(This letter has been sent to Interior Health CEO Susan Brown in response to her letter about why Pathways was defunded)
When I first heard about the new urgent and primary care clinic, opening right next door to my clinic, I was encouraged. It is something that is needed in our community and frankly the Martin Street Outreach Clinic has been a disappointment. Partnering with the Penticton Indian Band and Ooknakane Friendship Centre is a tangible step forward in the level of health care offered in the South Okanagan. I believe Pathways Addictions Resource Centre (Pathways) clients and their families will benefit from access to an urgent and primary care centre for things like wound care and medication support; however, I find it hard to believe that it will be the “game changer for supporting people with mental health and addiction challenges” that you so boldly stated in your March 19th press release.
I want to give you the benefit of the doubt and suggest that you honestly believed what you wrote in what can almost be termed a “fake news” release. I never thought I would ever use that term but if not now, when? I must stand up and be counted, our clients are relying on me. I am going to go through the release and address some of the most egregious misinformation.
I think a real review of 2020 would be an eye opener for the community. For example, how many client visits occurred at the Martin Street Outreach Clinic (either in person or via some form of telehealth or video) from June 01 to Dec. 31, 2020? Were those clients able to speak to the same practitioner each time they called or presented at the clinic? Pathways staff conducted over 2,500 visits during that time and clients were able to speak with their counsellor the majority of the time.
Mainstream medicine has never been particularly good at addressing complex health challenges, addiction or otherwise. While I am sure you believe that new strategies, fresh thinking, innovation, and integration will do the trick it still looks like the old practice of trying to fit chronic, complex concurrent issues into an acute care model that does not work for clients in need of long-term management. Acute care models do work for a life-threatening situation such as an opioid overdose; however, what long-term support will be available for those clients who, once saved by acute care treatment, step into what for many may be a lifelong struggle? The majority of Pathways clients see our counsellors for alcohol use disorders, where will they fit in this new system?
Who are the rest of these community partners? You mention various groups under the purview of Interior Health and of course the Penticton Indian Band and Ooknakane Friendship Centre (were they completely aware of what Pathways’ fate would be?). Where are the other stakeholders, such as South Okanagan and Similkameen Brain Injury Society, or did you just stick with those you knew would give you the answers you needed?
Truly inclusive client centred care models reach out to clients and past clients from all segments of the community and the various community-based organizations that they work with to get input while in the formative stages of developing new programmes. They do not go to these same people after the fact and say we did not ask but we know this is what you need so you better get on board.
If Interior Health is so sure that Pathways is preventing people from full access to care, why are they still relying on Pathways to refer their patients to treatment? Is Pathways really preventing access to the full range of available supports and care or are patients saying, “No thank you, I feel more comfortable with Pathways and the counsellors I have formed strong, reliable relationships with.”
Pathways may have a dedicated time for intake on Tuesday afternoons, but no one is ever turned away and can go through the intake process at anytime the office is open. Drop-in access sounds lovely but will it actually include being able to attend a drop-in group to help bridge the gap between intake and one-on-one counselling as is the practice at Pathways? Is tracking the client progress really about making sure people do not fall through the cracks or is it about collecting stats for outcome measures that then justify the spending?
When Daryl Meyers, our Executive Director, and Steve King, a long-time member of staff, attended transition meetings with Interior Health and asked basic questions about the who, what, where, when and how’s of the programmes you are initiating there were basically no answers. It is not ethical to transition clients, many of whom are very vulnerable, to an unknown which could potentially put them at risk. Just because you say there will be no disruption in service does not make it so. A number of “pie in the sky” promises have been made but no concrete evidence has been given as to how all these promises will be met.
You neared the end of your statement by saying that services will be enhanced and improved. I am going to end this letter with a quote from Daryl Meyers, as she said it best:
“IH has informed us that they will not be providing assessments for the Ministry of Children and Families so parents can work to get their children back. Who will be providing that? IH has informed us they will not be working with probation or the correctional facility to work with people who have committed a crime. Who will be providing that? Who will be providing the 1,200 prevention education sessions the students in School District 67 receive on substance use? Who will be answering their phone to work with an opioid use disorder client at 10 p.m. or on the weekend because they may relapse?… Did anyone do their homework? Talk to the people who use the service? NO. A decision was made and now the fall out begins.”
Dr. Sherry Ure
Chair, Pathways Addictions Resource Centre