Inuit treatment centre in Ottawa adapting, refocusing to stay afloat
Ottawa-based Mamisarvik treatment centre "too big to fail" say managers
OTTAWA — More than a year after Mamisarvik lost the bulk of its budget from federal cutbacks, the Inuit-specific treatment centre in Ottawa is still afloat and looking for new ways to expand services and diversify its clientele.
And those who run the 11-year-old centre credit staff teamwork, a dogged managerial commitment and Inuit values of innovation and creativity for doing what some thought was impossible.
“We were too big to fail,” said Nunatsiavut-born Jason LeBlanc, executive director of Tungasuvvingat Inuit, the Ottawa-based provincial service organization for Inuit that runs Mamisarvik.
“Too needed to fail,” added Pam Stellick, Mamisarvik treatment director, during an interview with Leblanc at the centre March 26.
“Yes,” LeBlanc agreed. “Too important to lose this service. If we were going to go down fighting, we’d have to fight for a way to make it happen.”
Mamisarvik, a 12-bed residential facility in southeast Ottawa, provides an eight-week residential addictions and trauma treatment program, day treatment and post-treatment counselling and care.
In 2013, the federal government discontinued a pot of money called the Aboriginal Healing Foundation fund which pulled about $900,000 in direct funding from Mamisarvik’s annual budget, LeBlanc said.
The demise of Aboriginal Healing Foundation money also meant that $500,000 Mamisarvik used to funnel through to the Pulaarvik Kablu Friendship Centre in Rankin Inlet was cut as well.
To deal with the budget shortfall, Mamisarvik was forced to cut extras and expenses. A four-day retreat to a farmhouse outside the city had to be eliminated, for example. And the centre can’t afford to bring in elder mentors anymore.
To better facilitate a steady stream of revenue, Mamisarvik switched from a fixed eight-week program to a continuous intake model, meaning if someone drops out of the program half-way through, staff can fill that bed with a new client.
It sounds simple, but it posed some challenges for staff who had to tailor counselling and therapy to meet the multiple needs of new clients at the same time they were treating those who had already spent weeks at the centre, LeBlanc said.
But it also allowed the “veterans” to help new people get settled by sharing their personal strategies to deal with detox, to face those early fears and to stick with the program.
“I’d say we’re still in a learning mode around that,” said Stellick. “But it seems to be working. And as Jason said, the clients don’t see it as much. It’s more of a struggle for staff.”
Right now, about 85 per cent of Mamisarvik’s budget comes from the Government of Nunavut, which pays $420 per day for each client they send from Nunavut for treatment. That comes to about $22,260 by the time they complete the program.
Those clients are first identified at the community level by nurses and counsellors, who then consult with GN health department staff and Mamisarvik staff to determine if candidates are appropriate and ready for the program.
The remaining 15 or so per cent of Mamisarvik’s clients are referred by Corrections Canada, a number that is growing.
Those clients are often inmates nearing the end of their incarceration and treatment is part of their release plan, said Stellick, who helped launch Mamisarvik in 2003, then left to work for the federal government, and again returned to the centre in July 2014.
As those corrections numbers creep up, the clientele mix changes, Stellick added. It means more male clients and different needs, she said. But they’ll adapt.
The biggest losers in this new fee-for-service scenario are Inuit from Ottawa, people who are sometimes in the greatest need of trauma and addictions counselling, Stellick and LeBlanc said.
Because they don’t live in Nunavut, the GN doesn’t pay for their care. And because their services are not covered under Ontario Health Insurance Program, the provincial health plan, Ontario won’t pay either.
Mamisarvik is currently exploring how it might be able to contract with OHIP, but in the meantime, it does accept a few urban clients at a time within the eight-week program.
It just means instead of 12 clients, they might have 14 or 15 in the room, Stellick said, and those clients go home at the end of the day so there’s no need for a bed.
Meanwhile, managers are looking at new and different ways to tailor services and reach out to other client groups.
In the past, the odd client has been referred from Nunavik or Nunatsiavut, but Mamisarvik managers are hoping to market themselves more to those jurisdictions in the future, LeBlanc said.
Mamisarvik is the only comprehensive Inuit-specific treatment centre in Canada, other than Kuujjuaq’s Isuarsivik treatment centre.
Mamisarvik is also hoping to expand into youth services, the two managers said, because of an obvious and growing need for mental health programs for Inuit youth. Currently, Mamisarvik only accepts clients 18 years old and older.
Mamisarvik has helped more than 600 residential clients in the past 11 years and thousands more in outreach and day programs.