Former addictions worker worries agency's merge into Shared Health could create delays, stifle innovation

A former staff member with the Addictions Foundation of Manitoba is concerned about the plan to roll the arm's-length Crown agency into a newly created health authority — and she has questions about the province's long-term plan to fight methamphetamine addiction.

"It feels as if a lot of things end up being put on hold [and] decisions aren't made in a timely way," said Sheri Fandrey, the former lead of knowledge exchange at the Addictions Foundation of Manitoba.

"Speaking directly about methamphetamine, I think there's been an unconscionable delay in taking effective action."

Fandrey, an expert in pharmacology and toxicology, worries the planned transition for the agency will create more delays on a plan that's needed now.

In March, the province announced legislation that will roll the Addictions Foundation of Manitoba into Shared Health, the new provincial organization responsible for co-ordinating health-care services.

The new health authority is also taking control of operations at Winnipeg's Health Sciences Centre and the Selkirk Mental Health Centre, as well as certain mental health services from the Winnipeg Regional Health Authority.

The changes, expected to take place over the next two to three years, were a recommendation of the Virgo report — a lengthy review into the Manitoba mental health and addictions system. 

The province has said the move will enable integrated planning and delivery of mental health and addictions services.

AFM told not to discuss safe consumption

Fandrey worries the move into a government health model is more about finding cost efficiencies than improving services.

"I do have concerns that innovation and accountability, for the addiction piece specifically, may become compromised," she said.

She also worries that under provincial control, AFM won't have the freedom to determine its own policies. For example, staff are currently told "certainly do not ever talk to the media in a positive way about safe consumption sites," which have been consistently opposed by the Progressive Conservative government.

While that direction came from supervisors within the foundation, Fandrey said she felt it left the organization out of an important conversation.

"It looks like [the AFM has] nothing to offer on that topic, and certainly we know that there is good evidence for the benefits of safe consumption sites," Fandrey said.

In a statement, AFM said it routinely provides information and recommendations on harm reduction initiatives.

"At no point have we received directive from the province on this," the statement said.

Damon Johnston, board chair at the Addictions Foundation, said the decision to not publicly weigh in on safe consumption sites was made from within AFM.

"There is no consensus anywhere that necessarily we should jump to some conclusion and implement these things tomorrow," he said.

 "We're taking a slow steady approach." 

Beds being added

A spokesperson for the province said the Winnipeg Regional Health Authority and the western Manitoba Prairie Mountain Health Region are currently developing models for withdrawal management services to address substance use, including opioid and methamphetamine use. 

The projects are being paid for with $4.1 million the province received from Ottawa last December to help people struggling with addictions.

Six residential beds are being planned in Brandon, as well as five mobile withdrawal management spaces in Winnipeg.

The services will be provided by community agencies and should be up and running by late summer, the province said.

Last month, the province also announced the addition of 12 beds to the 28-day residential treatment program offered by the Addictions Foundation of Manitoba and four beds through the Behavioural Health Foundation's residential program for women and children. 

Job fears at AFM

Fandrey retired from the foundation at the end of May. "There's a lot of fear" from staff about its operations going forward and what the new structure will look like, she said.

"It feels like we don't know what the plan is."

The Addictions Foundation said it does not anticipate any changes to the size of its workforce during the transition, and is actually expanding some of its services and creating new positions.

"We are keeping staff up-to-date with respect to system integration with our involvement in the development of a provincial-wide clinical and preventative services plan for mental health and addictions," a spokesperson said in an email.

The foundation's board chair acknowledges that there may be fear of the unknown.

"There will always be some caution around change, with any of us," said Johnston.

So far, he said, AFM has been part of the discussions and the agency is confident it will continue to be part of the process.

"So far, I have not heard anything that would cause me to be overly concerned with the change process."

The foundation and its board see the changes as "a positive move," he said.

"For years we've wanted to see mental health and addictions come much closer together … because in the individuals who present with addiction, oftentimes there are mental health issues or illness diagnosed as well."

Johnston says while the merge will take time, that doesn't mean progress won't continue, citing the recent addition of treatment 16 beds for women at the AFM headquarters on Portage Avenue.

"We are supporting this change process, working with the government, wanting in a real way to improve the system," Johnston said.

While he acknowledged that delays in service because of the changes could happen down the road, he's not ready to sound any alarm bells just yet.

"I'm not rushing to judgment," he said. 

"I'm exercising some patience. I'm giving the minister and the government an opportunity to do this."