AHS disbands team that prepared front-line workers to help clients with addictions

Harm reduction advocates are angry and frustrated that Alberta Health Service has eliminated an Edmonton-based mental health and addictions prevention team.

With opioid overdoses reaching record highs in 2020, critics say the timing is terrible for disbanding the Addiction Prevention and Mental Health Promotion Team.

Retired counsellor Denise Salanski said she was "shell-shocked" when she heard the news.

"I was totally amazed," she said. "Why would they cut this?"

Salanski, who worked with the team until about six years ago, said it began its provincial prevention work in 2009 after the Alberta Alcohol and Drug Abuse Commission (AADAC) was absorbed by the newly formed Alberta Health Services (AHS) in 2009.

The team's employees trained other health-care workers, teachers and employees of non-profit organizations and social services agencies, and gave presentations to students and parents. Salanski said the team had 6.5 full-time staff, but AHS was unable to confirm that on Monday.

Among the 370 courses the team ran last year were workshops on harm reduction, suicide prevention, vaping, cannabis, alcohol and tobacco use, self-harm, depression, anxiety and other topics.

An internal AHS letter said the team's work ended on Oct. 20, 2020, and AHS was looking for other roles for the employees.

"We will certainly feel the loss of these services and the expertise provided," AHS director Liana Urichuk wrote in October.

Addiction and mental health services in the Edmonton zone recently "realigned services and redirected resources to ensure direct frontline mental-health care to children in the Edmonton area is maintained," AHS spokesperson James Wood said in an email.

All of the team members were moved to other jobs, he said.

Salanski said the demand for the free workshops was huge and the courses were tailored to each audience.

The courses prepared people in health and community service roles to recognize when addictions or mental health concerns were becoming problematic, and how to intervene, she said. They helped combat stigma about addictions, corrected misconceptions and were based on current research.

The courses also prepared people to support family members and clients who had completed addiction recovery programs and needed help adjusting to their changed lives, Salanski said.

Prevention not just a budget line, supporters say

She said a failure to recently evaluate the program left AHS without an understanding of its value, leaving it an easy target for a budget cut.

However, AHS was unable to say on Monday whether the change would save any money.

Wood said there are still prevention resources and online workshops available for community groups, parents and students.

He said the services the team offered remain "largely available" from other places, an assertion contested by critics of the move.

Public health prevention advocates say the effects of eliminating the team's workshops will be gradual, expensive and devastating.

Instead of being directed to counselling to help prevent serious problems, they say, more people in crisis will show up in emergency rooms and jails.

Though they often fly under the radar, public health prevention programs aren't just "nice to have" but essential, said Rebecca Haines-Saah, an assistant professor in community health sciences and prevention at the University of Calgary.

"It would just be a real mistake to end a program like this right now," said Haines-Saah.

She didn't work directly with the AHS team, but does similar community engagement sessions about youth drug use.

Research emphasizes the importance of public health messages being clear, consistent and based on good evidence, she said.

With a provincial government that emphasizes abstinence-based recovery over harm reduction approaches to addiction, Haines-Saah said she's concerned about what services might replace the team.

"If you can't educate the workforce, if you can't educate communities and front-line people about what best practices are, we're really just going backwards," she said.

Lorna Thomas, a co-founder of the advocacy group Moms Stop the Harm, is calling for AHS to reinstate the team.

Data released by the Alberta government last month showed drug poisoning deaths, including from alcohol, were at their highest rate in five years near the end of 2020.

After COVID-19 reached Alberta in March 2020, opioid overdose deaths began to spike. By the end of October, 2020 was already Alberta's deadliest year on record for opioid overdoses.

Thomas, whose 24-year-old son died by suicide while in the clutches of drug addiction, said now is the worst possible time to eliminate prevention programs.

She said the pandemic has left more people using drugs alone, which increases their chance of dying.

The advocates interviewed for this story knew of no other programs with a provincial reach that offer free community workshops on these subjects. Thomas said other free workshops are offered by groups like hers that are far too small scale to have broad reach. Many organizations won't be able to afford to pay for such training for their staff, she said.