Building treatment centres in the Northwest Territories won't work, despite election candidates and residents urging the reintroduction of such facilities, the NWT's outgoing health minister says.
Glen Abernethy, who held the post for six years but is stepping down as Great Slave MLA, told Cabin Radio all the evidence he has seen suggests treatment centres based in the territory will fail.
He believes the NWT should keep sending people south for addictions treatment under existing partnerships, adding the next government's priority should instead be the creation of much better aftercare within the territory once those people return home.
"If I was a candidate this time, I wouldn't be focusing on a treatment centre," said Abernethy. "It's really easy to say, 'Let's build a treatment centre, rah, rah.' But is it going to work?
"Where we're going to see real benefit for our buck, and where I think the next government needs to go, is more aftercare transition programming – to bring our people home once they've completed the valuable programming that they're going to get at a treatment centre.
"Places for them to stay that are safe. Places for them to get their aftercare program solidly in place before they venture out, back into situations where they'll be with friends or relatives who are currently struggling."
The Nats'ejee K'eh treatment centre, on the Kátł’odeeche First Nation, was the last residential treatment centre to operate in the NWT.
The territorial government closed the centre in 2013. At the time, occupancy of the centre – which cost $2.2 million annually to run – had been reported at lower than 50 percent for the past two years.
On February 26, 2013, then-health minister Tom Beaulieu had said his department saw "an important role" for Nats'ejee K'eh.
However, by September of that year, only one counsellor remained employed at the facility and its board had raised this as a "safety issue." The department closed Nats'ejee K'eh at the end of the month.
"I hear people say, 'Just build it, people will come,'" said Beaulieu's successor as health minister, Abernethy, six years later. "Well, the evidence says exactly the opposite."
Abernethy continued: "We've had four treatment centres in the Northwest Territories, and every one of them has failed for a variety of reasons.
"What we know is even when we had 32-bed facilities here, at any given time we had a dozen people in the Northwest Territories who said they were ready for facility-based treatment," he said, noting people cannot be forced into treatment but must choose it.
"So do you build a 12-bed facility that's always full, or is there going to be a 32-bed facility and you hope that magically some people are suddenly going to decide that they're ready, because it's here?
"That didn't happen but, obviously, some of our candidates feel strongly that something magical is going to happen when you build one. And then you've got to find the individuals to run it – and successful treatment centres have psychologists, psychiatrists, and other professionals that we've never been able to afford for 12 clients."
Abernethy said he had spoken to NWT residents attending southern treatment centres who told him they found their time at Nats'ejee K'eh counterproductive.
"I asked some of them why it didn't work," said Abernethy. "They said, 'There are 12 of us in the building and I'm related to four of them. There's no anonymity. I don't want to talk about the struggles I'm having when I know everybody sitting around the table.'"
'No support' back home
Despite Abernethy's bleak portrait of the sustainability of a northern treatment centre, the majority of candidates speaking to Cabin Radio during this NWT election campaign have advocated for some form of facility to once again be built.
However, Julie Green – seeking re-election in Yellowknife Centre – agrees with Abernethy.
Writing to NNSL this month, she said: "The people I met from the North at the [southern] treatment centres in December 2017 were satisfied with their experience. Past northern-based treatment centres have failed due to the inability to attract and retain addictions treatment professionals.
"The weak link in treatment is aftercare, especially in communities outside Yellowknife which do not have the good fortune to have the Arctic Indigenous Wellness Foundation camp."
Speaking to APTN last week, Melaney Gardebois – a resident of Fort Good Hope – said the lack of aftercare had been her downfall on returning from treatment in Hay River, back when the facility was open.
As a teenager, Gardebois told the broadcaster, her drinking was out of control. She enrolled in a 28-day residential treatment program.
"Even in that short amount of time, I did want sobriety – but coming back to my community, I had no support," said Gardebois. "I was so young and thought so far ahead, convincing myself I couldn’t stay sober. It was just present everywhere I go."
While others interviewed by APTN said a treatment centre would make a big difference, Abernethy told Cabin Radio better aftercare is where the NWT must focus its resources to make a real difference with the money available.
"We now offer more than we've ever done," he said, "but we still struggle.
"The new action plan that came in talks about some of the big holes that we have – and one of the big holes is aftercare."
'It needs to be meaningful'
The issue of how best to invest the NWT's resources in helping people with addictions has received particular attention in the Tu Nedhé-Wiilideh district, where two candidates specifically addressed the lack of aftercare.
Candidates Steve Norn and Richard Edjericon want both aftercare programs and the creation of a new treatment facility.
"We do need a facility," said Edjericon, "but most importantly, we need programs at the local level for aftercare, after you're done your treatment."
Norn said he would "love to see a main facility" built in the district, adding: "I could never understand for the life of me why they closed down the addictions facility we had up in the North. I tried wrapping my head around it. Sure, it's going to cost money. But the long-term cost down the road of not having one is far greater.
"We're still spending a great deal of money sending people for opioid addictions, alcohol addictions, and so on down south. And then we're sending them back here with no aftercare. And they fall back into that vicious cycle again, and it just hurts."
In Yellowknife South, both candidates urged the introduction of better aftercare for patients.
"If we are sending people away and not then giving them aftercare treatment when they get back, it will fail," said Caroline Wawzonek. "That needs to be improved, and it needs to be meaningful, needs to have investment."
Gaeleen MacPherson said: "If we have a local treatment centre [it will be] able to also ensure that we have aftercare programming that looks at partnerships outside of just the treatment facility.
"I do 100-percent believe that we need a local treatment centre. We've had treatment centres in the North in the past, they haven't been successful.
"And you know what, I'm not saying we follow that old model. What I'm saying is, let's look at what didn't work and make the necessary changes."