OPINION: BC addictions minister carries a heavy burden as deaths mount

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Until recently, Sheila Malcolmson was focused on the environment at university, as a consultant, and as a politician at the local, provincial and federal levels.

In any year, that would have made her a surprising choice for mental health and addictions minister. But 2020 was the province’s worst ever for opioid overdose deaths, with a record 1,716 British Columbians dying.

This past January, B.C. hit another monthly record — 165 people died despite four years of investments that focused on harm-reduction measures such as naloxone to reverse overdoses, drug testing sites, and a safer supply of pharmaceutical drugs as replacements.

Meanwhile, the failure to provide adequate services for people with addictions and mental illness has ramped up street disorder, led to more violent assaults and growing homeless camps in Metro Vancouver, Victoria and across the province.

So, here Malcolmson is. She is a rookie cabinet member in a job that rivals the Ministry of Children and Family Development as the toughest and least-appreciated in government. No, strike that … it’s worse than Family Development, which at least has a big budget of more than $2.2 billion.

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Last year, the addictions ministry got $36 million, although that could change in the coming budget. But if the status quo remains, this minister will have to go cap-in-hand to cabinet colleagues in health, housing, children and family, the attorney-general and public safety for the money to fulfill her mandate.

(In a recent interview, Malcolmson didn’t raise the budget issue or complain about it. That’s my outsider’s perspective on one aspect of a brutally hard job.)

She did admit that taking over the ministry has been like “stepping onto a fast-moving train.” And that train is heading in a completely different direction from advocating measures to deal with abandoned vessels and oilspills, topics she tackled as a first-term MLA and during her four years as member of Parliament for Nanaimo-Ladysmith before that.

Malcolmson’s long and detailed mandate letter from Premier John Horgan should be titled Great Expectations. The new minister is charged with nothing less than building a comprehensive mental health and addictions care system — something that has eluded B.C. for decades. Part of that is an accelerated response to the opioid crisis “across the full continuum of care: prevention, harm reduction, safe prescription medications, treatment and recovery.”

There is a real urgency to this. People are dying in record numbers, and what the NDP did in its first term seems to have made little discernible difference.

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Here are a few of the items on her to-do list:

• A new mental health and addictions care initiative for children and youth.

• more detox, treatment, recovery and after-care facilities for all ages, including youth under 24.

• ensure quality care, accountability and value for money in recovery homes and other private treatment centres.

• oversee investments in more community-based mental health and addictions services that will include training more people with specialized skills.

Oh, she is also supposed to help develop better ways to deal with chronic pain, since prescription opioids have been tagged as a pathway to addiction.

And, along with Attorney-General David Eby and Public Safety Minister Mike Farnworth, Malcolmson will be lobbying Ottawa to expand the safe supply of drugs allowed under a special COVID order, and decriminalize possession of small amounts of illicit drugs for personal use. Failing that, they are supposed to, “develop a made-in-B.C. solution that will help save lives.”

It’s ironic, but safe supply and decriminalization may be among her smaller problems.

The system-building work was begun by Judy Darcy, the former minister. Last August, Darcy announced $36 million for 123 youth treatment beds, more than doubling the current number. Malcolmson might be cutting ribbons for some of those later this spring.

Darcy also announced $13.5 million for 50 to 60 new adult treatment and recovery beds, and the ministry says there are more announcements expected soon.

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But as Malcolmson’s mandate letter suggests, physical infrastructure is only part of the job. Also lacking is the human resources system to churn out hundreds of specially trained workers that B.C. needs but doesn’t have.

And the whole system has to be high-quality and accountable. Malcolmson must ensure that the non-profits, agencies and companies paid hundreds of millions of dollars annually by the government actually deliver what they say they will.

What could go wrong? Well, for a glimpse, Malcolmson might read the B.C. seniors advocate’s report, A Billion Reasons to Care, that found that some seniors’ care providers failed to deliver 30 per cent of the hours they were paid for.

She might also want to have a long, long chat with the Surrey bylaw enforcement people who have been playing whack-a-mole with unlicensed and unregulated recovery houses for more than a decade.

To do all this with no personal experience in the sector, Malcolmson is relying heavily on a cobbled-together staff that has gone through many changes since the ministry was established. One of the deputy ministers who came from Indigenous affairs is a lawyer, so is the associate deputy minister who was previously in the solicitor general’s office.

What they can’t help her with is the worst part of the job. With close to five people dying every day, Malcolmson has to carry the burden of being one of the province’s chief mourners.

dbramham@postmedia.com

Twitter.com/bramham_daphne