The committee met at 7:05 p.m.

[J. Sims in the chair.]

J. Sims (Chair): Good evening, everyone. My name is Jinny Sims. I'm the MLA for Surrey-Panorama and the Chair of the Select Standing Committee on Children and Youth.

I really want to say how much I appreciate everybody's accommodation in agreeing to a Zoom meeting for all of us. As you might have heard, today is Eid, and I'm in my riding for Eid. This was very important for me.

I would like to acknowledge that I'm joining this evening's meeting from the traditional territories of the Coast Salish people, and I encourage each and every one of you to consider the Indigenous connections to the land where you are located.

We have a couple of agenda items this evening. Our first agenda item is the Detained report. We'll begin with updates from government bodies on the status of implementing recommendations from the representative's 2021 report called Detained: Rights of Children and Youth Under the Mental Health Act. Members will remember that we had a discussion last fall, quite a lengthy one, about following up on previous reports of the representative, and we agreed to follow up on this one.

Now I'd like to welcome the guests who will be speaking on this. From the Ministry of Mental Health and Addictions, we have Christine Massey, the deputy minister; Francesca Wheeler, assistant deputy minister; and Kristina Ponce, senior director.

From the Ministry of Children and Family Development, we have David Galbraith, deputy minister; Kelly Durand, assistant deputy minister; and Cassie McCaffrey, associate executive director.

From the Ministry of Health, Darryl Sturtevant, assistant deputy minister, and Roxanne Blemings; and from the Ministry of Attorney General, Paul Craven, assistant deputy minister.

Welcome, and we're looking forward to hearing from you. What I'm going to do now is turn it over to the presenters, who are taking the lead.

Consideration of Representative
for Children and Youth Reports

Detained: Rights of Children and
Youth under the Mental Health Act

C. Massey: Good evening, everyone. My name is Christine Massey, and I'll take the lead in the presentation. Paul Craven from Attorney General will also present, and all the folks on the screen here are available to answer questions.

Thank you, everyone, for having us here.

I will also take the opportunity to acknowledge that I'm gathering here this evening with you on the territory of the lək̓ʷəŋən-speaking people, today known as the Songhees and Esquimalt First Nations. I do want to thank all First Nations Indigenous communities, including Métis peoples, who provide us with their invaluable insights into Indigenous ways of knowing and understanding the world. We think every day about how their work informs the work we do, particularly for children and youth.

The table of contents that we've presented shows a little bit about what we hope to cover with you today, as we report on how we've been doing on the Detained report. Before we get deep into the presentation, I do want to acknowledge the recent update that that you received from the representative, just in the last couple of weeks, providing her most recent assessment of how we've done.

[7:10 p.m.]

Her assessment was based on evidence we all gave to the representative's office up to and including actions to September of 2023, almost a year ago. What we're going to present today will provide the most up-to-date information on our progress, including what has happened since we last reported.

her assessment was based on evidence we all gave to the representative's office up to and including actions to September 2023 — so just almost a year ago.

What we're going to present today will provide the most up-to-date information on our progress, including what has happened since we last reported to the representative. All of the data and actions that you see here today will be represented in our three-year progress report to the representative, which the AG, I acknowledge, has already submitted theirs. We're presenting you with as much update information as we can today. I'll also just touch on a couple of other points that were in the representative's letter.

First, she pointed to findings from the McCreary Centre Society's 2023 B.C. adolescent health survey. This is a critical survey that we were all eagerly awaiting and certainly informs all the work of ministries across government who serve children and youth as we review the results of this critical report to see how we need to adjust our survey. The representative highlighted just one of the many important findings from this survey. The representative, in her letter, also pointed to data on involuntary admissions. We've brought today some most up-to-date data on involuntary admissions, and I'll speak to that later in the presentation.

Moving to slide 4. Do we need to provide Kristina Ponce access to share?

K. Riarh (Committee Clerk): All participants should have access. There we go.

C. Massey: There we go, just as I said it. Excellent. Thank you, Kristina.

On slide 4, I think you can see from the gathering of government officials here that we really have a commitment to adopt a whole government approach to respond to all 14 recommendations in the Detained report. We have to recognize that there are critical intersections between the health systems, child and family services, mental health and substance use and the justice systems, and that children, youth and families may come into contact with all of these systems during a time of crisis. The representative also emphasized the need for meaningful engagement by all of us, particularly with Indigenous communities and youth with lived or living experience.

Ultimately, these reports challenge government to improve the coordination of our services, information sharing and service pathways. I'm hoping we'll be able to describe to you over the next few minutes how we think we've made progress towards those recommendations.

On slide 5, we're going to start with the specific recommendations that the representative made to change the processes for children and youth under the Mental Health Act. I'm going to hand it over now to Paul Craven from the Attorney General to talk about the changes that they've been leading.

P. Craven: Thanks, Christine, and thanks, committee. Pleased to be with you this evening, and also want to acknowledge coming to you from the traditional territories of the lək̓ʷəŋən-speaking peoples this evening.

Our focus and my focus and my remarks and update will be on recommendation 5 from the representative's report and from Detained. Just as a reminder, that was that the Attorney General, in partnership with the Ministries of Health, Mental Health and Addictions, ensure an independent body is notified every time a child or youth is detained under the Mental Health Act and that this body is mandated to provide rights advice and advocacy to children and youth.

In meeting this recommendation, the ministry has been involved in the development of what we term "the rights advice service," an independent rights advice service, which provides information and support to people who are experiencing involuntary treatment under B.C.'s Mental Health Act. The service is available to people of all ages who are involuntarily detained. That includes children and youth as well as youth under age 16 admitted on the request of a parent or a guardian. The person can choose to have a family member or other support person attend these meetings with them, or they can meet with a rights advisor on their own.

[7:15 p.m.]

The role of this rights advisor includes explaining the rights and options under the Mental Health Act, supporting the person to exercise these rights — for example, helping them apply for a review board hearing — and referring them to a lawyer or other legal help when that is requested. The service also is to develop

options under the Mental Health Act, supporting the person to exercise these rights — for example, helping them apply for a review board hearing — and referring them to a lawyer or other legal help when that is requested.

The service also is to develop resources and maintains a website with information on rights and options under the Mental Health Act. The web service was launched this past January and is available at IRASBC.CA, all in capitals. There's a library there of resources on the website that is planned to expand over time and will include rights information in multiple formats — print, video — and targeted to different audiences including, of course, children and youth.

The ministry also led in development of new brochures, one-page summaries and posters on rights and options under the Mental Health Act. These materials were developed with input from individuals who have lived experience in the involuntary mental health system. Some of those images of the brochures you'll find on that slide.

We're currently in an implementation phase with respect to the independent rights service. It's the first of a two-phase implementation. The first phase will focus primarily on virtual rights advice services, i.e., through video conference and phone, available on request of the patient.

When we move to phase 2, the rights advice service will be automatically notified, and meetings will be proactively set up at key points in the process following that initial admission under the Mental Health Act. The plan is that phase 2 will be introduced starting in 2026 or sometime later.

That brings us to slide 7. I can talk a little bit about the service and the rollout. As you can see on the slide, the service is provided through the Canadian Mental Health Association, B.C. division, and is delivered by several regional offices — Vernon, Prince George and Nanaimo — and non-profit community partners. They responded to an RFP process in partnership and were the winners of that process.

The service is designed to be independent of health authorities, mental health facilities and community mental health centres. Organizations such as Health Justice have been subcontracted to develop and deliver the training and curriculum for rights advisors and lead the development of the website content and other education and communication materials.

We started rolling out the rights advice service to select facilities in February, one of those in each of the health authorities. To date, there have been approximately 25 rights advice meetings. The service is now live at seven mental health facilities. That includes Nanaimo Regional General Hospital through Island Health, Peace Arch Hospital through Fraser Health, University Hospital of Northern B.C. through Northern Health, Vernon Jubilee Hospital through Interior Health, Lions Gate Hospital through Vancouver Coastal Health, Red Fish Healing Centre through the Provincial Health Services Authority and the regional treatment centre at the Pacific Institution through Corrections Canada.

The plan is, and I think if we move to the next slide, you'll start to see…. Oh, that's about engagement. I will get to that in a minute. Service will be rolled out to additional facilities in what we call "waves." At least ten of these facilities will start offering rights advice service in April and early May, so quite soon, including large hospitals such as St. Paul's, Royal Jubilee, here in Victoria, and Kelowna General Hospital. The goal is to have phase 1 complete and rolled out to all 75 facilities under the Mental Health Act by this fall, fall 2024.

Now to slide 8, which talks a little bit about some of the engagement that we did in order to get here. In 2021 and 2022, the ministry led engagements with a range of partners and stakeholders to get input on the service model for the rights advice service.

[7:20 p.m.]

That included legal advocacy groups, legal service providers, health authorities, of course, and operators of mental health facilities, mental health and advocacy organizations and Indigenous organizations. A key focus, too, here, a very important element of our outreach

for the rights advice service. That included legal advocacy groups, legal service providers, health authorities, of course, and operators of mental health facilities, mental health and advocacy organizations and Indigenous organizations.

A key focus here too, a very important element of our outreach, was a total of 27 people with lived experience in the involuntary mental health system; 19 individuals and eight family members participated in consultations through virtual focus groups, individual interviews and written submissions. That's outlined here in slide 8.

If we move to slide 9…. This just goes over the rollout and the waves that I talked about previously and the work that we're doing in terms of also hiring and training our rights advisors, and then the movement to roll out broader to the community. Finally, in February 2025, we'll move to the amendments officially being brought into force, new forms being brought into force, and updated standards finalized and published in that time frame — February to May in 2025.

That means additional rights advisors need to be hired and trained. We'll be expanding that service. The amendments that I talked about were passed in June 2022. Those need to be brought into force. That's what I was referring to previously. It sets out the patient's right to speak with a rights advisor in legislation. It sets out the duties of rights advisors and the responsibilities of directors of mental health facilities to facilitate that rights advice service. Again, we're focused on that in early 2025, including that updated guidance.

We'll move on to slide 10, just in terms of our governance and important milestones. Referenced on the screen is the governance committee, which is formed and provides leadership to ensure the service is meeting the needs of people across British Columbia. It includes people with lived experience — Métis Nation B.C., the B.C. First Nations Justice Council, First Nations Health Authority, Health Justice, Urban Native Youth Association and other community partners.

We have the continuing work of the Lived Experience Leadership committee through Health Justice, using the advantage of diverse individuals with lived and living experience in the mental health system. This group plays a key role in engaging on the development, particularly, of educational communications materials for the rights advice service.

There is also an interim complaints process in place where people who have received rights advice for their family members, or supporters who attend the meeting with them, can report any concerns about the service or the conduct of a rights advisor. We are also developing an evaluation plan and process under the development for the rights advice service.

The plan is intended to cover four broad perspectives: people who receive rights advice, health care providers and staff at the mental health facilities that we've talked about, the rights advisors themselves and service staff and, of course, downstream services such as the Mental Health Review Board and Legal Aid B.C.

That summarizes our response to that recommendation. It has been a lot of work to get here, but it is still early days in rollout. We are pleased with the progress, and I look forward to making further progress.

I've also been asked to speak a little bit on the next slide about the Mental Health Review Board processes — a different topic. Paul Singh, the chair of the Health Review Board, is not available to be here with you today, but he did ask me to relay some of the things that the Mental Health Review Board has been up to in response to these issues.

In May 2023, the board launched a new process for hearings for children and youth under 25 years following consultation with children and youth groups, their families, advocates, academics, government offices, Indigenous people and agencies and health authorities.

[7:25 p.m.]

As part of that new hearing process, the board employs a child and youth navigator who works to assess patient needs. The navigator is a point person for communication and coordination with children and youth hearings from the time that filing is made to the conclusion of the hearing.

hearing process. The board employs a child and youth navigator, who works to assess patient needs. The navigator is a point person for communication and coordination with children and youth hearings from the time that filing is made to the conclusion of the hearing.

The navigator's job and role is to have ongoing communication with the parties to ensure patient is provided inclusive trauma-informed, procedurally fair and timely access to justice. This includes patient access to timely disclosure, legal representation and general information about the hearing process. The navigator also assesses and incorporates any necessary accommodations for the patient, including a hearing option, whether it should be in person or video; a mode of patient evidence, written or oral; personal clothing, if that's something that they wish to have for the hearing; cultural protocols, including indigenous protocols; and community and health supports.

Just to give you an idea of the number of applications, there are about 350 applications from child and youth patients under 25 in the last fiscal year. Of those, one-third are sought and were provided accommodation from the navigator to a system with a hearing. So that is starting to illustrate that the navigator is providing a helpful role and a more trauma-informed process for child and youth patients, which was the focus of the initiative.

Those are my remarks. That concludes what I've been asked to do. I can now return it back to Deputy Minister Christine Massey.

C. Massey: I'm now going to turn to some work we're doing to support improved practice in how the Mental Health Act is applied, in particular, to respond to the representative's recommendations around the importance of ensuring that mental health and services are culturally safe and inclusive of Indigenous children, youth and families.

There are a number of important documents that we are building new guidance into that you'll see noted on this slide. The first one is the Guide to the Mental Health Act, a really critical reference document. It's intended for use by families, hospital staff, health care providers, police advocates and others. It's meant to be a plain language.

The other two documents noted on this slide: the Standards for Operators and Directors of Mental Health Facilities and the Child and Youth Substance Intoxication Withdrawal Guidelines, which is prepared by Child Health B.C. Those are both meant for clinicians, and those have already been updated. Right now, the Guide to the Mental Health Act is in the process of being updated.

In recommendation 4, the representative recommended that a child or youth be able to notify their community or nation of their involuntary admission. So where children and youth wish to share information with their Indigenous community, clinical guidance documents now explain how to support that information-sharing and explain how this can support treatment goals.

The representative recommends that children and youth receiving services under the Mental Health Act should also be offered services by navigators, liaison nurses or elders who can support them. There are now 32 Indigenous health liaison positions in the health authorities throughout the province. These Indigenous health liaisons can be part of that key support structure to help Indigenous children and youth receiving mental health services.

The Standards For Operators And Directors also speaks to improve cultural safety and inclusion supports and include in there the right to access Indigenous navigators, elders or others and how that can be facilitated. We are undertaking the same set of revisions as part of our process of updating that Guide to the Mental Health Act and particularly highlighting cultural safety, humility and trauma-informed care. Similar to the Standards For Operators, the Guide to the Mental Health Act will outline the right to access Indigenous-specific liaisons.

Other revisions to the Guide to the Mental Health Act that we are hoping to improve are more guidance on how to contact family members and, to the extent allowed under the laws that we have here and B.C. around mature minor consent, keeping family members informed on decisions involving their child.

[7:30 p.m.]

We have or will also be enhancing information on how to respect individual dignity and rights, how to provide health care in a way that's culturally safe and trauma informed, and this includes upholding the right to access Indigenous-specific

around mature minor consent, keeping family members informed on decisions involving their child.

We'll also be enhancing information on how to respect individual dignity and rights, how to provide health care in a way that's culturally safe and trauma-informed, and this includes upholding the right to access Indigenous-specific care. It also recognizes and discusses Indigenous people's inherent right to health care and how one can undertake that with a distinctions-based approach.

For the guide to the Mental Health Act, we're currently engaged on consultation with some of our key partners, and particularly with First Nations under the Declaration Act. After engagement is complete, we will support the rollout of the updated guide across the health care system so that the updates are well understood and can be put in practice.

Another source of guidance for clinicians is the withdrawal guidelines. These are for acute care settings. They were released September 2023. This document speaks to information-sharing with chosen people identified by the child or youth, which can include members of a child or youth's nation.

The document fills in the nuances of how consent works for youth. As you're probably aware, for youth over 12 years of age, care providers cannot share information without a youth's consent, as described under the Infants Act. And information on a youth's right to confidentiality must also be shared with that youth by their care providers.

To improve the sharing of information and to provide clarity to children, youth and their families, the Ministry of Health has created new Mental Health Act forms which advise children and youth of their rights. They can also be provided with videos or pamphlets, and they're provided information about the service that Paul just described.

And the guide to the Mental Health Act…. We're building a new chapters, specifically for children and youth.

All of this work is also reflected in the standards for operators. All of these changes are meant to collectively provide a more transparent child- and youth-centric approach to treatment during a crisis that requires Mental Health Act services.

Moving to slide 13, I'll talk about the use of isolation restraint and recommendation 11 from the Detained report, which recommended that these only be used as a last resort when all other interventions have been exhausted.

As we know, in an emergency where a person's life is at risk or there may be serious harm to that person's health, and that person may be incapable of consenting to treatment, emergency treatment may include the restraint of a person. That restraint can be physical or pharmaceutical.

Child Health B.C., which is a provincewide organization, in 2022 updated the provincial least restraint guideline specific to children and youth who were exhibiting unsafe behaviours because of a psychiatric or behavioural crisis. We are going to reflect these changes as we update the guide to the Mental Health Act.

There's now a webinar series that's been implemented and is available for a detailed description of the new guidelines. It's directed to physicians and emergency department staff and other staff serving in-patient children and youth. It also supports children and youth with developmental disabilities when they show up in emergency rooms.

So the goal here is to ensure that health care providers understand that seclusion and physical restraint are short-term emergency measures only, and they are a last resort, when all other efforts have failed.

I'm next going to turn to the data on slide 12. This is the most recent data we have on admittance of children and youth for involuntary care under the Mental Health Act. The representative, in her report, recommended collecting and reporting key information. That is standardized across the province and reported regularly.

So I will confirm that data is collected in a standardized approach that supports evaluation and trend analysis — for example, the data you see here — but of course, we know that we need to do more work on collecting more data to better understand the care that's being provided.

The data that I have for you here shows that involuntary admissions are showing a slight decrease across the age span, particularly in younger age brackets. Now, we have to do further analysis to see whether this is a real trend and what its cause might be.

[7:35 p.m.]

We need to see this data over more cycles in the future. In terms of our working hypothesis as to why, it may reflect new investments in voluntary systems or also be due to increased oversight of the completion and adherence to forms

over more cycles in the future.

In terms of our working hypothesis as to why, it may reflect new investments in voluntary systems or also be due to increased oversight of the completion and adherence to forms and procedures under the Mental Health Act. This is a direct response to the Ombudsman's report in their 2019 report.

On slide 15, you'll see a reference to the quarterly audits that the Ministry of Health collects. That's another source of data on how we are doing and performance under the Mental Health Act.

Another data process I do want to flag is the data that we're collecting on patient experience. There's an organization known as the Patient-Centred Measurement, and it's got a dedicated office, and they develop surveys specifically to get qualitative and quantitative information from patients about how they feel about the care they've received. So now surveys, specific to youth, have been developed as part of this suite of measurements and surveys. There are surveys developed for youth inpatient units, as well as opioid agonist therapy and early psychosis intervention. Those surveys will be able to roll out in the near future and that will be added to our cohort of data that we have available to us to inform the services and where we need to improve.

I also want to flag that this office of Patient-Centred Measurement just recently had an Indigenous advisory committee established, which is specifically mandated to assist this office in how to decolonize the current measurement processes in how patient experience is measured. This is an integral part of embedding anti-racist and anti-Indigenous racism in the health care system so we can better understand what's happening and how to measure the experiences of Indigenous patients. All of this work is designed to promote clinical practices that are consistent with what the Mental Health Act requires and the guidelines.

Moving on to the next and the last part of my presentation today on the voluntary system of care. The Representative was clear in her report that we need to identify immediate opportunities to improve voluntary services or improve practices that reduce involuntary admissions. We have in Budgets 2021 and 2023, in particular, been able, through those investments, to grow the number of beds, services and other supports for children and youth who are struggling with substance use or concurrent mental health and substance use disorders.

We're continuing to find ways to decrease wait times and remove other barriers that prevent young people from accessing care. We've looked to implement new voluntary services across the province that focus on prevention and early intervention. Our focus is on that area because we know that most mental health challenges have their onset during childhood or adolescence, and intervening early, before a child or youth's mental health is deteriorated to the point where they might meet the criteria for involuntary treatment, is clearly far preferable to having problems develop into more severe or lifelong conditions.

The actions that I'm going to describe reflect the feedback that we receive from engagements that we've been doing since 2020. We started around engagements with Bill 22, the former Youth Stabilization Care Act, where we sought to amend the Mental Health Act to allow for the use of involuntary detainment for youth.

That work is in advance as we continue to work on voluntary services. In developing the services we work and that engagement for that bill, we heard very specific suggestions from Indigenous partners, the Representative, the Ombudsperson and a number of advocacy groups around exactly what types of services they were looking for.

On slide 18, it describes some of those services that we've been building up. These initiatives are meant to provide support from birth to young adulthood. We're trying to invest across the entire continuum of age, as well as from prevention into treatment and recovery. Some of the highlights here are mental health in school strategy.

[7:40 p.m.]

There's been $15 million allocated for programs that embed positive mental health and wellness programs in all school districts. Also for early childhood services, we've invested over $30 million. This is around supports for the development in the first six years of life, and it includes training for parents and foster care

allocated for programs that embed positive mental health and wellness programs in all school districts. Also for early childhood services, we've invested over $30 million. This is around supports for the development in the first six years of life, and it includes training for parents and foster care givers.

I'm going to speak, on the next slide, to some of the work we're doing on integrated child and youth teams and the Foundry. Before I do that, I just want to note that MCFD has also invested over $22 million in step-up and step-down services. That's both outreach and bed-based services for youth. We've also allocated $75 million to the health authorities to increase services in early psychosis intervention. Finally, we've been able to see 19 new youth concurrent-disorder clinicians hired across the health authorities for those youth who have concurrent disorders, and that is a critical specialty we're trying to build up support in.

The additional actions you see on these slides refer to the withdrawal guidelines I referred to earlier. This is specifically for emergency settings and acute care and about how to make sure, when youth are discharged from emergency care, that they get to community-based services that ensure that they don't come back to emergency care and that they're getting the service they need in the community.

We're also working with the Provincial Health Services Authority to create a new provincial child and youth substance use and wellness framework that will guide future investments. And we're hopeful that that framework will be released this year. This is work we're undertaking with MCFD, Education and Child Care, as well as Health and a number of other partners. We're also including youth with lived and living experience in this work. And we have a number of advisory tables, including clinicians, the McCreary Society, which I mentioned at the top of the presentation, as well as parents and families. We are quite confident that will be a robust framework when it's ready for release.

On slide 9, I'll just take a moment to highlight two key initiatives. Integrated child and youth teams. We've invested just over $54 million in these teams. These are community-based, organized by school district. They're multidisciplinary teams that are designed to deliver mental health and substance use services for children and youth up to age 19. They have members that come from a number of different areas — from Children and Family, from health authorities and school districts — so that all folks who have eyes on kids can bring the wraparound services to those children and intervene early and also so that there's no wrong door for children and youth. There are currently 12 communities with integrated child and youth teams. An additional eight communities are going to be announced later this month.

Children and youth can self-refer to their services or be referred through their school counsellors, through MCFD's child and youth mental health teams, through their primary care physician, or even through a community-based service provider. And we're already hearing how these teams are making a difference for kids in communities and also outside school districts. That was the case, for instance, recently in the northwest, when a new school-based counsellor hired through this process became an integral part of a community response to a tragic set of suicides last year, and there was an all-community response.

J. Sims (Chair): Christine, we are running very short on time. I know we started a little bit late, so I've given you quite a bit of leeway, but if we could get through this, because I want members to have time to ask you questions as well.

C. Massey: Okay, so I will leave the Foundry data for you here. Just note that we've invested $150 million in Foundry, and we have quite a bit of data available on Foundry if you are interested in any more information that's not on this slide.

Slide 18 is a visual to demonstrate the collection of services we are putting in place.

Moving along to the next slide, which is around our commitment to engage with Indigenous partners and youth with lived and living experience.

[7:45 p.m.]

I just want to emphasize that this is a strong commitment around all the partners here, and we have strong progress to report back to the Representative for Children and Youth in this respect.

We're moving to next steps. So on slide 20

around all the partners here. We have strong progress to report back to the Representative for Children and Youth in this respect.

We're moving to next steps. On slide 20, the last slide, we have a number of slides here that we continue to work on and will happily answer any questions on those. I'll just conclude by saying, again, a cross-government approach…. Perhaps you could just leave the summary up. We have a number of actions underway. We still have more work to do to finish our work on the representative's recommendations, and we'll finish our final report to her on year three and complete our report to her later this spring.

I'll conclude my remarks there. Thank you, Chair, for your indulgence.

J. Sims (Chair): Thank you, Christine, Paul, and your whole teams for making a very comprehensive report out. As I was listening through, I know that putting together the report takes time, but also the significant amount of work you've done so far also shows in the presentation you made.

Now we're going to turn to members who have questions. Karan, are you going to keep a speakers list? Then we'll go from there. I will look out, too, to see if I have hands going up.

K. Riarh (Committee Clerk): I can add it to the chat, if you like.

D. Routley: Thank you for that comprehensive report. Congratulations on the work you've done. The family members who have been affected…. The change in advocacy for youth who are apprehended under the act is really, really a great step forward. I love seeing the Foundry numbers. It's very promising.

I'm interested to know how, when you spoke — I think it was David who spoke — about the persons with lived experience being at various stages of this process, review and oversight, how exactly you reach out to people and recruit them into those roles? Has there been a good uptake there?

J. Sims (Chair): I'm going to suggest we take two questions from the next speaker as well, and then we'll get to a response, just to speed things up a little bit.

B. D’Eith: We were very fortunate to have a couple of pilot projects in my riding in Maple Ridge. I know ICY, for example. It'd be great if you could maybe comment a little bit about the progress of expanding out ICY teams across the province.

We are also piloting the youth emergency shelter. Which…. I'm just wondering if that was included in your slide in terms of beds, or whether that's a separate issue entirely that is a discussion for another day. But we're piloting that right now, and we did have the minister out to tour. It seems to be going very well. But I'm just wondering if you could comment on those two programs. Thank you.

C. Massey: Yes, in terms of the first question with respect to people with lived experience, was that directed to Paul with respect to the rights advice, just to clarify?

Yes, okay. Over to you, Paul. Then I will ask Francesca to speak to progress on the ICY teams and how that's implemented and turn it over to David or one of his team members on the pilot in Maple Ridge.

P. Craven: Yeah, I can't speak, unfortunately, to the specifics of how individuals were recruited. But I do know that Health Justice was a critical help in identifying those individuals through some of the committees that I mentioned during the presentation. But that's been, certainly, a source, and from the beginning, a real focus of the initiative to hear from individuals who have that lived experience.

[7:50 p.m.]

That's a focus throughout all of this work — something that we're trying to emphasize and trying to get as many avenues to getting that feedback as we can and should be able to enhance that through the rights advice service itself. Because we'll have a much better sense of data and through evaluation of individuals who are using the service and may be willing to

to get as many avenues to getting that feedback as we can and should be able to enhance that through the rights advice service itself, because we'll have a much better sense on data and through evaluation of individuals who are using the service and may be willing to speak to their experience.

D. Routley: Thank you.

F. Wheler: I'll just jump in on the integrated child and youth teams. As Christine mentioned, we have 12 communities identified. The original five were selected back in 2019. Then we announced seven more in February of 2023. We're set to announce the next eight.

The original five, or the phase 1 communities, are almost fully implemented. They continue to hire a few critical positions, but they are delivering services. We are collecting data on those services that are running and in operation. The next seven communities are, I would say, approximately 50 percent in operation, so still recruiting. But the community convening — getting the community services lined up and everybody working together — is going very well. Then the next eight…. We feel that we build momentum every phase that we move into. We have lots of lessons learned from the original five and from that next seven. We're hoping the implementation timeframe keeps shortening.

I'll just add that we're having a bit of a gathering this month for all communities that have an ICY team. It's really about sharing stories and learning from each other. We're looking forward to that.

J. Sims (Chair): Well, seeing no other hands up, I want to thank each and every one of you for your very thorough presentations and for the additional work you did and took out of your busy schedules to come and give us updates on the work that you have been doing. I can tell you that all the members who are on this committee really appreciate the work you do to assist our most vulnerable.

We're going to say thank you and goodbye to you. Then I'm going to have Karan bring in the second delegation, so to speak — set of speakers. Then I will start the second part of the meeting at that time.

K. Riarh (Committee Clerk): Hi, Alan, Samantha, Pippa.

J. Sims (Chair): Okay, we've got on the agenda now a consideration of a new report from the Office of the Representative for Children and Youth titled Missed Opportunities: a review of the use of youth justice resources. Joining us this evening are Alan Markwart, executive lead, legislation and special initiatives; Samantha Cocker, deputy representative; and Pippa Rowcliffe, deputy representative. I'm going to hand over the presentation to our guests for them to speak to the report.

A. Markwart: Yes, we can.

J. Sims (Chair): Okay, who would like to start?

A. Markwart: All right.

J. Sims (Chair): That's great. Thank you, Alan, you can start.

[7:55 p.m.]

A. Markwart: I will start. I'm leading on this. Good evening. Dr. Charlesworth's not available tonight. She's taking a well-deserved, albeit short, break

A. Markwart: Good evening. Okay. Dr. Charlesworth's not available tonight. She's taking a well-deserved, albeit short, break to…. I am…. Can you hear me?

K. Riarh (Committee Clerk): Yeah. Alan, do you have another window open with the live audio?

A. Markwart: I can hear you.

K. Riarh (Committee Clerk): Chair, could I suggest a short recess?

J. Sims (Chair): We will have to take a three-minute recess.

The committee recessed from 7:55 p.m. to 7:57 p.m.

J. Sims (Chair): Yeah. I'm calling the meeting back to order, and we are going to go over to Alan so he can make the opening comments on the report.

A. Markwart: Okay. Good evening. Dr. Charlesworth isn't available tonight. She's taking a well-deserved, albeit short, break to celebrate her daughter's 30th birthday in Chicago. Her daughter is a professor there at the University of Chicago.

Instead, you get me. Perhaps the saving grace is that I was the actual author of the report that we're discussing tonight, which is called Missed Opportunities: A review of youth justice resources. This is my particular area of expertise and experience. I spent 40 years working in the youth justice system at all levels, including as an ADM in MCFD for many years, where I was responsible for youth justice services, along with several other program areas.

I've led national research projects in youth justice, led a national review of federal legislation, been an adjunct professor at Simon Fraser University School of Criminology for many years and authored many academic journal articles and chapters of books about youth justice. So this is my thing.

As the title obviously indicates, this report is about youth justice services administered by MCFD, but what it's really about is the poor management of underutilized and surplus fiscal, human and facility resources that for many years could have been and should have been reallocated to areas of greater need.

As you're well aware, and as the representative's many previous reports have detailed, there are service areas in MCFD, whether that's child welfare, children and youth with special needs or child and youth mental health, that have been and still are wanting, and sometimes dearly wanting, for more resources.

[8:00 p.m.]

There are wait-lists, for example, in child and youth mental health services and sometimes services where there's nothing to wait for, such as services for children with FASD. Yet, with one very recent

more resources.

There are wait-lists, for example, in child and youth mental health services and sometimes services where there's nothing to wait for, such as services for children with FASD.

Yet, with one very recent exception, the ministry sat by for many years while youth justice services experienced a huge drop in demand for services, resulting in a gross underutilization of resources and a consequent surplus of unused resources. Hence, we have the title "Missed Opportunities." Opportunities have been missed for many years to redeploy resources to other areas of greater need. Those opportunities are still available; they're still there. And that's what this report recommends: to take the initiative now and to capitalize on those opportunities going forward.

I mentioned that the ministry had been idle on this file until very recently. Last November, the ministry announced the closure of the Prince George Youth Custody Centre by the end of this last fiscal year, actually, just a couple of weeks ago. That centre was vastly underutilized, and it's now closed. It's notable that that closure announcement by the ministry, which in our view wasn't handled very well, only happened after our office shared a draft of this report with the ministry for administrative fairness review. Obviously, the draft report prompted action by the ministry.

The decision to close the Prince George facility is perhaps a measure of how RCY reports can sometimes influence government decision-making. And you heard other examples just earlier in the previous hour. Yet, there's much more work for the ministry to do before it can rest on its laurels. And let's hope that this report continues to inspire some further action.

The report is also a good news report and a bad news report. The good news is that there's been a dramatic increase in the demand for youth justice services of all types, including, in particular, custody services, which are very expensive resources. Over the past decade and even longer, this decrease in demand for services has been driven by very significant reductions in the youth crime rate, including violent youth crime, which, as we shall see, is not just a B.C. phenomenon. It's actually an international phenomenon.

The bad news, of course, is how these very welcome decreases in youth crime, and in the consequent demand for youth justice resources, has led to that surplus of resources that have been ignored and therefore wasted for many years.

First, let's turn to the good news. As you know and as you hear almost every day, there's been a great deal of quite understandable public concern in recent years about street crime, random violence and social disorder, which continues to this day. What's been missing in this narrative is the much better news that youth crime rates, including violent youth crime, has been declining dramatically for at least 20 years.

I didn't bring PowerPoints. I assumed that you would have the report and you could turn to some pages. If you look at the two graphs on page 14 of the report, they show that the total crime severity — and this is youth crime in B.C. in 2022 — was about half of what it was ten years ago, and about a quarter of what it was 20 years ago.

If you look at the bottom of that page, and you're looking at the violent youth crime severity rate, there's a similar trend of decline, albeit a more modest decline in the youth violence crime severity rate.

To explain what a crime severity rate is, it's a way of measuring the seriousness of crime.

[8:05 p.m.]

If you count simple numbers, for example, one shoplifting is the same as one homicide, if you count just numbers, but obviously, they're hugely different. A crime severity rate attributes a value or seriousness to more serious crimes, so a breaking and entering has a higher value than a shoplifting. A homicide has a much higher value than a common assault.

homicide if you count just numbers, but obviously, they're hugely different. A crime severity rate attributes a value or seriousness to more serious crimes. A breaking and entering has a higher value than a shoplifting. A homicide has a much higher value than a common assault. That's how you calculate it.

It doesn't matter which way you look at the numbers. Whether it's simple numbers or crime severity rates, the trends are all the same. There are very significant drops over the last decade and more. The interesting thing is that these very significant drops in youth crime rates aren't just in B.C. It's across the country. It is international, and the report goes into this. It applies across Western countries, particularly in the last decade. By Western countries, I'm including the rest of Canada, the U.S., the United Kingdom, Australia, New Zealand, and several European countries — Spain, Denmark, Netherlands, Sweden, Finland, Germany. You name it.

What we have with…. This very welcome news of very dramatic decreases in youth crime rates has led to equally dramatic declines in the demand for youth justice services such as probation and custody services. I would add that the same thing has happened in other provinces in Canada, as well as in other countries such as the U.S. and, again, the U.K., Australia, New Zealand.

If you look, for example, at page 9 of the report, you see a graph that shows that the number of youths under community youth justice supervision by MCFD youth probation officers has dropped dramatically. The average provincial caseload in 2022-'23 was less than half of what it was ten years ago.

Even more dramatically, if you look at page 10, at the graph there, it shows that the number of youths in custody in 2022-'23 dropped to an all-time low of only 15 youths in custody in the entire province, which is less than one fifth of what it was ten years ago and less than a tenth of what it was 20 years ago. Contrary to what some might believe, that fewer youths in custody will lead to more youth crime…. That hasn't been the case. In fact, youth crime rates have been going down at the same time as the number of youths in custody has been going down.

Finally, if you look at page 11 of the report, the graph there shows something that we should really celebrate. There was an average of only eight Indigenous youths in custody in the province in 2022-'23. That number is less than a quarter of what it was ten years ago, and it's less than one tenth of what it was 20 years ago. That's just a huge change and a very welcome change.

I don't think anyone would argue that such substantial decreases in the number of youths becoming involved in the youth justice system is anything but a good thing. That's the good news. Now for the not-so-good news.

The result of those dramatic changes is that we have had for several years and continue to have an excess of resources. What the news release says is a squandering of resources being directed to one area — youth justice — that no longer needs them. Given the demand and scarcity of resources for children and youths in other service areas — such as children and youths with special needs or with mental health issues — that's obviously something that has to change.

As an illustration of this, in 2022-'23, the two youth custody centres in Burnaby and Prince George were staffed to accommodate 108 youths on any given day. Yet there were only 15 youths on average in custody.

[8:10 p.m.]

That's an occupancy rate of only 14 percent, or 86 percent unoccupied — but nonetheless, staffed. In Prince George, the situation was worse. There was an average of only a little bit more than two youths in custody

That's an occupancy rate of only 14 percent — or 86 percent unoccupied — but nonetheless, staffed. In Prince George, the situation was worse. There was an average of only a little bit more than two youths in custody, yet it was staffed to accommodate 24 youths, less than 10 percent occupancy. That underutilization was not related to the pandemic. There have been consistently very low rates of occupancy for several years in youth custody centres, including before the pandemic.

That excess of resources, if you look at page 19 of the report, is best illustrated by the chart on that page, which shows that there were 156 staff and teacher FTEs used for only an average of 15 youth in custody in 2022-23. That's more than a 10-to-1 ratio. In fact, there were more than twice as many managers and supervisors in youth custody services as there were youth.

Those figures I just gave you about staffing don't even include all staff. They don't include contractors such as for food services, building maintenance, contracted addictions counsellors or part-time doctors and psychiatrists, nor does it include executive management and corporate support services staffing.

What all this overstaffing translated into was an annual cost of $2.5 million a year, or nearly $7,000 a day, to keep a single youth in custody in Prince George. The Burnaby Youth Custody Centre was more efficient — I use that word advisedly — at $1.2 million per year per youth, or more than $3,000 per day per youth. As I mentioned before, following the sharing of the draft report with the ministry, the ministry abruptly announced the closure of the Prince George Youth Custody Centre.

It's important to highlight that even with that closure and with the centralization of all youth custody services to the one remaining facility in Burnaby, and even with a modest increase in numbers that we've seen this year, the Burnaby facility will still only be operating at about 25 percent occupancy, of staffed capacity — or, put another way, 75 percent unused staff capacity.

The closure of Prince George is only a beginning step, and the ministry has a lot more work to do. This gross underutilization of resources goes beyond just youth custody services and applies to other types of youth justice services.

For example, we found, there is a youth forensic psychiatric services in-patient assessment unit in Burnaby. That's a small, specialized assessment unit with a budget of $2.4 million a year. In 2022-23, there was only one youth in residence for one-third of the days of the year. For another one-third of the days of the year, there were no youths in residence. Otherwise put, for two-thirds of the year, there were either zero youths or only one youth in residence, at an operating cost of $2.5 million.

As well, if you look on the community side, there were 25 youth probation officers in the province with caseloads of ten or less. Now, a caseload of 20 is good — a small caseload can certainly lead to good case management, and we do see that — but extraordinarily low caseloads that are ten or less are just simply beyond the pale and are simply not a good use of talented human resources.

[8:15 p.m.]

I've been a probation officer; I've supervised probation officers. I don't know what I would do if I had a caseload of less than ten. Another example: there are contracted residential programs through agencies. In 2023 and 2022-23, they

been a probation officer. I've supervised probation officers. I don't know what I would do if I had a caseload of less than ten.

Another example is that there are contracted residential programs through agencies. In 2023 and 2022-23, they were operating at only slightly more than one-third of capacity at an average cost of more than $1,700 per day, per youth. So obviously, something needs to be done and actually should have been done a long time ago.

The closure of the Prince George facilities is just a beginning step. Much more needs to be done. I can't emphasize enough that the representative is not suggesting budget cuts — that would be the last thing representative would be doing — but rather a redeployment of services so they're used more effectively and efficiently for services to children, youth, and families where there's a clear need and a clear demand for services.

We expect, in a redeployment of services, that every penny saved would be reinvested in other needed services, wherever and whatever that may be. There's no shortage of possibilities. There's a number of options. Of course, not all can be satisfied.

It's not for the representative to be making specific recommendations about exactly what youth justice services should be redeployed to what and to where. Hence we recommend — and the recommendation is at page 28 — that the ministry engage in a comprehensive review of the full gamut of youth justice services in consultation with key partners, including the First Nations Justice Council and the Métis Nation B.C. Justice Council. And develop and implement a plan for redeployment of services, setting out expected timelines for engagement and consultation, planning, and then the beginning of implementation over the course of the next year.

I would like to highlight two parameters to that recommendation. First, as I said before, there should be a reallocation of all savings to new services, not a cut in resources. Second, that reallocation of resources should go to new services that are delivered by or in partnership with Indigenous peoples in the same proportion as the representation of Indigenous youth in the youth justice system.

To explain that, like in the child protection system, Indigenous youth are vastly overrepresented in the youth justice system. For example, in looking at the redeployment of resources…. Let's look at Prince George. Although the number of youth there was very small, in fact, 82 percent of the youth in Prince George were Indigenous. Therefore, in our view, 82 percent of the savings should be redeployed to services to Indigenous young people in the same proportion as their representation at that centre.

Those are my comments. I think I took less than 25 minutes. I welcome your questions.

J. Sims (Chair): Thank you, Alan, for keeping your points, as you said, within the time allotted. I do have a number of hands up, and this is an opportunity for all members to ask questions. So I am going to turn to MLA Letnick first.

N. Letnick: Thank you, Alan, to you and the team for the report.

As you were doing the research for the report, did you get any idea, any indication, as to why this is what's happening and the reallocation wasn't being done earlier?

A. Markwart: Quite frankly, it's a mystery to me.

I know that these declines have been observed over the years. It's not like they're unknown.

[8:20 p.m.]

There are other actors out there who have brought the issues to the ministry's attention and, in fact, lobbied for changes. But for reasons that are just a mystery to me, there hasn't been appreciable action taken. Even those actions,

brought the issues to the ministry's attention and, in fact, lobbied for changes, but for reasons that are just, you know, again, a mystery to me, there hasn't been appreciable action taken. And even those actions could have been modest and graduated.

For example, in Prince George. The very small numbers there have been known for many years, but the ministry maintained staffing levels at that facility despite it. What they could have done very easily was impose the staffing freeze, you know, let it downsize it by way of attrition gradually, and then perhaps leading to the final decision to close. That would have been a far better way of approaching it, a far better way of dealing with staff as well than, you know, a kind of peremptory decision to all of a sudden close it and then all 50 staff or more were served notice.

J. Sims (Chair): Thank you, Alan. I'm going to ask for the questions to be brief and the answers to be brief as well, please, if we can.

MLA D'Eith.

B. D’Eith: Yeah, just a couple of quick questions. Thanks for all your work on this, Alan, and your passion for this issue.

Just a couple of questions. In regards to reallocation of resources, one of the issues that comes to mind is, you know, the specialized nature of the workforce involved. You're talking more financial, because one would think that with the challenges to get people trained and into specialized positions to work with children and to work with Indigenous children, particularly, that you couldn't just, you know, do straight, transferable FTEs over. If you could ask that.

And then just in regards to the Prince George Youth Custody Centre, are you speculating that it was because of the report, or do you actually know that it was because of the report? Because it seemed to me that they may have been planning it anyway. I wouldn't want to put words into the ministry's mouth, so to speak, in terms of their plans. I mean, they may have been planning this for some time. So if you wouldn't mind commenting on that. Thank you.

A. Markwart: Well, what I can say about Prince George was it was awfully coincidental –– without going into particulars, because, you know, I had conversations that were in confidence, which lead me to believe that it was prompted by the report, although I can't say absolutely for sure.

Your question about the redeployment of resources is a good one. It's a mix. I mean, obviously there can be a redeployment of financial resources. The question is human resources. So in some cases –– for example, the staffing in Prince George –– not all could be redeployed to, you know, other Indigenous child and family services. They may not have the suitable qualifications to do so. But in other cases, resources, the same staffing could be used. Youth forensic psychiatric services is a good example of that. It's a specialized psychiatric service. They can serve, in effect, any population. They could, for example, expand their range of clientele to include youth who are not involved in the youth justice system –– say, particularly, kids in care –– or they could expand their services to include young adults who are involved in the adult criminal justice system and who are transitioning through. So it could go both ways.

J. Sims (Chair): Thank you very much, Alan. I can hear your passion for this work.

I see no other hands up. I want to thank all three of you for taking the time to come and meet with the committee and for elucidating the new report that is before us. So thank you very, very much.

[8:25 p.m.]

And now the committee is going to be moving on to deliberations on the Missed Opportunities report. As you know, we did agree to a process that after each report we would have a discussion to see whether we wanted, in writing or by appearing before the committee, representation from the ministry to get an update. And as I'm going through this

we did agree to a process that after each report, we would have a discussion to see whether we wanted in writing or by appearing before the committee representation from the ministry to get an update.

As I'm going through this, I'm thinking we have just received the report today, and the report would have gone to the ministry. So I feel this is a bit premature for us to be having this discussion at this time with the ministry because the ink isn't dry on the report and they're going to be reading it and going through it. My suggestion is that we have that discussion at a future time.

If everyone is okay with that, seeing no hands up, I want to thank each and every one of you for helping to facilitate this meeting and making it online so that all of us could participate. Have a wonderful evening.

I call for a motion to adjourn. I see that MLA D'Eith was really anxious. So was MLA Kirkpatrick. I know you all have another meeting to go to as well.

The committee adjourned at 8:26 p.m.