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Yahel Alumni Advancing Social Change: Jens Jacobsen

In honor of Yahel’s 10th birthday and in the wake of the Covid-19 crisis, we would like to honor our Alumni Community by taking a closer look at some of the important social change work they are involved in around the world. Over the next few weeks, we will be sharing interviews and conversations we’ve been having with Yahel alumni about the causes they address through their careers, the lessons learned, and the challenges and accomplishments along the way. Today's interview is with Jens Jacobsen, Senior Policy Analyst at the Ministry of Mental Health and Addictions in the Government of British Columbia, Canada. Jens is an alumnus of the Yahel Social Change Fellowship in Rishon Lezion in 2104-2015.

*Note from Jens: I want to stress that I’m happy to talk about the work of the ministry, but any opinions that I mention are my personal opinions and not the official opinions of the ministry.* The ministry you work for is relatively new. When and why was it established? What are the special circumstances in BC that led to the establishment of a Ministry of Mental Health and Addictions?

The Ministry of Mental Health and Addictions in the province of British Columbia was created in 2017 to build a seamless, coordinated network of mental health and addictions services that works for everyone in BC, and to lead the response to the overdose crisis. It is the first ministry of its kind in North America. In 2016 BC declared a public health emergency for what was determined as an overdose epidemic. Mental health and substance use treatment is currently split between multiple different ministries and authorities in BC such as the Ministry of Children and Family Development, the Health Authorities, the Education System and others. When we’re talking about mental health and addictions in BC, there are a lot of people around the table who are all balancing multiple priorities. Our ministry is not a direct service provider, but rather sets a strategic direction for the province, works with all of the partners and delivers funding for specific programs. Our mission is to try to reduce the siloization of the mental health and substance use system in BC. Vancouver in particular has had a longstanding substance use problem. Since the majority of substance use issues start in adolescence and largely stem from people self-medicating as a result of some form of trauma, often inter-generational trauma, substance use is considered a public health issue. What has changed in recent years is that the drug supply is more toxic than ever before. This began in the early 2010s with Fentanyl which is a synthetic opioid that is similar to morphine but is 50 to 100 times more potent. Fentanyl has been used for decades in medical circumstances in very tiny and precise doses. And then about a decade ago, it got leveraged by illicit drug suppliers because it is stronger and therefore cheaper, and street drugs began to be cut with Fentanyl. Since it is extremely difficult to cut it with the necessary precision for it to be safe, we saw a massive rise in overdoses and deaths almost out of nowhere. This is why the state of emergency was declared and the ministry established. The ministry has two main branches – one focuses on overdose response in the present. The other branch, which I belong to, is the strategic planning branch that looks at prevention beyond immediate response and works to ultimately build a better system, one that is able to give the right person the right service at the right time across the province.

How did you personally get to this position? Did you have a specific interest in mental health and addictions prior to working for the ministry? What led you to work at the government level?

I started with an interest in government. After I did the Yahel fellowship I got a Master’s degree in Public and International Affairs with the hope to end up in the public service. I think it’s an incredible career. You get to work with a whole bunch of talented people trying to improve aspects of public life. When your feet hit the cold floor in the morning and you ask yourself 'what am I doing this for?' you know that you’re doing it for the public. I really believe in the role of government and the good that government can do for society. I see government like a piece of machinery that has parts that are old and need to be updated. That’s why we need people who are passionate to join government and update the machine to ensure that our society has the supports that it needs. Unlike many people who end up in government by accident, I actually joined with the intent of being a public servant. There are 3 main reasons I chose this specific position. My previous job was with Transport Canada working on prevention of drowning deaths, finding ways to reduce the number of people who die each year from recreational boating accidents. This was an area where I learned how if government takes action it can really make a difference. It gave me a taste of what public health was. Another reason has to do with my time as a Yahel fellow in Rishon Lezion. We worked with community members, NGOs and with local government. It was interesting to see the different layers of civil society, and the role each layer played in ultimately bringing about change. I also learned how important mental health is when working with youth. The third reason is that unfortunately almost everyone has a personal connection to mental health and addictions, myself included. We’ve all lost friends or been touched in other ways. I felt I couldn’t pass up an opportunity to be involved in making a better system for when my own kids grow up and need these services in place.

I see government like a piece of machinery that has parts that are old and need to be updated. That’s why we need people who are passionate to join government and update the machine to ensure that our society has the supports that it needs.

Tell us about your role? What are some of the major projects you’re working on right now?

I’m a Senior Policy Analyst in the Child and Youth Partnerships and Planning team. Last June, the ministry released a 10 year strategy for improved mental health and substance use services in BC titled a Pathway to Hope. My team focuses on the child and youth pillar, ages birth-24. We’re looking overall at the system of care for youth and trying to improve it. Our system is highly fragmented and difficult to navigate for anyone, let alone a young person going through mental health or substance use challenges. One of our main projects is establishing integrated child and youth mental health and substance use teams – the program will start in 5 different communities, both urban and rural. One of the challenges we face is working in dramatically different types of communities – BC is 5 times the size of Germany with a population of 5 million, roughly half of which lives in the greater Vancouver area. So we need to find solutions for highly dense urban areas, extremely rural areas and Indigenous communities. The Child Youth teams will be mobile and multidisciplinary – the teams will include a school counselor, mental health clinician, substance use worker, peer parent and youth support workers, Indigenous support worker – and will be outbound. This is to avoid creating an overly clinical environment with rigid office hours etc., and instead have the teams go out to the communities working to wrap services around the youth where they are.

Since the majority of substance use issues start in adolescence and largely stem from people self-medicating as a result of some form of trauma, often inter-generational trauma, substance use is considered a public health issue.

What are some of the things you are most proud of in your work? What are the things you would like to change or improve?

I’m really excited to be working as part of a team of such talented and dedicated people. We are working every day to try to improve this system that we inherited. I already look back at certain things and see the difference – for example the way people talk about mental health and substance use now compared to when I was growing up in BC, even in mainstream society. One of the things I love about my job is that it really varies from day to day. It includes visits and meetings with communities and individuals with lived experience and service provision in the field to learn in depth about the needs on the ground. It includes project management – articulating steps and overseeing their implementation, reporting and briefing for senior management who need to know on a regular basis what is happening, what’s new, what the major flags are, where there are opportunities, etc. It’s also the higher level aspects like determining the policy direction and securing funding, submissions of programming to the cabinet and, once they’re approved, submitting them to the treasury board for funding.

How do you see your Yahel experience reflected in your work today and in your career in general?

Something I found really helpful from Yahel was the experience spending a year engaging in the complexities of Israel. It gave me the ability to understand and learn how to deal with a high level of nuance. This is a skill that has helped me with my work in my own country as well. In BC we have Indigenous people who are still experiencing the ongoing consequences of colonization, racism and inter-generational trauma. Justin Trudeau has recognized what happened to the indigenous people in the past and what is still happening today as cultural genocide. Like I mentioned earlier, mental health and substance use challenges are often a result of trauma. Some of the overarching questions for me are how do we build and improve life in BC given the dark realities today and the tough history that we have? Or how do we make our services and institutions more culturally safe and welcoming for people with different traditions of healing? What role will local indigenous organization have in terms of co-governance and oversight of how our system works, especially when serving Indigenous communities? And many more questions related to finding responsible ways to respectfully assist people in need.

During my time as a Yahel fellow we worked with community members, NGOs and with local government. It was interesting to see the different layers of civil society, and the role each layer played in ultimately bringing about change.

(Pictured left: Jens with Yosef, a boy he volunteered with during his time as a Yahel fellow in Ramat Eliyahu, Rishon Lezion).

How has the ministry adapted its approach to intervention and care during the COVID-19 crisis?

British Columbia is now facing a double state of public health emergency - the overdose crisis and the COVID-19 crisis. The two are tied of course, as the overdose situation has gotten worse since COVID-19. For the first time in Canada’s history (except for times of war) the border with the U.S. has been closed and, among many other things, it has affected the drug supply coming in from the U.S. Fentanyl is being used a lot more instead of other drugs that were coming in through the U.S. Even right now the drug supply is significantly more toxic than it was in March this year. BC is setting a new record for overdoses every month since the beginning of the COVID-19 crisis. This of course is also a result of people generally using more substances due to COVID-19. On the bright side, the way our ministry has adapted to COVID-19 is something I’m actually very proud of. For example, we were able to rush funding and massively expand virtual care and counseling for youth over the past few months. We’ve also been able to provide surge funding to boost preventative programming in the school system. Our ministry immediately transitioned to online work in March, and I would say that today we are as effective at getting as much done as we were when the entire staff was in the office. We are lucky to benefit from a very stable political environment which allows government ministries to work efficiently. The whole COVID-19 experience has given us a huge kick - we really have to rethink how we do things. Suddenly certain projects that would have taken a year are now taking weeks, especially projects that involve leveraging technology – which is something we probably should have started a long time ago. For example when providing mental health services to youth digitally, we are now able to serve a lot more youth than we were before. I recently heard anecdotally from a doctor who spoke to a young person in northern BC. Northern BC is an area that normally doesn’t have a mental health specialist, and without digital access to the service this person would have never been able to speak with someone of that caliber. Obviously we’re in the middle of an unprecedented crisis with a lot of negative impacts for mental health, but I think that once COVID-19 subsides our governance and health system overall will be better. Government will be a much better machine because of the lessons learned during this crisis.

Yahel gave me the ability to understand and learn how to deal with a high level of nuance. This is a skill that has helped me with my work in my own country as well.

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