‘It’s not going to work’: Health-care professional critical of province’s involuntary treatment plans

University of Calgary Assistant Professor, Jennifer Jackson, speaks with Alberta Primetime host Michael Higgins about compassionate intervention centres.

University of Calgary Assistant Professor Jennifer Jackson speaks with Alberta Primetime host Michael Higgins about the province’s plans to create two new compassionate intervention centres.

This interview has been edited for clarity and length.

Michael Higgins: What degree of need is there for facilities in our province providing mandatory treatment?

Jennifer Jackson: What the government is currently proposing is building jails, because any place that someone is forced into and cannot leave, they’re being held against their will, that’s not a treatment facility.

It’s going to cost us a lot of money and it’s not going to work.

MH: What is it about the approach that doesn’t work? Why are you weighing in against it?

JJ: Whenever we’re telling somebody to do something without their consent, especially when it involves being institutionalized, it’s very concerning. We have a long legacy of residential schools, conversion therapy, all of this has caused far more harm than good.

We know from research evidence that mandatory treatment for addictions is not something that is consistently of benefit. We do need more infrastructure here in Alberta, but we have more than enough people who desperately want treatment. They want to be part of this recovery model, but they are turned away daily because we don’t have enough beds to access services.

So while we do need to have more facilities, the idea that we have to force people to go there is gravely concerning.

MH: Are there scenarios where this would be necessary?

JJ: My heart really goes out to people that see their loved ones struggling, and I can understand the need that someone may say, ‘I have lost my son or daughter. This isn’t a person I recognize anymore and I just want them to get some help.’ However, I am concerned with the idea that the police can apprehend someone who’s having mental health difficulties.

I think, in the long run, this isn’t the best strategy and we have lots of other faster, cheaper ways that we can try and increase the services that are available to families that are struggling.

MH: Is this the place of the provincial government to be providing services such as this, if there is the demand?

JJ: The provincial government, with health care being a devolved power here in Alberta, they certainly have a role. We also have a lot of organizations at the community level that are trying to bridge the gaps where the Alberta recovery model has been insufficient to provide services, in terms of harm reduction or giving people other options.

We need both a community response, and also to see leadership from the government that’s based on research evidence, not ideology about what people should or shouldn’t do with their lives.

MH: What will you be watching for in legislation the government will need to bring forward?

JJ: I’m really concerned about the potential to be able to force people into treatment. That is the key thing that I will be looking for as we go forward.

We do need more support for Albertans who are struggling with mental health and addiction issues, but we can do a lot of other things, like increasing support for family doctors. It costs us nothing to remove the prescribing barriers that prevent family doctors from prescribing agonist medications that can really help people right now. You can only get them from a psychiatrist, you can only get them in specialized clinics, and there’s no reason we couldn’t have that prescribed widely.

There’s lots of services that are already doing really good work in the communities and we could avoid micromanaging them and just give them more resources and funding to do the work, because they already know their community best. Somebody in Edmonton doesn’t necessarily know the nuances of what’s going on in High River or Fort Chipewyan, and by empowering local people we’re going to get the best care for our communities.

MH: Earlier, you made the reference to jails. How do you see these facilities being operated?

JJ: We don’t have a lot of clarity around that, which is another factor that’s concerning. Technically, Recovery Alberta is proposing, from what we have in the public domain so far, that they would split off from Alberta Health Services and operate in a separate module. However, there’s potential that that violates the collective agreement of our nurses in the province, never mind that of other health-care workers and physicians and other groups.

We also don’t know where people’s private and personal health care records are going to be stored, how they fit in that model, how are people even going to get to these facilities? If there’s a treatment order from Lethbridge, how are they supposed to get to Calgary? Is EMS going to take them?

We just have so many questions here and I feel like we’re rushing into something where we could potentially have a nursing strike, we could potentially overtax first responders. We have all these other issues that lots of experts are trying to provide a steer and the government is just deciding that they’re going to move forward with these policies regardless.

MH: What kind of markers do you think the government will need to establish to consider this form of treatment a success?

JJ: This is challenging because it’s easy to manipulate statistics to make them say what you want. We’ve seen that a lot already. The rates of overdose or drug poisoning deaths have decreased across North America under multiple different governments, many different political stripes, and yet the Government of Alberta has taken credit for that decrease when, in fact, it’s a broader trend that exists well beyond our borders.

We also don’t have a lot of information about how the CORE team, who is going to be looking after this data, how they are going to protect the privacy of Albertans. Where is this going to be stored? Are private companies going to have access?

We need to be looking at whether these treatments are effective for people, their experience of these treatments, how they are doing in one year, five years, and not just if we got them in the door safely or something along those lines.

All of this measurement is well established, and what we need the government to do is to listen to experts on how we can put these things into place safely.