The right treatment plan each time
Michele LeTourneau
Northern News Services
Monday, November 14, 2016
NUNAVUT
There isn't a one-size-fits-all program for those caught in a cycle of problematic substance use (abuse) or substance use disorder (addiction).
"Each client is different," said community mental health specialist Opal Mcinnis, when asked how the health-care workers determine whether a client is better suited for treatment in the home community or out-of-territory. "Certainly there is something to be said for an individual being able to stay in their community, particularly if they have good familial and community support. But ultimately what works to treat substance abuse disorder with one client is going to be different for the other."
There is one thing all clients have in common: they must be the ones to seek help. The first step is to start the conversation - and this includes family members who may be concerned.
Ideally clients will stay in their home communities, and Mcinnis said the Department of Health is looking at ways to increase capacity across the territory. That includes providing financial and technical support to programs at wellness centres and wellness organizations across the territory, as well as offering training to clinicians in the areas of cultural safety and cultural competence.
The September 2015 inquest into the high rate of suicide in the territory ended with recommendations aimed at the mental health and addictions division.
"There was a clear recommendation to increase substance use services and programs within the communities," said Mcinnis.
However, in-community care is not always the best choice.
"The clinician will work with the client to reduce some of the harms related to their substance use. If the client and the clinician feel that out-of-territory treatment or more intensive treatment such as a residential facility is necessary, they will work with the client to assess their readiness for treatment to prepare them."
She said the main substances abused in the territory are alcohol and cannabis.
"Fortunately opioids (such as the synthetic fentanyl) haven't touched the territory as they have other jurisdictions across Canada," said Mcinnis.
The department collects information on the ratio of clients being treated for substance use disorder by gender but the data is used for internal purposes and could not be released to Nunavut News/North by press time.
During the 2015-16 fiscal year, 40 Nunavummiut attended out-of-territory residential treatment. Health has standing offer agreements with several facilities and there is always the option of another if those don't fit the bill.
"The facilities we have are high-quality, accredited facilities," said Mcinnis. "We do work with the facilities so that they are culturally sensitive and there are certain facilities that have indigenous healing components. And sometimes those are First Nations based but we'll work with the facility to see about increasing culturally sensitive practices."
Mcinnis adds some of the facilities are used to having Inuit clients so they've adapted their practices to best accommodate Nunavummiut.
Quality of care, she says, includes meeting the cultural needs of the client.
As well, after-care is a factor.
"We do have some facilities that offer distance after-care for clients who return to the territory," said Mcinnis, adding after-care is available in the communities.
Asked if a territorial residential treatment centre was still on the books for Nunavut, the Department of Health responded by e-mail, saying it is "committed to the development of addiction treatments capacity across Nunavut, with a focus on community-based services and supports."
