Thank you very much for inviting us here today. It's really a privilege to appear before this committee.
I think it's doubly important to acknowledge the Algonquin people, who are the traditional custodians of this land. I'd also like to pay respect to their elders past and present and recognize the strength, resilience, and capacity of indigenous peoples in this land. I think this is particularly important, given the recent tragedy in northern Saskatchewan. I'd like to acknowledge that today.
I want to begin first by stating very clearly that I am not an expert in this area. I am not an indigenous person. You've heard from Dr. Rod McCormick and Dr. Mike DeGagné and other indigenous thought leaders. They've talked to you about restoring families and providing healing. You've heard that the answers lie in communities, something that the Mental Health Commission of Canada very much agrees with.
I can attest to this, having learned a great deal in visiting the Esketemc First Nation in June. I had the privilege of meeting Chief Charlene Belleau, who has initiated healing within her community that is very impressive.
I have with me today a commitment stick that I was honoured to be presented with. It was part of my reconciliation journey. Having spent time with her and also listening to the stories of elders within her community, I think the sweeping transformation that has taken place under her leadership is an inspiring example of reconciliation. As I said, I learned a tremendous amount. The community was very generous and gracious in welcoming us. It isn't an exaggeration to say that my experience was nothing short of life-changing. I spent a couple of days there, and it really was very enlightening.
I took away from that visit three key understandings that have really reshaped my world view, both personally and as a leader of a national organization.
Firstly, my commitment to reconciliation has been strengthened. Like all Canadians, I bear a responsibility to play a role in the healing of our country. As the leader of the Mental Health Commission of Canada, I'm learning what it means to be a partner in this unique context. I've come to understand that being invited to the table is a privilege and that the best thing we can bring is an open mind and a willing spirit. We've set aside our past attempts in favour of a nuanced understanding, born very much from humility.
Secondly, I recognize that the work that lies ahead must be undertaken by indigenous peoples, and they have the capacity, regionally and nationally, to lead this effort. Research tells us that intergenerational trauma and its effects are the legacy of residential schools and the relocation of Inuit in our northern communities, and it means generations affected by poorer health outcomes.
I often liken the stigma associated with mental illness to an iceberg—being from Newfoundland, I'm quite familiar with those—and what we see is really only the very tip of the problem. I think it might be fair to say that the same is true when it comes to assessing the damage incurred by indigenous peoples through decades of colonialism and cultural subordination.
There are ways and means to support indigenous peoples as they action their own solutions to the crisis they now face. Layers and layers of research and evidence support this work, and, as an external entity, the commission, for example, waits to be invited to align and partner with indigenous organizations, as we were privileged to do with the ITK this past summer around the Inuit suicide prevention strategy, in the launch of that strategy in northern Labrador. Our knowledge as an organization was enriched by this experience. We understand that it can take years to build a foundation of trust and that this foundation will likely remain delicate for quite some time.
Finally, I recognize that chronic underfunding has ill-served indigenous peoples and harmed Canada's overall health and reputation. That is why the federal government should support sustained, long-term funding of non-political indigenous organizations like the former Aboriginal Healing Foundation, organizations that deliver evidence-based, strength-based community development and culturally based initiatives.
I specify non-political, because any efforts must be undertaken with a view to a long-term solution. Critical health outcomes cannot be dictated by the political will at the time. To echo my colleagues, Dr. McCormick and Dr. DeGagné, direct service provision should never be politicized.
To conclude, I would like you to consider some of the small successes of which the commission is very proud. We are working on implementing the Truth and Reconciliation Commission's calls to action. One step we are taking—this very week, as a matter of fact—is implementing reconciliation dialogue workshops, which are now mandatory for every staff member in the commission, and our board of directors is also undergoing that training.
As part of our commitment, and in our role as a convener, we have invited HealthCareCAN and the Canadian Centre on Substance Abuse to join us on our journey.
Finally, I would be remiss if I didn't take a moment to personally thank Senator Murray Sinclair; Chief Charlene Belleau; Natan Obed, president of ITK; and Joe Gallagher, CEO of the First Nations Health Authority, all of whom have become trusted advisers to me and everybody at the commission on this journey.
Thank you very much.
Thank you very much for having me here today.
In April, May, and June of this past spring, I was humbled to be a part of Ontario's emergency medical assistance team, EMAT. The EMAT deployed to Attawapiskat, Ontario, in the wake of its youth suicide crisis. It was the only time in history that the team had been deployed to a first nations community and the deployment of almost 60 days was the longest in the team's history.
As a psychosocial member of the EMAT, I provided risk assessments, safety planning, clinical supports, psychoeducation, and resources to the existing community staff and community members.
I will speak today about some the experiences and knowledge that are informed by what I refer to as the “survivor's lens”. As a survivor of suicide loss myself—I am the survivors chair for the Canadian Association for Suicide Prevention—my focus is always on postvention.
At CASP when we use the term “suicide prevention” we inherently mean suicide prevention, intervention, and postvention. We have made significant strides in raising awareness and public dialogue about suicide prevention and education, but clearly much work lies ahead.
In Attawapiskat, I learned a great many things. Namely I learned that although the media at times may have suggested otherwise, that community and its people have a great many strengths, strengths that in the context of suicide prevention deserve our focus and deserve to be celebrated.
On many occasions in Attawapiskat, I was aware that I was not the best person to be providing support to that community. Although I am an ally and I embrace first nations' learning, I am not from them. I am an outsider. There were many occasions when in working with an individual or family we would make every effort to bring in a local resource or a person to provide additional support and continuity, knowing that our team would be leaving. It was more often the case than not that we learned that the resource person was profoundly impacted themselves. So I am reminded that we must not forget that the caregivers are also hurting.
From the literature we know that each suicide death leaves in its wake a number of survivors who are deeply impacted following a suicide death. Traditionally we have reported that number to be between seven and 10 survivors for each suicide loss. New research tells us that it is much more likely to be 25 people per suicide death who are profoundly impacted. In smaller and remote communities when a suicide occurs, virtually everyone is impacted, including the first responders and the emergency personnel.
We also know that suicide-related grief and loss is a significant risk factor in suicidality for those survivors who are bereaved by a suicide loss. However, clinically or on the front line, we often fail to recognize or address the suicide-related grief, which may have been the very experience that brought somebody to thoughts of suicide or suicidality in the first place. We must not forget the healing that must occur after a suicide has happened. Postvention is prevention.
During my time in Attawapiskat, I was lucky enough to have been included in several experiences that promoted not only healing, but life promotion and a celebration of culture: arts-based workshops including painting, drum making, and a gathering of youth in a music recording session. The youth of Attawapiskat are truly amazing. Although these types of gatherings are not not traditionally viewed as suicide prevention interventions, we have to make room for this to be so.
In Attawapiskat and all of Canada the focus is on youth. There was also much involvement and concern for the elders and older adults in that community. But what about that generation in between, those who are mothers and fathers and also daughters and sons? We know that the middle-age demographic is among the highest risk demographic across Canada, although not specifically for first nations communities. We do know that all individuals and entire communities must be engaged in reconciliation and holistic life promotion practices. This critical age group are most often caregivers for aging parents and for children and youth. How then are we reaching and engaging them in life promotion? This is an important question that begs our attention.
Since 1985, the Canadian Association for Suicide Prevention has attended to the critical public health issue of suicide across our nation. As an unfunded volunteer organization, we rely on the strength of our partnerships with national partners such as the Mental Health Commission of Canada and the First Peoples Wellness Circle.
In addition, we also work closely with many community-based organizations, and many successes in the field of suicide prevention are both community driven and innovative.
I have some more to say about that, but I'm going to leave some space for my colleague.
I'm Dr. Ed Connors. I'm of Mohawk-Irish ancestry. I'm a band member of Kahnawake Mohawk Territory.
As a psychologist, I've worked across the country in our first nations communities for the past 35 years. In those 35 years I have been intimately involved with the experiences of suicide in our communities.
I'm going to share with you now a synopsis of what I've shared with you in the form of a document that you'll find in your package. I apologize to the French members of the committee that I did not have time to have this fully translated for you because we were just recently notified of the invitation. We will ensure that it will come to you in full translation, as required.
I'm going to make a few comments here with regard to this paper. I'm going to begin with an acknowledgement. Thank you, Louise, for acknowledging the first nations indigenous peoples of this territory and their lands. I will also acknowledge that these are in our territories as well in more, what we call, modern time.
I will begin by giving a comment as an opening, which we do when we open any gathering and when we come together. It's the opening of the thanksgiving prayer. When we begin, we begin in this way, and I think it's significant as an opening to my remarks. What we say when we open in the thanksgiving prayer is that we are now gathered and we see as we gather the cycles of life that continue. As we see those cycles of life as they continue, we recognize that we've been given the duty to live in balance and harmony with each other in all of life. As we do this, we bring our minds together as one, and we give greetings and thanks to each other. Now, as we have done so, we acknowledge that our minds are as one.
I am going to make comments regarding not just our indigenous populations of Canada, because my involvement has been worldwide. I've acknowledged and recognized the similarities in the patterns of suicide globally. The indigenous populations worldwide are at the highest risk of suicide. While indigenous communities worldwide generally present the highest rates of suicide, there are many examples of indigenous populations, such as the Sami people of Norway, and communities in Canada, the B.C. first nations that have been reported by Chandler and Lalonde as having extremely low suicide rates, and in many cases no suicide.
In Canada, high suicide rates range from five to seven times that of suicides among non-indigenous populations. In extreme cases, suicide rates have exceeded over 800 times those of non-indigenous communities. Suicides in indigenous communities globally are overwhelmingly overrepresented among our youth. I draw that to your attention because I think it's an important question and a focus that we need to have about why our youth have such high suicide rates, not just in Canada, but indigenous populations globally.
There are no-to-low suicide rates in many of our communities, and that has been accounted for in many of the studies that have been done. Some of the most recent works show that in those communities we can account largely for the low suicide rates to no suicide rates as being connected to strong self-governance and strong cultural renewal.
Elevated rates of suicide in indigenous communities have also been linked globally to colonization, colonialism, and acculturation. Indigenous world views as expressed through languages, cultures, beliefs, values, and lifestyles have been disrespected, suppressed, and oppressed through the process of colonization.
I share with you at this moment a wampum belt. It is the way that we made treaties in the past, and we made treaties with my ancestors. As I pointed out to you, I am both of indigenous ancestry, Mohawk, and Irish ancestry.
My ancestors came together in the formation of this treaty. This treaty was made in 1613, with the Dutch and the Haudenosaunee, or the Mohawk people. When this treaty was made, it was made to identify the fact that we were of two different world views, two different cultures, two different languages, and different ways of understanding ourselves, the world around us, and all of creation.
It said that we will live together in peace and harmony on this land, but to do so we need to be able to respect each other's cultures, each other's ways of knowing, understanding, and believing, and that we need not only to respect each other's ways, but to recognize that they are equal, that they are not one greater than the other. I believe today that we are faced at this time.... There are many things that tell us today that we're at at time in our history where we can actually come back full circle to this treaty. We can fulfill the vision of our ancestors, of my ancestors and yours.
We talk about today as a time of reconciliation. What is reconciliation? Reconciliation, in many ways, has to do with re-establishing this vision, re-establishing the true relationship of equality and respect.
In our communities today, indigenous world views that have been repressed are now being expressed again and being renewed. As they are being renewed in our communities, and I've seen this happen in many of our communities—as is now being shown within the research—and as that renewal occurs, the rates of self-harm...and the process of healing is taking shape.
The renewal of indigenous world views and associated lifestyles serves to protect against the negative effects stemming from the trauma and losses associated with colonialism. Cultural renewal enables our youth to answer four questions known to be important for healthy development, especially during the period of childhood to early adulthood: Where do I come from? Who am I? Why am I here? Where am I going? This knowledge also relates to recent insights provided through the First Nations Mental Wellness Continuum Framework. It identifies meaning, purpose, belonging, and hope as core concepts underlying the state of wellness or health within our people.
First nations communities have known that cultural renewal is primary to the recovery of healthy indigenous people's families and communities. This has been the core of our effective healing programs for many years. Twenty-seven years ago, I was part of the development of the sacred circle, providing a way of life within the Ojibway Tribal Family Services in Treaty 3, northwestern Ontario.
This was one of the earliest examples of cultural renewal within our communities as a process of healing. It was the first time that we really spoke to the experiences of life promotion, as opposed to suicide prevention. It was the first time that we supported cultural renewal and healthy community development. It was discontinued, and this is an important point, and I'll close on this note. That work that was done, and many of the pieces of work that we've done in the past that we've proven to be effective, were discontinued across the nation. Programs that were focusing on this at one point in time, which were once federally funded, moved from federal funding to provincial funding. When that happened, there was a change from what we called family support programs and cultural renewal to a process of child protection and child welfare agencies. When that happened, we moved from the process of cultural renewal and the healing of our communities to where we are today.
I challenge you in your thinking about this to consider that we know what works. We have seen what works, and we have had many example of that. We know this within our communities.
I hope that we are able to gain the support of your committee as we continue to come together in the process of reconciliation and of healing within our communities.
Thank you to all of you for your presentations. I'm the member of Parliament for Northwest Territories.
Since the study was undertaken, we've experienced quite a few suicides. In under five months, we've had four. When you start adding the people who are passing from drug overdoses, because drugs have hit the north too and are in the small communities, we're really seeing the impact on our communities. I find it really interesting when you say 25 people per suicide death are impacted, and maybe that number is even a little low. I know in our communities that people are all pretty much connected. People are related, and when somebody passes away, it's significant and it takes a long time to recover. Some people never recover.
We have had a chance to study this issue for a while now. We've gone to several communities and a lot of the facts that you've raised here today we've heard in most places.
I represent 33 communities and in some of our smaller communities, especially the ones that are made up of larger aboriginal populations or predominately aboriginal, we have real issues with trusting and using the health centres or the RCMP. We have limited capacity and we have very few programs that address some of the issues that need to be dealt with as a result of the residential schools or trauma or how they've been impacted. We virtually have no infrastructure to house programs or offices.
We heard in some of our testimony, mostly by the youth, that there should be a recommendation that investment be made in community-based youth facilities to be used for recreation, for reconciliation, for healing, for hunting, and for sports. We do have some facilities such as friendship centres or cultural centres, but I haven't heard anybody speak to actual infrastructure, so I'd like to ask that question.
We also heard lots about the issue of housing and how that's impacting people in the communities and causing a feeling of despair, because there's no place to stay. There's no place for people who are homeless. It's a growing issue.
Maybe I could ask the two organizations to touch on those two areas.
Thank you very much for coming here. I have enormous respect for your work, and I want to thank you for your work with EMAT. I don't know if we met at the emergency ward, but I went there a couple of times to see the work.
I want to talk about suicide contagion and clusters, because when we had the Attawapiskat state of emergency and we had to fly in an emergency team, across Canada that same month, there were states of emergency declared in Neskantaga and Cross Lake, and three in Saskatchewan. Imagine three non-native communities declaring a state of emergency because their kids were killing themselves. The government would turn itself upside-down, but we get an emergency response.
No offence to the great work that was done, but this crisis didn't just happen. None of these crises happened accidentally. They are clusters.
I just want to walk you through this. In 2008-09, we lost 13 kids in James Bay in a winter, and they were laying off the front-line staff. The government was going to come in with a program to get kids to play, but they were cutting off the front-line workers. In 2012, they cut them off. When Sheridan Hookimaw died, we couldn't get her home for four or five months. The contagion started then. They were surprised that all of these children were starting to self-harm? I find that shocking.
I want to ask you this. If we know that suicide is a contagion, and if we know that we have to move in, and if we know that we have to have those supports, then why now when a 10-year-old girl has killed herself in Saskatchewan are we still scratching our heads at the federal level and saying, “Oh, my God, what are we going to do? Maybe if we got a program. Maybe if we got them to fill out a form to get some of kind of youth thing happening, they'd be better off”?
It's a band-aid after a band-aid.
I would like to hear what you, given your experience on the ground at Attawapiskat, see as a long-term solution so we don't have to fly in emergency teams anymore.
That's what Jen was talking about in terms of providing the services that are necessary to help them with grieving and bereavement. That's the initial service that needs to be provided to them. I do a lot of that work with a lot of the police services that are serving our northern communities. That's happening, and we are trying to do that, but we don't have a sufficient amount of resources to respond to the need. Part of it is actually a funding issue in terms of ensuring we can provide those services to those people.
There's another point, Charlie, that is important to recognize in terms of your question about how we change the system. You're right. These figures that I quoted have been the same for 35 years. The same conditions have continued to repeat themselves. What can we do differently, though? We have learned over that time, but we haven't been utilizing a lot of what we've been learning. That's particularly the knowledge that Louise was referring to, saying that we do have the knowledge within our first nations communities about what can work.
I gave you an example of one that was working really well, but then it was gone. We had 12 communities that we were working with, and huge change was occurring. We were addressing the true needs, and then all of a sudden the funding changed. Priorities change and the resources and the services that are needed, that you're looking for and that you're asking about, are gone. I did that work over 25 years ago. We do learn, but sometimes we don't pay attention to what we have learned that works. I say that first nations people know what has been working.
The other point that I think is really important is the systemic point, and that has to do with the borders. In this country, we've created borders that are not first nations borders; they're the provincial borders and the federal borders. Then, as you know, the politics of it all becomes wrapped up in how children are treated, or how they're not treated. I've got an example of one of the young people from Attawapiskat. We identified the need for that child's services as being immediate and extremely high-risk. A lot of those children were at extremely high risk. She was the highest. We identified where those services were that were culturally appropriate, but they were across the border. They were in Manitoba, so what happened? We couldn't access those services for her. They ended up placing her into a southern Ontario psychiatric facility for adults, where they had virtually no understanding of that child's cultural background, what her needs were, or what was happening in the community.
How do we help? We think we're helping, but we're not. As first nations people, we recognize that. We know that's happening, and we try to educate people and share that. This is where we need to bring together and start sharing that knowledge, listening to each other, and giving some credence to the knowledge that's there within our communities.
I wanted to start off with my own thing.
[Witness speaks in Ojibwa]
I asked the spirit to forgive me, as I use English. I can only speak a little bit of my language, but I'm still learning. I acknowledge all of you and thank you for giving the time to hear me today.
My true identity is Standing White Bear. I come from Rat Portage First Nation just inside Treaty No. 3 territory, and I belong to the Lynx clan. Today, I am here representing the AFN to discuss our calls to action and discuss the grim circumstances that are facing our communities. Before I even really get into it, I'm sure you are aware that a 10-year-old girl took her own life earlier this week.
As we're sitting here talking today, these issues are very real and they're happening every single day, whether they be an attempt or a successful suicide. Our calls to action that I'll be presenting today reaffirm our treaty rights and their sacred relationship between the crown and our people. Our calls to action also communicate our ideas supporting life and reducing risks for suicide attempts among first nations children and youth.
I've been an Anishinaabe youth leader. It pains me. It absolutely crushes me to my core that there are children as young as 10 years old committing suicide. It pains me to know there are young mothers and fathers taking their own lives and leaving children behind with questions as to why their mom and dad are no longer with them, why they chose to leave that way, much like my sister-in-law who left behind my niece and nephew.
I attempted suicide in January 2016. These are things that are not happening to at-risk youth; they're not strictly related to them. These things are happening to people like me, with a strong cultural background, who grew up in a home with my family. There are deeper issues at work than the simple surface issues that we continue to look at, and that's what we need to try to address.
The responses from the previous government have really left me frustrated, and even now, as the youth councils across this nation try to work as hard as they can to address this issue. Because these suicides are nothing new. They've been affecting our nation for quite some time now, and these crises happen in cycles. With the lack of address from previous governments, and more understanding as to how or why these things are happening, it's easy to see why our relationship with the crown is as tense as it is now.
But, I will say there is hope, hope that we can come together and begin to realize that treaty relationship that our elders had envisioned many years ago; to not renew our partnership, but to get to that level of partnership where our people all across this nation, including the Canadian people, are strong. It's going to be the passion for our young people, the care for those young lives. They are going to help us get there.
The way forward requires a first nations' social determinant of health to be addressed. Health outcomes cannot be assessed by the health institutions alone. First nations people need to take a lead, and we are taking a lead in addressing these issues, but what we really need to start seeing is being able ourselves to control the resources and to have the freedom to develop the programs, using our framework of wellness and our frameworks of healing.
The way forward also requires a full implementation of the first nations mental wellness continuum framework. The framework outlines opportunities to build on community strengths and control of resources in order to improve existing mental wellness programming for first nations communities.
There is clear evidence that pride in one's identity can reduce suicide rates. I've picked up a lot of my language, more than I ever did. I'm starting to learn my ceremonies. I carry this with pride, to the person that I am: strong, healthy, and positive. My healing began in January 2016, and it's only October 2016. With my experiences I never thought I'd ever be in this position, or have these positive emotions back again. Yet, here I am, and I credit it to this most importantly. Because, as we all know, colonialism, residential schools, the sixties scoop, have left us disconnected from our lands, our identity, and our culture. When you look through our calls to action, you will see that we ask for those specific resources and programming to be allocated to supporting youth to reconnect with their culture, to find a way to reconnect with their language, their spirituality, and who they are, so that when they have that pride and that identity, that pride in themselves, they won't believe suicide is an option. They'll know where to go. They'll know that our lodges and our elders are our true mental wellness people, our healers, just like your psychologists and doctors. That is where we go, and that's where I went, and that's clear evidence that I'm doing much better.
I want to go through our calls to action with you point by point because I would do a disservice to the experiences of the youth who contributed to this if I just simplified it or bullet-pointed it or anything like that, so please bear with me.
One, a priority should be placed on taking immediate action to address growing inequities in education, employment, income, and healthy living environments. In keeping with a social determinants perspective, first peoples must control, design, and define their systems of health, education, and child welfare with funding that is at least equal to what all other Canadians receive.
Two, adequate and sustainable funding should be provided to ensure that a comprehensive range of culturally safe prevention, health promotion, and mental health treatment services are made available to all first nations communities.
Three, regular and accessible training opportunities should be made available to youth who want to learn how to be supportive peer mentors to other young people in their communities, such as safeTALK or ASIST training.
Four, adequate funding should be provided to enable young people to attend regional gatherings related to life promotion and suicide prevention. Young people need spaces to come together, be heard, and develop their helping skills.
Five, support should be provided to first nations communities so that elders and cultural advisers can provide cultural teachings that will enable young people to know where they come from, who they are, what their purpose is, and where they are going. This will help to re-establish the strengths of first peoples' cultural identity that are vital for reconciliation.
Six, culturally appropriate, land-based teachings and educational programs should be made available for all first nations children, youth, and young adults, including traditional language revitalization opportunities, since valuable ways of knowing come from speaking one's own language.
Seven, all government departments should work closely with indigenous leaders and local, provincial, and territorial governments to implement recommendations 6 to17, outlined in the TRC report.
Eight, specific efforts be made to re-establish relationships of equity and respect between first peoples and the crown. These forms of relationships are crucial to sustain and advance healthy communities. This is the foundation of reconciliation and health upon the land, Manitu-wakhi, Mother Earth.
Nine, education for first nations students should be inclusive of the values and beliefs of first nations communities as determined by first nations communities themselves. In this regard we envision a Canadian public education system that is inclusive and respectful of all Canadians' beliefs and values, as cultural safety dictates.
Ten, all Canadian children should learn about Canada's colonial roots and indigenous pre-contact history to advance the restoration of peaceful and equitable relationships between first peoples and the people of Canada.
Eleven, give programs that are proving to be successful in communities, of which there are plenty, and on our nations, increased and enhanced flexible funding.
In closing, as we sit around this table we must not only talk about our partnership on a nation-to-nation level, we must also begin acting on it. That sacred relationship must be re-established for the sake and well-being and health of our nations' young people.
As you look at our calls to action, keep this in mind. It was 143 years ago that Treaty 3 was signed. I'm a descendant of those signatories, here today talking about a crisis for our youth in our communities. For as long as I can remember, it's always been the young people who have faced the brunt of colonialism, when you look at residential schools, sixties scoop, suicides. It's been our young people in our communities who have faced the most hurt and have had to deal with that.
In keeping with that, my parents are survivors of a residential school. I am a father of a six-year-old girl. They apologized to me for not being the best parents that they could be. How could I have accepted that apology when I knew it was not their fault? It was that system.
I say that, keeping this in your minds. When we make decisions, when we come together as nations and leaders, we effectively make change for generations ahead. I say that in 143 years from now, when it's our future sitting in these chairs, let's not make them come here to talk about another cycle of suicide. When they come to this table again, let them say that we came together—the crown, our leaders, our youth, our elders—that we established a solid foundation of healing and well-being for the future generations, and that we did that together.
I leave that with you. Now that's up to you to come to us and determine, along with us, how that's going to look in the immediate future and in the long term. I thank you. Gichi meegwetch, again, for giving your energy and hearing these opening statements.