NWT counselling wait times ‘dropped 79% in two years’

The Mental Health Commission of Canada says NWT wait times for some forms of counselling have reduced by 79 percent over the course of a two-year project.

A new report from the commission, known as MHCC, examined the effectiveness in the NWT of what is known as the stepped care model – and where there is room to improve.

Launched in 2020, the program was designed to improve access to mental wellness and addictions recovery services. 

At the time, the territorial government said stepped care would match people with the right level of service – from in-person counselling to virtual supports or facility-based addictions recovery treatment – and in doing so, reduce wait times and barriers to care while also expanding options.

People were encouraged to schedule their own sessions at their own pace through what was termed a care-first, assess-later model.

New services like e-mental health became available. Online options included things like Breathing Room, a self-guided program for youth to help them reduce stress, anxiety, and depression; Strongest Families Institute, which offers coaching for children, adults, and families with mild to moderate mental health concerns; and Wagon, an app that offers addictions recovery aftercare support.

Most people who took part in the program used more than one type of counselling support. The average person used two to three different services, MHCC’s report found, while others reported using nine or more.

Of people who accessed care virtually, 81 percent used a phone, 30 percent used video, and just three percent used apps or web-based tools, according to a 2021 satisfaction survey.

The final report suggested “the lack of reliable, stable internet service in some parts of the NWT” was a key reason that uptake of some e-mental health services was low.

Those services “may not yet be a viable option for all residents,” the report stated, adding staff “noted that some users simply prefer to speak to someone in person.”

Another key change between 2020 and 2022 was introducing same-day, unscheduled drop-in counselling.

Over the two years, 13,000 sessions were unscheduled while 34,563 were scheduled.

One service user, quoted anonymously in the report, said the community counselling program was understanding, good to work with, and “worked around my schedule, and that is rare.”

“The drop-in was good because things happen, and you could email and cancel without any costs to me,” they were quoted as saying.

Users more satisfied than staff

Prior to 2020, the median wait time for an appointment was 19 days. By the end of the two years, that had dropped to four days.

More than 70 percent of people surveyed were satisfied or very satisfied with counselling they received and their level of involvement in decisions about their care. Just over 60 percent said the care they received was effective (26 percent responded ‘neutral’ to the question). 

However, only 36 percent of service providers agreed that they had seen positive impacts from the stepped care programming (36 percent responded ‘neutral’). Only around 40 percent said the approach helped them provide person-centric or family-centric care, or recovery-oriented care.

“Some providers may not yet be entirely convinced of the benefits,” the report stated.

“More work should be done to better understand their perspectives and look for opportunities to make improvements to address their concerns.”

Just over 80 percent of Indigenous service users said they were satisfied with the “safety of the counselling environment.”

“More work is also needed to expand culturally safe programming that integrates Indigenous approaches to care and wellness,” the report stated, noting that an addictions recovery experience survey had stressed the importance of on-the-land cultural programs in addition to other services.