Better is Possible - A True System of Care
BACKGROUNDER: INITIAL FUNDING COMMITMENTS & DEFINITIONS
Total Initial Operating & Capital – $1.520 billion over 3 years
Recovery: Recovery from a substance use disorder is defined as a process of improved physical, psychological, and social well-being and health after having suffered from a substance-related condition.
Recovery capital: Refers to the internal and external resources that are used to initiate and sustain recovery. Recovery capital includes human and physical resources such as housing and employment, as well as emotional health and knowledge. The social and cultural aspects of recovery capital encompass recovery supports, policy, intervention and social integration.
Recovery-oriented system of care: A ROSC is a coordinated network of community-based services and supports that is person-centred and builds on the strengths and resiliencies of individuals, families, and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems.
Recovery community: Also known as therapeutic communities, recovery communities are a form of long-term residential addiction treatment that focuses on the whole person and overall lifestyle changes. They provide opportunities for people to enhance their life skills and social competencies to help them return to full community living. Recovery is seen as a gradual, ongoing process of cognitive change through clinical and peer interventions.
Red Fish: The Red Fish Healing Centre for Mental Health and Addiction provides assessment and treatment services for people who live with complex and severe concurrent disorders. For admission, clients must have both a complex mental illness and a substance use disorder. The program is designed for people who have experienced several relapses, and whose treatment needs are beyond what their local community health resources or health authority can meet.
BACKGROUNDER: AFFORDABLE, ACCESSIBLE TREATMENT NOW
Affordable and accessible treatment: Eliminate user fees at publicly funded addiction treatment beds and provide direct government funding for private beds through surge capacities agreements to ensure no-one faces financial barriers to treatment.
The vast majority of addiction treatment beds in B.C. are in privately-run facilities that are primarily funded by users. Not-for-profit (NFP) facilities receive some government funding, and charge user fees based on a sliding scale of up to $45 per day or approximately $1,300 per month, depending on income. Licenced private treatment operators receive no funding at all.
The BC Liberals will invest $150 million a year to help expand access to addiction treatment beds by eliminating user fees at not-for-profit facilities and contracting with licenced private treatment operators to directly fund the cost of residential addiction treatment. This will be based on the surge capacity model developed in 2016/17 under the BC Liberal Government. Criteria for entry would be established by government in conjunction with the private operator. These beds would be reserved solely for government-sponsored patients.
Recovery communities: Build a minimum of five regional recovery communities for addiction treatment where residents can stay for up to a year with individualized, holistic, long-term residential treatment including indigenous-specific care.
By focusing on lifestyle changes, these communities aim to enhance patients’ life skills and social competencies to ensure a full return to living in their communities. These communities are a proven approach in cities like Red Deer, Calgary, and Edmonton.
Treatment on demand: Create a virtual opioid dependency program to ensure immediate access to lifesaving medications like suboxone for those who don’t have a doctor and can’t get into a walk-in clinic.
Comprehensive care: Building on the model of the Single Parent Employment Initiative (SPEI), embark on a pilot project to support single parents struggling with addiction to enter residential treatment, counselling, job training and other supports for one year.
Established in 2016 by the BC Liberal Government, the Single Parent Employment Initiative provides counselling, job training, child care and other supports for single parents on income or disability assistance, while allowing them to continue on income or disability assistance. The program cost $5 million per year, and provided support to 4,712 recipients in its first two years.
The BC Liberals will invest $5 million a year in a similar program for single parents on income or disability assistance with addiction disorders, to provide residential treatment, counselling and other supports for up to 2,000 British Columbians in need per year.
Corrections & rehabilitation: Designate living units inside correctional centres as treatment centres staffed with therapists alongside corrections officers. This will allow inmates to participate in addiction treatment while their sentence is served and improve the chances of re-integration into society following their sentence.
A 2021 Simon Fraser University study found that one-third of all inmates in B.C. prisons suffered from co-occurring mental health and substance use disorders in 2017, a rate that more than doubled from 15 per cent in 2009. The prevalence of methamphetamine use disorder increased nearly fivefold, from 6 per cent to 29 per cent, and heroin use disorder increased from 11 per cent to 26 per cent.
Moreover, the 2018 BC Coroners Service Death Review Panel report found that 66 per cent of British Columbians who died of an illicit drug overdose had BC Corrections involvement at some time in their lives, and 25% died while under community corrections supervision or within 1 year of release from a correctional facility.
The BC Liberals will invest in addiction treatment units within correctional facilities, to help improve treatment and life outcomes for inmates after they have completed their sentences.
BACKGROUNDER: COMPASSIONATE CARE FOR COMPLEX NEEDS
Complex mental health support: Triple the beds at the Red Fish Healing Centre and build additional regional centres using that model in the North, Thompson-Okanagan, Kootenays and Vancouver Island to ensure those requiring highly specialized mental health support can receive it close to home.
According to a Ministry of Mental Health and Addictions Budget 2022 Estimates Note, an estimated 2,200 British Columbians require complex care. Yet the new Red Fish Health Centre on the former Riverview lands in Coquitlam added only 11 net new beds when it replaced the Burnaby Centre for Mental Health and Addiction. And despite repeated promises of new complex care beds in the past year, the NDP government has yet to produce a public, provincewide benchmark report detailing total mental health and substance use treatment beds by location, including complex care beds.
The BC Liberals will build four new regional complex care centres in the North, Thompson-Okanagan, Kootenays and Vancouver Island that will add new complex care spaces around the province, in addition to the new spaces announced but not yet delivered by the NDP in January 2022.
Compassionate involuntary treatment: Bring forward legislation allowing the limited use of involuntary treatment to keep our most vulnerable youth and adults at risk of harm to themselves or others safe at modernized, compassionate facilities with 24/7 support.
In its June 2019 “A Pathway to Hope” plan, the NDP government stated, “The safe practice of involuntary admissions under the B.C. Mental Health Act balances the rights of the individual with the obligation to help and protect people living with mental illness,” and committed “to establish clear and consistent provincial standards to achieve 100% compliance with the Mental Health Act. These standards will be supported by a quality improvement framework specific to the involuntary admission process under the Act.” Instead, no such standards have been established in the four years since. While involuntary treatment must always be a last resort, it is a necessary tool to treat mental health and alcohol and substance use disorders.
Homelessness: We endorse the ‘Call to Action’ plan proposed by Dr. Julian Somers and Simon Fraser University in July 2021, providing an effective roadmap to address street homelessness. The plan places a focus on evidence-based services, a “new approach to supporting people who have been persistently excluded and harmed by current practices,” partnerships between Indigenous and non-Indigenous peoples and organizations, scaling up “highly effective model of person-centred services,” and especially much greater transparency and accountability.
The BC Coroners Service has recently reported a 75 per cent increase in the number of lives lost among individuals experiencing homelessness between 2020 and 2021. The BC Coroners Service’s 2022 Death Review Panel report found that one-third of the deaths reviewed by the panel were those either living outdoors or in temporary shelters.
BACKGROUNDER: AWARENESS & PREVENTION
Awareness and prevention: Create and deliver youth-focused public education campaigns about addiction and recovery. Establish workplace campaigns to assist employers in recognizing substance use disorders and better support employees in recovery.
System navigation: Create programs to support families struggling with addiction recovery system navigation, general questions, and supports for impacted family members. The program would provide therapy and ongoing support as they work to help their loved one recover.
Data and transparency: Establish public provincewide performance measures and targets, to clearly benchmark the number of publicly-funded mental and addiction treatment beds available to British Columbians, meaningfully measure outcomes and ensure the standardization of care.
Key to this will be implementing the Auditor General’s 2016 recommendations “to implement a province-wide performance management framework for adult tertiary care, including performance measures and targets,” and to “report publicly on access.” As well as recommendations of the 2018 Coroners Service Death Review Panel, which was reiterated by the 2022 Death Review Panel, to “ensure accountability for the Substance Use System of Care.” In 2018, the panel identified “the need to provincially regulate and appropriately oversee treatment and recovery programs and facilities to ensure that they provide evidence-based, quality care; and that the outcomes are closely monitored and evaluated” as a key area to reduce deaths in this crisis.
The NDP government’s 2019 “A Pathway to Hope” plan made a lot of promises, but left out one of the most important: to establish public, provincewide performance measures and targets for mental health and addiction treatment in B.C.
The NDP’s 2021 “progress report” includes a lot of activity, but no public performance measures and targets to measure the outcomes of those actions. Instead, a Ministry of Mental Health and Addictions Budget 2022 Estimates Note blames lack of capacity: “Some outcomes and associated measures will take time before the effects begin to be realized and are subject to organizational capacity to gather data.”
BC Liberals will establish public provincewide performance measures and targets, to clearly benchmark the number of publicly-funded mental and addiction treatment beds available to British Columbians, and meaningfully measure outcomes and improvements in care.