Overhaul started on Mental Health Act
New legislation to include Inuit values of family and community
Michele LeTourneau
Northern News Services
Monday, November 30, 2015
IQALUIT
Nunavut's Mental Health Act, inherited from the Northwest Territories in 1999, is receiving a thorough overhaul by the Department of Health and, according to executive director of planning Lynn Ryan MacKenzie, the goal is to make it relevant to Inuit.
"To reflect Inuit values throughout," said Ryan MacKenzie. "As opposed to a statement at the front of the act."
To that end, the department has travelled to communities to consult and engage people. The team hosted its last public meeting in Iqaluit Nov. 26. Consultations were held in 11 communities throughout November. A meeting in Cambridge Bay Nov. 17 was postponed due to weather and is being rescheduled to a date yet to be set.
In Iqaluit, director of mental health for the capital Victoria Madsen and policy analyst Jonathan Paradis outlined what the act is used for.
Paradis explained the act is for crisis situations, when "because of mental illness a person is at risk of harming themselves or somebody else."
He compared it with cancer treatment, which a patient can refuse. But it's different with mental illness.
"If the person was mentally well, they would be making different decisions," he said.
Ultimately, the Mental Health Act allows for temporary removal of a patient's rights.
At the inquest into the high rate of suicide in the territory in September, the Mental Health Act came under fire. There are aspects of the act that do not take into account Inuit values.
As Ryan Mackenzie notes, "families are the biggest support" in crisis situations.
At the time, the inquest heard how privacy laws got in the way of families becoming involved in helping a mentally ill patient and, in some cases, obstructed them from helping a suicidal family member.
Shuvinai Mike lost her daughter to suicide, she testified.
"When I asked for my daughter's coroner's report, I was shocked to learn that my daughter had gone to the hospital many times, according to the report," Mike told the inquest jury. "If I had been informed of this, I definitely would have intervened.
"She may still be alive, and be here for the kids. When one calls a help line and says they are suicidal and the protocol is to call the RCMP, the protocol should also be to call the parents, regardless of the age."
In fact, within its four pages of recommendations, the inquest jury specifically recommended the act be changed "to allow for family members to be contacted and immediately involved after a suicide attempt regardless of the age of the person."
The recommendation also says counselling should take place with the family.
"This is a new recommendation that involves allotment of resources to retraining and a change in orientation to a more family and community intervention approach," stated the jury.
As MacKenzie explains, under current legislation health practitioners can't even tell family members when someone is being held under the act and is medevaced from a community.
"People could literally disappear," she said. "Given the history in this territory with tuberculosis, that's not acceptable."
Mackenzie says the process to revise the act is a long one. A lawyer has been contracted to look at other jurisdictions to inform future legislation.
After consultations and the cross jurisdictional work, "drafting instructions" will be written, and a plain-language outline will go back to communities for verification. Finally, the material goes to a legal team which will draft new legislation.
The legal aspect is important, said MacKenzie, because "it's very serious to suspend rights."
But, she says, the lengthy process is worth it.
"The upside of thorough consultation, the benefit is that we will craft something appropriate to Nunavut."
For those who live in a community that has not had a public meeting, questionnaires are available at all hamlet offices and health centres. There is also an on-line version.
"We're also offering to individuals and families who have had direct experience with the Mental Health Act a private conversation through the telehealth equipment," said MacKenzie.
