“We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.”

–Truth & Reconciliation Commission of Canada

Issue: Intergenerational Mental Health

TRC CALL TO ACTION #21 is of particular importance because it addresses the issue of intergenerational mental trauma which was caused by the experience of Residential Schools.

Intergenerational mental trauma is the collective trauma that multiple generations of a family or community experience due to the ripple effect of an emotional, mental or physical trauma that is directly experienced by an initial subject.

The Intergenerational Trauma Model affirms that public policies have negatively impacted Aboriginal peoples on the level of the individual, family, community, and nation and therefore renders Aboriginal peoples more vulnerable to threatening social conditions.

The trauma of Residential Schools has been found to affect at least two generations beyond those who attended these institutions, as the cycle of abuse and neglect was continued with the descendants of those who had internalized and consequently perpetuated the treatment they received in the schools due to PTSD, anxiety, depression and other adverse impacts, which affected their ability to parent and develop healthy and positive familial and communal relationships

Another source of intergenerational trauma is the loss of language, traditions and culture caused by the assimilation strategies of Residential Schools and which has resulted in feelings of alienation and hopelessness for the Aboriginal community which can be categorized as poor mental health.  [Menzies, P., (2010). Intergenerational Trauma from a Mental Health Perspective. Native Social Work Journal, 7, 63-85].

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Status of Aboriginal Mental Health

Research and Statistics on Aboriginal Mental Health issues make it clear that this community is in a state of crisis in this area. First Nations experience higher rates of depression and twice the suicide rate of the general Canadian population (Source: First Nations and Inuit Regional Health Surveys, 1997: A Synthesis of the National and Regional Reports). The suicide rate of Inuit people is up to 11 times the rate of other Canadians. Nunavut has one of the highest suicide rates in the world and since 1999, 27% of all deaths have been due to suicide. (Aboriginal People Issue of Visions Journal, 2008, 5 (1), pp. 6-7). Therefore, due to the adverse effect of Residential Schools on Aboriginal mental health, it is imperative that action be taken by the Federal government to redress these issues.

Reconciliation Proposal: Establish Aboriginal holistic mental health centres

TRC Call to Action #21 can be realised in contemporary Canadian society through the establishment of new Aboriginal holistic mental health centres and increased funding for existing mental health centres to help them meet the demand of the Aboriginal community.

• An ongoing contributor to Aboriginal mental health issues is forced acculturation. Holistic mental health centres are the most appropriate way to address Aboriginal mental health issues because research has shown that Aboriginal peoples are more receptive to holistic mental health services which are culturally appropriate because they see “mental wellness as a state of balance with family, community and environment” (Public Health Agency of Canada, 2006)
• In our research of a number of Aboriginal Mental health programs, we have found that the programs take an intersectional approach to addressing mental health issues and use traditional healing methods such as the medicine wheel, along with clinical mental health practices.
• Nunavut’s Addiction and Mental Health Strategy “calls for a community-based approach to addictions and mental health services, which blends the Inuit tradition of care for one’s family and community with the western biological and psychiatric sciences.” (Mental Health Commission of Canada, 2012, p. 38).
• Northwest Territories’ A Shared Path Towards Wellness- Mental Health and Addictions strategy is based on a ”‘population health approach’, [where mental health is] part of a larger picture that includes physical, social, spiritual and cultural health.” (Government of Northwest Territories, 2012)
• There is an urgent need for Aboriginal mental health services since 17% of Aboriginal people seek help for mental health issues, compared with 8% of the general population. Given the even higher rate of Aboriginals who need help than who seek help, increased culturally sensitive services would be highly beneficial. (Health Canada, 2000).
• Collective traumas may encourage greater reliance on coping strategies involving social support and shared belief systems (religion or spirituality) that could potentially encourage resilience to stress- related outcomes. (Zarowksy, 2004).

Model: Anishnawbe Health Toronto

The federal government in collaboration with the Aboriginal community should establish culturally appropriate mental health centres, following the model of Anishnawbe Health Toronto

• This model is ideal because of its culturally sensitive methods, its high rate of success and its low administrative costs. In our interview with Harvey Manning a social worker at AHT, he revealed that their program has been used as a model for other traditionally focused Aboriginal mental health facilities.
• Anishnawbe Health Toronto (AHT) was established as part of the Aboriginal Health Access Centres that resulted from the Aboriginal Health Policy for Ontario that was developed in consultation with First Nations, Inuit and Métis communities. Anishnawbe Health Toronto was found to “play a powerful role in improving the health and well-being of Aboriginal communities throughout Ontario.“ (AOHC, n.d.)
• A study of AHT by the Canadian Centre for Policy Alternatives concluded that they are “achieving positive patient outcomes and addresses specific health needs of the Aboriginal population: needs that are not apparently being met by other traditional or conventional health care providers.” (CCPA, 2010, p.479)
• AHT philosophy is rooted in traditional naturopathic healing methods from Elders and Traditional healers, the facilities include a sweat lodge. They also provide clinical healing.
• AHT offers many programs and services to address a wide range of issues related to mental health, including general health services, counselling, addiction services, family services and medical training. (Toronto Star, 2015)
• AHT has moved towards a model of reducing Aboriginal Homelessness through the O Ta Ti Baen program. Harvey Manning stated that the most pressing challenge AHT faces is a lack of housing for their clients. CMHA lists safe affordable housing as a necessity for mental health recovery.
• In 2014 AHT served 545 people, who visited over 11, 000 times, they have annual funding of approx. $5 million from the government of Ontario. (MSAA Agreement, 2014-17)
• 11 percent of funding goes to administrative costs, 89 % of funding goes to programs and services. (Toronto Star, 2015)

Our Plan: Overview

This is a conceptual plan which we advance to the federal government in the spirit of solidarity with the Aboriginal community. Our goal is not to impose a plan for Canada’s Aboriginal peoples but to demonstrate a way that the TRC’s recommendations can be put into action, to encourage the government to work collaboratively with the Aboriginal community to implement whatever course of action they determine to be best.

1. Public Campaign using media, social media, and public demonstrations to raise public awareness and garner public support for the #ReconciliationNOW! movement, in order to put pressure on the federal government to respond in a productive way to the TRC’s Call to Action.
2. Appeal to the Federal Government for funding through the Ministry of Health to implement TRC Call to Action #21
3. Establish a consultation group of stakeholders including Aboriginal community leaders, traditional and clinical mental health professionals, poltical leaders and policy makers.
4. Implement Aboriginal Holistic Mental Health Centres in Nunavut and Northwest Territories within two years.
5. Expand Aboriginal Holistic Mental Health Centres nationwide within 5 years.

Funding

Our plan conceptualizes a funding model that the government of Canada can use to provide funds to Aboriginal communities to facilitate their implementation of holistic mental health centres and continued funding for existing Aboriginal mental health facilities.

• The federal government, through the Ministry of Health, is the ideal entity to provide funding and administrative assistance for the establishment of new Aboriginal holistic mental health centres and to provide additional funding for existing centres. The public campaign will solicit the Hon. Rona Ambrose, MP Minister of Health and Health Canada
• Health Canada “supports the delivery of health care to First Nations and Inuit” and “funds organizations which promote best practices in Canada”. Health Canada’s The First Nations and Inuit Health Strategic Plan: A Shared Path to Improved Health supports Aboriginal peoples having administrative control of their health services.
• The Federal government is increasingly off-loading costs of health care to the provinces. We do not support transfer payments to the provinces for funding Aboriginal holistic mental health centres because, potential funding cuts from the federal government may make the centres unsustainable. We seek to make the Federal government directly responsible for these centres, in keeping with their fiduciary duty to Canada’s Aboriginal peoples.
• We seek initial funding of $20 million to establish two Aboriginal holistic mental health centres, with one each in Nunavut and the Northwest Territories. Funds allocation of $10 million per centre is calculated based on AHT operating cost of $5 million per annum and endowment of land (est. $500 000 value), and an additional $1. 5 million for the construction of an AHT centre. Finally there is a need for an endowment of $3 million per centre for special initiatives that address the unique circumstances of the province/territory’s Aboriginal mental health issues, such as housing for the homeless.  (MSAA Agreement, 2014-17, p. 53)
• We seek additional funding of $110 million over 5 years to establish additional centres in the remaining 10 provinces and territory.
• We seek additional funding of $50 million that will be set aside in an endowment grant that existing Aboriginal mental health centres may apply to for funding.
• After initial costs, it is expected that the federal government will continue to provide funding of $5 million per year, per centre for operating costs and will develop a model to facilitate this based on the MSAA accountability agreement between AHT and the government of Ontario through the Local Health System Integration Act, 2006.

Implementation

• Increasing numbers of Aboriginal people are moving off reserve and into city centres. Therefore, we believe it is prudent that the Aboriginal holistic mental health centres be situated in city centres in each province/territory. However, the location of these centres would best be determined by a group of stakeholders.
• The federal government can either give an endowment of land for the establishment of a centre or prove $500 000 in funding for the purchase of land for a centre. Suitable available properties can be found through the Directory of Federal Real Property
• It is imperative to establish a consultation group of stakeholders that can oversee the implementation and administration of the centres on an ongoing basis.
• In Nunavut the Qikiqtaaluk Corporation is an Inuit owned development corporation that has developed properties for the government of Nunavut including the Allavvik Building and the Qikiqtani General Hospital. We recommend that this corporation be utilized for the development of a centre in Iqualuit.

Final Words

• Our conceptual proposal promotes improved relations between Aboriginal and non-Aboriginals in Canada, because it stems from a social movement that will encourage solidarity between the two groups.
• Providing mental health healing through these centres will also curtail intergenerational trauma, and allow Aboriginal peoples to reclaim their culture through culturally sensitive practices. This will facilitate Aboriginal self-determination that will allow them to establish a relationship of equal status with the Canadian population.
• The Federal government’s funding of these centres will demonstrate that they take responsibility for Residential schools and are willing to make positive changes going forward.

 

Special thanks to Social Worker, Harvey Manning of Anishnawbe Health Toronto & Billroy Powell, Policy Analyst at the Ministry of Training, Colleges and Universities