Thank you, Madam Chair. I move that this committee strongly recommends that the government take immediate action to identify additional funding for health promotion and education initiatives in areas such as healthy eating, active living and early childhood development.
Thank you, Mr. Hawkins. A motion is on the floor. To the motion. Mr. Dolynny.
Thank you, Madam Chair. This motion clearly indicates that we need to focus on some better initiatives in the education and promotion of healthy, active living. I just want to share a couple of key statistics with you to put a light on this motion.
Life expectancy is six years lower in the NWT than the Canadian average, and I think that’s why this motion has been brought forward. Sixty-three percent of NWT residents 15 and over are overweight or obese compared to only 51 percent of Canadians. It is clear and obvious that we need to do a better job in health promotion and education so that we have much more healthy residents in the years to come.
Thank you, Mr. Dolynny. Mr. Bromley.
Thank you, Madam Chair. Active living and physical activity levels is one area where we in the North are challenged. I think there needs to be some additional attention. It’s demonstrated that is so important, even during early childhood to the brain development, but also for health throughout life. The committee has repeatedly asked, as one specific example, for some form of milk subsidy. We, apparently, haven’t done that because parents need to take responsibility for raising their own children. Our employment rates are as low as 30 or 40 percent in some of our communities. This is not a matter of them not wanting to take care of their children. That’s one example. Let’s get that done. I still get requests for that and I know other Members hear about it occasionally as well. I will be supporting the motion.
Thank you, Mr. Bromley. To the motion. Mr. Moses.
Thank you, Madam Chair. Just to briefly touch on this motion here. I think committee members and residents don’t have to look any further than some of the key findings in the Health Status Report that was brought forth in August 2011 and some of the key findings that need to be addressed to protect and increase the healthy living of our residents of the Northwest Territories. Obviously, with my background, and seeing the effectiveness of health promotion and education initiatives, and putting more dollars into that and investing into our people, I will be supporting this motion. Like I said, you don’t have to look much further than the Health Status Report of residents of the Northwest Territories.
Thank you, Mr. Moses. To the motion.
Question.
Question has been called.
---Carried
Page 8-31, Health and Social Services, activity summary, community wellness and social services, operations expenditure summary, $89.259 million. Mr. Bromley.
Thank you, Madam Chair. I just want to ask a little bit about the family violence and counselling. I know we’ve had our third, sort of, Phase 3 recommendations on this area, and this year we weren’t able to advance on all of those but I think there was general agreement to them as priorities. Could I just get, maybe, an update on what we’re proposing to do in this fiscal year under consideration here in the way of addressing family violence and the Family Violence Plan, Phase 3.
Thank you, Mr. Bromley. Mr. Beaulieu.
Thank you, Mr. Chairman. We are continuing the work that was being done under the family violence prevention initiatives in 2012-2013. Social Marketing Strategy, $82,000 community protocols, $120,000; community response teams, $90,000; recovery and support programs for children, $75,000; for a total ongoing contribution of $367,000.
That sounds like a good response. Can the Minister confirm that that addresses all of the recommendations of Phase 3 based on the recent review?
The information I have is that it does address the recommendations and that we are working with the Coalition on Family Violence to address the recommendations in the original plan.
Thanks for those remarks from the Minister. I know Health is working with the Department of Justice, as well, and there are some other programs in that department working on this initiative.
I guess, just on the mental health side, I was happy to see that there is now some attempt to fund the Mental Health Action Plan that resulted from the extensive review that was done. Can this Minister tell me if that will address the needs for assessment and diagnosis and care that would be required out of mental health court, the services that would be required for a mental health court in the Northwest Territories.
I would just have the deputy minister read through some of the information of the programs and information where we’re spending the money to try and address that issue.
Thank you, Mr. Beaulieu. Ms. DeLancey.
Thank you, Mr. Chairman. The money in this budget to start implementing year two of the action plan does start to address some of the requirements that were identified in order to address gaps and services, most notably the continuing support to the Stanton Hospital/Dalhousie Psychiatric Program which provides both psychiatric treatment in Yellowknife and also telehealth. That also involves working with Dalhousie to document the after-care and follow-up programs, because right now one of the gaps in our service is very much that when people are dismissed from Stanton, especially when they go in for outpatient psychiatry, they often don’t have a fully developed care plan or there’s not proper communication back to their authority. So a big part of the project with Dalhousie is to put those in place. That’s married with – you’ve heard about the Chronic Disease Management Pilot Project on Mental Health Care Pathways; these two initiatives are marrying. That’s a big part of it.
Another part of it is putting in place some staff to continue the work on standards, updating the manuals – this is an outstanding commitment – so that we do, again, have consistent standards of practice for follow-up in every authority. To that extent the budget does start to address those service gaps.
Thank you, Ms. DeLancey. Mr. Bromley.
That is positive news. But, of course, I think the committee is looking to fully address all of the gaps. What would it take? What is left to be done? These are the sorts of things that will be useful in discussions to come.
Thank you, Mr. Bromley. For that response we’ll go to Minister Beaulieu.
Thank you, Mr. Chairman. We don’t have a lot of the detail here on the gaps in order to fill all the requirements that are needed and the work that’s needed by the department in order to meet the needs of the development of a specialized court. What we have and what we will work on – and, of course, that motion was passed today – is that we have some work being done with the development of a youth and detox program models as one of the pieces. We are looking at hiring some mental health specialists in the professional development and also in the quality assurance. Also, looking at some other positions. Chronic disease management that we spoke of a bit will also have a relation to that since mental health is also considered a chronic disease. During the development of the chronic disease, the department will see, and there will be some correlation between the development of the chronic disease on the mental health portion of the development of the Chronic Disease Strategy and also the finalization of the specialized courts. In addition, we’d have to work with the Department of Justice to do, sort of like, the final gap analysis or assessment in order that we could be prepared to fill the gaps for the specialized court.
I will ask for the chair’s indulgence to have the deputy fill in some other information.
Thank you, Minister Beaulieu. Ms. DeLancey.
Thank you, Mr. Chair. Just two final pieces of information. The work with Justice on feasibility assessment is ongoing. I believe the Committee on Social Programs has had a presentation on that, and part of that is the final assessment of gaps. The other piece of information we have as part of the partnership with Stanton and Dalhousie University, Dalhousie has worked with all of our authorities to identify gaps in service. We received a report on that very recently. We do need to marry those two pieces of work together in the coming couple of months and then we would have a much more complete sense of where the gaps in service are.
I guess, in summary, what we’ve got in year two of the action plan is addressing those things that were already identified and we’re now doing the final work to try to identify anything outstanding.
Thank you, Ms. DeLancey. Mr. Bromley.
Thank you, Mr. Chair. Thanks to the Minister and deputy minister. I think those comments are very useful and help fill in my understanding.
I guess my last question is, you know, I frequently heard that we need… I’m sorry. I don’t know the terminology, but is it a forensic psychiatrist or somebody who’s able to do the assessments and so on for a mental health court to be workable. Where are we on that? On having those talents ready and available within our government.
Thank you, Mr. Bromley. With that, we’ll go to Minister Beaulieu.
Thank you, Mr. Chairman. We will be addressing that through our collaboration with Dalhousie psychiatry work that we’re doing. I guess it would be the Dalhousie psychiatric telehealth.
Thank you, Mr. Beaulieu. Mr. Bromley, your time is up. If you want to get back on, just give me a cue. Moving on with questions on page 8-31 I have Ms. Bisaro.
Thank you, Mr. Chair. A few questions here. I’ll start with, hopefully, a relatively easy one. I know that the Minister has committed in the House that funding for the Yellowknife Dene Ko Day Shelter will continue at least for another year. I haven’t managed to find where the budget indicates that funding, so if I could be directed to the spot in the budget that indicates where the funding is for the day shelter and the amount. Thank you.
Thank you, Ms. Bisaro. For that we’ll go to Minister Beaulieu.
Thank you, Mr. Chairman. That budget is in the contribution to YK Health and Social Services. The overall contribution and the total amount is $175,000.
At the risk of going beyond this page, there is an amount on page 8-32, at the very bottom, for mental health and addictions authorities, $125,000. Could I know what that references?
Okay. Ms. Bisaro, I will allow it, but we’d like to keep on page 8-31 for further questions. Mr. Beaulieu.
Thank you, Mr. Chairman. It looks like the Yellowknife homeless day shelter and the Canadian Mental Health Association are the money that may be going to Health and Social Services, but we have agreed to an additional amount of $50,000 because of the withdrawal of BHP. If this is the actual same number, but we don’t understand this to be the same number. Our understanding is that it’s within the overall contribution to YK.
The deputy has just advised me that within the $1.463 million that’s within the department, that a separate contribution agreement aside from the grants and contributions that are issued to the authorities, that this, within the $1.463 million, is where the $175,000 sits.
Thank you all for that explanation. I think I’ll just leave the $125,000; $175,000 sounds a lot better, so I’ll take that. Thank you very much.
I have another question. It’s more of a concern, really. The Minister’s Forum on Addictions and Community Wellness, I think it’s now called, has been going on for some time. When the forum was first designed, it was a forum on mental health and addictions, and the terms of reference were designed under that title, and then the title was changed.
Mr. Chairman, I think a fairly common thing has been that people sometimes end up with mental health issues as a result of addictions. Sometimes people with mental health end up with addictions. That’s why we see the two items fairly linked. We’re trying to give the forum the ability to, as we appointed them as experts in the community, that they are well known in the community and had good community knowledge, that they felt that removing the mental health from their forum would net better results and better consultation at the community level by using the term addictions and community wellness as opposed to mental health and addictions. They chose that term, so that when they go out, individuals are addressing them in the community level were addressing them with their addiction issues and their wellness issues. They felt that there was a bit of a stigma attached to mental health and they chose to stay away from that as a part of their title.
However, when we do evaluate their report and determine that the work that we’re going to do as a result of their report, we’re not going to separate the two. We are going to, wherever it is necessary to work on the mental health in the community level and where it is necessary to work in addictions or wellness, and also where it is necessary to work in all of those three areas in concert, that’s what we intend to do.
Thanks to the Minister. I appreciate the Minister’s explanation, but I have to disagree with his assessment because I don’t believe that you can separate the two. I think, by the forum and the Minister agreeing that there is a stigma on mental health, we are simply making it worse. I think, until we start talking about mental health and accepting that it is an issue, some people refer to it as a disease, but until we start bringing that to the fore and accepting that is a problem that we have, we won’t adequately deal with it. I think it’s unfortunate that the forum members wanted to remove that particular phrase and replace it with community wellness. I will just leave that as a comment.
My last question has to do with the Nats’ejee K’eh Treatment Centre in Hay River. It has been quite a while now. It has probably been since the 16th that Standing Committee on Social Programs members have been concerned about the usage at Nats’ejee K’eh. My understanding of the latest statistics, that Members received, it was anywhere from a 50 percent occupancy up to maybe 60 or 70 percent. I don’t believe it was any better than that. Sometimes it was less than 50 percent occupancy, from what I understand. I believe we have had conversations with the Minister about whether or not something will be done with that facility to bring the occupancy and the usage to a much higher percentage.
I would like to know from the Minister whether or not a review has been done. There was talk of a review probably at least a year or two years ago now. There was going to be an analysis of what the centre was currently doing, what we needed as a territory to deal with, what we needed in a treatment centre and how we were going to change the centre, and use it better and have a greater occupancy rate.
I’d like to know from the Minister whether there has been any review of the centre, whether there is any intention on the part of the department to try and revise the programming at Nats’ejee K’eh to make it better utilized by our people. Thank you.
Mr. Chairman, I find the questioning rather interesting since the Member indicated it was difficult to separate addictions and mental health and that Nats’ejee K’eh has moved solidly into the area of counselling mental health patients, and that the councillors have a background in mental health.
Knowing that, we looked at the amount of the capacity, I should say, of the individuals, the capacity of the building as they are doing their intakes. The capacity is actually around 46 and dropped to 43 percent, so lower than 50 percent in the last two fiscal years that we’ve looked at.
I met with the board. I went down to Hay River and met with the board. The board asked me if they would be allowed to develop a plan on how they think the program should work.
It’s a rather interesting thing because this is a long story. The need for Nats’ejee K’eh could be an essential part of the overall recovery of people with addictions issues. What they had asked was… We went in there and were basically of the thought that there was not much capacity and low success rate. And that is true. But the more we work with the department, within addictions of all of the communities and so on, the more we’re seeing a possible role for Nats’ejee K’eh, an important role for Nats’ejee K’eh.
One of the things we are doing in addition to allowing the community, that group, the Nats’ejee K’eh to develop a plan to provide to the department, is we’re going to move Nats’ejee K’eh from Deh Cho Health and Social Services under Health and Social Services, the department. Right now we are looking at it as perhaps an opportunity for addicts to go to Nats’ejee K’eh to get educated. We looked at it from that perspective.
I had discussions with other Members in here. They thought that might be an opportunity to use Nats’ejee K’eh to maximize Nats’ejee K’eh. Right now we’re thinking that we still come away with the understanding that addressing addiction issues is a personal responsibility, so that we can provide as many aids as possible to individuals, and Nats’ejee K’eh being one of those aids that we can provide to an individual to go through an intensive 28-day educational process on the harmful effects of alcohol and drugs.
Also, the Nats’ejee K’eh could be a complementary type of treatment to all of the other personal responsibilities, on the land treatment, supporting parents in the communities. Some of those ideas are initial ideas that we’re getting back from the Addictions Forum. Once we have that report, we’re going to be able to then, we think, slot Nats’ejee K’eh into the overall spectrum of addressing addictions.
Thank you, Mr. Beaulieu. Committee, we’re on page 8-31, and continuing on with questions I have Mr. Moses.
Thank you, Mr. Chair. Actually, I had my questions focused around chronic disease management and dollars that are being allocated to that. However, the Minister did make a comment there to my colleague’s previous question and one of her concerns was why the Addictions Forum doesn’t contain mental health, and the Minister did mention that he feels that addictions is a personal responsibility. But when you get into the frontline work and you work with individuals that are battling addictions, and you sit down with people that are having a hard time and they can’t get out of the rut of addictions, a lot of it deals with mental health issues. A lot of it is more than just a personal responsibility.
Some of these guys need education; they need an education into personal life choices. You can’t just assume that because they’re a young adult, that they’re an adult or even an elder, that they can make those personal decisions on their own, or those choices. I think that’s where my colleague was trying to go with why we’re not focusing on mental health with addictions, because they do go hand in hand, and we just have to go down and walk into some of these communities where we’ll see people who are battling with addictions that need that extra support.
I don’t agree with the Minister’s comments that it comes down solely to personal responsibility because this government has a responsibility to offer those services to help those that need that help. If you go and talk to somebody who might be battling addictions, they don’t have the education, they might not have had education.
We’re going through a curriculum right now where we’re going back to residential schools. People’s lives are traumatized at an early age and they can’t make those decisions on their own. So I disagree with what the Minister had said to my colleague, and that is a personal responsibility because there are some people that can’t make that decision or choice on their own. So I just wanted to, for the record, state that, and I will make sure that there will be questions asked in the House and get it on for the record when we’re trying to help our residents of the Northwest Territories, because comments like that really do upset me, Mr. Chair.
Moving forward on to my initial questions and I’ll allow the Minister to respond to that comment. As well, I would like to get more clarification on his thoughts.
In the NWT, 70 percent of all deaths and more than 50 percent of the number of days spent in hospitals were related to chronic conditions. Also, I wanted to throw a couple more stats in there. Approximately 200 new cases of diabetes are diagnosed each year, which are a direct correlation to nutrition, active living and, as stated earlier today, that 63 percent of our NWT residents are overweight and obese. Then when you look at the chronic disease mortality rates, 23 percent are related to cardiovascular deaths. I want to know what the Minister is doing to decrease any one of these statistics that we see, that the public sees that we’ve got to be making plans to cut these down, whether it’s the 70 percent of all deaths, the number of hospitalizations related to chronic disease.
We’ve got to set performance measures. We’ve got 200 new cases of diabetes. How can we set a performance measure that next year we’ll only get 150? That would be success. Or even better, how do we not get any at all? That all leads to prevention and promotion, and that’s where we’re not focusing our dollars. How do we cut down on the 23 percent of cardiovascular deaths that we see each year?
I want to know what the Minister is doing and if he’s looking at providing more dollars into the prevention and promotion so that we can start addressing some of these issues that are clearly stated in the 2011 Health Status Report. I don’t want to get into asking him questions again if he’s read that report, or not because I’m doing my homework over here and I hope the Minister is doing his. He’s got a big stack, he’s got a big department and, honestly, I was just going to ask a nice question, but his comments to my colleague earlier really got me hot under the collar here. Thank you, Mr. Chair.
Thank you, Mr. Moses. For that we’ll go to Mr. Beaulieu.
Thank you, Mr. Chairman. I didn’t indicate that addictions was the responsibility, solely a personal responsibility. I’d indicated that addressing addictions was a personal responsibility and what we’re trying to do is to try to provide some supports, and mentioning the Nats’ejee K’eh would be one of those supports in addition to some of the community programs like on-the-land programs, also, in addition to some of the early findings of the forum of maybe addressing some parental issues, putting in programs to assist parents at the community level and so on.
So it wasn’t to take all the money out of trying to address issues with addictions and writing it off as a sole responsibility. That, I didn’t say. I said that it was a personal responsibility. A lot of people with addiction issues have gone to complete sobriety on their own. That, we know for sure. That’s a fact. Many individuals that have addressed the issue on their own are sober.
There are people that need assistance. That is true. If you’re into the counselling business you have people coming to you. The Community Counselling Program, we’re spending $6 million in the Community Counselling Program. We’re continuing that. We recognize that people come to get assistance, but if you make a personal choice to try to address your addiction issues, then all of the support that can be provided by the department, by the Community Counselling Program or any new programs that are recommended through the addictions forums, will all be aids in place to be able to help people address those issues.
Just on the management of chronic disease, I think what the Members are trying to get from the department is to zero in on having a specific Chronic Disease Management Strategy, but in reality it is throughout our work. If we develop a Chronic Disease Strategy, that’s okay, because it can refer to all kinds of programs that are in the system, but in our system the areas of prevention and promotion, which is an area where the Members don’t agree with the amount of money that we’re saying we’re putting into prevention and promotion. So we encounter that. We see prevention and promotion throughout the entire budget. We see chronic disease management throughout the entire budget. We’re looking at the whole area of anything to do where we’re working with like, one example is TAMI, Talking About Mental Illness. That program, as an example, is a program that we’re working on. So we’re not doing nothing at all, we’re working there. We have Mental Health First Aid, we’re putting money into mental health and addictions, we’re working on three separate pilots right now, a cancer strategy, healthy eating pilots, and renal is the other one. Then we’re piloting three, I guess, that we were going to use as a base, renal, diabetes – and I don’t remember the locations, but we could have the deputy provide the locations – and mental health.
There are lots of different things happening in the department. I go through a lot of reports that were there before I started. I don’t memorize the reports. I’ve got a huge job trying to move this department forward, trying to address the issues. I think issues that are important to the health of the people in the Northwest Territories. If Mr. Moses asks me questions specific to whether this is in the report or whether you read this report, he talked about several reports yesterday that he mentions again today. One of the reports I hadn’t heard of but the reporter had it. When the guy opened it up and showed me the consultation of it and so on, it was a bit different than the consultation that we’re doing under the forum that we’re doing now. I had indicated to him that we are trying to get more of a community, people going out there doing consultation with the communities and trying to develop something from that. It is costing a bit of money, $300,000, but we think that once we get that report and once we action the report, we will gain that money back in the long run.
Thank you, Mr. Beaulieu. Are you concluded? Just one more question I will allow for Mr. Moses.
Thank you, Mr. Chairman. I know that both comments were pretty long there, and I do understand the Minister does have a very big department and a lot of responsibility to be working with, he and his staff. When I do refer to reports I refer to it from a ground-level worker, which I’ve done for many, many years, and some recommendations when I left a conference or a workshop feeling good knowing that those recommendations were to be addressed or looked at and they never, ever did. Now that I’m in a position to see if we can try to get those addressed, I feel good about it because I’m saying stuff here now that I’ve been saying for the last 12 years sitting on committees at the ground level working with community members, people who have the challenges with the lack of funding trying to help people that they genuinely care about. So when I go to reports and talk about recommendations, I’m coming at it from a true working level from the ground level. I just want to make that comment to the reports.
Based on the stats, can I ask the Minister why we are piloting three projects when I listed all the stats, and the stats show that we need something concrete. We don’t need pilot projects; we need something concrete. Whether he’s going to allocate specific dollars on an ongoing, year-to-year fiscal budget process to address all these stats that I had mentioned earlier, and not keep them as pilot projects, and not focus on just three communities, but try to find a way to make it a territorial project that addresses all residents of the Northwest Territories, and not just three communities in terms of piloting because it is an issue. I read out the stats earlier. People are dying. People are suffering. We can’t just go out and do a pilot project and say we might be able to help you out, we’ll see how these projects do first in these three communities. As we’ve said, all regions are different. Demographics are different. Costs of living are different throughout different regions. That’s just my question.
Thank you, Mr. Moses. For that we’ll go to Mr. Beaulieu.
Thank you, Mr. Chairman. We’re using pilot projects as exactly what they are, pilots. They will end, those projects. The information gathered from those programs, those specific programs would probably continue, but not as pilots. They would continue as the regular course of business that we do in the chronic disease management.
As a result of those projects, we’re going to be able to expand into other programs we’re seeing that we need to address the chronic disease issues. We know that initially when we forge into this work, we do the same thing too. We look at the stats. That’s what we use as a starting point. We know that diabetes is growing at 200 persons per year in the Northwest Territories. We know that diabetes is higher among Aboriginal people than it is among non-Aboriginal people. What we are doing is dealing with, really to address the diabetes issues, we’re saying exercise and eating healthy.
Then we talk about people that, when we talk about cancer, we’re talking about not smoking. We’re trying to get out there and work on prevention programs and smoking cessation programs. Also drinking. Heavy drinking seems to have a very negative impact on a person’s health. So we’re trying to address that issue, too, so we’re talking about that and that’s why we’re doing our addictions work and so on.
We are looking at the stats and trying to put programs into effect and dealing with the authorities, through the authorities, through social services, through the health authorities and so on, health and social services authorities, trying to address these issues, as well, by looking at the stats.
I don’t know if the trend has been where diabetes is growing by 200 persons per year in the Northwest Territories if we’re able to get people starting at the schools, trying to start at the schools, we thought that would be a good point to start healthy living, healthy eating and exercising. We’re able to curb the new diabetes in the Northwest Territories, if we can turn the curve down that would be something we want to achieve. Same with cancer. Cancer rates are very high. The various different types of cancer rates are very high, so we’re trying to address those issues by developing a cancer strategy, by piloting that through two communities in the Northwest Territories.
