.C. Housing projects. I’m just wondering: is that your responsibility, and if so, are you going to deal with that?

The Chair: After the minister’s response, I will be going back to the member for Surrey–White Rock.

Hon. S. Malcolmson: Thank you to the member for the question. The problem, sadly, was well known, the problem that he alludes to, despite the amount of supportive housing and affordable housing that we, as a government, have been able to stand up in the last four years — the fact that there are still people with untreated addiction and mental health challenges.

Particularly, as I’ve witnessed in my own community, if they are evicted from supportive housing, and many of them have lost their ability to be good roommates or neighbours and can be quite disruptive…. They are evicted, then are living on the street, even more disruptive to neighbourhoods. It’s no way to live, either for the people living the life on the ground or for businesses and neighbourhoods affected.

The member is quite right. In Nanaimo, which I represent, this is a problem that pre-dated COVID. But absolutely, the closure of shelters and closures of places like libraries that often people would spend time at during the day because of COVID has pushed the homelessness crisis into more visibility, let alone exacerbating mental health and substance use challenges.

The mandate letter that the Premier gave to me and to many of my fellow ministers speaks directly to the need to act urgently on this basis. My ministry is working actively with the Minister Responsible for Housing; Health; Children and Family Development; and Social Development and Poverty Reduction, at a cross-government basis, to identify the people for whom supportive housing has not had adequate supports but also how we can better support supportive housing and get more mental health and addiction supports to those people.

[4:50 p.m.]

I do commend…. On Vancouver Island, for example, a number of the B.C. Housing supportive housing developments have supervised consumption sites built right into their operations. Some of them are inhalation sites, a particularly new and emerging way of people using illicit drugs and a particular contributor to the overdose crisis.

Our ministry was particularly tasked with the assignment to develop complex care housing. It was a campaign commitment of our government to design a new form of housing that is more appropriate for people for whom supportive housing is inadequate.

The core planning table that we are establishing now will include government, housing and health system partners, Indigenous partners, municipal governments. We’ve been working particularly closely with the Urban Mayors Caucus, which the member will be well familiar with. They’re very strong advocates and willing to be partners on complex care housing. So the framework to both identify what the needs are and what some of the pilot projects might be in different regions of the province.

I guess I would emphasize that we’ve heard from the Urban Mayors Caucus. Also, something we’re feeling as a government is the recognition that this is not a one-size-fits-all problem. What Kelowna might need might look very different from what Victoria needs or Vancouver. So we are determined to act early and generate some results.

I’ll maybe just end by talking a little bit about the ACT teams, the assertive community treatment teams. A second one has recently been added in Nanaimo, and there are two teams operating in Kelowna under the umbrella of Interior Health.

ACT teams are particularly focused on addressing street disorder and public safety concerns by expanding mental health intervention teams. Their design is to provide flexible, individualized support for adults with complex and serious, often persistent, mental health challenges that make it difficult for them to manage day-to-day activities. They’re often also people who have not felt comfortable — or who don’t have access because of transportation challenges or whatever, as the member again has alluded to — to be able to walk into a more conventional mental health clinic.

ACT teams are mobile. They operate 24-7. They may come to a client’s home. They may come to them in a park or at recreation locations. These ACT teams are the highest standard for delivering community-based mental health services for people with serious challenges. They’ve been shown already to de-escalate situations, to be able to help stabilize people and, in many cases, to stabilize them to the point that they can get into some of our transition housing designed to set people up for success.

Having obtained housing and given them the skills to be able to retain that housing and then advance to more conventional, affordable housing is the focus. It’s certainly a long-term project and takes a team-based approach across multiple ministries.

T. Halford: Thank you to my colleagues for the questions they asked and to the minister and her staff.

A quick question — I think it’s a fairly direct one — to the minister. I’m hoping I get a quick and direct answer. Yesterday in question period, the minister stated: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” Can the minister produce that quote?

Hon. S. Malcolmson: Yes, I can. If the member gives me a minute, then I can…. Why don’t I actually undertake to get that? I don’t think I’ve got it right here in my binder.

T. Halford: Sorry. When can the minister produce that quote? Is that something we can get…? You’ve got staff on the phone. I think you’d be pretty quick. When will that be produced?

Hon. S. Malcolmson: As soon as possible. I’d suggest, if the Chair is willing, we move on, and I’ll get it and read it into the record as soon as we have it.

T. Halford: Does the minister herself support residential treatment?

[4:55 p.m.]

Hon. S. Malcolmson: Yes.

T. Halford: I just would like the minister’s comments — and we did canvass this in question period — on a specific quote that was given by an Interior Health executive director.

The quote, I believe — it was dated on April 14, and we did canvass this in question period — was: “Literature shows that residential treatment is not effective…. Going to a treatment centre is intrusive, and it plucks them away from their community, family and job. It puts them in a false environment where they learn new skills, and they are expected to transition back into their community. It’s effective for some but not the majority.” Does the minister agree with that quote?

Hon. S. Malcolmson: I’m going to do two things. One, I will read into the record the Interior Health statement in response to the quote that the member provided.

This is from Chris Shewchuk, director of public affairs at Interior Health:

“We understand a recent media story about substance use treatment options in Penticton is causing concern. We would like to offer clarification.

“Interior Health’s position is that in-patient treatment services are an important part of the overall continuum of care for people living with substance use. Interior Health recognizes every person’s experience of addiction and recovery is unique. We offer and support a range of evidence-based treatment approaches tailored to an individual’s specific needs, and this certainly may include in-patient treatment options.

“We apologize for any confusion the comments in this article have caused. We have requested the story’s author correct the inaccurate content that was published.”

[5:00 p.m.]

I’ll say, on the part of our government…. Although we are offering addiction treatment services across the continuum of care — from harm reduction, safe supply, medication-assisted treatment — the expansion of addiction treatment and recovery beds in this budget and in the budgets of my predecessor, Judy Darcy, the first Minister of Mental Health and Addictions, is unprecedented in British Columbia’s history. So yes, we support addiction and recovery treatment beds.

We have already opened 101 adult beds in this calendar year. We are doubling the number of youth treatment beds, and in the budget just tabled, we are funding another 195 treatment beds.

We believe that people suffering addictions deserve a range of options, and absolutely, treatment beds should be one of them and one that we are investing deeply in.

T. Halford: The question I asked the minister, which took her almost five minutes to respond to, is…. I asked the minister directly: does she agree with the quote? I will ask her again: do you agree with the quote provided by this Interior Health employee?

Hon. S. Malcolmson: I have read Interior Health’s statement on that person’s quote. I talked to the individual by phone. She says that that was not her position at all, that the quote in the media was taken out of context.

I will say again to the member that I believe, and I am leading investment, in treatment and recovery beds. So yes, I believe that treatment and recovery beds are a very important part of responding to the addictions crisis British Columbia faces.

T. Halford: When I canvassed this in question period with the minister, I believe the minister said that there was an error in the reporting. The headline did get changed, but the quote did not.

I will ask the minister again: does the minister agree with the quote that was provided by this director from Interior Health?

Hon. S. Malcolmson: I have answered the member’s question in question period and here. I look forward to his questions on our budget.

T. Halford: I will take that as indecisive, where we have an employee of Interior Health that is speaking out against recovery and saying that recovery is not effective, and this minister has failed to stand in this estimates and say that that is simply a wrong statement. I’ve given the minister multiple opportunities to correct the record, which she has, to her credit, not done. When I say to her credit, she is just choosing not to be direct in saying that she disagrees with the quote.

I will ask the minister a follow-up question. Does she believe in private residential recovery? Does she support that?

[5:05 p.m.]

Hon. S. Malcolmson: In response to the member’s preamble, I will say for the record that I have answered the question by saying I support treatment and recovery beds. I am funding them, and Interior Health has clarified its employee’s statement. I’m in no position to retract the statement of another person. Interior Health, the employer, has done that.

The question from the member was whether I believe in private recovery beds. Was that the phrase? Yes, I believe that they exist. Yes, I believe that people suffering addiction challenges deserve options. The focus of our government is on investing in publicly funded treatment beds. That we just have added 101 adult publicly funded treatment beds is going to represent filling out a serious gap in the province’s addiction response system.

It used to be that either you had to be on public assistance or else, as a family or as an individual, you really had to be of means in order to access the private recovery and treatment homes. They’ve obviously played a very important role in addictions recovery, but they haven’t been accessible to everybody. So the part of the gap that we have been working to fill is the publicly funded treatment and recovery beds.

Again, we continue to try to build up a system, to work very hard, and are already building up a system that meets people where they’re at, that provides a range of responses. Both publicly funded and private treatment and recovery beds and homes are certainly part of the system of care that British Columbia has.

T. Halford: I’m pretty troubled by the minister’s response, along a couple of fronts. I’ve given the minister a direct opportunity to try and set the record straight on a very troubling statement that was made by an employee of Interior Health, at a very senior level — whom, we now find out, this minister has talked to directly on the issue.

I will correct the minister, who says that she herself is funding the beds. That funding is not coming out of the Ministry of Mental Health and Addictions. That resides in another ministry, and we’ve already canvassed that.

What I find from the minister’s answer is that either there is a lack of respect or there is a lack of support for residential recovery and treatment centres. We saw this with Pathways, when we discussed this in the House, and what the minister has advocated for in terms of government-funded and government-run treatment centres.

The average household income in B.C. is $87,000. That’s based on 2018 numbers. If someone in that family wanted to enter a private residential treatment centre, how much would be funded by the province of B.C. based on that annual income?

[5:10 p.m.]

Hon. S. Malcolmson: I’ll start by saying the Pathways service that the member referenced in his question…. It may be that I misunderstood you, but I just want to clarify for the record that it did not offer any residential bed services. That was not a service that was offered by Pathways.

In response to the member’s question, we don’t subsidize private treatment beds, unless you consider the per diems a public subsidy, and those are only available for people that are on income assistance. Our government did raise the per diems for the first time in ten years, so that is a little bit more. I know that the private recovery home operators were very happy to have that additional support.

We are funding directly publicly funded beds. That is not means-tested, so there is no income test for that. We believe so much in publicly funded residential treatment beds that we are funding them and their operations in the following ways. This is, I believe, all in Budget 2021. If not, then I’ll specify it.

So $330 million over the fiscal plan to provide a full spectrum of substance use treatment and recovery services, including the creation of 195 new substance use treatment and recovery beds in communities throughout the province. We have committed $36 million over three years to create the 123 new youth treatment beds that I referenced earlier, and that will also enhance existing provincially accessible specialized beds.

We continue this investment through to 2023-’24 as part of the $330 million cited earlier. We provided, in last year’s budget, over $2 million in one-time grants to support service providers of residential treatment beds to address the financial impacts of COVID-19 — service providers, actually, across the spectrum.

[5:15 p.m.]

We provided, in the 2019 budget, $13.5 million of one-time funding to Canadian Mental Health Association to support 101 new adult substance use treatment and recovery beds. Again, those are not means-tested. In 2019 and 2020, we provided one-time funding of $3 million to the Provincial Health Services Authority through the Canada-B.C. home and community care and mental health and addictions service funding agreement, also referred to as the federal early actions initiative, to enable the surge residential beds to continue to operate.

In 2018, our ministry invested $4.7 million to support Our Place Society to open the New Roads therapeutic recovery community on Vancouver Island.

In 2017-18, our ministry provided $10 million to all health authorities, including PHSA, in one-time funding to support 60 residential treatment beds and 50 intensive outpatient spaces to help combat the overdose crisis and support access to medication-assisted treatment.

The budget update in 2017 that we stood up provided funding to respond to the overdose emergency. That was through Ministry of Health — $6.5 million per year to the regional health authorities to maintain surge residential treatment beds and intensive outpatient treatment services.

We don’t believe that there are enough residential treatment beds yet, and we are determined to continue to build out and fund more.

T. Halford: I do, at times, appreciate the minister’s answer, but I do, at times, understand there’s a bit of a game plan to continue to read and read and read on things that sometimes often don’t have to do with the subject. I don’t know if it’s to delay time or what, but I will leave it at the minister’s purview.

I have met with parents, as I am sure the minister has, where cost has been an impediment in terms of getting care and in getting treatment. I hope and I would think that the minister would agree with that. When you look at families and they cannot get into government funded beds or they’re looking at a private option…. I’ve met with families that actually have to take out a second mortgage on their house to get their 20-year-old son or daughter into treatment.

I’m hoping I can get a very direct answer from the minister — and maybe a timely one, but that’s up to the minister and her staff — on whether or not she thinks that’s appropriate and whether or not she is determined to make treatment more affordable for British Columbians at every income level.

Hon. S. Malcolmson: I’m going to answer this question, and then we will see whether we can get the Bonnie Henry quote written out now or whether I’ll add it into the next answer.

Yes. I have heard stories like the member cites, as well, of families recognizing that it was only because they had means that they were able to get their teenagers or young adults into treatment. It’s exactly those kinds of stories that resulted in our commitment — my predecessor, Minister Judy Darcy’s commitment — to double the number of publicly funded youth substance use treatment and recovery beds. That’s a core part of our commitment to build out that continuum of care that did not exist when we formed government in 2017.

[5:20 p.m.]

Our long-term aim, and the aim of the Pathway to Hope, is that people who present to our public health care system, whether they have a skin cancer scare or whether they’re suffering a heart attack or whether they have a mental health or an addictions challenge, are able to access the public health care system with equal access — that there is no stigma, that there are no barriers, including cost. That’s why we are standing up an unprecedented number of publicly funded beds.

There is more to do, absolutely. We are strong believers in publicly funded residential treatment beds. That’s why we are funding them, in past budgets and particularly in this one.

To the member’s comment that he thinks that I’m stalling by reading budget details into the record, this is a budget estimates debate. I think it’s important to people that are watching from home or reading Hansard that they see the details of where our government is spending money, in response to a strongly articulated public demand and need. This is in full transparency that we’re getting all these details on the record.

T. Halford: Does the minister want to read the quote or…?

Hon. S. Malcolmson: This was a quote…. This is in response to the member’s earlier question about the Dr. Bonnie Henry quote. This is June 11, 2020, 3 p.m., the legislative gallery theatre: “You can’t fix a system when there is no system there.” There’s a longer piece, and we can provide the full text to the member if he desires it.

T. Halford: The quote that the minister just read, I believe, is: “There is no system there.” She didn’t reference a year or anything like that. The quote from the minister yesterday in question period: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” I’ll ask the minister again: does that quote reflect the comments that the minister made in the House yesterday?

Hon. S. Malcolmson: Chair, can I ask for a clarification? Are we allowed to read from a screen in this proceeding, or do I need to be reading from a piece of paper and produce the quote?

The Chair: I will ask.

Okay, there you go.

Hon. S. Malcolmson: This is a quote, from the press gallery theatre, on June 11, 2020, 3 p.m., from Dr. Bonnie Henry. This is the full paragraph, so that the member has the whole context.

“I will speak first just to say that has been one of the overriding things that we’ve been working on with the Ministry of Mental Health and Addictions to try and put together. As my predecessor said” — that would be Dr. Perry Kendall — “you can’t fix a system when there is no system there. There were a lot of pieces, and it was very challenging for people to navigate those pieces. We’re not where we need to be yet, but we are making progress in trying to pull a system together.

[5:25 p.m.]

“This is one of the things we have worked so hard on in the health authorities, with the Ministry of Mental Health and Addictions and the Ministry of Health — to try and understand the person’s journey when it comes to substance use disorders and addictions and how we can best support people to understand the underlying causes and then help them get to a place where recovery and a path to recovery are in sight for them or is a possibility for them.”

T. Halford: Thank you to the minister for finding that. I find it quite troubling. The minister states in the House: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” At that time, prior to 2017, Dr. Bonnie Henry was a public officer. She was working for the government of British Columbia. We have talked about Foundry being established prior to 2017. I think the minister acknowledges that. We’ve talked about the previous minister, Minister Terry Lake, who declared that we were in a pandemic. We just had the five-year anniversary of that.

The quote that the minister just read I don’t think accurately reflects what she stated in the House yesterday. What she stated in the House yesterday: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” That is not the quote that reflects this. I would like to clarify. Does the minister stand by the comments she made yesterday that Dr. Bonnie…? I’ve heard the minister say it directly. I actually heard the minister apologize for it in a question period once.

She’s continued to resay it: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care in place for mental health and addictions.” Now, there was no ministry in place. I fully acknowledge that. But to say there was no system in place…. I’m having trouble comprehending what the minister has read into the record today and what she said into the record yesterday. I’ll just give the minister a chance to clarify those comments before I canvass them again.

Hon. S. Malcolmson: If the member can point me to a place that I have ever said that there were no resources available for people preceding the establishment of the Ministry of Mental Health and Addictions, I will be surprised, but I will absolutely retract them.

What I have been careful to say, in my own words, is that it is the continuum of care, the system of care that deals with exactly the kind of gaps that the member and his colleagues have been identifying — that there is not help for people immediately when they need it, that they may well go to detox but then have to wait to get into treatment, that they go to treatment but they can’t get into a supportive recovery facility. That is the system of care that we are trying to build up. The work is not done.

I will contrast our…. Actually, no, I won’t. This is not question period; this is the budget estimates. I will certainly carry on the conversation with the member at any other time.

I will say that we are not a government that killed or stopped programs that were in place and were working well at the time that we took government, in 2017. Absolutely, examples like Foundry are ones that started under the previous government and that because they were working well, we carried on and expanded. Full credit to the founders of the Foundry and to the previous government for funding them. I’ve no difficulty giving credit where it’s due. But that is different from a system of care, a continuum of care.

That is why we are in this mental health and addictions crisis. That is what this budget that is ahead of us today, an unprecedented investment in Mental Health and Addictions, is trying to make up for — lost ground. Is it enough? No, not yet. Are people still dying tragically? Yes, they are. Are people still experiencing gaps in getting access to the care they need and deserve? Absolutely, they are. That is why we were working very hard. We are certainly in a better place than we were four years ago. Have we got a lot of work ahead of us? Absolutely, we do.

[5:30 p.m.]

To the member’s question a few minutes ago, I have certainly been paraphrasing Dr. Henry. I’ve never put quotes around what I’ve said in the House, and I….

Interjection.

Hon. S. Malcolmson: Well no. Just now I did. I read her quote, and it’s quite fair for the member to ask me to put that on the record.

I have been paraphrasing Dr. Henry, and I absolutely take his point. I will be careful about putting quotation marks around her words, to be clear that I’m not paraphrasing.

T. Halford: Can the minister retract? I believe that it can almost be construed that she misled the House when she said: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” That is not the quote that the minister read into the House. That is not the quote that the minister just read.

Will the minister retract the statement from yesterday and apologize for misleading the House?

[D. Coulter in the chair.]

Hon. S. Malcolmson: I’ll certainly look at the transcript and see where the commas are. If there is a mischaracterization as Hansard has recorded it, then I’ll absolutely take the member’s suggestion and ask to correct the record.

T. Halford: Well, I’ll read the quote again for the minister, who is obviously having trouble with her comments yesterday and her comments today. The quote from the minister in question period was very direct and very clear. I was there physically to hear it, and it is plain in Hansard.

From the minister: “As Dr. Bonnie Henry said, when we formed government in 2017, there was no system of care for mental health and addictions.” The minister cited a comment from Dr. Bonnie Henry that appears to be somewhat nonexistent, because the comment that she read in today was from something in, I believe it was, 2020. The minister said, “When we formed government in 2017, there was no system of care for mental health and addictions” — from Bonnie Henry.

Now, I think that the minister is coming to the conclusion that she was wrong to say that yesterday, so I’ll give the minister another chance to clarify those comments because, quite frankly, I’m being led to believe that she misled the House yesterday. Maybe there was an error in her briefing binder, but will the minister take this opportunity to clarify the comments or words that she put into Dr. Henry’s mouth in question period yesterday?

The Chair: Hold on a second, Minister. I just want to remind members that we are currently debating budget estimates, so please ensure your questions are relevant to the vote under consideration.

You can answer or not. It’s up to you.

Hon. S. Malcolmson: I have answered the member’s question, and I look forward to his questions about Budget 2021.

T. Halford: Thank you. I believe I did get an answer from the minister, and I think the answer was that she infactually cited a quote that is nonexistent into the House yesterday, and I find that quite troubling. But we’ll move on.

I think that this is a fairly straightforward question. Is the minister responsible for communication materials that go out in social media that have to do with mental health and addictions? My question, very directly, is: does the minister or ministry staff of Mental Health and Addictions see communication material that has to do specifically with mental health and addictions before it goes out?

[5:35 p.m.]

Hon. S. Malcolmson: As minister, no. I do not see social media before it is posted. I welcome the member’s clarification about what it was and particularly how it relates to budget.

T. Halford: The question I asked is whether the minister — and she says no — or the ministry staff or the minister’s office staff sees communication material before it is published, I assume, by GCPE or whoever. I reference that in February, I think we all agree that we saw a very unfortunate tweet on a self-care bingo card, which the government later apologized for. It was, quite frankly — I think we all would agree, and I would hope the minister would agree — done in…. Maybe the intentions were good, but it was in pretty bad taste. In fact, some people thought it was fairly offensive.

If the minister has authority, which she said yesterday, for the Ministry of Mental Health and Addictions, I find it very troubling that the minister or any of her minister’s office staff or ministry staff would not have seen or approved this before it went out, in terms of this bingo card, which the government — I think three or four hours later — went and apologized for.

So just to clarify, did the minister or any of the ministry staff see the bingo card…? And I’m not laughing because we’re talking about a bingo card, but did the minister or any of the ministry staff see or approve or have input on the bingo card before it was tweeted out by this government?

Point of Order

A. Singh: Point of order. Mr. Chair, can I make a point of order?

The Chair: Yes. What’s your point of order, Member?

A. Singh: I’m new to this, but my understanding is that estimates is a time to debate the budget and to debate the actual bills that are there, and not to replay question period. I’m not sure where the member from the other side is going with this. Correct me if I’m wrong. Again, I’m new to this. But I don’t think that that’s what we’re here for today. I would really like to get on with the business of today.

The Chair: Okay, Member, give me one second.

Thank you for your point, Member. I’ll allow the minister to answer this question. But I will just remind members again that we’re currently debating budget estimates, so please ensure your questions are relevant to the vote under consideration.

Debate Continued

Hon. S. Malcolmson: There are social media products that our ministry team has worked very hard on — the anti-stigma campaign to respond to the overdose crisis, the StopOverdoseBC series, which has been very successful. Those are absolutely things that we crafted and had a great hand in and are proud of. There was, from GCPE, acknowledgment at the time of the bingo card that the member cites — acknowledgment it did not hit the mark, that it was unfortunate and it wasn’t thoughtful. That was certainly said at the time, certainly fair.

I’ll look to see if we’ve got anything else in the budget that specifies the kind of communication social media products that we’re funding in this year’s budget. Certainly, I’m happy to talk with the member about that.

T. Halford: We’re canvassing the budget — I fully understand that — of the Ministry of Mental Health and Addictions. And within that budget…. The budget of the Ministry of Mental Health and Addictions is about, from the minister yesterday, 70 percent resourcing costs, staff costs.

My question was direct. And it was if either the minister or anybody in the minister’s office or any ministry staff, who all fall under that budget purview, have seen, weighed in, had comment, had authorized the social media that went out.

[5:40 p.m.]

I do not understand how that would not fit in to the estimates conversation. I’m wondering if the Chair could clarify.

The Chair: Absolutely. I did not rule you out of order. I just read the caution again, just for everyone’s benefit, but I did not rule you out of order.

T. Halford: I think it’s important to note that the questions that we are asking have to do with the Ministry of Mental Health and Addictions. We are asking questions, and some of them are policy-related — communications-related, for sure — but they have to do with the Ministry of Mental Health and Addictions. I don’t think any of the questions that have been asked here.… Maybe they’re difficult questions for the minister. Maybe they’re questions that are uncomfortable for the minister, but I think the opportunity that we have today is to canvass those questions.

If that is troubling for members of the government or for the minister or the ministry staff, then I feel bad. I’m not going to be apologetic for that. I think this is important work. I think we just heard a heartfelt statement from the minister that that tweet and that bingo card definitely did miss the mark. I think it was troubling for all of us to see….

The point that I was getting to, and will make, is that if neither the Minister of Mental Health and Addictions nor her minister’s office staff nor her ministry staff are seeing these materials that are specific to mental health and addictions — on this one specifically, mental health — I find that a little bit troubling, for a minister that spoke yesterday about the authority that she has on the file of Mental Health and Addictions. Yet nobody in her ministry seemed to have laid eyes on a piece of social media that was deemed fairly offensive, even by the minister herself today — which I applaud her for. I find that quite troubling.

So my question to the Minister of Mental Health and Addictions is: would she agree that if she is ultimately responsible for the Ministry of Mental Health and Addictions, she should be seeing those communication products — or at least, members of her staff or her deputy minister should be seeing those — prior to them being released and put out to the public?

Point of Order

A. Singh: Again, Mr. Chair, may I call a point of order again? I’m reading from the very simple policy guidelines that we have for budgets and estimates, and it says: “Scrutiny of the estimates takes place in the committee…. This process provides members the opportunity to ask detailed questions about ministry plans and proposed spending. The minister responsible is present to answer questions.”

It’s not about what has happened. We’re here to look at the plans, the budget and the proposed spending. Rehashing this, I find, is a waste of the resources that we have here. I’m sorry; I might be out of order. I’m new here, but I’m reading this from our very own policy guidelines here.

The Chair: Give me a second, Member.

Okay, thank you. The question is in order. The member asking the question did a pretty good job of explaining why, and the Chair agrees. So if we can move on.

Debate Continued

Hon. S. Malcolmson: To add to my earlier comment, I’ll say that in the budget and the service plan for the Ministry of Mental Health and Addictions — that is the half-a-billion-dollar budget that I direct and that we are discussing today — there is no plan to do a bingo card. But we certainly do intend to continue the very successful social media campaigns — and expand on them — that originated from our ministry, on stopping overdose and ending the stigma.

We’ve got a lot of very important work responding directly to the overdose crisis that fits into our work on decriminalization to combat stigma. Social media is an important tool, and we’re going to use it carefully. Those are the kinds of initiatives that are included in our communications plan looking ahead.

T. Halford: I’ll take, from the minister’s answer, that she does not have responsibility, nor does her staff have responsibility at the deputy level, at a minister’s office level, when it comes to communication products that have to do with mental health and addictions. I find that troubling.

[5:45 p.m.]

I will ask the minister this, in direct. When the minister…. When we’re talking about the sensitivity of addictions and we’re talking about stigma and how we can, in fact, try and find ways to end stigma — which I fully support — I will partner with the minister and this government in absolutely any way possible to end stigma. I fundamentally believe that.

Does the minister believe that if a comment is made…? And this is to do with the Ministry of Mental Health and Addictions, just to clarify so I don’t get another point of order here. We’re two for two. I want to make sure that if a comment is made that addiction is a choice, does the minister agree with that comment?

Hon. S. Malcolmson: No.

T. Halford: I agree with the minister. I applaud that. Does she…? Unfortunately, the Premier — and I know the minister knows where I’m going with this, so I’m not going to…. I’ll be direct about it.

On June 16, 2020, the Premier made a comment. There was a lot of public reaction. There was a lot of media reaction to it. He made the comment that addiction is a choice. I just want to clarify the minister’s quick comments because I do applaud her for that. Does the minister believe that those comments, made by the Premier, lead to further stigmas when it relates to mental health and addictions?

Hon. S. Malcolmson: The Premier retracted that comment, so I don’t think it’s worth us spending more time in estimates on that.

I am very happy to talk about our stigma campaign about knocking down the walls of silence surrounding substance use and addiction so that people are not afraid to reach out for help to begin their response or prevention of overdose or their pathway to healing and recovery. That the majority of overdose deaths right now are of people in their homes who are using drugs alone is a particular rationale why it’s so important for us to reinforce for people that addiction challenge is a health care challenge like any other.

We are particularly proud of and grateful to Vancouver Canucks, B.C. Lions, Vancouver Warriors, who all partnered with our government before the pandemic with really getting the message out about, particularly, teammates — this could happen to anybody — to make the challenge of addiction and overdose relatable.

The videos and the Hockey Talks event that we partnered on with the Canucks were particularly hopeful and encouraging. That then the hockey season was interrupted by the pandemic was a setback. This is a program that I personally am hoping that we’re going to be able to reactivate, because it’s one of those ways that we can reach out to people that are maybe not having those important conversations about addiction.

We’ve all got work to do together to combat stigma. I’m grateful for the member opposite’s willingness to partner on this issue, also.

T. Halford: I do appreciate the comments from the minister. I will say that I appreciated the direct straightforwardness of a quick answer on “No,” that she didn’t support the comments made by the Premier. I think we all definitely agree with that.

I do have trouble with the fact that about an hour ago, we were talking about comments made by a director from Interior Health that made, I think we all agree, very unfortunate comments regarding recovery treatment. I think we can agree that those comments do…. Those comments made by that director do affect stigma.

[5:50 p.m.]

I guess I’m having trouble that the minister would condone the comments made by the Premier, which I think we all fully support, yet she will not condone comments made by a director of Interior Health that specified that recovery treatment is not effective.

I have trouble with that, in terms of how importantly the minister values ending stigma.

Just to clarify and go back to the previous question on the director of Interior Health just one more time: Does the minister stand by those comments? More importantly, does the minister think the comments made by that director of Interior Health add to negative stigma regarding mental health and addictions?

Hon. S. Malcolmson: I think that the member has misquoted me. I condone neither the Premier’s statement, nor the misquote of the employee of Interior Health. We’ve adjudicated this well, already, an hour ago. I look forward to the member’s questions on Budget 2021.

T. Halford: Just to clarify, the minister — sorry to rehash this — is now saying that that employee was misquoted?

Hon. S. Malcolmson: I have already said that. That’s what the employee said to me, and that is what the Interior Health retraction was about.

The Chair: Member, if you might try a different line of questioning. It seems like you’ve hoed this row.

T. Halford: Yes, I’ve hoed this row, but I find it troubling that we’ve now had inconsistent answers from the minister, where I gave her ample opportunity — on the record — to speak out against the comments that were not retracted and were not misquoted.

The minister used the remark “misquoted” about a minute ago. The newspaper that put them out was very clear that those were the comments that were made. This minister failed to stand up in this House, in question period and in the committee room, and say that those comments actually add to stigma.

I do fully recognize that this minister takes the issue of stigma very seriously. I do hear it in the comments that she makes in the media quite often. I’m not disputing that.

What I take exception with is that if she is so quick to call out the Premier, which I fully agree with, with his comments, and I do realize that he’s apologized for those…. I have trouble with the fact that she failed to do that on an issue where a senior public employee with Interior Health basically called into question — well, said flat out — that recovery treatment is not effective.

Anyway, I will move on, but I’m a little bit disappointed by the minister’s comments on this. I am disappointed that there seems to be a bit of a pattern here, because we’ve seen the minister, I think, very loosely and somewhat disappointingly, use Dr. Henry quotes that aren’t…. Then used them in question period to serve political purposes. Yet now, the minister has pretty much gone on record to say that that was a mistake.

My question to the minister is…. We’ll move on to something else, regarding youth services. Can this minister specify what the average wait time is for youth to get treatment, whether it’s psychiatry treatment or counselling treatment?

[5:55 p.m.]

The Chair: Minister, just before you go, I’d like to make a statement.

Again, Members, I hesitate to interfere, but I will if I feel the debate is starting to veer into being irrelevant and repetitious. I would again caution members to keep questions to the budget estimates, please.

Hon. S. Malcolmson: In response to the member’s question, the latest numbers that we have compiled are to 2019-20. I’m hoping for more up-to-date information, but this is the most recent that we have.

Since 2016-17, there’s been a 21 percent reduction in wait times for first clinical services for children and youth. That’s down two weeks, from 69.3 days on average in 2016-17 to 54.5 days in 2019-20. At Foundry, there is no wait time, so that is a place that we are seeing an expansion of offer at our urgent primary care centres, which are open in many communities across British Columbia. That is same-day access.

For those clinical appointments, although the wait time has dropped, it’s absolutely not adequate, and we want children and youth to get connected to care faster than they are. That’s why we’re continuing to invest in that continuum of care particularly aimed at young people.

Since the pandemic began, we’ve invested $8.8 million in additional mental health and addiction supports that people can access more quickly. That includes new virtual supports for youth and young adults, including Foundry virtual.

The announcement connected again to this year’s budget, of $40 million to expand the integrated child and youth teams, is going to add, when it’s fully unrolled, 350 mental health workers and community supports intended to connect young people with the support and care that they get, particularly to give them the supports that they need at an early stage so that young people don’t get to the point that they need a more crisis orientation. That’s the system that we are working to build.

T. Halford: As a parent — I think there are a lot of parents in this House — I often tell the story. Last year my son fell off his bike, and he broke his wrist. We took him into emergency, got him X-rayed, and within the next day he was seeing the surgeon, he was in ortho, and within the Friday, he was going through his rehab.

[6:00 p.m.]

When we talk about the wait times that the minister just laid out…. We’ve seen some very, very sobering public cases that I don’t think we need to canvass directly today. I don’t see any point in that. But I do think that the wait times that we are seeing are very alarming and are, in some cases, having very, very tragic effects.

I will say this and ask this directly to the minister: in her mind, are the wait times that we are seeing right now acceptable? What is the minister’s target to have those wait times at, going into 2022?

Hon. S. Malcolmson: In response to, “Are the access times adequate,” no, they’re not. They’re heading in the right direction, but absolutely, the system of care that we’re trying to build would mean that young people, when they present with a mental health or addictions challenge, would get care on an equivalent basis to the member’s son’s broken arm, I think you said. That’s the aim. That’s what we are aiming towards. That’s what we are trying to build up.

That is reflected in the budget that we are debating here today. The budget commits an additional $97 million, as well as $101 million in contingencies over three years, to support increased access to integrated child and youth teams; access to step-up, step-down programs that are associated with MCFD; expansion of early childhood services; mental health in schools; youth substance use services; youth substance use treatment beds; and increased access to Foundry services — both virtual and physical locations.

This budget also continues funding of $22 million per year from Budget 2019 and provides base funding of $16.85 million per year to support the 123 new youth treatment beds announced in 2020. The federal mental health and addictions service funding agreement also provides $8.25 million per year to support the Confident Parents, Thriving Kids program, which is $5.75 million, and the Bounce Back program, $2.5 million. All of those are committed towards building up that system of care that reduces or eliminates wait times, which is the aim of Pathway to Hope.

T. Halford: I thank the minister for her answer. Is it fair to say that the Ministry of Mental Health and Addictions…? Does the ministry not have targets in terms of wait times that they would like to achieve?

I get that when we’re talking about wait times, specifically with mental health and specifically with youth, we want them as low as possible. But does the ministry not have benchmarks that would target meeting, based on the funding commitments that the minister just outlined that she would like to see, going forward? And does the minister not have an idea of what she would like those wait times to be in the future, whether that’s Q1 of 2022 or Q2? Does the minister not have benchmarks in terms of wait times that they want to achieve?

[6:05 p.m.]

Hon. S. Malcolmson: The end goal, as I’ve said, is no wait time. We want health care to be delivered on an equal access basis, whether that’s physical, mental or addictions care.

As we roll out the integrated child and youth teams…. The most advanced are in Comox and Maple Ridge, but even they are not fully implemented yet. That’s going to be one of our places where we’re able to test-drive what it looks like if we get services to people early, while the problems are still small problems. So we have got measurability, tracking results and outcomes as we go. But the end goal is no wait time.

T. Halford: Thank you to the minister.

Minister, just in terms of the issue of affordability when it comes to counselling services and psychiatric services, we have heard — and I’m sure the minister has heard and the minister’s staff have heard — that affordability is a massive impediment, oftentimes, for people to get care, whether it’s for themselves or whether it’s for their children or maybe for their aging parents.

How does this minister, within this budget, address the issues of affordability when it comes to counselling services and psychologist services for British Columbians at all income levels? I know that there are different subsidies, depending on your income level. But I also realize that getting psychiatric services…. We already talked about the wait times, but they can be massively, massively expensive.

How is this minister, how is this ministry, dealing with the issues of affordability when it comes to psychiatric care and counselling services?

Hon. S. Malcolmson: Agreed. Quality, affordable, consistent counselling can make a huge difference in the life of somebody who’s experiencing mental health or addiction challenges. Absolutely, the size of your pocketbook should not be an impediment to accessing the health care that people deserve. It’s a specific instruction in my mandate letter from the Premier to identify ways to remove barriers to people’s access to mental health and addictions supports.

[6:10 p.m.]

So far, we have increased access to low- and no-cost mental health and substance use counselling through $10 million in grants to community agencies. In the first year of that grants program, we’ve seen a 60 percent increase in the number of counselling sessions and a 58 percent increase in the number of individuals accessing counselling.

Early in the pandemic, access to community-based counselling was expanded and virtual services offered. In particular, that transition to a virtual platform expanded access not just from a monetary point of view but also for people that wouldn’t have been able to get out otherwise. We saw quite an expansion there. Those are now extended through March 2020, built on the success. This has been a particular benefit, I think, to rural remote Indigenous communities.

On the budget side…. So $10 million, I related already. In 2021, an additional $4.8 million was provided to extend that service provided by the first $10 million investment. This budget that we’re looking at today includes that additional $97 million, which is focused on children and youth and the other programs that I had cited earlier — mental health in schools, expanded youth substance use treatment. Also the Confident Parents, Thriving Kids, $5.75 million, and the Bounce Back program, $2.5 million, under the federal funding agreement umbrella that I referenced earlier as well.

Psychiatric is care is free if it’s referred. I am hearing some interesting outcomes of the move to virtual phone, video appointments. — the change in billing access that the Health Minister stood up during the early months of the pandemic — and that, particularly, communities that were having challenges accessing psychiatric care because of their location now are not impeded so far as their access to psychiatry.

That’s just anecdotal, but I think it is an interesting piece for all of us to ground truth in relation to lessons learned from some of the technology innovations that have been stood up during the pandemic. We look forward, as a government, to continuing to digest the outcomes of some of those technology innovations over this past year.

T. Halford: To the minister, thank you for the answer.

When we’re talking about referrals for psychology services that…. Just to clarify, the minister did talk about an extension of a program into March of 2020. I don’t know if the minister was incorrect on that or wanted to clarify. March of 2020 seems to have passed. Does the minister want to clarify that?

Hon. S. Malcolmson: My deputy just pointed out the same thing — that I misspoke. It was March 2022. Thank you to the member for catching it.

T. Halford: When we talk about referrals to get psychology services, whether it’s for a child, for a spouse or for a parent, and you are dependent on a referral for that from a physician for it to be covered, and then you are subject to, I think, what the minister and I would both agree is maybe a lengthy wait time….

Does the minister have any thoughts, through the Ministry of Mental Health and Addictions, in terms of affordability, when it comes to psychiatric care, whether or not that should be subsidized depending on income level, or does the minister think that right now costs for psychiatric care is an impediment for people to get services, and possibly while they’re dealing with an addiction? Does the minister believe that not having access to psychiatric care because of costs or wait times could be leading to addiction issues in British Columbia?

[6:15 p.m.]

Hon. S. Malcolmson: Access to psychiatrists — the barrier is not cost, because that’s covered by MSP. But absolutely, access to a number of specialists, just simply a scarcity issue, can be a barrier to care, whether it’s mental health or addictions. That is why the focus of our government for some time now has been building out the primary care network. An example of that are the urgent primary care centres that have been opened across British Columbia.

In April, we announced 32 additional primary care networks. How those work…. We just don’t have enough psychiatrists trained up and available in British Columbia, and it’s a long commitment. Despite the fact that we are now planning to open another medical school, that’s a long lead time. So in the team-based approach, people can access a primary care network or an urgent primary care centre and can have access to a team of practitioners — nurse practitioner, primary care doctor, addictions and mental health supports, social workers.

An example of this is in my own community of Nanaimo. The addition of the urgent primary care centre has not just taken the load off the hospital emergency room, but it has been able to connect people to care more directly and make up for the lack of access to psychiatrists. Because there simply aren’t enough of them.

The budget commitment…. The particular thing I want to focus on so far as budget is that through the Canada-B.C. home and community care and mental health and addictions services funding agreement, $33.37 million has been allocated to support primary care initiatives involving B.C.’s mental health and addiction services. That’s a major piece of overcoming that lack of access to psychiatrists.

As well, I’ve certainly heard anecdotally…. We may be able to generate some numbers if the member is interested in pursuing this. The access that I’m hearing from young people using the Foundry app is that being able to connect people with counselling appointments and using the kind of primary care framework within the Foundry system to be able to connect people, young people in particular, with care and counselling more immediately — group counselling in many cases; just trying things in different ways, particularly youth-led — has often led to better outcomes.

[6:20 p.m.]

To talk with some of the young people that have used these programs already…. I’ll just finish by saying how inspiring it was to hear them say: “Actually, I would really rather talk to one counsellor with a group of my peers than to have it be one-on-one.” There are many ways for people to access learnings. Sometimes doing it together in a group makes them feel more supported in their mental health and building up resilience journey.

T. Halford: Just to clarify the minister’s comments when it comes to psychologist fees. The minister stated that they’re covered under MSP for British Columbians. Is she able to clarify that comment? I believe I heard the minister state that they are covered under MSP. Can the minister clarify that?

Hon. S. Malcolmson: The member’s question was about psychiatry, and that’s the question that I answered.

T. Halford: When it comes to counselling services as well — the minister just referenced before, in terms of maybe possibly a group setting, and in some of those, whether it’s psychiatry, psychological services — does the minister agree that we are seeing and experiencing…? I’ve heard firsthand from individuals where they have said cost is a barrier to accessing those services. Does the minister agree that cost is a barrier to accessing those services?

Hon. S. Malcolmson: In relation not to psychiatrists but to psychologists and counselling, yes, cost can be a barrier. That is why our government has introduced the range of funding supports that I mentioned several answers ago and that are expanded enormously in this budget that is here on the table today.

There is absolutely more work to do. Again, as I referenced, the Premier has specifically mandated me to find ways to overcome that cost barrier. We don’t think people’s access to mental health or addictions care should be based on the size of their pocketbook.

T. Halford: I believe that we’ll have time tomorrow to canvass other areas, but just in terms of the minister’s thoughts when it comes to…. We talk about services for youth. I come from a riding of Surrey–White Rock that is probably about 80 percent seniors. I often talk a lot about youth in terms of services for counselling and psychology and psychiatry services and mental health. I don’t think, and I’ll include myself, that we talk enough about seniors mental health.

I will ask the minister, when we are dealing with, in the world of COVID, Zoom and apps and other things…. I am not tech-savvy at all. My kids are; I am definitely not. I will ask the minister how they are particularly dealing with seniors in mental health. A lot of seniors in my riding are on fixed incomes. A lot of them do have benefits, whether they’re former teachers and they do have, but usually they’re around $500 per year for those services. Those can run out after a couple sessions.

I’m wondering how the minister plans to deal specifically with seniors on the issue of them accessing support for mental health.

[6:25 p.m.]

Hon. S. Malcolmson: Chair, I’m going to be in your hands. I’ll look for your signal about when we are getting short, because I’ve got a number of programs that I think are helpful to read into the record just so that members throughout the health authorities are aware of some of the new programs that are being offered.

I’ll start by saying that with the exception of Foundry and the integrated child and youth teams and some of the other more obvious pieces, all of the supports that we have referenced are available to seniors. The 211 program that we stood up over COVID has been particularly important for people who are not tech-savvy, and maybe we could start tomorrow, if I can read in some of more specific pieces.

The Chair: That would be great.

Hon. S. Malcolmson: And with that, shall I move the motion?

The Chair: Please.

Hon. S. Malcolmson: I move that the committee rise and report progress on the estimates of the Ministry of Mental Health and Addictions and ask leave to sit again.

Motion approved.

The committee rose at 6:27 p.m.