Change to mental health report will likely cause distrust in 'era of suspicion,' politics prof says

The only real difference between a draft of a long-awaited report accidentally released to Manitoba media early Monday morning and the final copy issued hours later is six words: "a safe injection site in Winnipeg."

Spectre of political interference can influence public perception, political expert Paul Thomas says

Dr. Brian Rush presents his report, The Manitoba Mental Health and Addictions Strategy, Improving Access and Co-ordination of Mental Health and Addiction Services, to media Monday morning. (Warren Kay/CBC)

The only real difference between a draft of a long-awaited report accidentally released to Manitoba media early Monday morning and the final copy issued hours later is six words: "a safe injection site in Winnipeg."

CBC News used Microsoft Word to analyze the two versions of the highly-anticipated review of Manitoba's mental health and addictions strategies and found 210 differences. More than 170 of them were formatting — changes to font size and spacing — and most of the remainder removed chunks of text only to replace them again with identical wording.

Only one update changed the substance of the report: the removal of a recommendation to create a safe injection site in Winnipeg, which appeared in the first draft sent to media but not in the final copy posted to the government's website later Monday.

Paul Thomas, a professor emeritus of political studies at the University of Manitoba, said whatever the reason for the change, it's likely many people will distrust the official government explanation.

"We live in an era of suspicion and cynicism about politicians and the way they want to manipulate the news," Thomas said. 

Dr. Brian Rush, who co-authored the report, reaffirmed to CBC News Monday evening he'd removed the line weeks ago after careful consideration, and he's looking into the timeline of when versions of the report were changed.

"I can assure you this is a basic and unfortunate version control challenge," he wrote in an email.

Earlier Monday, Rush and Health Minister Kelvin Goertzen said government didn't give instructions to remove the line. Goertzen said official reports go through several iterations, and dozens of elements of this report were discussed as it underwent that process.

Manitoba Health Minister Kelvin Goertzen addresses questions about the report from media on Monday. (Warren Kay/CBC)

Goertzen said the draft of the report he was given on the weekend did not include a recommendation for a safe consumption site, but the issue came up in a conversation he had with Rush Monday morning.

"When I asked him this morning about a variety of things, he did raise the issue of safe consumption sites," he said.

"He did express to me his general support for safe injection sites, but said that there wasn't enough evidence in Manitoba to make the specific recommendation."

Safe injection sites are spaces where people can consume drugs while supervised by health professionals who are trained to provide help in the event of an overdose, as well as connect users with treatment resources.

Goertzen said in December 2017 and last month that he doesn't feel there is enough evidence to support the creation of a safe injection site in Winnipeg. 

Premier Brian Pallister also came out against the idea in April after a report from the Canadian Mental Health Association supported local calls for such a site.

Vancouver and Toronto and are among several Canadian cities with safe injection sites.

'Era of suspicion'

The report, Improving Access and Co-ordination of Mental Health and Addiction Services: A Provincial Strategy for all Manitobans, has been in the works since last year, when the government commissioned it from Rush's firm, Virgo Planning and Evaluation.

The 287-page report recommends more collaboration between primary and community-based treatment providers and a desegregation of mental health and addictions services.

Goertzen told CBC News in April he'd received a version of the report before it was ready to be released to the public.

"Often, consultants ask for a review by the department to ensure there are not inaccuracies in a report," a government spokesperson told CBC News in an email Monday night.

Thomas, who has authored reports for Manitoba governments, said officials are provided with early versions of independent reports so ministers can be prepared for tough questions from the media.

Questions continued today about why a recommendation for a safe injection site was removed from an exhaustive report to the province on mental health and addictions in Manitoba. 2:00

"In today's political world, there's a lot of emphasis on news management, to the extent that's possible. Governments really don't like surprises and anything that would lead to negative news for them," he said.

But he said in his career, he did encounter instances of political interference with the results before reports went public.

"If you think on the balance of the evidence that you've heard, including submissions from people in the field, that that is the best policy advice you can give, then you should give the policy advice," he said.

"You shouldn't be calculating what is politically acceptable to the government that authorized the study."

Thomas said the spectre of political interference — whether or not it happens in a particular case — can influence report authors as well as the public's perception of their findings.

"So a lot of people will take Goertzen's denial today and say, 'Ah, I just don't believe him.'"

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