Ensure a “whole-of-government” and “whole-of-society” approach to the implementation of the Virgo strategy, including a focus on the overall determinants of health in the province.
Create a formal health response structure to manage emerging substance use, addictions and mental health challenges, including the opioid overdose crisis and the current crystal meth situation.
This rapid response system should be flexible and include cross-sectoral surveillance system.Allocate eight per cent of substance use, addictions and mental health resources towards prevention.
Reinforce alcohol prevention and risk reduction. While there is a critical need for focused substance-specific work, such as for prescription opioids, crystal methamphetamine and cannabis, it is essential to retain a strong and consistent focus on alcohol given its burden on Manitoban society, including cost.
Expand access through the provincial drug formulary to naltrexone, including injectable naltrexone and two evidence-based medications for the treatment of alcohol use disorder.
Develop a coordinated provincial program for the prevention of suicide among adults and children and youth, including the development of options to intervene with treatment, thereby preventing the tragic loss of life through a more effective respond to suicide attempts.
Develop and implement system-wide strategies to increase the identification of substance use, addictions and mental health disparities including making maximum use of existing surveillance systems and respecting the importance of data collection, analyses, and storage in the context of Indigenous communities and governance structures.Implement a perception-of-care questionnaire to allow providers to ask for routine feedback.
Increase representation of marginalized groups on organizational boards and advisory committees.
Ensure surveillance of, and sensitivity to, gender-based inequities.
Review the policies and operational procedures of residential and inpatient services, including withdrawal management services, to ensure physical and psychological safety of those who identify with the LGBTQQ community.
Particular effort is need to support those who are transgender or are in transition.Recognize and work to reduce the effects of income disparity among the large majority of people needing access to services, such as potential waivers of dispensing fees for required medication.
Establish a provincial task force to investigate options for transportation, focused on the experiences and best practices in other jurisdictions like Ontario and British Columbia.
Develop and implement a substance use, addictions and mental health literacy program to educate the general public and key stakeholders.
Expand and accelerate services and supports to family members and other loved ones including increased support for family navigator services.
Design and implement a provincial program for facilitating consent to share information with family members and other loved ones, including employee training to allay fears about potentially violating the privacy act.
Increase capacity for all levels of withdrawal management, including community/mobile, social, and medical, with flexible lengths of stay to facilitate transitions to crisis stabilization and/or treatment.
Expand focus of medical detox at Health Sciences Centre beyond its current exclusive emphasis on alcohol and opioids.
In regional health authorities outside of Winnipeg, operationalize the provincial mental health hub model identified in the Peachey report.
Core services should include capacity for substance use and addictions including screening and assessment, 24/7 access to psychiatric consultation and acute assessment, treatment services, as well as a core set of professionals besides psychiatrists who can help.
Increase capacity for community-based treatment services including extended hours of operation and more flexible and streamlined intake and assessment processes.
Expand Telehealth for substance use, addictions, and mental health services in rural and remote communities.Increase capacity for supported housing options, including a harm reduction home in Winnipeg.
Increase capacity for residential substance use and addictions treatment, specifically with a focus on women and youth, and increasing flexibility concerning the 72-hour period of abstinence prior to admission.
Develop medical/psychiatric inpatient services at Selkirk Mental Health Centre, expanding services to include outpatient psychiatry.
Increase capacity for rapid access to specialized services, such as the Rapid Access to Addictions Medicine Clinics, as well as transition to primary care once stabilized.Increase capacity for harm reduction services, including creating a provincial needle exchange program and a better-coordinated provincial Naloxone distribution program.
Increase the number of provincial forensic beds and accelerate the process of coordinating transitions between forensic services at Selkirk Mental Health Centre, Health Sciences Centre, and correctional facilities.
Increase capacity within the full continuum of mental health housing supports, especially for people with complex needs, and transition housing to support women seeking to regain child custody following treatment.
Enhance and accelerate community-based services and supports for newcomers and refugees, with a focus on trauma-focused interventions delivered through community-based organizations.
Enhance and accelerate support for people experiencing sexual and other significant trauma, including, but not limited to, childhood physical and sexual abuse, victimization, and residential school/historical trauma.
Develop integrated centralized intake for services, with separate processes for children/youth and adults.Increase access to, and coordination of, psychiatry and clinical health psychology diagnostic, treatment planning and therapeutic supports.
Enhance program design and workforce competencies to work with older adults, recognizing the long-term impacts of their challenges including on physical health and high risk of suicide.
Improve coordination of services and supports provided by mental health self-help organizations.
Develop and initiate a provincial program for screening and brief intervention in primary care services with a focus on alcohol, cannabis and depression.
Increase capacity in personal care homes to support people with mental health, substance use and addictions issues so more of them can be transitioned out of inpatient mental health units.
Conduct a formal systems audit of barriers within and across sectors when it comes to access and coordination.
Enhance the role of spiritually-based community services at the community level, including leveraging the work in this area to bridge formal health services and Indigenous approaches.
Support and accelerate the development of community mobilization hubs for people with highly complex needs.
Enhance transition supports for those being released from corrections to substance use, addictions and mental health services.
Enhance and accelerate the coordination of services and supports provide to people experiencing both development disabilities and mental health challenges, ensuring an inclusive focus on substance use and addiction.
Significantly enhance the capacity of community services for children and youth, ensuring a strong role for non-profit, community-based organizations to increase flexibility.
Increase support for gang-related services.Review occupancy challenges at selected youth services.
Develop an integrated provincial plan to increase the coverage and coordination of services and supports provided to students in school.
Develop and implement a focused provincial program to support youth transitioning to adult services.
Given the high proportion of CFS kids with substance use, addiction and mental health issues, including high suicidality, it is recommended that these services be brought under one umbrella.
Acknowledge the role the strategy and its implementation is a critical aspect of a larger hearing process in the spirit of the Truth and Reconciliation Commission and the National Inquiry into Missing and Murdered Indigenous Women and Girls.
Work to ensure that Manitoba’s people of Inuit heritage have equal access to services.Acknowledge the importance of the First Nations National Mental Wellness Continuum Framework in guiding many of the recommendations.
Ensure treatment processes and content are culturally relevant and appropriate, including proactive offering of choice amongst services, including smudging, sweat lodge, the seven teachings, other traditional ceremonies.
Develop a comprehensive health human resource strategy that will address increasing the size and diversification of the workforce.
Pending evaluation results of pilot work, enhance the Rapid Access to Consultative Expertise or RACE program to include substance use and addictions.
Increase the amount of the health budget that goes to substance use, addiction and mental health services to between seven and nine per cent over the next three years.
Give funding priority to the expansion of services for children and youth, as well as adults who’ve experienced substance use and addictions issues, eating disorders and severe trauma.
Develop contingency plans for increases in costs for contracted services.
Develop a policy requiring other parts of government, like Justice/Corrections, to contract for psychiatric services through the public system rather than through independent fee-for-service psychiatrists.
Create one governance structure to embody all the current organizations including the Addictions Foundation of Manitoba and the Manitoba Adolescent Treatment Centre.
Develop provincial standards to ensure equitable access to services across the province and optimal coordination.Instate a provincial licensing process and related standards for privately operated residential services.
Evaluate the Priority Home initiative with a focus on determining how accessible it is to people with mental health challenges and its viability as an alternative to the WRHA home-based mental health teams.
Evaluate the appropriateness of the current heavy reliance at AFM on 12-step facilitation in residential programs with an eye to more flexible content.
— source: full version of report at www.gov.mb.ca/health/mha/strategy.html