Starting a pilot project that offers residential earth healing to adults over 30 amid a pandemic has not been without challenges, as the need for Gwekwaadziwin Miikan (Gwek) programs may have increased during this period. For the second time since the pilot project began last spring, Gwek has received funding for five additional beds, and a new evaluation report provides initial data that indicates the success of their treatment model.
Gwek has been operating since June 2018 with annualized funding for ages 19 to 30, COO Matt Maracle said. In March 2021, they received the green light to expand the pilot to people 30 and older, bringing the number of beds to 15. They have now received funding for five additional beds for their third cohort, which begins in January. .
Funding comes from their current funder, the Ministry of Children, Community and Social Services, and allows for an increase in staff. “I think people underestimate the logistics of providing everything you might need shelter and food and everything for 20 people,” Mr Maracle noted. “It really is a 24/7 operation, just in terms of laundry, cooking and maintaining equipment, preparing equipment, and then also managing the therapeutic environment. We are very fortunate to have this funding and it will meet some of this need across the province and locally because we have this provincial framework and this provincial watershed. But again, we’re looking at 20 beds that we can accommodate, but there are 120 people waiting to get into the program.
“At any given time, our waiting list for the 10 to 15 beds is between 100 and 150, if not a bit more,” Maracle said. “The demand is clearly there and the need is there and we didn’t have enough beds to operate. There just aren’t many referral options amid the pandemic. Many agencies are operating at reduced capacity. As part of our pilot expansion, we have secured an expansion of our expansion, so we will be operating 20 beds in January for our winter cohort.
This represents 10 beds for the 19-30 year old cohort and 10 for the 30+ year old cohort. Each cohort of 19 to 30 year olds typically has 10 people; two cohorts in 2021 also included five individuals over the age of 30. The winter cohort starting in January will see the participation of 10 people from each age group.
Gwek is currently advocating for another year of funding that would provide three and a half cohorts for another year of operation. “Ideally, we would like to see this annualized,” Mr. Maracle said. “We are very confident in the model and the framework. What we’re doing is trying to replicate what we’re already doing, creating more space and more beds, and ultimately increasing Manitoulin’s ability to deliver those kinds of programs to our people.
It is difficult to measure the success of a program like this, he explained. “It’s always hard to put numbers on these things, especially when we’re exploring concepts of cultural revitalization, identity and spirit. These are not exactly the most tangible or measurable things.
Gwek hired consultant Dr. Laura Mills to lead an outcome measurement project. She has just completed a first assessment report for Fall 2021, outlining people who attended Gwekwaadziwin Miikan from February to September 2021. The report includes information on cultural identity, spiritual health, mental well-being and participants’ social behavior before, during and after the program.
Participants self-rated their physical, emotional, and mental well-being before, during, and after the program, with results suggesting participants felt healthier during and after the program than before. For example, anxiety ratings increased from admission to 180 days after admission. Interestingly, the depression increased around the 45 day mark, about halfway through the program, before receding.
“That often happens when people start treatment and that increased experience in any type of mental health is often either people getting really honest with how they feel or they start to deal with things. deep things,” Dr. Mills explained. “It’s not a sign that the treatment program isn’t working. It’s probably really working.
That makes sense, Mr. Maracle agreed. When the staff reflected on the report and saw that the depression peaked after 45 days, they realized that was the midpoint of their group facilitation model. “That’s really when for most of them, it’s probably the longest period of sobriety they’ve had in recent times, so they feel those emotions for the first time and they confront head-on. This is the summit.
The report also shows changes where individuals feel a natural anxiety upon entering the program, he continued. “As they acclimate to a new environment and face things head on, around that 45 day mark you see the anxiety start to change as they become more comfortable and familiar with their environment and start to feel safe. They know their supports and know that this is not going to last forever. We also see the changes in where the anxieties come from, as they start to think about going back to the community and the following.
Substance use was very high in this sample, Dr. Mills noted, but after the program it was significantly reduced, particularly in the number of days used. The reduction in frequency of use is quite striking, she said. “For example, among people who responded to the survey, the average number of drinking days was 12 days (for the three-month period) after the program. It is three or four days per month whereas it was 58 days on average in the last three months before the treatment. This kind of reduction is quite striking.
For Dr. Mills, an even more profound result was the reduction in suicidal tendency. Suicidal tendencies were prevalent among participants prior to entering the program. Three-quarters of participants reported suicidal thoughts, including making a plan, and 39% had attempted suicide. At the end of the program, no participants reported suicidal thoughts, plans, or attempts in the past three months. Of those who responded to the survey three months after the program, only one in eight said they had had suicidal thoughts without a plan or attempt.
“To me, even if a person reduced their suicidal tendency, it’s amazing,” she said. “It looks like a number on this piece of paper and it’s not. It doesn’t do justice to the change in this experience. Seven out of eight had had suicidal thoughts during their very recent preprogram and life and weren’t thinking about it three months later. “Not having that as part of your daily thought process is pretty deep.”
Another good point was that more than two-thirds (67%) had completed the program. “That’s a big number in residential care,” Dr Mills said.
When looking at the numbers, what’s “glaring” is the tracking aspect of Gwek’s programming, Maracle added. “We are not just looking at the 90 days in the field, but ongoing support, if participants come to the home follow-up and have direct access to the traditional knowledge keepers and a home follow-up counselor, but also the counselor from community monitoring. which provides up to six months of support after they return to the community.
He explained that as individuals address their own complex needs, not everything will be resolved in six months. “Sometimes people can resurface seven months later or eight months or need that immediate support as soon as they get back, but one of Gwek’s philosophies was to have that open community and an open door policy for any need. . I think building trust and not dismissing them at the end of the program continues to build that trust, because that aspect of safety is so hard to come by within their communities. That would contribute to some of the numbers you see here too, just that continued support. »
In Ontario, programs that measure their impact are rare. The government doesn’t pay for it and no one has the resources to do it unless the leadership is dedicated, Dr Mills said. “Whether it’s numbers, testimonials or stories being passed on, in some way it should be on the agencies to demonstrate that they’re not hurting people. I think it’s amazing that Gwek had that leadership and dedication from the start.
Gwekwaadziwin means “honesty,” Mr. Maracle said. “We have to have that honest vision and thinking ourselves. We need to think about what we are doing, what is working and what is not. We cannot do this based on anecdotal evidence alone.
The most important thing is impact, he said, “because we see it, we hear it, and then we move on to the next cohort. I think we’re going to see continued success as we refine the program and have more cohorts. This is just a snapshot in time of a four-year program. We just completed another cohort (since the report) where we had a 74% graduation rate, so we’ve already seen an increase from the last one. It’s great to see those numbers and being able to compare them to something else is a measure of success. It is the responsibility, and it is absolutely imperative.
Lori Thompson, Local Journalism Initiative Reporter, The Manitoulin Expositor