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Inuit lead addiction and trauma treatment plan for territory in multi-million dollar partnership

When federal Minister of Indigenous Services Seamus O'Regan came to Iqaluit Aug. 19 to deliver the news the federal government is committing up to $47.5 million toward a territorial treatment centre, he was last on the roster of speakers.

This reversed the usual order of business for federal announcements in the territory, and signaled that not only was Nunavut's addiction and trauma treatment plan developed at home, it is led by Inuit.

Nunavut Premier Joe Savikataaq, federal Minister of Indigenous Services Seamus O'Regan and Nunavut Tunngavik Inc. president Aluki Kotierk sign a declaration of intent that commits millions from all three parties to build a territory-wide system of addictions and trauma treatment, including a recovery centre in Iqaluit.
Michele LeTourneau/NNSL photo

Master of ceremonies Joanasie Akumalik opened the event by sharing the story of his own recovery in the early 1990s.

Nunavut Tunngavik Inc. (NTI) president Aluki Kotierk, in Inuktitut, spoke of the hardships Inuit have endured and how some Inuit turned to drugs and alcohol.

"Because of our history, we have to work hard," she said, according to the translation.

To ensure that work takes place, firmly based in Inuit knowledge and values, the Makigiaqta Inuit Training Corporation, managed by NTI, is contributing $11.85 million to train Inuit staff to deliver services in the mother tongue. That money will go to Ilisaqsivik, who have for years forged the way in melding culturally-based healing programs with clinical models, already certifying many Inuit.

Read: Ilisaqsivik’s mobile trauma team seeks out addictions training

Jakob Gearheard, who worked for years as Ilisaqsivik's executive director, has been hired as the recovery centre's executive director.

NTI had previously pledged $5 million for the centre.

"Inuit have expected this for many years," said Kotierk.

Premier Joe Savikataaq, placing this agreement achieved by the Nunavut Partnership Table on Health on par with the devolution agreement in principle announced just days before, said it was an important day for Nunavut.

"We need an addiction and treatment centre. It's needed. We can't keep treating the symptoms. We have to go to the root cause of social issues," he said. "When we have the grand opening, that will be another good day. We won't have to ship Nunavummiut out of the territory to get the treatment that they desperately want and desperately need."

Savikataaq recognized the dedication of regional and community health and wellness societies which contributed to the vision.

"Without these organizations, we would not be here today. Together we will overcome trauma and addiction in Nunavut," he said.

The GN also committed millions to the plan, including 30 per cent of capital costs for the centre.

Savikataaq signed the declaration of intent on behalf of Minister of Health George Hickes, who was not present at the announcement, along with O'Regan and Kotierk.

O'Regan, in making the federal commitment, spoke of his own time in an addictions centre for five weeks.

"It changed my life for the better, much better. But it's hard, it's very hard. I would say the bravest thing I've ever done was ask for help … A weight was lifted. I needed to get that help right away," he said.

"That's why this is such a great day, because people will get better as a result of this … because it's in-community."

O'Regan also noted times have changed, and getting help is no longer as stigmatized as it once was, as it's about getting better.

More than a centre

The feasibility study for a residential addiction and trauma treatment centre was a commitment in Inuuusivut Anninaqtuq (United for Life), the 2017 to 2022 action plan for Nunavut's suicide prevention strategy, which received renewed attention and funding after a discretionary inquest into the high rate of suicide in the territory held in Iqaluit in late 2015.

Conducted by Iqaluit-based NVision, the feasibility study estimated the total price tag for a territorial treatment plan, including start-up costs and a budget for five years of implementation, at $102.5 million.

Read the feasibility study: Addictions and Trauma Treatment in Nunavut

That includes developing and maintaining on-the-land healing camps, in addition to creating and maintaining a recovery centre in Iqaluit, and Inuit workforce development associated with community-based treatment and the made-in-Nunavut facility.

The recovery centre's cost is estimated at roughly $55 million, with an annual budget of $10,664,126. Enhanced community services and on-the-land healing camps are estimated at $3.6 million annually, with each region receiving roughly a third.

To put these dollar figures in context, the overall costs of substance abuse in Nunavut have been rising, jumping from $68 million in 2007 to $96 million in 2014.

Read: Substance issues cost Nunavut $96 million: report

Treatment in Nunavut is envisioned as holistic, treatment tailored for those in need.

At the recovery centre, for example, a family-centred approach will be taken where needed, with a residential wing for families. Further, Iqaluit was chosen as the site for a centre because the Qikiqtani General Hospital would be in close proximity – all the better to help pregnant women who may be in need of treatment. A special unit is planned for them. A unit for youth is also planned.

Senator Dennis Patterson referred to the failed treatment centre in Apex, which the Government of the Northwest Territories, before division, attempted to establish.

"The problem was it was not driven by Inuit," he said, adding a team was brought in from the south.

"It was not culturally sensitive, it was not driven by Inuit. This is a new way forward."

The parties could not offer a specific timeline for when the recovery centre would open, but Minister of Health George Hickes said in February that if the feds announced funding in the spring, the earliest a building could be completed is 2022-2023 – 2024 is now the target date.

FACT FILE:

The Nunavut Partnership Table on Health signed an agreement for substance use and trauma treatment in Nunavut, committing to the following funds:

  • Government of Canada: Up to $47.5 million over five years for up to 75 per cent of capital costs, and ongoing operations. After five years, a contribution of up to $9.7 million annually.
  • Government of Nunavut: Up to 30 per cent over five years toward capital costs, 100 per cent of costs associated with enhanced community-based programming for on-the-land healing camps and other in-community supports, and support for ongoing operations and maintenance for the recovery centre and staff housing.
  • Nunavut Tunngavik Inc.: The Inuit organization committed $5 million in February toward the territory-wide plan.
  • Makigiaqta Inuit Training Corporation: To fund the Inuit counselling component, the corporation is providing $11.85 million over five years.

NOTE: Successful and timely implementation is conditional on all parties securing their respective funds.

source: Nunavut Partnership Table on Health

FACT FILE:

The Nunavut Partnership Table on Health was established in 2016 and includes the Government of Canada, the Government of Nunavut (GN) and Nunavut Tunngavik Inc. (NTI) as equal members.

The partnership table is focused on health-related issues of common interest, seeking to better align, coordinate, and integrate efforts between and among partners.

The partnership table meets quarterly. The main purpose is to establish a consensus on how investments should be distributed and discuss emerging issues.

A highlight for this Table was the signing of the 10-year Nunavut Wellness Agreement between the Government of Canada and the GN for the GN to implement community-based programs in the territory. The development of the Nunavut Wellness Agreement, which involved both the GN and NTI, consolidates a range of community-based health programs focused on healthy child development, mental wellness, and healthy living, as well as home and community care.

Source: Nunavut Tunngavik Inc.