Health committee  Unfortunately, we're still in that position today.

Health committee  I think that's where we're left questioning when we see the Peachey report on having a focus on mental health and addictions, the Virgo report saying we need increased funding, and then we're being asked to cut back annually—1% to 4% over the past few years—not only with Addictions Foundation of Manitoba, but other delivery of mental health and addictions as well.

Health committee  Absolutely that is a contributing factor and is concerning, given that we have a higher percentage. I think we're facing this issue of poverty dependency more and more in our social system. Again, a lot of trauma is surfacing in many ways. We know that. Again, in literature these people are more likely to experience it, given that it's a large risk factor in addictions and substance use.

Health committee  Anecdotally, we're certainly seeing high percentages of persons who have co-occurring conditions. One of the innate challenges that we have is that, because our system is siloed and funded, mandates are based on someone dealing with mental health and someone else dealing with substances.

Health committee  Certainly when we look at cost for northern transportation, it's astronomical, and typically has been, but even the ease of that process.... Persons might have to go from The Pas, down to Winnipeg, and then get up to Thompson, so there's a lot of rerouting. We know opportunities are always lost the moment that people are not essentially handed off door-to-door, so I think that is a growing concern.

Health committee  I would love to see that. One of the challenges, when it comes to addictions, is that it is so multifactorial and layered that we all need to be part of that solution. If we could engage other parties, such as pharmacotherapists, absolutely, I think there would be benefit to that.

Health committee  Sheri may want to follow up on that. Certainly in Manitoba we've been looking to some of the protocols and those are.... Earlier someone mentioned the olanzapine within the emergency medical services, but there can even be safety protocols for providing the environment within health care delivery, such as not having anything dangerous around and not using things that will escalate.

Health committee  I think what is really important is not only, like you were saying, the effects neurologically on the brain but to have ongoing supports for any other underlying mental health issue. We haven't really touched on that but most often residual depression and mood changes are experienced and need to be addressed along with that.

Health committee  I was going to add that, with homelessness, that's really important too. We are seeing increasing homelessness within Manitoba. Crystal meth is a strategy to help maintain your equities on the street, meaning that you stay awake longer, you can fend off people who might be a threat and you can survive on the street.

Health committee  It could be variable. If you were presenting with either psychosis or some kind of emergency, you might present into the emergency department. Typically what's happening is that people are presenting to our non-medical detox, which is the Main Street Project. It has about 20 beds for females and about 30 for males.

Health committee  In female, we have just about 30, and the male, I think there are 36 or 40. That's specifically in Winnipeg. Then, we have—

Health committee  Yes, many of them.

Health committee  Yes, and that's why we're saying that globally we need more service. Now, those are just within Winnipeg. We also have many who will go to residential treatment programs in either Thompson, Brandon, or Ste Rose. That increases some capacity, but we are grossly unmatched when it comes to—

Health committee  Like I said, if we're already under-serviced at 5.2% in terms of our mental health and addictions and the Virgo report is saying to increase it to 9.2%, I would say even higher, to 10%—

Health committee  Wait times are variable, because people in the north might be accessing services down south. Again, that's where that concentration is. We do need to improve access more equitably throughout the province, which can in turn help to reduce that wait time, and to also look at transition instead of people cycling through: showing up four or five times repetitively in emergency, for example, getting into detox, but then not having the bed and treatment to follow that.