September 24, 2018

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Report offers a 'breath of fresh air'

New strategy for mental health, addictions services a relief for those in the field

MIKE DEAL / WINNIPEG FREE PRESS FILES</p><p>Health Minister Kelvin Goertzen has only committed to implementing a few recommendations so far, but a spokesman for his office said they are all being considered and an implementation plan ‘is expected to be completed by fall.’</p>

MIKE DEAL / WINNIPEG FREE PRESS FILES

Health Minister Kelvin Goertzen has only committed to implementing a few recommendations so far, but a spokesman for his office said they are all being considered and an implementation plan ‘is expected to be completed by fall.’

A proposed new provincial strategy for mental health and addictions services is a welcome relief for many of those who work in the field.

If its recommendations are followed, the Virgo report — billed as the most exhaustive dive into Manitoba’s mental health and addictions services in years — will transform how the province’s most vulnerable and struggling residents access care, treatment and support.

Its numerous recommendations include: that Manitoba allocate more of its health budget to the issue, take special note of the numerous disparities among those needing care and look at additional social housing supports; rapid access to specialized services; centralized intake; help for families navigating the system; and, in general, more programming flexibility.

“The report hit the right problems,” said Paul Melnuk, founder of the Aurora Recovery Centre in Winnipeg and a recovering alcoholic.

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A proposed new provincial strategy for mental health and addictions services is a welcome relief for many of those who work in the field.

If its recommendations are followed, the Virgo report — billed as the most exhaustive dive into Manitoba’s mental health and addictions services in years — will transform how the province’s most vulnerable and struggling residents access care, treatment and support.

Its numerous recommendations include: that Manitoba allocate more of its health budget to the issue, take special note of the numerous disparities among those needing care and look at additional social housing supports; rapid access to specialized services; centralized intake; help for families navigating the system; and, in general, more programming flexibility.

"The report hit the right problems," said Paul Melnuk, founder of the Aurora Recovery Centre in Winnipeg and a recovering alcoholic.

Melnuk had immediate access to treatment when family intervened to help him get sober in the United States. That quick care was crucial to following through, he said.

"I worked hard to get out of going, and I almost did it," Melnuk said, chuckling. "There’s just a very short moment of time when somebody who needs help is willing to get help and will actually take help. This is a disease."

Removing barriers while increasing speed of access to care is the goal of the five rapid access to addictions medicine clinics (RAAM) Health Minister Kelvin Goertzen announced last week. It’s one of the only recommendations from the Virgo report Goertzen has thus far committed to implementing.

A spokesman for his office said Wednesday the recommendations are being considered and an implementation plan "is expected to be completed by fall."

While Melnuk said he sees the government’s backing of RAAM clinics as "a response to immediate crisis," and believes systemic change will require the tricky but necessary integration of mental health and addiction services.

"If I were (the government), I would start with the reorganization because I do not believe that you can increase capacity in some areas and try to get any efficiencies and effectiveness of treatment unless you take that integrated approach," Melnuk said. "Trying to patch the system or plug holes in the system right now, that’s just going to get more of what we’ve got."

There is no shortage of Virgo recommendations aimed at doing exactly that.

The report calls for a "whole-of-government and whole-of-society approach" with numerous new province-wide plans, programs and reviews. These include a plan for the prevention of suicide and another to increase coverage of services and supports to students in schools.

Virgo also calls for programs that look at screening for alcohol, cannabis and depression, as well as brief interventions at the primary service level. It recommends a program specifically designed to help youth transitioning to adult services and provincial standards to ensure people are getting equitable access to care.

Among the recommendations is a call for a health human resources strategy, a request the Manitoba Nurses Union made in a more limited scope last month. Shortly after the report’s release, Manitoba Government and General Employees’ Union president Michelle Gawronsky sent out a statement, saying it reiterated what front-line workers have been saying.

"That the system is overloaded, that more investments in front-line care are needed, and that services need to be better co-ordinated," she said. "While we welcome the promise of better and more co-ordinated addiction and mental health services, we hope the government is as equally committed to implementing the recommendations that call for increased investments in services."

The lack of clarity yet on what the Manitoba government will or won’t implement hasn’t seemed to dampen enthusiasm.

"I’m relieved and excited," the executive director of NorWest Co-Op Community Health Centre, Nancy Heinrichs, told reporters this week. "It’s a breath of fresh air to a system that needs enhancement."

NorWest’s Youth Hub was praised in the Virgo report as a successful way to connect treatment, support, prevention and health promotion. The project has been up and running for nearly a year and a half. More than 1,700 young people have come through its doors, where they have access to mental health services, addictions services, employment services, an elder and a variety of recreational services.

"Together, as a team, we’ve been able to knit our services together in a partnership to meet the needs of our youth," Heinrichs said.

That’s also what the Program for Assertive Community Training (PACT) program does in the Winnipeg Regional Health Authority. The WRHA’s three 14-person teams provide treatment and support to 100 or so people per team who have been hospitalized multiple times and have schizophrenia, bipolar disorder or other persistent mental illnesses.

The teams go out to people’s homes, said Dr. Jitender Sareen, medical director of the WRHA’s mental health program. They support patients and their loved ones, helping them remember to take medications, sharing recovery principles, and supporting them so they can volunteer and participate in their communities.

"(PACT teams) have been shown repeatedly across the world to reduce the number of hospitalizations, number of emergency visits and also help with recovery," Sareen said. People often stay with the team for between three and four years, before shifting to other more or less intensive programming as required.

The Virgo report is in favour of the teams, noting the WRHA should have between six and seven teams, as evidence suggests there should be one per 100,000 people. A fourth PACT team was approved earlier this year, Sareen said, which should help with the long wait list.

"It’s very exciting," he said. "It’s very important, as far as helping the people and their families."

jane.gerster@freepress.mb.ca

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