As I was saying, I want to express my condolences to the families and let it be known that, like it is for you, these are the people who are on our minds as we have this conversation. We've all been heartbroken, I think, by the tragedies that we've heard about across the country in so many communities.
I see the high rates of suicide in indigenous communities affecting youth in particular, I think, but it's not entirely the youth who are affected. It's a public health crisis and, therefore, a very important part of my mandate. I join you in the search for an appropriate response, knowing that no single person has all of the answers and that we must work together on something like this.
A number of issues of social inequity form the basis of the challenges I face in my portfolio in Health, but I think that when we look at social inequity in health and in mental health, the stark realities are nowhere more obvious than in the inequities that exist between indigenous and non-indigenous people.
When we look at the matter of suicide in first nations youth, I don't think I need to remind the members here of, for example, the rates of suicide among first nations young people, whether on-reserve or off-reserve, and among their non-first nations counterparts. I brought with me a lot of statistics, but I think you've probably heard a lot of them before. I think that statistics sometimes confuse us and sometimes even take us away from the fact that every single statistic represents a person, a person who is a loved one, a family member, and a community member.
Really, I wanted to focus on the fact that these disparities, the gaps in health outcomes, and the tragic statistics we read about have their roots in long-standing social inequity, and we can point to the causes. I'm not sure if we can say that we can find all of the causes, but I'm sure you've heard what many of them are. Some of them are historical. Many are ongoing. The roots of this crisis lie in colonialism, racism, assimilation, residential schools, intergenerational trauma, poverty, and so many other issues. The ongoing causes behind a crisis include things such as the bullying that exists among young people, issues of low self-esteem, overcrowded housing, unemployment, and lack of recreational activities. These are some of the reasons, which I'm sure you've heard about at this committee, as to why young people turn to self-harm and sometimes suicide.
The traumatic impact of losing cultural practices, losing the roots of communities, and losing languages, and the disruption of family structures and of social support networks, all affect the health and well-being of those communities, and we find that one of the most serious results is the high rate of suicide.
I know that you've heard many moving stories. I've heard many of them myself. I think about this summer, when I spent time in Alberta visiting Treaty 6, 7, and 8, and in one of those communities, I met a bright young man. He was talking about his battle with addiction and the fact that earlier in his life he had attempted suicide nine times. He became addicted to fentanyl. Getting treatment was very difficult for this young man, but eventually, with the assistance of a clinic that was supported by his band, he got the treatment he needed. He's now on Suboxone therapy and is slowly decreasing his dosage of Suboxone. He's on a path to healing. He said to me that he was becoming a better father and a better person, that he wants people to know that there's a way out, and that he wants them to know they can overcome this.
I am convinced that governments have an essential role in the strategies that we need to collectively gather to give hope and to give life to the ambitions of a young man like him. Change is only going to happen, though, when we work in partnership. Of course, that partnership has to include indigenous leaders. It has to include every level of government and, of course, many sectors of society far beyond the health sector.
My mandate includes making sure that I work with indigenous leaders. That includes the National Chief of the Assembly of First Nations, Perry Bellegarde. It includes the president of the ITK, Natan Obed. It includes working with chiefs and councils. Of course, I need to work with my provincial and territorial counterparts and multiple stakeholders to address health gaps that exist between indigenous peoples and other Canadians.
I believe that at its root this requires us to renew relationships in Canada and to ensure that relationships with indigenous peoples are based on a recognition of rights and on respect and co-operation. The healing process that I suspect you are finding your way toward as you have these conversations involves implementing the calls to action of the Truth and Reconciliation Commission.
What can government do? Much of what we are already doing is itself centred on righting some of those past wrongs and on addressing the long-standing challenges that have left this legacy of despair amongst young people. For example, we are supporting an annual assessment and support for the national aboriginal youth suicide prevention strategy. This is a strategy that helps to reduce risk factors through a focus on prevention, outreach, education, and crisis response.
We also have worked to support the national native alcohol and drug abuse program, another community-based program that includes residential in-patient treatment facilities.
We're supporting mental health counselling services through the non-insured health benefits program, through multi-disciplinary mental wellness teams that are driven and designed by communities. We're supporting the Indian residential schools resolution health support program, which has been successful in providing support through some of the residential schools discussions. It helps both former students and their families.
We're investing in research into mental health promotion and suicide prevention. Some of that is done through the Canadian Institutes of Health Research. It includes things such as the pathways to health equity for aboriginal peoples initiative and the Arctic Council initiative.
But we need to have new federal measures as well. As I have learned more about the challenges communities face, I've been deeply troubled by them. Communities face challenges in securing some of their basic necessities such as housing, water, and access to good education. Thus, as with all other parts of health, mental health needs go far beyond the provision of health care. It involves looking at both the causes and the consequences, which have deep roots and devastating effects on families and communities.
All levels of government, and, I believe, all departments of government, have a responsibility to look at the social determinants of health.
Have I already reached the yellow card? My gosh.
Thank you so much, Minister, for being here today. We greatly appreciate your input and feedback on this important study.
We recently came back from a trip in which we went to Vancouver's Eastside, visited a friendship centre and UNYA, the youth association across the road, and then went on to Sioux Lookout and visited a hospital and the indigenous health authority.
Everywhere we went, resources were the number one issue that so many are dealing with, especially at the indigenous health authority up in Sioux Lookout, where their building was fairly packed. They were in tight quarters. It was a smaller facility and an older facility.
We were in a brand new hospital up there, a spectacular hospital, which seemed to be providing very good services, but most of the people there were non-indigenous workers. The indigenous health authority is all indigenous workers, and they were in a facility that is not nearly as nice, and like I said, very.... You could tell that there was a lot of frustration and a lot of potential burnout amongst the workers there. This seemed to be a common thread: that they're burning out very quickly, and in some instances, a year or two into the job.
Has your department looked at the numbers that we need to hire and train to properly support places like Sioux Lookout and Vancouver's Eastside, both for counsellors and as health assistants in nursing in these remote communities?
Thank you very much for the question.
In fact, you've actually raised a whole series of issues there. It doesn't surprise me. As I think you've been discovering, you've come up with a list of some of the real challenges.
At the very beginning, you alluded to the programs themselves that are often under-resourced. I think that's one of the realities they're facing, and I'm not here to deny that many programs in indigenous communities are under-resourced. That's something that I'm certainly working very hard to address: the fact that in many areas there has not been appropriate support for programming. It's something I'm working on with the department to make sure that we respond to it.
You talked a bit about the facilities themselves, not just the programming, but what I call the “health infrastructure”, which requires that facilities are available. You may recall that in budget 2016, for example, we were able to get investments of $270 million to help with health facilities for first nations. That was fantastic, but it was actually only a drop in the bucket in terms of what the need is. One of the areas that's been severely under-resourced over a number of years is having the facilities available, but I think the bulk of your question actually related to human resources, which is certainly part of the whole picture.
The programs are not what they ought to be and the facilities are often in need of repair or in need of being built in the first place, but it is the human resources where I think we see some of the serious gaps, both in terms of having adequate people available and in terms of training. If people are there to work, often they feel overwhelmed and exhausted by the very difficult work environment they're in.
I will tell you that every single one of those areas has come to my attention repeatedly and that we are working on them. I've had the opportunity to speak across the country at a number of meetings that involve health care providers and people who work both to educate health care providers and in health facilities. I raise the issue of indigenous health, and particularly human resources for indigenous health, at every single opportunity that I can. That's the kind of thing that we're not going to fix overnight.
You asked a about the data a bit in terms of how big those gaps are. Like it is many other parts of my mandate, we don't have the kind of good data that we should have. We know for certain that whether you're talking about physicians, nurses, or other health care providers, there are challenges in terms of the absolute numbers of human resources that exist in these facilities and often also in terms of people who are not particularly trained in providing care to indigenous communities. Very often, the people who are providing care are not indigenous, which doesn't necessarily mean that they are not able to provide care, but it is sometimes part of the challenge.
Those are all things that I'm certainly working on. I've been very impressed with the work of the Canadian Indigenous Nurses Association and the Indigenous Physicians Association. I've been impressed with the work of the College of Family Physicians of Canada and other organizations that are working hard to find ways to prioritize getting indigenous young people into educational programs so that they will seek careers, and then we need to find the ability to make sure they get to the places where they're needed.
I hope that adequately answers your question.
Thank you, Mr. Chairman.
Thank you, Minister and staff, for the presentation. I think you've captured pretty much all that we have been hearing over the last while as we've been doing this study. There are so many things. As you've stated, there is no one solution, and there are so many things that need to be addressed in order to correct and change the trend happening all across the country.
In different parts of the country we see a lot of need, but in the north we seem to see it more than in other parts of Canada. That's where we're seeing the suicide rates go through the roof, especially in Nunavut and in my area, the Northwest Territories.
Also, there's a real need for investment, a real need for catch-up. It's the first time in many years that we have money for housing. We're hitting a crisis level with housing. It's the first time that we have all our land claim negotiations moving again.
Those things are really positive, but at the same time, we still have a lot of other things that have to be looked at in terms of dealing with addictions and with the residential school fallout, yet we don't have any facilities. Our facilities are lacking, as are our staff. We don't have enough people on the ground.
In the Northwest Territories—and I believe that in Nunavut it's the same thing—our funding comes on a per capita basis for the most part, for a lot of the programs, and it really doesn't amount to a whole lot. I remember a housing program being announced. It was on a per capita basis. I think we were able to build two houses.
If health money comes on a per capita basis, it doesn't go far enough. We need base-plus funding. Is that something you would consider as we move forward in the discussions with the Northwest Territories, Nunavut, and the northern jurisdictions?
Good afternoon, Mr. Chairman, committee members, and distinguished witnesses and guests.
My name is Lynne Groulx. I'm the executive director of the Native Women's Association of Canada. My colleague Amy, who is with me here, is a senior manager at NWAC. She's also a researcher par excellence, and she will probably be able to answer many of the questions that you might have on this subject.
First, I'd like to acknowledge the Algonquin peoples on whose traditional territory we are meeting today.
Thank you for the opportunity to present. I am a Métis woman of mixed Algonquin and French descent. I bring with me the voices of my ancestors, the concerns of aboriginal women from across Canada, and the hopes of our future leaders, our youth.
NWAC is the national aboriginal organization in Canada that represents the interests and concerns of aboriginal women and girls. NWAC is made up of provincial and territorial members' associations from across the country. Our network of first nations and Métis women spans north, south, east, and west, into urban and rural on-reserve and off-reserve communities.
We've all read the staggering headlines reporting the high rates of suicide among aboriginal youth, including some girls as young as nine years old. In light of these recent tragedies, I encourage all of you to join me in picturing someone in your life who you deeply care for, whether it be a family member, a friend, or a colleague. For me, I envision my own daughter, a 17-year-old aboriginal woman full of potential and enthusiasm for life. It is devastating to hear on the news that another one of our communities is struggling with this issue of youth suicide. The thought of losing my own daughter to suicide is absolutely unbearable.
In Canada, we must act quickly and compassionately to address this urgent crisis occurring in our aboriginal communities. We must allow the reality and the impacts of these suicides not only to touch our hearts but to drive us to take action now. I cannot stress this enough. Every single life matters.
The forced assimilation through discriminatory government practices such as the Indian Act, residential schools, the sixties scoop, and Bill have tremendous negative impacts on the health and well-being of aboriginal people. Socio-economic and cultural factors that contribute to the suicide crisis among aboriginal people include but are not limited to: poverty, unemployment, lack of access to health and social services, substandard housing, food insecurity, and the loss of culture, language, and the land.
Many continue to suffer the impacts of these policies generations later, including my own daughter. Aboriginal women and girls, their families, and their communities continue to experience anxiety, depression, homelessness, post-traumatic stress, and other mental health problems and illnesses that can contribute to harmful behaviours such as drug and alcohol abuse, self-harm, and suicide.
For decades, researchers have been reporting and continue to report various high suicide rates among adults and youth in our aboriginal communities that are several times higher than rates among non-aboriginal peoples. In the past year, the community of Bearskin Lake First Nation in northern Ontario declared a state of emergency after a series of deaths, including that of a 10-year-old girl. Then, the Pimicikamak Cree Nation in northern Manitoba, over a three-month period, had six youth suicides. In the month of March, Attawapiskat First Nation in northern Ontario declared a state of emergency after 100 people had attempted suicide since September 2015 alone.
In the latest news reports, Stanley Mission, La Ronge, and Deschambault Lake in northern Saskatchewan lost five young girls aged 10 to 14 within a week, because of suicide. These innocent children, who should be outside playing and enjoying their youth, have lost hope and are choosing to end their lives. For many isolated aboriginal communities, suicide or attempts at suicide have become normalized behaviour.
Recently, NWAC collaborated with Statistics Canada on an article, “Past-year suicidal thoughts among off-reserve First Nations, Métis and Inuit adults aged 18 to 25: Prevalence and associated characteristics”. Some of the key results do not come as a surprise. At 27%, the prevalence of lifetime suicide thoughts among young adults was almost double that of their non-aboriginal counterparts, at 15%. Most interestingly, aboriginal young women in particular showed a trend towards a higher prevalence of lifetime suicidal thoughts and were more likely than men to report mood or anxiety disorders and a bullying environment in school.
Research shows that high self-worth, strong family ties, strong social networks, and education can help prevent suicide in our communities. Also, in 2008, research by Chandler and Lalonde found that community and individual empowerment, control over personal lives, connection to culture, participation of women in local band councils, and the control of child and family services within the community protect against suicide.
The remote first nation of Bella Bella in British Columbia is a great model for preventing youth suicide by reconnecting the youth with land and culture. They built a youth centre to run youth programming 14 hours a day, seven days a week, which focused on traditional songs and culture, hunting and fishing activities, language revitalization, and education on their history and community.
There's also another indigenous youth program in terms of southern Treaty No. 3, which has identified five key priorities for moving forward. Those priorities are listed in a report and come from the youth themselves: one, the need for support to learn how to be a healthier family; two, crisis support workers; three, support around death, loss, and suicide; four, access to elders and culture; and five, safe spaces. We think this is a very interesting and informative report.
It's time to act on the knowledge and the need for change as voiced by our communities. We need to develop gender-appropriate and community-driven youth programs and services to help build self-esteem and self-worth and rebuild the connection among our youth to land and culture.
We acknowledge the Liberal government's recent commitment of $70 million in new funding over the next three years to address health and the suicide crisis involving indigenous peoples living on and off reserve territories. However, long-term solutions, improved resources, and gender and culturally aware mental health services, both on- and off-reserve, are urgently needed to effectively address the crisis and the underlying systemic issues contributing to the risk of suicide and suicidal thoughts in aboriginal youth across Canada.
It is too often easy for leadership and governments to forget about these matters as long as they do not occur on their doorsteps. If Canada refuses to spend the necessary funds on aboriginal communities, thereby denying children access to clean water, safe housing, education, and equitable health care, Canada is essentially deciding by doing so that aboriginal families and children matter less. This institutional form of racism allows for disproportionate spending.
On January 26, 2016, the Canadian Human Rights Tribunal issued a landmark ruling that found the federal government guilty of racially discriminating against first nations children in its delivery of child welfare services on reserves. The Canadian government was ordered to take immediate action to ensure its program budget responds to the unique needs of first nations children and their families and to apply Jordan's principle to all first nations children on- and off-reserve.
It has been nearly one year since that decision, and still the Liberal government has not adequately responded to the discriminatory underfunding of child welfare services and is also failing to properly implement Jordan's principle. Cindy Blackstock has stated that equity in social services can reduce the tragedy of youth suicide, but still the Canadian government has not acted on this.
Canada is a wealthy country, and our children deserve better. We must continue to work together to realize our children's potential and to help them have hope so that they can begin to accomplish their dreams. That requires us to take bold and immediate steps forward to create the change necessary and to make it a reality.
Let's show them that we are a caring and inclusive society where the future is bright. Thank you.
Thank you for coming today.
I'm Ontario's only first nation member of Parliament and a member of Treaty No. 3 territory, which you referenced. I actually worked for the organization as the executive director. It seems like a million years ago, but it was a while ago, and I know about the problem with government funding and the way in which organizations and communities are funded.
You spoke about long-term solutions to solve the problem. Right now, I see it as first nations people and indigenous people across this country having been put in a place of dependency through the Indian Act. The Indian Act was good at what it did; it made our people very dependent on someone else. That needs to stop.
I'm not deflecting the responsibility of the federal government and the provincial governments right now to resolve the problem as it exists. We're in crisis mode. You've referenced the unacceptable suicides that are happening right across the Northwest Territories, Nunavut, northern Ontario, northern Saskatchewan, and right through all of our first nation communities across the country. This is deplorable, and it needs to be stopped.
Over and over again while we've been working as a committee on the study, we've heard about some of the things that you've referenced. One is that youth centres are very helpful in giving indigenous youth some meaning, starting from a very young age, and that goes a long way to preventing these tragedies from occurring.
I'm somewhat familiar with your organization. Again, in the long run, I see indigenous communities and first nation communities across this country building programs to help ourselves, to help our own people. I understand that there is not a lot of capacity in some communities.
My vision in terms of first nations communities would be that we would have our own revenue, perhaps through agreements with the provinces and the federal government on sharing natural resources, so that we don't have to be—I'm careful when I say this, because I think some people misinterpret it sometimes—beggars in our own land.
Throughout history, we've signed treaties and agreements to share this land, and that's not what has been happening. Our land has been taken and we've been marginalized. We've been placed on small patches of land called “reserves”, which are usually scrub land, and then given money from these governments and told how to run our programs and our communities.
That's for the long term. It needs to change. I don't have all the answers for how it's going to change. It's going to have to come from the individual communities across this large land.
My question for NWAC is, what has your organization been doing in the short term to partner with community groups and other organizations to deal with this crisis immediately? What support can the federal government give to your organization and to other organizations that are helping with the immediate crisis?
Just quickly, I want to reiterate that NWAC lost 100% of its health department funding in 2012 and has had no capacity to address any health issue.
Luckily, in 2014 we were funded by the Canadian Institutes of Health Research to start engaging in health research and partnerships. That's why I'm called a “PEKE”, a partner for engagement and knowledge exchange. This funding opportunity allows us to do some work on suicide prevention and mental health.
With the work we're doing right now, we're able to partner with research teams that are doing participatory research with communities in different areas throughout Canada. These are really innovative partnerships, such as looking at resiliency factors through innovative research projects like dance, theatre, and art, working with the youth, and working with the communities. I think these have been really fabulous research partnerships and approaches to dealing with suicide.
We also engage with Statistics Canada. We have no funding to do so, but we partner to do joint publications and to analyze the data. We look at a lot of APS stuff that we have, and I think we're going to be promoting the next APS as well.
We partner with a lot of different organizations that work on mental health through providing feedback on their mental health frameworks for first nations, Métis, and Inuit. It's really difficult, because I'm a department of one. We're looking at suicide and at every health issue. I work on every health issue in Canada, and you know there are many issues that are impacting our aboriginal women.
We're trying to do more. We realized after everything that was happening that we.... It's hard to be able to do. Although we consult with a lot of the women on the ground in our regions, I am not in the communities myself, unless we go to do some of our research collaborations and I get to work with the women. So things—
Thank you for the presentation.
I've had the opportunity to meet with the association in the Northwest Territories and have had some good discussions with staff and some of the executive there. I've heard that the issue of funding and resources is a huge concern. I've also heard it from the friendship centres. I've heard it from the band councils. I've heard it from every organization that deals with aboriginal people. That needs to change. We have a crisis situation in our communities.
It's estimated that in the west and in the north we have over 150,000 unemployed aboriginal people in our communities. In some of my communities, up to 60% of the people are not working.
We haven't had investment in housing for a long time. This year was the first year that we've had investment in quite a few years. We don't have any work, so people can't build a house and they can't provide for their children. We don't have a housing program. We're starting to develop one now so that people will have a place to stay.
What's happening in our communities is an out-migration of people to the regional centres, but there's no work there, and maybe, for some reason, they can't find a place to stay, so they're ending up on the streets. We're starting to get quite a few homeless people in our regional centres and in Yellowknife, which is the capital of the Northwest Territories.
We don't have any treatment centres. We have 12 communities that have no RCMP. The policy in the Northwest Territories is that if you don't have the RCMP, you don't have a nurse either, because of the safety issue. There are too many instances of nurses being attacked or abused. We know that we're dealing with the fallout from the residential schools in almost all our communities. I'm one of the people who went to a residential school, but all people my age and younger, and all the elders, went through a residential school, so there are a lot of issues in our communities.
As the executive director from the Native Women's Association said, in the Northwest Territories there are no resources. If there are resources, they're short term, so it's almost a day-to-day operation in cramped little quarters. We know we need to do more. Treatment centres are in the south. We send our residents to the south at a huge cost and, almost a day after, most of them are back in the communities where nothing has changed and they're back to what they were doing before.
We need healthy people, but we need healthy communities first. Could you talk a bit about what it would take to have a healthy community so that we can start developing healthy people and what kind of investment we'd make? You are now in front of us. You have the ability to make recommendations. What do we need to recommend to the government to do to change the situation we're in?
I'm going to let Amy speak to some of the health aspects of it, but I'm going to speak to the funding part, the money part of it.
Damage has been done through colonization, and we are living with a problem that is systemic. We need multiple layers: short-term solutions, medium-term solutions, and long-term solutions. We need a concrete action plan, not just research again and again. We need investment, and it has to be mapped out.
In the short term, there is a crisis. That's there. As for core funding for the organizations, I don't know, I think that's a crisis as well. If we're trying to fix all these problems that are systemic, who has the answers to the problems? Grassroots people have the answers. The organizations have the answers. We are there to help. We're there to collaborate. We have to be able to do that on an equal footing, so we need that in place.
I would say that it comes back to short-term, medium-term, and long-term funding to get the communities healthy again. It takes money to undo, right? People need access to mental health care. That costs money. Physical care costs money.
It does cost money, and it is going to take time. That's why I would say the plan has to be all three: short-term, medium-term, and long-term. If we only deal with the short term, we're definitely not going to get to the root of the problem, which is very long term.
Did you want to say something, Amy?
What I'm going to speak to is the Fort Frances Tribal Area framework that was developed 100% by youth on what they felt about how to get to a healthy community. They listed five areas on how to move forward with this.
The first one is that they need support to learn how to be healthier. Everything they recommended under that first point was all about family: family trips in the bush, family-based treatment programs, family counselling services, sweat lodges for family, groups of families coming together where everyone shares, and family projects. That is number one.
Number two was about needing programs built around the cycle of the life cycle; healing for families; crisis support workers; ongoing workers who don't just walk in and leave immediately; and strong support systems.
Support around around death and loss is number three, but it's about a safe place to go; places to talk to somebody; hobbies; activities; opportunities; and, volunteering.
Number four is access to elders and culture: learn more about your traditions, your language, the sun dance, and ceremonies.
I'm sorry. I'm trying to get through them all, so I'm summarizing quickly.
Number five is about safe places: somewhere to go before a crisis happens; a place where you don't feel judged; a real welcoming; helpers; having pets and animals; healthy activities; crafts; friends; food; and, events.
This was released in August of 2016. This was 100% done by youth. I think the solutions are within the youth.