Your Standing Committee on Social Development is pleased to provide its Report on the Statutory Review of the Mental Health Act and commends it to the House.
And, Mr. Speaker, I move, seconded by the Member for Mackenzie Delta, that Committee Report 16-20(1), Standing Committee on Social Development Report on the Statutory Review of the Mental Health Act, be deemed read and printed in Hansard in its entirety. Thank you, Mr. Speaker.
Thank you, Member. The motion is in order. To the motion.
Question.
Question has been called. All those in favour? Opposed? Abstentions? Motion passed.
---Carried
Standing Committee On Social DevelopmentReport On Statutory Review: Mental Health Act
Executive Summary
The Standing Committee on Social Development (Committee) was tasked with undertaking the first statutory review of the Mental Health Act (Act). Committee sought feedback on the Act to inform its statutory review.
Committee appreciates everyone who offered their feedback at public meetings and in written submissions. Committee thanks the Department of Health and Social Services for their willingness to work with us, and for providing great insight on the current operations of the Act, including challenges and strengths. Committee believes the fourty (40) recommendations listed in this report will help improve the Act and its operations.
The Standing Committee on Social Development recommends the Government of the Northwest Territories conduct a comparative analysis of the Northwest Territories’ Mental Health Act against other jurisdictions’ mental health care legislation, to significantly reduce and mitigate the administrative burdens and procedural complexities of the Mental Health Act (including Forms under the Mental Health Act) and present constructive amendments to the Mental Health Act for consideration.
Recommendation 2: The Standing Committee on Social Development recommends the Government of the Northwest Territories allow flexibility to the Mental Health Act Review Board to hold hearings outside of the current notice requirement of seven days with the consent of all parties by reviewing Section 70(1) of the Mental Health Act to remove the seven-day notice requirement and defer the minimum notice requirement to the Mental Health Act Review Board Regulations.
Recommendation 3: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Section 10(2) of the Mental Health Act to determine a more realistic timeline to issue a Certificate of Involuntary Assessment, in consultation with the Royal Canadian Mounted Police and physicians including psychiatric professionals.
Recommendation 4: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Section 17 of the Mental Health Act and compare to similar provisions in other jurisdictions to determine the appropriate length of time before a certificate expires in order to issue a renewal certificate.
Recommendation 5: The Standing Committee on Social Development recommends the Government of the Northwest Territories assess the addition of a provision added to the Mental Health Act for the Mental Health Act Review Board to review a certificate after a cancelled hearing based on best practices and national standards.
Recommendation 6: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Sections 66(1)(a) and Section 74(1)(a) and (b) of the Mental Health Act to remove the ability to apply to the Mental Health Act Review Board to cancel Form 2 – Certificate of Involuntary Assessment.
Recommendation 7: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the Mental Health Act and its regulations (e.g. Section 16(1) of the Mental Health Act Review Board Regulations) to reflect timelines in days or business days, rather than hours, where appropriate.
Recommendation 8: The Standing Committee on Social Development recommends the Government of the Northwest Territories work with the Mental Health Act Review Board to clarify where and how the Interpretation Act applies to the Mental Health Act and determine if the current two-day timeline in Section 67(2) remains a challenge despite the flexibility afforded by the Interpretation Act.
Recommendation 9: The Standing Committee on Social Development recommends the Government of the Northwest Territories work with the Mental Health Act Review Board to find ways to streamline the hearing process and evaluate the time it takes to conduct a hearing and reasons why the hearing process may be deemed too long.
Recommendation 10: The Standing Committee on Social Development recommends the Government of the Northwest Territories review and expand the role of the cultural advisor under Section 71(5) and Section 68(1) of the Mental Health Act including adjusting the wording “to a review panel” in the Mental Health Act to “a time deemed appropriate for patient needs”.
Recommendation 11: The Standing Committee on Social Development recommends the Government of the Northwest Territories include a specific provision in the Mental Health Act that outlines that the Mental Health Act Review Board panel may disclose information to the cultural advisor to the extent the panel deems necessary or wording that outlines how and when the cultural advisor will receive information.
Recommendation 12: The Standing Committee on Social Development recommends the Government of the Northwest Territories provide training to staff and Mental Health Act Review Board panel members on the disclosure of information provisions held within the Mental Health Act, and the processes that follow them.
Recommendation 13: The Standing Committee on Social Development recommends the Government of the Northwest Territories review, compare and adjust definitions and terminology in the Mental Health Act against healthcare operations and language to promote appropriate and streamlined operationalization of the Mental Health Act.
Recommendation 14: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the suitability of the Inuvik Regional Hospital and the Hay River Health Centre as designated facilities (including an analysis of environmental and staffing capacity) under the Mental Health Act and review the ability to add different classes of designated facilities within the Mental Health Act and its regulations, using other jurisdictional models as an example.
Recommendation 15: The Standing Committee on Social Development recommends the Government of the Northwest Territories review and expand the definition of “mental disorder” in the Mental Health Act by conducting a jurisdictional review of definitions.
Recommendation 16: The Standing Committee on Social Development recommends the Government of the Northwest Territories establish an ongoing territorial working group with involvement from the Royal Canadian Mounted Police and health staff/professionals to ensure legislation, mandates and processes align in administering the Mental Health Act and providing services for mental health crisis emergency response in communities.
Recommendation 17: The Standing Committee on Social Development recommends the Government of the Northwest Territories evaluate whether the definition of the acceptance of a patient after conveyance can be moved to the Mental Health Act’s regulations.
Recommendation 18: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the definition of “health professional” within the Mental Health Act to determine if the list can be further expanded where appropriate.
Recommendation 19: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions related to the apprehension, conveyance, and transfer of patients under the Mental Health Act, including consulting with Royal Canadian Mounted Police and medical staff to have agreement on proper protocols and the development of a flow diagram for the transport of patients under the Mental Health Act in and out of territory.
Recommendation 20: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions of the Mental Health Act and its regulations related to the apprehension, conveyance, and transfer of patients to specify the responsibility of peace officers in these processes.
Recommendation 21: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions related to Short Term Leave in the Mental Health Act, especially related to the enforcement of a lack of compliance and streamlining administration so that Short Term Leave is less burdensome on staff, and that the review of these provisions be done with the lens of reviewing similar provisions in other jurisdictions.
Recommendation 22: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 52(1.2) of the Mental Health Act, Section 7 of the Apprehension, Conveyance and Transfer Regulations, and other sections of the Mental Health Act related to the temporary detention of patients, and bring forward changes to the Mental Health Act that provide solutions to issues related to the temporary detention of patients. This review should be completed in collaboration with the Royal Canadian Mounted Police, designated facilities, and relevant staff.
Recommendation 23: The Standing Committee on Social Development recommends that the Government of the Northwest Territories create a strategy to analyze and close the gap in pediatric psychiatric care in the Northwest Territories.
Recommendation 24: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend the Mental Health Act to specify an authority who is responsible for oversight of the Mental Health Act, while also allowing flexibility to the Minister of Health and Social Services to designate such responsibility.
Recommendation 25: The Standing Committee on Social Development recommends that the Government of the Northwest Territories significantly reduce the administrative burden on the Director of Designated Facilities as defined in the Mental Health Act through legislative amendments and regulatory change.
Recommendation 26: The Standing Committee on Social Development recommends that the Government of the Northwest Territories consider amending Section 9.1 and Section 28(2) of the Mental Health Act after evaluating their capacity and operational effectiveness.
Recommendation 27: The Standing Committee on Social Development recommends that the Government of the Northwest Territories provide additional education materials and training support to staff responsible for providing patients with information about their rights under the Mental Health Act.
Recommendation 28: The Standing Committee on Social Development recommends that the Government of the Northwest Territories explore the possibility of an independent rights advisor or neutral party that vocalizes and reviews patient rights under the Mental Health Act with the patient, including whether this responsibility can be added to the cultural advisor role.
Recommendation 29: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review, amend and simplify Form 1 – Notification of Patient Rights and Other Information using an operational lens and a lens of persons with lived experience while also evaluating the benefits of creating a separate form specific to patient rights, as depicted in Alberta and British Columbia’s mental health care legislation.
Recommendation 30: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 37(6)(d) of the Mental Health Act and in particular, the use of the word “willing” within this section.
Recommendation 31: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend the requirement of assessment and appointments for patients under Assisted Community Treatment and Short Term Leave prior to the expiry of a Certificate of Involuntary Assessment or a Renewal Certificate to ensure better coordination, streamline information, and reduce the number of forms and administrative tasks.
Recommendation 32: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend provisions in the Mental Health Act related to Assisted Community Treatment to expand Assisted Community Treatment to align with Community Treatment Orders as seen in other jurisdictions, including:
-Removing the requirement that a person be an involuntary patient to qualify for Assisted Community Treatment;
-Ensuring that care is decentralized from an institutional setting, and;
-That there is a greater commitment to culturally safe and decolonized practices in health care.
Recommendation 33: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 40(1)(b) of the Mental Health Act to ensure clear information on the extent to which housing and income supports are available to patients under Assisted Community Treatment.
Recommendation 34: The Standing Committee on Social Development recommends that the Government of the Northwest Territories ensure external stakeholders involved in community care understand their obligations to support the operationalization of Assisted Community Treatment under the Mental Health Act, including increasing awareness of obligations to ensure efforts are made to inform patients of non-compliance and the consequences of non-compliance.
Recommendation 35: The Standing Committee on Social Development recommends that the Government of the Northwest Territories establish more supports and funding to action Assisted Community Treatment as defined in the Mental Health Act in small communities across the Northwest Territories.
Recommendation 36: The Standing Committee on Social Development recommends that the Government of the Northwest Territories establish the addition of a public facing navigator role for Mental Health Act processes.
Recommendation 37: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review the role of the psychiatrist during hearings under the Mental Health Act and provide information about their role to the Mental Health Act Review Board, psychiatrists and other staff to ensure there is a clear understanding of their role.
Recommendation 38: The Standing Committee on Social Development recommends that the Government of the Northwest Territories create internal processes to mitigate concerns regarding discharging mental health patients under the Mental Health Act too early by working with physicians.
Recommendation 39: The Standing Committee on Social Development recommends that the Government of the Northwest Territories improve on the ability to cancel certificates on involuntary assessment issued under the Mental Health Act through policies, procedures and legislative change.
Recommendation 40: The Standing Committee on Social Development recommends that the Government of the Northwest Territories embrace technological change by implementing procedures for Forms under the Mental Health Act to be signed electronically or verbally, as well as implementing secure file transfer processes for Forms under the Mental Health Act.
Introduction And Background
The Mental Health Act (Act) requires the Legislative Assembly or one of its committees to commence a review of the Act, and any other related legislation, policies, guidelines, or directives considered appropriate by September 1, 2023, and every five years thereafter (s.105).
The Standing Committee on Social Development (Committee) has conducted the review process for the Act’s first statutory review.
The Northwest Territories (NWT) Mental Health Act was passed on October 8, 2015, and came into force September 1, 2018. This Act repealed and replaced the Mental Health Act from 1985, which came into force January 1, 1988.
The Act sets the processes and rules that must be applied to the way people living with a mental disorder receive care and treatment. The Act aims to protect and support the rights of people living with a mental health disorder and those acting on their behalf.
Public Engagement
Between March 2024 to April 2024, Committee engaged the public.
On March 25, 2024, Committee received a public briefing from the Mental Health Act Review Board (MHARB). Committee also received a technical briefing from Department of Health and Social Services (the Department) on the Mental Health Act.The MHARB and the Department’s presentation is included in Appendix A.
Committee also received written submissions from:
Association of Psychologists of the Northwest Territories
Royal Canadian Mounted Police – G Division
Canadian Psychiatric Association
Raymond Pidzamecky – Registered Social Worker
Department of Health and Social Services – Materials to support the review of the Mental Health Act and Technical Briefing
These submissions and presentations are included in Appendix B.
Committee appreciates everyone who offered their feedback at public meetings and in written submissions.
Committee categorized public comments received into ten (10) themes.
Before presenting each theme, Committee would like to note the importance of an Act that both protects the rights of individual patients and others, while also ensuring that its’ administrative processes are streamlined and avoid instilling more burden on the health care and emergency services sectors. Committee believes that the Mental Health Act is in need of numerous updates and therefore presents its first recommendation:
Recommendation 1: The Standing Committee on Social Development recommends the Government of the Northwest Territories conduct a comparative analysis of the Northwest Territories’ Mental Health Act against other jurisdictions’ mental health care legislation, to significantly reduce and mitigate the administrative burdens and procedural complexities of the Mental Health Act (including Forms under the Mental Health Act) and present constructive amendments to the Mental Health Act for consideration.
The themes are listed below:
Issues with timing
There were a few issues in the Mental Health Act raised to Committee that were related to timing.
Firstly, the MHARB and the Department both highlighted that as currently legislated, the 7-day requirement to hold a hearing is very stringent, and more flexibility is required. The MHARB emphasized that a review of Section 70(1) is required to allow for the process of scheduling a hearing to proceed at a quicker pace which in turn would make greater strides in addressing the needs of the patient. Their recommendation was to remove the wording “give seven days” and replace it with “on consent of all parties”. Whereby the consent of all parties cannot be obtained, their recommendation was for there to be a minimum wait time-period set in the Act’s regulations. As noted above, the Department presented similar concerns regarding the seven-day notice requirement and recommended that a shorter time period be set out in regulations, with an added ability to shorten the notice period with the consent of all parties.
Committee notes these concerns and presents the following recommendation:
Recommendation 2: The Standing Committee on Social Development recommends the Government of the Northwest Territories allow flexibility to the Mental Health Act Review Board to hold hearings outside of the current notice requirement of seven days with the consent of all parties by reviewing Section 70(1) of the Mental Health Act to remove the seven-day notice requirement and defer the minimum notice requirement to the Mental Health Act Review Board Regulations.
The second issue related to timing is related to timelines in issuing a Certificate of Involuntary Assessment. The Royal Canadian Mounted Police (RCMP) noted to Committee that there are issues when no involuntary assessment can be reasonably issued within 24 hours, and as it is currently required under the Act. They presented that the current 24-hour requirement may be an issue for nursing stations that are busier and/or with minimal or stretched resources.
The Canadian Psychiatric Association (CPA) noted that the 24-hour requirement seems to be excessively short, and that in many jurisdictions it is one week. They described an example whereby a health professional may conduct an assessment, conclude that a person may meet the criteria and want more information before completing a certificate. They note that attempts to contact a secondary person to obtain collateral information can easily take a few days.
Committee would like to mitigate these concerns and therefore presents the following recommendation:
Recommendation 3: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Section 10(2) of the Mental Health Act to determine a more realistic timeline to issue a Certificate of Involuntary Assessment, in consultation with the Royal Canadian Mounted Police and physicians including psychiatric professionals.
Another issue related to timing relates to Form 4 – Renewal Certificate, which can only be issued within 72 hours of the Certificate of Involuntary Admission or previous Renewal Certificate expiring. The Department made it clear to Committee that in other jurisdictions, renewals may occur within seven days of the form expiring.
Committee therefore presents the following recommendation in hopes that this review will be conducted with an operational lens and the review will analyze data respecting the length of admissions to inform appropriate timelines:
Recommendation 4: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Section 17 of the Mental Health Act and compare it to similar provisions in other jurisdictions to determine the appropriate length of time before a certificate expires in order to issue a renewal certificate.
Another issue raised to Committee by the MHARB is that they would like to determine or understand why hearings are being cancelled. They note in their presentation to Committee that out of approximately 70 applications received in the past five and a half years, they have conducted approximately 15 hearings while the rest of the applications were cancelled before a hearing occurred – and three quarters of those cancellations occurred within 48 hours of the hearing date. It was noted by MHARB that they currently have no authority to review a certificate after its cancellation, and because of this they lack statistics and research that may be helpful to strengthen the hearing process.
Committee therefore recommends:
Recommendation 5: The Standing Committee on Social Development recommends the Government of the Northwest Territories assess the addition of a provision added to the Mental Health Act for the Mental Health Act Review Board to review a certificate after a cancelled hearing based on best practices and national standards.
Currently under the Act, applications can be made to the MHARB to cancel any certificate issued. Due to this ability, patients admitted under Form 3 – Certificate of Involuntary Admission could potentially be required to apply to the MHARB twice within the span of only a few days if they had applied for their initial Form 2 – Certificate of Involuntary Assessment to be cancelled. In short, the review of Form 2 – Certificate of Involuntary Assessment would not result in an automatic review of their Form 3 – Certificate of Involuntary Admission as it is currently legislated.
The Department noted to Committee that there have been several instances when a patient on Form 2 – Certificate of Involuntary Assessment has applied to the MHARB; however, a hearing could not be arranged due to the legislated timelines for the review as well as the short duration of the certificate (currently 72 hours). It was suggested to Committee by the Department that the ability to apply to the MHARB for a review of Form 2 - Certificate of Involuntary Assessment be removed as it cannot be reasonably provided.
Noting the above reasons and issues related to the timing of certificates, Committee presents the following recommendation:
Recommendation 6: The Standing Committee on Social Development recommends the Government of the Northwest Territories review Sections 66(1)(a) and Section 74(1)(a) and (b) of the Mental Health Act to remove the ability to apply to the Mental Health Act Review Board to cancel Form 2 – Certificate of Involuntary Assessment.
The Department let Committee know that the timelines for screening applications to the MHARB may be too short, especially if a weekend or holiday intervenes. Currently, the Act requires that the chairperson of the MHARB review an application within two days of receiving it, and either refer it to a review panel or dismiss it. Committee clarified with the Department that the Interpretation Act currently applies to the two-day timeline set out in Section 67(2) of the Mental Health Act. Although, it was emphasized by the Department that work is needed to confirm with the MHARB that the Interpretation Act applies were there is a time of office closure during the two-day timeline. Another piece of clarification is needed to determine whether the two-day timeline remains a challenge despite the flexibility afforded by the Interpretation Act.
Committee notes that timeline requirements stated in hours versus days, may lead to confusion and inconsistent application. Committee therefore recognizes that the Mental Health Act and its regulations requires review to change timelines of hours to business days or days, where appropriate.
Committee presents the following two recommendations:
Recommendation 7: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the Mental Health Act and its regulations (e.g. Section 16(1) of the Mental Health Act Review Board Regulations) to reflect timelines in days or business days, rather than hours, where appropriate.
Recommendation 8: The Standing Committee on Social Development recommends the Government of the Northwest Territories work with the Mental Health Act Review Board to clarify where and how the Interpretation Act applies to the Mental Health Act and determine if the current two-day timeline in Section 67(2) remains a challenge despite the flexibility afforded by the Interpretation Act.
Another issue related to timing brought to Committee by the Department is that hearings need to be shorter, especially because longer hearings have an impact on psychiatrists, patients and families, and their time. The duration of hearings is not set out in legislation, but Committee finds it important for the Department and MHARB to work together to streamline the hearing process. Committee therefore presents the following recommendation:
Recommendation 9: The Standing Committee on Social Development recommends the Government of the Northwest Territories work with the Mental Health Act Review Board to find ways to streamline the hearing process and evaluate the time it takes to conduct a hearing and reasons why the hearing process may be deemed too long.
Cultural support
Currently under Section 71(5), on request by a patient, by their substitute decision maker or by the medical practitioner, the MHARB shall engage an Elder or cultural advisor to a review panel. During their public meeting with Committee, MHARB emphasized that cultural advisors can make an important contribution to the patient-centered approach and help the MHARB conduct its business in a culturally sensitive manner. It was brought forward to Committee by MHARB that the role of the cultural advisor is not clearly delineated and the procedures for their duties during a hearing are not set out.
During their presentation, MHARB suggested to modify the wording in Section 71(5) of the Act, specifically the wording “during the hearing”, to afford the MHARB the flexibility in bringing in the cultural advisor at a time deemed more appropriate for patient needs. The Department also suggested to Committee that clarity is required regarding the role of the Elder/cultural advisor, specifically that the current “vagueness” of their role could be addressed by expanding Section 68.1 in the Act so that they can be engaged to the extent for any purpose(s) requested by the patient.
Committee understands the importance of an Elder/cultural advisor to support the patient, and therefore presents the following recommendation:
Recommendation 10: The Standing Committee on Social Development recommends the Government of the Northwest Territories review and expand the role of the cultural advisor under Section 71(5) and Section 68.1 of the Mental Health Act including adjusting the wording “to a review panel” in the Mental Health Act to “a time deemed appropriate for patient needs”.
It was brought to Committee’s attention by the Department that information being disclosed to the Elder/cultural advisor may be too broad, and at this point, they may receive every relevant or relied upon record which could be interpreted as being the patient’s chart. It was noted that this disclosure of information could be detrimental to the patient – and requires review to determine how the disclosure of information fits within the cultural advisor role under the Mental Health Act and in accordance with the Health Information Act.
The MHARB suggested that a provision be added to clarify that the panel may disclose information to the extent the panel deems necessary for the cultural advisors to perform their role. Related to the same issue, the Department suggested to Committee that a provision be added to outline what information may be disclosed to the cultural advisor, and that consent of the patient or their substitute decision maker be required prior to disclosing information. It was also proposed by the Department that staff and MHARB members may need education on the disclosure of information provisions and processes for withholding information.
Committee hears these concerns and presents the following two recommendations to help mitigate challenges related to the disclosure of information:
Recommendation 11: The Standing Committee on Social Development recommends the Government of the Northwest Territories include a specific provision in the Mental Health Act that outlines that the Mental Health Act Review Board panel may disclose information to the cultural advisor to the extent the panel deems necessary or wording that outlines how and when the cultural advisor will receive information.
Recommendation 12: The Standing Committee on Social Development recommends the Government of the Northwest Territories provide training to relevant staff and Mental Health Act Review Board panel members on the disclosure of information provisions held within the Mental Health Act, and the processes that follow them.
It was highlighted to Committee during the Department’s briefing, that a review and clarification of terms and definitions within the Act is required, and more specifically to review and compare terminology for consistency with current operational language. It was reiterated that some of the language in the Act can be quite confusing operationally. For example, under the Act, a patient can be Involuntarily Assessed or Involuntarily Admitted. Therefore, if they are Involuntary Assessed, they are admitted to the hospital, but they are not admitted as a patient under the Act. It was suggested to Committee by the Department that there needs to be an assessment of the Act for clarity and simplification of definitions for the ease of appropriate operationalization. In hearing this feedback, Committee recommends:
Recommendation 13: The Standing Committee on Social Development recommends the Government of the Northwest Territories review, compare and adjust definitions and terminology in the Mental Health Act against healthcare operations and language to promote appropriate and streamlined operationalization of the Mental Health Act.
The Department made Committee aware of concerns regarding “Code Gridlock status” – meaning that bed allocation is over capacity and may impact the ability of healthcare staff to provide critical care services, especially at Stanton Territorial Hospital (Stanton). This can be seen as a barrier to transferring clients from a designated facility to receive acute psychiatric treatment at Stanton, which has the only inpatient psychiatric unit in the NWT. Committee notes that there are challenges in providing appropriate standard of care for inpatient psychiatric treatment when there are consistent fluctuations in environmental and staff capacity at designated facilities across the NWT.
For this reason, the Department suggests that there be a review of the suitability of the Inuvik Regional Hospital and the Hay River Health Centre as designated facilities under the Act, with an assessment as to whether their designations need to be revoked. It is recommended by the Department that the Act be evaluated to consider different classes of designated facilities based on the levels of service provision available, standards of inpatient psychiatric treatment and care, and levels of responsibility.
Committee takes in this feedback, and presents the following recommendation:
Recommendation 14: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the suitability of the Inuvik Regional Hospital and the Hay River Health Centre as designated facilities (including an analysis of environmental and staffing capacity) under the Mental Health Act and review the ability to add different classes of designated facilities within the Mental Health Act and its regulations, using other jurisdictional models as an example.
It was recommended by the Department at the public technical briefing that the definition of “mental disorder” in Section 1 of the Act be reviewed and compared against Alberta’s recent new definition. It was suggested to Committee that changes to the definition could be reviewed against other jurisdictions where recent changes have occurred to determine if updates should be made to the NWT’s legislation. Committee notes this suggestion, and presents the following recommendation:
Recommendation 15: The Standing Committee on Social Development recommends the Government of the Northwest Territories review and expand the definition of “mental disorder” in the Mental Health Act by conducting a jurisdictional review of definitions.
In a written submission by the RCMP, they note that there is no clarification as to what the meaning of the word “accept” is, when conveying patients to a designated facility under Section 90(d) of the Act. The RCMP state that it is their position that “accept” means that the patient has been conveyed to a designated facility and that it is up to the facility to safeguard the patient as a duty of care. They go on to emphasize that often RCMP personnel have been required to remain at the facility as the patient is not deemed to be “accepted” until they have been fully assessed. In their submission, the RCMP stress that this is a medical situation, and the involvement of the police should end with the conveyance to a designated facility.
Similarly, the RCMP also note that the term “other authorized persons” listed in numerous sections of the Act requires review as there is no definition of “other authorized persons”. In response to this uncertainty and need for clarification, the Department suggests that consideration should be given to the establishment of an ongoing territorial working group to ensure legislation, mandates and processes align in administering the Mental Health Act and providing services for mental health crisis emergency response in communities. Committee therefore presents the following two recommendations:
Recommendation 16: The Standing Committee on Social Development recommends the Government of the Northwest Territories establish an ongoing territorial working group with involvement from the Royal Canadian Mounted Police and health staff/professionals to ensure legislation, mandates and processes align in administering the Mental Health Act and providing services for mental health crisis emergency response in communities.
Recommendation 17: The Standing Committee on Social Development recommends the Government of the Northwest Territories evaluate whether the definition of the acceptance of a patient after conveyance can be moved to the Mental Health Act’s regulations.
It was brought forward to Committee by the Department that there are challenges for health and social services professionals who are not authorized to complete forms under the Act in reporting mental health crises to the RCMP. Committee was informed that in some cases, despite the summary of concerns of persons meeting the criteria for involuntary assessment under the Act, the RCMP’s assessment overrides the health and social services professionals’ concerns.
It is suggested by the Department that this issue could be addressed by reviewing the definition for “health professional” under the Act to better determine if the list can be further expanded – whether it be in the legislation or its regulations. This review may require the evaluation of the scope of practice of various health and social services professions to determine if it is within their scope to issue a Certificate of Involuntary Assessment. In particular, it was noted that there is no guidance or process for a Community Mental Health Nurse or other health professionals to fill out forms. There may also be a lack of awareness or support for registered nurses and registered psychiatric nurses to issues forms under the Act and this leaves a gap in facilitating emergency mental health care in communities. It was suggested by the Department to Committee that a jurisdictional review to evaluate how other health and social services professionals are able to complete forms under their legislation, may also be of value. The Association of Psychologists in the NWT suggested that there may be some confusion over the terms “Health Professionals” and “Medical Practitioner”, which may be helpful in clarifying. It was also suggested by the Department that a review of the current Standard Operating Procedures and scope of the Community Mental Health Nurse and/or other Registered Nurse roles be conducted in relation to the implementation of the Mental Health Act.
Noting the above, Committee presents the following recommendation:
Recommendation 18: The Standing Committee on Social Development recommends the Government of the Northwest Territories review the definition of “health professional” within the Mental Health Act to determine if the list can be further expanded where appropriate.
Responsible custody, transfer, and detainment of patients
In their written submission, the RCMP note that Section 23(1) of the Act does not specify who is responsible for the transport of the patient to a designated facility or to another health facility. They also note that when “authorized persons” is not described within the Act, it tends to default to the police. The RCMP also brought forward to Committee that Section 10(3)(a) of the Act does not state who the patient should be delivered to, and they suggest that there could be a provision whereby peace officers turn over the patient to a specific person to take over custody. They provide an example that other provinces have an Institution Safety Officer who takes over custody of the patient.
The Department was also made aware that it is unclear whether or not a peace officer remains with an involuntary patient who has been apprehended and is being conveyed/transferred to a designated facility. Moreover, no one is specified as responsible for the “care” of the patient while they are being conveyed, only until they have arrived at a designated facility. Committee notes that this responsibility could be given to the peace officer, but also understands the importance of not overburdening the police with more responsibilities. Committee therefore finds it important to use the word “supervise” in replacing the word “care” in relation to the duration of the conveyance of the patient to a designated facility and the role of the peace officer under the Act, as to balance the responsibility to the patient and the ongoing duties of peace officers.
Related to the comments by the RCMP, it was brought forward by the Department that the transportation of patients under the Act from the Inuvik Regional Hospital to Stanton Territorial Hospital and/or a facility in Edmonton is reasonably common and unreasonably complex. It was suggested that a dedicated flow diagram be created to help explain the processes for the transport of patients under the Act - both for in and out of the territory.
Committee notes this feedback and presents the following two recommendations:
Recommendation 19: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions related to the apprehension, conveyance, and transfer of patients under the Mental Health Act, including consulting with Royal Canadian Mounted Police and medical staff to have agreement on proper protocols and the development of a flow diagram for the transport of patients under the Mental Health Act in and out of territory.
Recommendation 20: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions of the Mental Health Act and its regulations related to the apprehension, conveyance, and transfer of patients to specify the responsibility of peace officers in these processes.
In their written submission, the RCMP mentioned to Committee that there is no clearly defined role for who enforces lack of compliance if there is an Absent WithOut Leave (AWOL) person during Short Term Leave. They highlighted that Section 47(2)(a) and 52(1) of the Act place the responsibility for compliance on the police, and suggest that health professionals should be the first consideration. They continue by saying that decisions to release patients rest with health professionals, while the consequences of non-compliance defaults to the police.
t was also brought forward by the Department that processes related to Short Term Leave are administratively burdensome, often requiring multiple passes to allow involuntary patients to leave the facility for short periods of time for walks, smoke breaks, etcetera. It was highlighted by the Department that provisions related to Short Term Leave were created to allow leave from the facility for up to 30 days, but do not account for shorter leaves of absence that most, if not all, patients should have for daily fresh air breaks, errands, to attend appointments, etcetera.
Committee presents the following recommendation:
Recommendation 21: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review provisions related to Short Term Leave in the Mental Health Act, especially related to the enforcement of a lack of compliance and streamlining administration so that Short Term Leave is less burdensome on staff, and that the review of these provisions be done with the lens of reviewing similar provisions in other jurisdictions.
In their written submission, the RCMP note that Section 52(1.2) of the Act was written without their consultation. They note that the default in the circumstances of temporary detainment of patients under the Act, is the incarceration of patients in jail cells, even though in most cases they have committed no crime, and this is strictly a medical situation. The RCMP emphasize that this Section should be either repealed or reworded to emphasize that this should only occur if there are criminal circumstances associated to a particular situation. They also highlight that there may be medical alternatives to control unruly or intoxicated patients awaiting conveyance.
It was also brought forward to the Department that there is a lack of safe and appropriate space to hold clients during waiting periods for conveyance to a designated facility, especially from rural and remote communities.
Committee hears their feedback, and presents the following two recommendations:
The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 52(1.2) of the Mental Health Act, Section 7 of the Apprehension, Conveyance and Transfer Regulations, and other sections of the Mental Health Act related to the temporary detention of patients, and bring forward changes to the Mental Health Act that provide solutions to issues related to the temporary detention of patients. This review should be completed in collaboration with the Royal Canadian Mounted Police, designated facilities, and relevant staff.
Committee believes it is a significant issue that there is no youth psychiatric unit in the NWT. The lack of a designated unit may relate to staff and institutional capacity issues; however, it has concerning impacts on the quality of youth patient care. It was also brought forward by the Department during this statutory review that there are concerns about the safety of pediatric psychiatric patients both under the Act and not under the Act at Stanton, as well as the suitability of the Pediatric Unit at Stanton to provide care to psychiatric patients under the Act.
Committee believes that not having a suitable youth psychiatric unit in the NWT is a serious problem, and therefore presents the following recommendation:
Recommendation 23: The Standing Committee on Social Development recommends that the Government of the Northwest Territories create a strategy to analyze and close the gap in pediatric psychiatric care in the Northwest Territories.
During their presentation to Committee, the MHARB suggested that there should be an authority with a specific oversight role for the Mental Health Act. The Department also noted to Committee that this suggestion warrants further review, and added to it by mentioning that a larger oversight role could allow for more comprehensive reporting to identify trends and outcomes, identify gaps in the healthcare system, and inform future service delivery improvements. The MHARB also requested statistics and data that may inform whether the number of applications they receive seems reasonable, which correlated with the Department’s recognized need to substantiate data that could help inform MHARB’s annual reports to the Minister of Health and Social Services. Committee notes that this information could be part of the role of the body charged with oversight of the Act.
Therefore, Committee makes the following recommendation:
Recommendation 24: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend the Mental Health Act to specify an authority who is responsible for oversight of the Mental Health Act, while also allowing flexibility to the Minister of Health and Social Services to designate such responsibility.
The Department informed Committee that there is overall concern about the role of the “Director of the Designated Facility”, and specifically what roles can and cannot be delegated or shared. The current processes and roles may cause delays in the review of forms and is administratively burdensome. Committee believes it is important to clarify and streamline their role to prevent burnout, and presents their recommendation as follows:
Recommendation 25: The Standing Committee on Social Development recommends that the Government of the Northwest Territories significantly reduce the administrative burden on the Director of Designated Facilities as defined in the Mental Health Act through legislative amendments and regulatory change.
Patient rights
In their written submission, the Canadian Psychiatric Association (CPA), notes that while unusual, Section 9.1 of the Act is “good from a rights perspective”. They highlight that many patients are discharged prematurely, and a case could be made for giving families more of a say in the timing of discharge and perhaps a substitute decision-maker could be given the same right to ask for a second opinion. They provide insight that there may also be a downside to this section at the system level, where there is already a trend of too few psychiatric beds.
The CPA also commented that Section 28(2) of the Act seems unnecessarily restrictive. Currently, the provision requires a second medical opinion before administering emergency treatment, and they go on to note that in an emergency, even the time required to contact a second physician could result in a bad outcome. The CPA suggests to Committee that they review this provision as it could be problematic, and at the least consider the word “readily” be inserted before “available”. Committee hears their concerns, and presents the following recommendation:
Recommendation 26: The Standing Committee on Social Development recommends that the Government of the Northwest Territories consider amending Section 9.1 and Section 28(2) of the Mental Health Act after evaluating their capacity and operational effectiveness.
The Department told Committee that postage of information about patient rights under the Act as a permanent part of the individual space may not be appropriate, particularly for the Pediatric Unit rooms that are designated for psychiatric admission at Stanton as they are adaptive spaces that may be utilized for acute medical treatment as needed. The Department also informed Committee that it is unclear whether patients are being informed of their rights to retain and instruct counsel without delay, and whether their access to counsel is being facilitated. It was suggested that it is critical that patients know their rights upon admission – and in particular, that it is communicated to the patient that should they wish to be discharged and there are any immediate safety concerns, they may be held involuntarily for further assessment. The Department suggests that further education and awareness is needed for staff who are responsible for providing patients with information about their rights under the Act.
A suggestion was brought to Committee by the Department to establish an independent rights advisor, as patients may be too upset at their doctors or physicians to fully understand their rights under the Act. The Department described that the explanation of rights often falls onto the responsibility of nurses to provide, and issues arise when high turnover of staff causes issues in ability to adequately provide this information. The Department also notes that there have been operational challenges in cases where patients on a voluntary hold are then placed on an involuntary hold if they want to or try to leave – which can create a false narrative for patients who may not understand that the Act balances addressing acute mental health needs with the safety of themselves as patients, and of others.
To help with the explanation of rights to patients and to help monitor change in patient status and potential interventions, it is suggested to review and amend Form 1 – Notification of Patient Rights and Other Information to simplify language and layout, and consider including information on how to access advocacy and/or legal supports. A suggestion by the Department was to create a separate form specific to patient rights, as depicted in Alberta and British Columbia’s mental health care legislation. It was also noted that when reviewing Form 1, attention be made to including the ability to monitor change in patient status and potential interventions. They also suggested to make it standard that the patient is given a copy of the patient rights poster along with Form 1.
Committee presents the following three recommendations related to patient rights:
Recommendation 27: The Standing Committee on Social Development recommends that the Government of the Northwest Territories provide additional education materials and training support to staff responsible for providing patients with information about their rights under the Mental Health Act.
Recommendation 28: The Standing Committee on Social Development recommends that the Government of the Northwest Territories explore the possibility of an independent rights advisor or neutral party that vocalizes and reviews patient rights under the Mental Health Act with the patient, including whether this responsibility can be added to the cultural advisor role.
Recommendation 29: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review, amend and simplify Form 1 – Notification of Patient Rights and Other Information using an operational lens and a lens of persons with lived experience while also evaluating the benefits of creating a separate form specific to patient rights, as depicted in Alberta and British Columbia’s mental health care legislation.
Community Treatment Plans
In relation to Section 37(6)(d), the Canadian Psychiatric Association raised that the use of the word “willing” is very problematic. The CPA noted that in Ontario, the wording is “is able to comply”. The word “willing” could suggest to clinicians that the person is consenting and that if they do not agree then they are not eligible for Assisted Community Treatment. They highlighted to Committee that if this is the intention of this Section, then the Assisted Community Treatment has a very limited function. Committee recommends the following:
Recommendation 30: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 37(6)(d) of the Mental Health Act and in particular, the use of the word “willing” within this section.
The Department brought forward to Committee the issue of administrative burdens related to the required coordination of assessments prior to the expiry of a Certificate of Involuntary Assessment or Renewal Certificate, as well as the assessments and appointments required under the Assisted Community Treatment Certificate are needlessly cumbersome and often results in more appointments than is necessary. It was noted that this issue could be addressed through reviewing current process and assessment requirements in the Act and its regulations to allow for better coordination of timelines and requirements, streamlining information and the duplication of administrative tasks. Therefore, Committee proposes this recommendation to the Government of the Northwest Territories (GNWT), in an effort to streamline administration of the Act:
Recommendation 31: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend the requirement of assessment and appointments for patients under Assisted Community Treatment and Short Term Leave prior to the expiry of a Certificate of Involuntary Assessment or a Renewal Certificate to ensure better coordination, streamline information, and reduce the number of forms and administrative tasks.
The Department raised the issue that a patient, under the NWT’s Mental Health Act, must be involuntary admitted in order to be eligible for Assisted Community Treatment (ACT). Furthermore, this restriction has been causing confusion for patients and their families, and distress to staff. The Department informed Committee that the issue may be that Assisted Community Treatment, as stated in the NWT’s Mental Health Act, is sometimes being equated with Community Treatment Orders, as seen in legislation in southern jurisdictions. In comparison, Community Treatment Orders (as depicted in southern jurisdictions) are designed for individuals, who may or may not be admitted under the Act, but allows for reasonable treatment to be provided without the consent of the person when it is considered less restrictive than keeping the person in hospital. Community Treatment Orders are typically used for individuals who are frequently re-admitted.
The Department made Committee aware that there are challenges in administering Assisted Community Treatment in the NWT as there is not enough operational guidance for staff to confidently manage care for patients on ACT. It was highlighted by the Department that most small communities in the NWT do not have the required services to manage clients who would benefit from ACT and therefore ACT has not been effectively utilized. The issue of ACT plans and forms located on Electronic Medical Records was also brought forward, stating that current information is not available for community staff and practitioners, including processes to flag changes in medications or other aspects of the plan.
The Department informed Committee that changes to provisions regarding Assisted Community Treatment are necessary so that ACT is available to those who are not or are no longer involuntary patients under the Act, similar to Community Treatment Orders as shown in southern legislation. It was recommended to Committee by the Department that a review of provisions is necessary to align ACT to the Community Treatment Order model, including removing the requirement that a patient be involuntary. Notably, this review should be conducted using a northern lens, and should consider the differences on the impacts of services in small communities, the rural/remote and northern context, and operational requirements inevitably placed on the only designated facility with a dedicated psychiatric unit (Stanton). Committee recognizes the importance of properly implementing community treatment, and that making changes to Assisted Community Treatment provisions is an important step in making a greater commitment to culturally safe and decolonized practices in health care. Changes to Assisted Community Treatment provisions may aid in making the Mental Health Act less administratively burdensome to acute care and community services.
Committee recognizes all these elements at play, and presents the following recommendation:
Recommendation 32: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review and amend provisions in the Mental Health Act related to Assisted Community Treatment to expand Assisted Community Treatment to align with Community Treatment Orders as seen in other jurisdictions, including:
- Removing the requirement that a person be an involuntary patient to qualify for Assisted Community Treatment;
-Ensuring that care is decentralized from an institutional setting, and;
-That there is a greater commitment to culturally safe and decolonized practices in health care.
Similar to the above, it was noted to Committee by the Department that the exact requirement for providing housing and other supports under provisions related to Assisted Community Treatment is not immediately clear and can be confusing. Questions were raised about whether these supports were required to be available for patients prior to their eligibility for ACT, what is considered adequate, and concerns about patients who have unstable housing and income. Committee believes it is crucial for staff and patients to feel prepared when operationalizing ACT, and therefore Committee proposes the following:
Recommendation 33: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review Section 40(1)(b) of the Mental Health Act to ensure clear information on the extent to which housing and income supports are available to patients under Assisted Community Treatment.
An issue brought forward to the Department is that the nonadherence to the required monitoring and treatment under ACT would typically lead to the apprehension and conveyance of the patient to the closest designated facility for patients who reside in small communities. There are concerns by the Department that this may lead to an overuse of emergency transportation services which may impact the available resources in the communities for other emergencies, could be costly, and may not reflect principles of recovery-oriented care. While Committee understands that there needs to be a balance between protecting the patient and potential harm to themselves or others, Committee also recognizes the need to ensure that the patients are made aware of non-compliance, and that external stakeholders are equipped to adequately provide this information:
Recommendation 34: The Standing Committee on Social Development recommends that the Government of the Northwest Territories ensure external stakeholders involved in community care understand their obligations to support the operationalization of Assisted Community Treatment under the Mental Health Act, including increasing awareness of obligations to ensure efforts are made to inform patients of non-compliance and the consequences of non-compliance.
Staffing capacity, resources, and programs available
In his written submission to Committee, Raymond Pidzamecky, registered social worker, highlights that there is research that shows the most effective models for intervention, which are multisystemic in nature. Mr. Pidzamecky encourages the GNWT to create a multi-departmental team for children, adolescents, and families that include membership from at least health, social services, education, and justice. Committee understands that the GNWT is currently developing models of integrated service delivery to create multi-departmental responses to complex matters. Committee is interested in knowing the results of the development of these models, and is also researching healthcare sustainability and accountability in NWT’s healthcare system.
The Department made Committee aware of burnout of some staff members related to the operations of the Mental Health Act. Committee would like to ensure that GNWT staff, including staff in smaller communities, feel supported so that there is proper and meaningful action for patients under the Act, including for actioning certificates such as Assisted Community Treatment. Committee notes that there is a need for more community mental health services to be provided in partnership with Indigenous Governments and non-government organizations for additional supports necessary for meaningfully providing Assisted Community Treatment. Committee brings forward the following recommendation, in an effort to increase supports to small communities in the NWT:
Recommendation 35: The Standing Committee on Social Development recommends that the Government of the Northwest Territories establish more supports and funding to action Assisted Community Treatment as defined in the Mental Health Act in small communities across the Northwest Territories.
The Department brought to Committee’s attention that there is a lack of guidance for families and caregivers to apply for Orders under the Act, and there was a suggestion to explore the addition of a public facing navigator role to help explain processes related to the Mental Health Act. This navigator role would involve reviewing, and revising public facing resources and guides to the Mental Health Act and assisting families in applying for Orders under the Act. It was suggested by the Department that this position could be housed at the Office of the Client Experience or within the Mental Health Act Review Board Officer Manager role. Committee agrees that this type of support is greatly needed for patients and their families, and proposes the following:
Recommendation 36: The Standing Committee on Social Development recommends that the Government of the Northwest Territories establish the addition of a public facing navigator role for Mental Health Act processes.
Additional feedback the Department provided to Committee was that more clarity is required around the psychiatrist’s role during hearings. There seems to be uncertainty about whether they are to be a hospital representative, or a general witness. They highlighted that there is worry that at times, the psychiatrist is being asked legal questions which is beyond their scope. Committee believes it is important to determine their role so to better streamline the hearing process:
Recommendation 37: The Standing Committee on Social Development recommends that the Government of the Northwest Territories review the role of the psychiatrist during hearings under the Mental Health Act and provide information about their role to the Mental Health Act Review Board, psychiatrists and other staff to ensure there is a clear understanding of their role.
It was brought forward by the Department that in some cases, involuntary patients that are disagreeable to care are being discharged from the facility. The Department highlighted that the Act currently requires attending medical practitioners to conduct ongoing assessments of involuntary patients to determine whether they continue to meet the criteria for involuntary admission. If the patient is not meeting the criteria, the physician must cancel the certificate of involuntary admission and any renewal certificate, allowing the patient to be discharged.
Committee notes this concern, and finds it important to ensure that patients are not being discharged too early. Therefore, Committee puts forward the following recommendation:
Recommendation 38: The Standing Committee on Social Development recommends that the Government of the Northwest Territories create internal processes to mitigate concerns regarding discharging mental health patients under the Mental Health Act too early by working with physicians.
It was noted that by the Department during their briefing to Committee that currently, there is an inability to cancel a Certificate of Involuntary Assessment. Related to this issue, , there may be struggles with access to an immediate assessment by a medical practitioner in small communities, and this may result in a medevac to have that assessment – even if the patient’s condition has improved. It was suggested that this goes against the principles of the Act and person-centered care to hold and transport a person unnecessarily based on legislative requirements.
Committee presents the following recommendation:
Recommendation 39: The Standing Committee on Social Development recommends that the Government of the Northwest Territories improve on the ability to cancel certificates on involuntary assessment issued under the Mental Health Act through policies, procedures and legislative change.
It was raised by the Department that there is overall concern about the number and complexity of forms, as well as duplication across forms. There are also concerns that when forms are not filled out correctly, they are considered to be invalid. More specifically, there was a comment of discrepancy between Form 23 – Community Treatment Plan and the requirements for the form set out in Section 19 of the Forms Regulations. It was stated that currently, Form 23 requires the patient or the substitute decision maker to initial Part 3 (Patient Agreement), while the entire Form 23 does not require a patient signature where there is a substitute decision maker place. Moreover, Section 19 of the Forms Regulations requires acknowledgement from the patient that they understand the requirements or obligations set out in Part 3 of Form 23, yet the Form does not require their signature.
Another example of reviewing consistency between Forms and Regulations includes Form 22 – Assisted Community Treatment Certificate, which currently indicates that the signature of both the patient and a substitute decision maker (if applicable) are required. However, as per Section 17(2) of the Forms Regulations, where there is a substitute decision maker in place, the Form is only required to be signed by the substitute decision maker.
It was brought forward that formatting changes also need to occur to the Forms, including adding the form name to the page number location, and ensuring forms have room for a 3-hole punch when filing.
There were also comments of difficulties and delays in retrieving signatures from substitute decision makers. It was suggested to allow for the substitute decision maker to consent verbally, instead of relying on faxes or other means to obtain signatures – especially if this is in the best interest of the patient. There is also an issue of forms that cannot be sent electronically. An example was provided for Form 10 – Summary Statement Respecting Apprehension or Conveyance which must physically accompany the client to the designated facility.
In the first recommendation of this report, Committee has recommended the GNWT streamline elements of the Act that are deemed administratively burdensome, including reviewing and amending all forms under the Act to ensure they are appropriate, efficient and reduce unnecessary make-work for staff, patients, and families. It was also suggested by the Department that staff are educated on secure file transfer, and internal procedures to address concerns about form completion. Committee also puts forth the following recommendation, related to technological change:
Recommendation 40: The Standing Committee on Social Development recommends that the Government of the Northwest Territories embrace technological change by implementing procedures for Forms under the Mental Health Act to be signed electronically or verbally, as well as implementing secure file transfer processes for Forms under the Mental Health Act.
This concludes the Standing Committee on Social Development’s statutory review of the Mental Health Act.
Recommendation 41: The Standing Committee on Social Development recommends the Government of the Northwest Territories provide a response to this report within 120 days.
Member from Monfwi.
Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the Member for Mackenzie Delta, that Committee Report 16-20(1) be received and adopted by the Legislative Assembly. Thank you, Mr. Speaker.
Thank you, Member from Monfwi. The motion is in order. To the motion.
Question.
Question has been called. All those in favour? Opposed? Abstentions? Motion passed.
---Carried
Member from Monfwi.
Mr. Speaker, I move, seconded by the Member for Mackenzie Delta, that, pursuant to Rule 9.4(5)(a), the Government of the Northwest Territories table a comprehensive response to Committee Report 16-20(1), including all recommendations, within 120 days or at the earliest opportunity subsequent to the passage of 120 days. Thank you.
Thank you, Member from Monfwi. The motion is in order. To the motion.
Question.
Question has been called. All those in favour? Opposed? Abstentions? The motion is carried. And Committee's Report 16-20(1) has been received and adopted by the Assembly.
---Carried
Reports of Standing and Special Committees. Member from Great Slave.
