N.W.T. government not doing enough to treat, prevent addictions, says federal auditor

The Northwest Territories government is not doing enough to provide residents equitable and culturally safe addictions prevention and recovery services, despite promises to do so.

That's according to a report by the Office of the Auditor General of Canada looking at addictions prevention and recovery services in the N.W.T. 

The report, tabled in the Legislative Assembly on Tuesday, said that despite commitments from the territory, the Department of Health and Social Services and the three health and social services authorities did not do enough to meet the needs of N.W.T. residents when it comes to prevention and addictions recovery services.

"Overall, this audit demonstrates a need for improvement," said audit principal Jo Ann Schwartz in a statement. 

"Addictions services are important in the Northwest Territories because addictions can have a far-reaching impact on the lives and well-being of individuals, families, and the broader community."

The audit also said either the design of the territory's services right now, or its deficiencies, cause services to vary over time and by location.

For example, some communities had resident or visiting counsellors under the territory's free community counselling program, while others relied on virtual or phone counselling services.

The report also notes that residents of most communities had to travel to access detox services, which were available on a case-by-case basis in Yellowknife, Inuvik, and Hay River, or through facility-based treatment centres outside the territory.

"Having some services only in certain locations," the audit reads, "could cause barriers for some individuals, such as those with concerns about treatment not reflecting their culture."

Culturally-safe addiction services critical

At the start of its term, the N.W.T. government said its 22 priorities included increasing the number and variety of culturally respectful, community-based mental health and addictions programs.

The audit said, however, not enough is being done by the territorial government to make sure addictions services for Indigenous residents were culturally safe, which it calls critical "given the legacy of colonization."

Further, neither the department nor the health and services authorities have figured out how to fulfil their commitment to providing equitable access to addictions services across the territory, the audit found.

The report said there are still gaps in the coordination of addictions services "even though it has been 20 years since the department committed to better coordinate the health and social services system," according to a news release that came out with the report.

It said that if the system is not well coordinated, it can't help more people move through it.

The audit also found the department and the three health and social services authorities did not do enough to know whether their addictions services were effective in helping residents achieve their desired outcomes.

The audit noted problems with aftercare services for some people who went to facility-based addictions treatment programs in southern Canada.

The audit reviewed files from a random sample of 32 clients who attended a program between 2018 and 2021 following a referral through the territory's community counselling program, and found that health authorities did not provide the aftercare supports that their clients needed to support their recovery goals.

"Aftercare plans are very important so that when someone returns from facility based treatment, and they come back, there's something that's in place to help them maintain any progress that they have been able to achieve while they've been away," Schwartz said.

The audit lists seven recommendations for the territory, all of which were accepted. They included that the territory work to improve the cultural safety of addictions services in part by adapting its current hiring approach to "formally recognize the value of Indigenous qualifications." 

"We're optimistic that those things will be followed through on," Schwartz said. "I think that's something that the Legislative Assembly can be keeping an eye on to monitor how those recommendations are going to be implemented in the future."

N.W.T. has one of highest rates of addictions in Canada

The audit notes that N.W.T. has one of the country's highest rates of addictions and substance use in Canada, and that according to the territorial government's 2019–20 annual report on the territory's health and social services system, smoking was two times the national average and heavy drinking in the territory was 1.5 times the national average.

In that same 2019-20 report from the territorial government, adults and youth were hospitalized
for harm caused by substance use, mainly alcohol and cannabis, at a rate over three times the national average.

There are no addictions treatment centres in the N.W.T. Instead, residents are referred to facilities in southern Canada, including in Alberta, B.C. and Ontario.

Improvements in the works

Northwest Territories Health and Social Services Minister Julie Green said in a statement Tuesday that the department and the health and social services authorities "participated fully and willingly" with the audit, and work to make improvements is already underway.

"The department is committed to offering a system of support, based on programs and services that meet the needs of those afflicted by addictions. This audit provides important insight into those programs and services, and it provides us with a guide to improve that system," Green said in part.

"We value the findings of the auditor general, and this report helps us understand where our programs are on track and where we need to do better."

She said many of the territory's initiatives that were in place or in development at the time of the audit align with the audit recommendations.

That includes, she said, creating a Cultural Safety and Anti-Racism Unit, implementing same-day access to counselling, establishing community-based funding programs, and taking steps to establish managed alcohol, detox and transitional housing options for addictions recovery.

Back in February, Green said in the Legislative Assembly that the territory provides on-the-land funding so that communities can adapt the wellness treatment to the way that suits their community best. She said there are plans to build a wellness and recovery centre in Yellowknife in 2024, but no others are "on the books at this time."