Addressing Mental Health and Addiction

The Greatness of British Columbia

If a vote was held to identify Canada’s most trailblazing province, that recognition would likely go to the province of British Columbia.  What distinguishes B.C.  from other provinces is its transformative approach to addressing mental health and substance use from a crisis-response approach to a wellness promotion, prevention, and early intervention, where people are connected to culturally safe and effective care when they need it, and it meets people where they are at.  B.C.  answered that call with the distinction of being the sole province to request that the federal government make changes to criminal law regarding drug possession, requesting that the province be granted a special exemption if the federal government was not prepared to make broad policy changes.  The federal government obliged and granted a first-of-its-kind exemption to B.C., which also went on to create a first-of-its-kind new ministerial role focusing on mental health and addiction.

The Minister of Mental Health and Addictions introduces “A Pathway to Hope”.

Prior to creating a ministry of mental health and addiction, B.C.  had the distinction of having one of Canada’s highest rates of hospitalization due to mental illness and substance use.  There was a realization that the province’s mental health and addiction care was not working for everyone, especially for those on the lower end of the socioeconomic spectrum who had limited financial resources to seek out private health supports.  Ultimately, it resulted in the creation of “A Pathway to Hope” which was an investment to improve mental wellness and address small problems before they became bigger ones.

The initial six priorities that B.C. set out for their three-year plan might be best described as a masterclass in public policy.  The first focused on increasing access to affordable counselling and support for those without extended health coverage or who face other barriers related to race, ethnicity, religion, gender, age, class, or sexual orientation.  The second focused on launching integrated child and youth teams connected to school to offer wraparound services and supports directly to young people in places where they felt safe and comfortable so that caregivers would not have to navigate the system on their own.  The third focused on opening more Foundry centres that served as “one-stop shops” for health and wellness resources, services, and supports.  The fourth focused on expanding First Nations-led treatment centres to better address the cultural needs and safe access to substance use services.  The fifth focused on expanding intensive services for children and youth to better address severe mental health and substance use challenges by providing new family care home spaces with clinical care and as an alternative to hospitalization.  And finally, the sixth focused on early childhood social emotional development and growing early intervention services and program in child development centres and community-based organizations and offering new professional development tools and educational resources for service providers and caregivers of children.

The latest report on the program, titled A Pathway to Hope: Progress report 2019-2022, explores the first three years of the program but it might be the testimonials that are the most significant part of the report due to how they provide a glimpse into the lives of the individuals rediscovering their agency and starting to live healthier lives.  One such quote reads, “There’s this outsider feeling, and you need these people to connect with because you’re a little bit rejected by society.  If you’re one in 100 people, then you’re surrounded by only the other 99, then you feel alien, but if you find the other 1 per cent, then it makes you feel like you’re not alone.  With peers, you can compare stories and lives, and understand it’s just how it was supposed to be at the time.” Another reads, “When I went to Foundry, I was accepted, I didn’t need to explain why I made the choices I did because they already knew why, and they didn’t care.  They just wanted me to feel supported and loved.” Both of these quotes are reflective of the fact that there is so much more to the lives that people live and the power of being granted a second chance at life.

Supervised consumption sites are not perfect, but they are an effective harm reduction service.

Perhaps the most important starting point in the discussion on supervised consumption sites and decriminalizing the possession of small amounts of drugs, enough for a single use, is the shared understanding that the traditional approach to drugs has been criminalization.  The next sense of shared understanding this should lead us to is that the “war on drugs” ended up being a “war on addiction”, because targeting drug users and jailing them was far easier than going after criminal enterprises, and it gave the impression that something was being done about the issue.  Additionally, it should lead us to the shared realization that the fear that has been created around being criminalized for having a substance use disorder has  also created the conditions where people will hide their addictions and so has resulted in the loss of so much life.  If these shared understandings can serve as agreed upon starting points, then the realization that should lead us to is that there is a lot of ground to make up in the fight to helping individuals overcome their struggles with addiction, as well as the need to do something different.

Creating the context necessary for improving health outcomes.

A big misunderstanding about decriminalization that occurred in B.C.  is that it only applies to very specific conditions, none of which provide safe haven for narco- terrorists or death dealers.  The specifics around the decriminalization have strict rules stating that the possession of drugs is prohibited from schools, child-care facilities, and airports.  And read that only individuals over the age of 18 can possess only up to 2.5 grams of cocaine or opioids, without arrest, charges, or seizure.  Instead, these individuals will be offered information about health and social supports, including local treatment and recovery services.  So, decriminalizing should not be confused with legalization, and individuals caught trafficking, producing, importing, or exporting drugs will still be arrested and prosecuted.

The promise that lays ahead.  Keeping the lamp lit by the golden door.

Overcoming an addiction to opioids, cocaine or other addictive drugs does not occur overnight and it takes time.  That said, nobody should feel comfortable about seeing another person struggling with addiction or under the influence of different substances, because these actions are slowly draining the life out of their body.  But “how people feel” should never come in the way of what it might take for a person whose life has been overwhelmed by addiction to get back on track.  Some critics may argue that supervised consumption sites do not provide a guarantee that they will help a person overcome their addiction, but these critics do so by ignoring that safe consumption sites do offer the promise for a person to return to a healthy life—to rediscover their purpose.  And for individuals whose brains may have been completely ravaged by these poisons, people who are no longer capable of looking after themselves or might be a danger to the public, then maybe we need to revisit permanent placement centres where these individuals can live out the rest of their lives with dignity.

The difference between how Canada and how other places in the world address addiction is that in Canada there exists a promise to people telling them that should they ever be stumble over addiction, there will always be a hand that stretches out to them with the aim to lift them up and out of their despair.  All of this, regardless of their reasons for engaging in substance use, and as many times as is necessary to get them standing up again, with the hope to eventually see them running and jumping again.  To sum it up, there is courage and joy that can be found in this promise and for whatever might lay ahead, and that power is symbolized with A Pathway to Hope.

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