First Nations

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First Nations Inuit Child-Youth Mental Health
Addictions Building Bridges in Atlantic
Canada

• Cheryl Copage
• Atlantic Policy Congress
• of First Nation Chiefs (APC)
• Barbara Broom
• First Nation Inuit Health
• Health Canada
• CMHA, August 22, 2008

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Presentation Objectives

• Showcase the First Nations and Inuit (FNI)
  Child-Youth Mental Health and Addictions Plenary
  Sessions held in NB, NS, PEI and Labrador in 2007
  and 2008.
• Describe the journey to date of the working group
  established to address the issues identified in
  the plenary sessions.

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Plenary goals

• To begin the first steps of a process to spark
  systems change in the delivery of mental health
  and addictions services for First Nations and
  Inuit children and youth in NB, NS, PEI and NL.
• To build and support collaboration and networking
  between potential partners.
• To determine the next steps in the process, with
  a working group.

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First Nations Inuit Communities

• Within the Atlantic Region there are 33 First
  Nations communities along with 5 Inuit coastal
  communities in Nunatsiavut
• New Brunswick -15
• Nova Scotia -13
• Prince Edward Island - 2
• Newfoundland and Labrador - 8

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Population

• Over 20,000 Mikmaq and Maliseet people live in
  NB, NS and PEI and in Conne River First Nations
  in Newfoundland
• Almost 5,000 Inuit with Nunatsiavut Government,
  live in 5 coastal communities plus in Happy
  Valley-Goose Bay and Northwest River in Labrador
• 2,000 Innu people live in Natuashish and
  Sheshatshiu in Labrador

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Atlantic Region Aboriginal Communities
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Governance

• First Nations are governed by the Indian Act,
  administered by INAC
• FNIH health activities are rooted in policy
  historical practise focus of FNIH programs is on
  health promotion and illness prevention (upstream
  programs)
• FNIH has contribution agreements with each band
  council several First Nations organizations to
  deliver programs
• Flexibility/control varies by agreement type
• FNIH also has contribution agreements with the
  Atlantic Policy Congress of First Nations Chiefs
• APC is the Secretariat for FNIH-Chiefs
  Co-Management Board

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The Atlantic Policy Congress of First Nations
Chiefs Secretariat Inc.

• The Atlantic Policy Congress (APC) is a
  non-profit organization that was formed in 1992,
  and incorporated in 1994.
• The Mandate of the APC is to research, analyze
  and develop alternatives to federal policies
  pertaining to First Nations in Atlantic Canada.
• The members include 37 Mi kmaq, Maliseet,
  Passamaquoddy and Innu Chiefs from NB, NS, PQ,
  PEI, NFLD/Labrador.

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The Atlantic Policy Congress of First Nations
Chiefs Secretariat Inc.

• The APC has a mandate from the Chiefs to focus on
  the following three main objectives
• 1. To create a forum to enable First Nations
  Chiefs to speak with one voice on policy
  matters affecting its member First Nation
  communities and Nations
• 2. To research, analyze and develop
  alternatives to Federal Policies
• 3. To develop and table First Nations policy
  positions.

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What were the Plenary Sessions in Atlantic?

• Opportunities to bring together the providers of
  Mental Health Addictions services for First
  Nations and Inuit (FNI) children and youth for
  purposes of networking and information sharing.

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Child-Youth Services

• It was recognized that there is a distinct set of
  provincial providers at the health district
  level, and
• the IWK Mental Health and Addictions Program in
  Halifax and the Janeway Hospital in St. Johns
  all serve the mental health addiction needs of
  children and youth in Atlantic Region.

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Child-Youth Mental Health Services

• Providers of child-youth mental health services
  get missed when the theme is mental health in
  general.
• The service providers in the adult system make up
  the bulk of MH providers and child-youth services
  can get overlooked or lumped-in with adult
  services.
• There is always, however, some overlap.

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First Nations Inuit Child-Youth Mental Health
Addictions Plenary Sessions

• Plenary sessions held in NS, NB and PEI May/June
  2007
• Mental Health Forum held in Goose Bay, Labrador
  March 2008
• Next Plenary in Miawpukik (Conne River First
  Nation) in Newfoundland in 2008-09

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Child-Youth Addictions Services

• IWK Choices Program serve youth in Atlantic
  Region.
• NB has Portage Program.
• First Nation Treatment Centres serve youth in
  adult treatment programs.
• There are presently no First Nation Treatment
  Centres just for youth, with the exception of the
  Charles J. Andrew Youth Solvent Abuse Centre in
  Sheshatshiu, Labrador.

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Child-Youth Addictions Services

• There are no detoxification programs exclusively
  for youth.
• Provincially, youth occasionally do enter adult
  detox programs at NS Hospital.
• There are no First Nation detox programs.

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Who were the partners in NB, NS PEI?

• First Nation communities
• Atlantic Policy Congress of First Nation Chiefs
  (APC) and other tribal organizations
• Native Council of NS
• IWK Mental Health Addictions Program
• District Health Authorities/Health Regions
• Provincial DOHs
• Health Canada, FNIH
• Private practice professionals (NIHB)
• NGOs, RCMP, schools and others

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DOH NS, NB, PEI

• Representatives attended from each province
• Patricia Murray NS (for Linda Smith)
• Barb Whitenect NB
• Joanne McInnis PEI

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Speakers and Presentations

• NS Keynotes Dr. Stan Kutcher and Dr. Patrick
  McGrath
• NB After the Thunder - play about teen suicide
  by drama club students from Eel Ground First
  Nations High School in NB
• PEI Perceptions - video of play written and
  performed by participants in The Young Moms
  Program on barriers faced by young, single
  aboriginal mothers

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First Nations Cultural Presentations

• Elders opening prayers
• Sweet grass ceremony
• Drumming and songs
• Elsipogtog Jingle Dancers

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First Nations Presentations

• Andrea Currie, therapist Colonial Trauma,
  Community Strengths and Cultural Competencies
• Mike Degagne, Executive Director of Aboriginal
  Healing Foundation - Promising Healing Practices
  in First Nations Communities

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First Nation Communities present

• Eskasoni, NS
• Indian Brook, NS
• Elsipogtog (Big Cove, NB)
• Wolastokwik NeGoot-Gook (Maliseet Nation at
  Tobique), NB
• Abegweit, PEI
• Lennox Island First Nations, PEI

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First Voices of Youth

• First Voice Presentations by First Nations Youth
  Stories of personal experiences accessing help
  from mental health and addictions services

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Break-Out Sessions

• Small groups session to identify issues for
  discussion of next steps
• Identification of people interested in forming a
  First Nations child-youth mental health and
  addictions working group through APC

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General Impressions

• Good to meet others working in mental health
  addictions
• Not enough time to share discuss
• Good networking!
• Speakers provided the audience with lots of
  things to talk about.
• Just the beginning of the conversation more to
  be said/do/learn about.

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So what?

• Increased appreciation and understanding of each
  other
• Not enough time to share and discuss
• Knowledge exchange started
• Contact info exchanged
• Solutions on the spot (NIHB paying for
  transportation to Choices Day Program)

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Feedback

• Traditional healing practices
• Community strengths
• Collaboration
• Jurisdictional issues
• Access to services
• Follow-up services
• Knowledge exchange

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Traditional healing practices

• Can traditional healing services and practices be
  integrated into existing MH Addictions
  programs?
• Need to promote cultural knowledge values
• Elders stories and talking stories
• Ceremonies

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MMAYC

• Mikmaq Maliseet Atlantic Youth Council
• Putting focus on accomplished charged
  Aboriginal youth
• http//www.atlanticfnyouth.com

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Collaboration

• How to ensure that children in care with Mikmaq
  Family Children Services, Community Services,
  Protection and Corrections receive the proper
  mental health assessments and treatment?
• Need to identify what is already working well and
  build from there.

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Jurisdictional Issues

• Between provinces and federal govts
• the relationship between the IWK and the District
  Health Authorities in NS, NB, PEI
• Is there a way that the IWK, Provincial Health
  Authorities and First Nation communities could
  implement multi-disciplinary teams for the
  communities?
• Myths vs. truths

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Access to Services

• Need knowledge on how to navigate the system
• How do First Nation communities access
  child-youth mental health addiction services
  from the provinces?
• What tools are used to assess children and youth
  referred to programs?
• Are the tools culturally appropriate and valid
  with Aboriginal children and youth?

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Follow-up Services

• Need discharge protocols and MOUs
• Need follow-up in the communities
• Stigma what does it look like in Aboriginal
  communities?
• How might provincial child-youth mental health
  and addictions services be modified to include a
  cultural component for Aboriginal people?

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Knowledge Exchange

• How do we get information out to share with
  communities?
• Look at community models that work dont
  reinvent the wheel
• Youth need a stronger voice in planning.
• Myths facts vs. fiction
• How does health work in partnership with
  families, schools, RCMP, Community Services, etc?

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Young people living off reserve

• Many clients in Halifax, Truro, Moncton
• Communication is a problem
• Loss of on-reserve services
• Youth from all First Nations across Canada
  different cultures
• Sense of exclusion because reserves support their
  own people
• Need culturally relevant services

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Young people living off reserve

• Native Council of NS has offices in Sydney, Truro
  Liverpool
• Friendship Centre in Halifax has methadone
  program and AHSOR
• Childrens Programs also in Sydney, Truro,
  Liverpool
• Can access NIHB

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Labrador Plenary Partners for March 2008 MH Forum
in Goose Bay

• Natuashish, Mushuau Innu First Nation
• Sheshatshiu Innu First Nation
• Nunatsiavut Government
• Labrador-Grenfell Health
• NL DOH
• Janeway Hospital, St. Johns
• Labrador Health Secretariat
• FNIH, Health Canada

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Labrador Plenary

• March 2008 in Goose Bay
• Labrador Mental Health Forum
• Funding recipient was the Nunatsiavut Government
  (organizer of event)
• Had follow-up teleconference call in May
• Will follow-up with Aboriginal Health Transition
  Fund (AHTF) Projects, rather than a working group

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What next? FN Child-Youth Mental Health
Addictions Working Group

• What will be the mandate of the working group?
• How can this group make a difference?
• Sub-committee of Mikmaq Maliseet Atlantic Health
  Board (MMAHB) Child-Youth Committee
• Has met three times in March, May and June 2008
  at the IWK Health Centre
• Fall sessions - Be the change!

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Thank you! Questions? www.apcfnc.cawww.naho.ca
www.hc-sc.gc.ca/fniah-spnia/