Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology
Issue 16 - Evidence - May 31, 2005 - Afternoon Meeting
WINNIPEG, Tuesday, May 31, 2005
The Standing Senate Committee on Social Affairs, Science and Technology, met this day at 1:15 p.m. to examine issues concerning mental health and mental illness.
Senator Wilbert J. Keon (Deputy Chairman) in the chair.
[English]
The Deputy Chairman: Honourable senators, our first witness this afternoon is Christina Keeper from the Assembly of Manitoba Chiefs.
Ms. Christina Keeper, Suicide Prevention Envisioning Team, Assembly of Manitoba Chiefs: Senators, I would like to start by telling you that I am currently the chairperson of the Assembly of Manitoba Chiefs envisioning committee on suicide prevention. My background is as an actor. I became involved in the issue through the development of a theatre project for suicide prevention for Aboriginal youth in Manitoba in 1999, at which time we had enormous problems because of the lack of resources.
I am presenting the part of the report that we developed in the region with the envisioning committee. It is called "Towards a First Nations Suicide Prevention Strategy in Manitoba." We call it in Cree, Kanatan Pimatisiwin. And it reads, loosely translated "Speaks to the sanctity of life."
Introduction: The Assembly of Manitoba Chiefs' resolution of May 2003, no. 6, on First Nation youth suicide prevention, was passed by the Chiefs-in-Assembly. This resolution supported the activities undertaken by the Assembly of Manitoba Chiefs Youth Secretariat on suicide prevention as well as the proposal for a suicide prevention strategy for First Nations Manitoba.
The purpose of the project: The Manitoba First Nation suicide prevention project was undertaken to develop a Manitoba First Nation strategy and multi-year work plan that would impact on the lives of First Nations people so that suicide is not an option; to transform attitudes, policies and services to make this aim a collaborative effort between governments, organizations and individuals to develop prevention, intervention and postvention models for First Nations people.
The long-term process for Manitoba First Nations suicide prevention strategy is based on four cornerstones.
1. An envisioning team comprised of Elders, facilitators, specialists, front-line workers and youth to guide the process.
2. A framework for information and knowledge that is appropriate, comprehensive, available and accessible.
3. A strategy that ensures and develops the ability of communities, organizations and individuals to use the information and knowledge effectively.
4. Infrastructure that facilitates the information and communication.
The research was conducted by the project manager/researcher, including a literature review, interviews, site visits and consultation with the Assembly of Manitoba Chiefs Youth Suicide Prevention Coordinator. The group discussions on the research findings laid the foundation for the suicide prevention strategy and the multi-year work plan.
The envisioning committee was comprised of First Nations individuals from Manitoba and included a psychologist; a BHC coordinator, that is the Building Healthy Communities program; a professor of social work at the University of Manitoba; a community development worker who is also an Elder; a survivor, Mite'win, Sun-dancer, Pipe-carrier, who is also an Elder; the administrative assistant to the Director of Programs for the Manitoba First Nations Education Resource Centre; the Manitoba Youth Suicide Prevention Coordinator with the Assembly of Manitoba Chiefs; the Executive Director of the Manitoba First Nations Youth Secretariat of the Assembly of Manitoba Chiefs; and an educator.
The envisioning committee's statements: That First Nation programs and services must be culturally relevant and therefore must be developed and delivered by First Nation people with the cultural understanding and qualifications necessary. That the strategy must address the concepts of our traditional world view, which affirms the interconnectedness of all life, must affirm that suicide is not traditional to our people, and must affirm a grieving people related to the efforts of colonization that First Nations have endured.
The background: Most of the current research speaks to the elevated risk and contributing factors for suicide within the First Nations population and makes specific recommendations; however, there continues to be a serious lack of appropriate resources to address this issue either at a regional or local level. Neither Canada nor Manitoba has a federal or provincial policy to address the issue of suicide.
Due to the elevated level of risk, First Nations require specialized resources and expertise on prevention, intervention and postvention.
The research for this report included a literature review, a model review and Elder teachings.
The literature review included numerous strategies, programs, models and reports related to suicide prevention from Canada, the United States, Australia and New Zealand.
The model review was of the Jicarilla Apache Nation Mental Health and Social Services Program. This model was chosen as it had been recognized as a recommended program in two recent Canadian reports; Acting on what we know: Preventing Youth Suicide in First Nations and Suicide Prevention and Mental Health Promotion in First Nations and Inuit Communities.
The third component of the review is First Nations Elders' teachings as they relate to suicide. The teachings came in the form of oral tradition and are also delivered in an excerpt from a speech in 1989 by Tobasonakut Kinew entitled "Healing Our Own, Our Traditions Speak to Us Today."
The Elders on the envisioning committee provided spiritual support, guidance based on their own experience as survivors, and traditional knowledge of their cultures. They said, "To address this great problem requires great effort. It is our purpose in this world to preserve life, and suicide is not traditional to our people."
Key considerations out of the report were that the mental health framework may be a viable one for addressing suicide in the general population, but for First Nations the framework requires expansion for a working understanding of the historical context of First Nations' heightened level of risk; enhancement of models to reflect the cultural context of First Nations and to examine the population-level protective factors, including cultural and spiritual values, knowledge and practice and Elders' knowledge.
Key considerations also include that the rate of suicide for First Nations is not subsiding — a sustained effort in commitment and funding is required. This must be for First Nations by First Nations, including development, implementation and advocacy. Research must be initiated by or in partnership with First Nations. Research must include parasuicide. Suicidal behaviours are significant risk factors. Suicide and parasuicide are inextricably linked to attempts to colonize of First Nations. This is manifest as historical trauma.
First Nations' history and culture must be the context for addressing suicide rates and suicide prevention strategies. First Nations in the Manitoba region must be supported in their response to the issue of suicide.
The strategy:
1. Establish a First Nations wellness resource centre to address suicide prevention.
2. Promote awareness of the context of suicide in the First Nations population.
3. Promote awareness on suicide prevention as a critical issue in First Nation communities.
4. Establish a network for national/regional political representation and advocacy.
5. Develop mechanisms to secure resources for the suicide prevention strategy.
6. Increase the availability of resources on suicide prevention relevant to First Nations.
7. Train professional and support personnel about suicide prevention and First Nations cultures.
8. Promote and support research on suicide and suicide prevention related to First Nations people.
Recent and current activities of the Assembly of Manitoba Chiefs envisioning committee in 2005 include a suicide prevention workshop in partnership with NAHO, the National Aboriginal Health Organization, and the Treaty 3 area; a population health/indigenous methodology research partnership with Dr. Chris Lalonde, University of Victoria, and the Manitoba First Nations Centre for Aboriginal Health Research at the University of Manitoba.
We have a current commitment from the assistant deputy minister of FNIHB to fund the AMC suicide prevention initiatives. That includes the AMC Youth Secretariat and the Manitoba First Nations Education Resource Centre.
No decisions will be made without the full participation of the Assembly of Manitoba Chiefs on the proposed upstream investment in youth suicide prevention.
Mr. Jason Whitford, Coordinator, Youth Council, Assembly of Manitoba Chiefs: Good afternoon. Thank you for the opportunity to be here and present to the committee. I am an Ojibway member of Sandy Bay First Nation, born and raised here in Winnipeg. I am also a father of two children.
I have been with the Assembly of Manitoba Chiefs for close to eight and a half years. For approximately 10 years, I have been working with First Nations young people to create opportunities and implement strategies to address the numerous issues, one of which is suicide.
Unfortunately, this issue has directly impacted me. I lost a brother a little over 11 years ago. My brother would have been 26 now. Amanda also shares that personal experience. She lost a brother, too.
Amanda and I and Kathy are suicide prevention trainers. We do the assist training. We have been doing that for approximately two years now. In the youth department, this is one of a number of activities that we carry forward in the Manitoba region. As you know, the First Nation population is growing very fast and the youth are very diverse. There are a lot of them out there.
Some of the other work the youth department engages in is summer employment. We have done that for the past six years — youth internships, creating employment opportunities for youth; traditional activities, providing and creating and promoting the traditional values and teachings. We have done consultations on the topic of the Winnipeg Police Service and the RCMP, trying to bridge the gap between the youth and the police, workplace safety, and again suicide prevention.
Let's just step back a little. About three years ago, we did some consultations on the National Aboriginal Youth Strategy and the nine priority areas that were identified. In a sense, we held similar hearings. We went throughout Manitoba, urban and rural areas, and we talked to a total of 900 youth, First Nations, Metis, and I think there was one Inuit. We asked them what their priorities were under those nine topics and under the category of health. The most prevalent issue was suicide and the youth saw that as an area that needed immediate attention.
The second area that received the highest attention was the need for recreation, the need for on-reserve recreation and resource facilities for youth.
We presented also to the committee on urban Aboriginal affairs two years ago. We hosted the standing committee at one of our offices and we were identified in the report as demonstrating best practice. That was an honour. It is good to receive recognition.
In addition to that, I just want to say that of the close to 300 people we have met with and talked to about suicide prevention, probably 95 per cent had had suicide directly impact their family or a close friend.
When working with the mainstream, it was the reverse. It was probably 10 per cent who had a family member or a close friend die by suicide. Therefore, it is a very serious issue that needs to be addressed. With that, I will turn it over to Amanda to talk about some of the other work.
Ms. Amanda Meawasige, Youth Council, Assembly of Manitoba Chiefs: I am an Ojibway member from Eagle Lake First Nation in Ontario. I have been working with the Assembly of Manitoba Chiefs and the Youth Secretariat as the Suicide Prevention Coordinator for about a year now.
I think the youth department is unique in its approach to developing youth suicide programs. We tried to develop a holistic approach to addressing this issue that will hopefully engage youth, because that is who this issue affects most critically. That is the target audience of all of our programming, in that we want to engage youth, who are the fastest growing segment of the population. Soon, these young people will be going through the at-risk years and this problem will continue to grow.
That is the basis of our training. We want to train young people to be helpers to other young people, because research indicates that when young people are at risk of suicide, they are most likely to go to a friend rather than an adult or a teacher.
We have done a five-day pilot program in the community. Included in this training was asset mapping to help communities sort out the roles and responsibilities of different agencies so that they can collaborate and coordinate services better as well as identify gaps in existing services.
Are you aware of the NADA program, the national Aboriginal drugs and alcohol program? That is with the BFI, the Brighter Futures Initiative. In case you are not aware, the BFI and the BHC workers at the community level are responsible for the entire mental health mandate of First Nations. They are intended to support community-based activities within a community development framework that fosters the well-being of First Nation children, families and communities. It covers the areas of mental health, child development, parenting, healthy babies and injury prevention. Its objectives are to increase awareness and improve knowledge and skills in those areas for front-line workers and community members; to provide opportunities to improve health services and develop community-based model projects; to address health problems affecting children and families in a community-based, holistic and integrated manner; to improve the health of children by facilitating the prevention and early detection of health problems; to support community development and ensure integrated and coordinated health care for children and families in a human service sector.
Currently, the BFI, BHC workers are responsible for the mental health mandate and that is their job description, which is very broad. That creates a lot of confusion at the community level with regards to service delivery.
The other issue is that all of the work that we engage in starts with the belief that the strengths are found in communities and we have to work with existing resources to further build capacity at that level for them to be self-sustaining.
Ms. Kathleen McKay, Youth Council, Assembly of Manitoba Chiefs: Good afternoon. I am Cree and Ojibway from Nisichawayasihk Cree Nation and Pine Creek. I have been working with the Assembly of Manitoba Chiefs for almost two years, but I have also been involved for a few years as a member of the regional youth council, where I represented Manitoba at the national level at the Assembly of First Nations.
My involvement has primarily been in youth leadership development as a mechanism for suicide prevention. Suicide has been our focus because the ultimate result of a suicide has the largest impact, that is, the loss of a life. When we talk about mental health, suicide is the worst-case scenario. We all agree that there have to be several approaches to prevent that.
Jason talked about intervention, that we are all trained in applied suicide intervention skills, so that is one component. A second component is youth leadership development, and that has to do with the revitalization of culture and reclaiming our cultural identities as young people.
We had the opportunity to partner with the Assembly of First Nations Health Secretariat and Youth Council last year to develop a curriculum based on the four components of personal well-being — physical, mental, emotional and spiritual. Out of that, we developed a 20-day training model.
That was another approach to providing a suicide prevention strategy, where we were addressing a lot of the mental health issues that are prevalent in our communities, such as depression, low self-esteem, identity issues, drugs and alcohol.
Speaking of suicide prevention, when we talk about our approaches and our goals on suicide prevention, we are also addressing a lot of other social issues such as crime, such as addictions. We are promoting healthy living for First Nations, but not just First Nations; we do work with everybody. That is all I have to say. Thanks.
Senator Gill: I am from a reserve in Quebec. I am from the Innu Nation close to the Cree in the North. I was born and grew up on the reserve and I am still living there.
I read the report from Amnesty International talking about the women here. It is a good report, but it is not good news about the women. Also, last night I went onto the street right there. To be frank with you, I think the situation is not improving at all from an outsider's viewpoint.
This morning, for example, I asked a question of some people about their perception as a non-native, to see what is going on with the Aboriginal people and how they feel about themselves. As you mentioned, the problem of suicide is increasing, the population is increasing. However, I think the population is also leaving the reserve and coming more and more to Winnipeg. What is your first reaction to that? I would like to know. Will it be for the better or for the worse?
Ms. Meawasige: Just to give a little clarification, the problem will get worse with people making a transition from a reserve to the urban centre. Currently, the chief medical examiner's office does not determine race in an urban setting. The determination is made through postal codes right now. We know that there are First Nation deaths when we see First Nations postal codes. However, when there are deaths in, say, Thompson, Brandon and Winnipeg, in an urban setting, we do not know how many are Aboriginal. They do not determine race. That is something that needs to be looked at before we can say the problem is getting worse. We need to look at the data collection.
There are ways of working around that through combining databases with INAC for registered status Indians to clarify that situation. Before we look at the problem, I think we have to address the data collection in getting our needs appropriately represented.
Ms. Keeper: As I mentioned, we found in our research the special report that the RCAP put out in 1994, which called for a 10-year campaign in Canada to address the crisis on suicide; 10 years later, we are at a worse place than we were in 1994.
One of the issues that we have been dealing with here in the region is lack of funding, lack of cooperation with FNIHB to address this issue. The answer is that there is a deficit, there is no funding available. In fact, the AMC Youth Secretariat is one of the two readily available resources for suicide prevention in the region. I commend them for the role that they have taken on, because as an adult, I feel that this is not a role that the youth should have to participate in. It is far too great a burden for a youth secretariat. Yet they do it because they care. They know what their peers are saying; they know what their peers are dealing with. We have all lost a loved one to this issue. They are motivated in a way and work in a way they should not have to, and yet, FNIHB pulled their funding.
In that vein, I would like to talk about the Chandler-Lalonde study which, for those who are not aware of it, was released in 2002, I believe. One of the basic premises in the Chandler-Lalonde study on suicide in the Aboriginal community or First Nations, specifically in B.C., was that the greater the number of elements that a community has control over correlates directly with a decline in youth suicide rates. In fact, they found eight factors. If a community has control over those eight factors, they will not have a youth suicide problem. The study was over a 14-year period.
The envisioning team is now a co-investigator with Chris Lalonde on trying to do a study here, looking at how we can broaden it, at suicidal behaviours and all of that. In that partnership we have had so many discussions. It sounds ridiculous, but we said that basically subjugation is not healthy. It is not healthy, and that is across the board.
As our populations are growing, our lives are changing. Our lifestyle has been impeded upon in the last 50 years and we have to make changes, we have to move to the urban centres. Yet Canada continues to keep this iron-fisted hold on the funds, how they are used, and how that relationship will happen. Until that starts to change, I believe that the situation will get worse. I believe that the social conditions and the health of our people will continue to decline.
There has to be a true partnership. There has to be decision making by First Nations about what will make changes in their lives and we have to incorporate our cultural values. I think that until that happens, the decline will continue.
It is appalling to me as a First Nations individual when 10 years after that special report, which was a beacon of hope when it came out, this has happened. We should not be sitting here. I really believe that until there is true partnership and there is decision-making by First Nations about their own health, things will not change. Thank you.
Senator Gill: You mentioned that suicide was not within the culture before, now it is there. Some years ago, we did not see this phenomenon, but we had a movement across the country and lots of young people fighting within this group. I am not suggesting going back to that, but through the red power and these kinds of organizations, people can do something. However, today it seems that most of the young people decided to turn the violence against themselves. In other words, there is a need to express what you are, what it is you are feeling, good or bad. You need the channels. Everybody needs that. You need to show your talents.
Non-native people are the same way. Everybody needs to express themselves. Of course, I also think you need reference points. I do not know about here, but in my area, I am surrounded by young people on my reserve, and I sometimes ask them why, why? Usually, the answer is "I am not happy, I do not feel good about myself; I am not comfortable in my skin. I do not have any role models other than my father or my mother." Usually, these are the answers.
Of course, I am not saying this is the only reason. Do you not think that we have to put the emphasis on values, values of the past, values and talents we should develop for the future and do that ourselves? I think you mentioned that. You have to do that yourself and for yourself.
Do you think that doing what we have been doing so far as First Nations, waiting for the biggest budget and these kinds of things, will solve something? I just would like to have your view on that.
Mr. Whitford: We are part of the youth secretariat, the staff working in the Assembly of Manitoba Chiefs. There are five of us right now. We also have a 10-member youth advisory committee that is comprised of volunteer youth from different parts of Manitoba representing the five different nations here.
We encourage and promote the concept of youth involvement, youth leadership, in First Nations communities. We are trying to send a message that if youth are not happy in their current situation and want to create change, they should take the initiative to assemble and establish youth councils, youth organizations, in their own communities.
We are telling the youth if they do not like the way things are there are enough of them that they can take over their communities and re-create them the way they want to see them. Through volunteerism and youth councils, youth organizations, they can start to take ownership of the issues and create opportunities for the other youth around them. They want to see change in their own communities, but there are a lot of youth out there who just do not have the means to express themselves positively.
It does not always take a lot of money to do something in communities. The Elders are there, the youth are there. However, sometimes it is easier for youth to get together and chip in to buy some alcohol or drugs, something negative rather than something positive. It is unfortunate sometimes, and there is a big need for role models and some positive opportunities. In a way, we here are trying to lead by example, but there is a lot of work to be done.
Ms. McKay: I just want to add that in the work that we do in our communities, we try to promote as much as possible the idea that things will not happen if we sit around and wait for a bag to be thrown into the middle. This is how we have been functioning for the past three years in our suicide prevention initiative. It is not about dollar amounts, but it is about the quality of the services that are provided. We are trying to provide the best quality service that we can with no money, and I think we have done a pretty good job. However, it is about working with other government departments, other service providers, and ensuring that they are doing the same thing with whatever funding or resources that they have. We all have to be on the same page.
Ms. Keeper: I just have to add something. A National Aboriginal Youth Suicide Prevention Strategy is in the process of being developed and there was a draft released without consultation with youth. Again, the report Acting on What We Know: Preventing Youth Suicide in First Nations, which was a joint effort between AFN and Health Canada, was released in 2003 and was also developed without consultation with the youth.
This new Aboriginal Youth Suicide Prevention Strategy, which was developed without the youth, is recommending dollars for a coordinator in the region. That is what I am talking about — how things are implemented, how they are planned, where the money should go. The youth are operating without funding. That is the process that is currently happening, where Canada will say they are doing things but the impact has not been felt over the last 10 years. There is a chasm between communities and government and medical research, and it is just getting worse.
That is what I am talking about in terms of a true partnership. That is a fine example of this strategy at the regional level when they were not even considering the youth and the work that they were doing. They have been at it for a number of years and they are truly one of the priority initiatives in our region.
I just had to mention that.
Senator Johnson: Tina, could I ask you how the strategy for your envisioning committee is working? How far along are you with this process?
Ms. Keeper: Well, we completed the report in 2004. We had no commitment for funding from FNIHB. As I mentioned, FNIHB had pulled out all funding on the issue of suicide in the last couple of years. The youth lost their funding this fiscal year and last fiscal year, but we had a commitment from INAC. Therefore, the federal government is not on the same page all the time.
However, we continue to meet. We applied for a health research grant to enable us to continue to meet and explore the partnership with Chris Lalonde. We are very excited about that.
We also continue to work with NAHO, the National Aboriginal Health Organization. They do research implementation and are developing a new community toolkit, so we hosted a gathering. We expected about 25 people and we had 110 people attend. They are the people that Amanda talked about who work right at the grassroots level. They are Brighter Futures and Building Healthy Communities coordinators. We had a lot of community support and are developing a good partnership with NAHO.
Also, we are continuing to develop the network in the region with our community wellness working group and the tribal council health people.
We are continuing to meet without funds. We try to stay in place, and actually we just secured some funding from the region to develop a best way to work strategically and a web page, a resource page. We are really excited about that, one of the first tangible resources for our communities.
Senator Johnson: What is the urban suicide rate compared to people on the reserve?
Ms. Keeper: As Amanda said, there is an issue with the statistics.
Senator Johnson: Is there not less help on reserve than in the urban centres?
Ms. Keeper: There is less help on reserve, although there is a similar rate of suicide in the Aboriginal population, urban and rural.
Senator Johnson: What percentage of the population is in transition, moving from reserve to the urban centres?
Are they more at risk? I have been on the Senate Aboriginal Committee for 11 years and we did an urban Aboriginal youth study. We found that that was an issue, services for the people moving into the city for the first time.
Ms. Keeper: There is a lack of services in the remote communities. A study was just done in the region. The Centre for Aboriginal Health Research released a report in partnership with the Assembly of Manitoba Chiefs on a number of health studies. One of them talks about geographical location and health. There seems to be a better level of health in the more remote communities. Although it may appear statistically, on the issue of suicide, that the remote communities are suffering the most, actually there seems to be a very similar pattern. However, in general, the health, especially of men, seems to be better in the more remote areas.
Senator Johnson: Would you say Manitoba is pretty indicative of the rest of the country in terms of the mental health issues and suicide rates?
Ms. Keeper: That is the question. That is one of the areas we intend to explore with Lalonde. That study in B.C. found that in fact, 50 per cent of the communities over a 14-year period had no youth suicides. Therefore, they feel that there is a problem in how Aboriginal suicide has been interpreted and that it is not a problem for about half of the communities.
We felt that not enough research has been done on suicidal behaviours. There are a number of communities here in Manitoba that have been listed as using best practices and promising strategies in a new report from the Centre for Suicide Prevention. They were communities in crisis, with a cyclical pattern of crisis, and they have managed to curb the rate of suicide. However, the number of suicide attempts is as high as it has ever been, and we call it a high stress battle that they are in.
That is what we want to look at with Chris Lalonde in terms of the research we do here. One of the things we are saying is that maybe those communities that have no youth suicide are at risk, because there may be suicidal behaviours. That is what we want to explore.
Senator Johnson: When you talked about decision-making in terms of your own health, is that key?
Ms. Keeper: What I have found in reviewing a lot of the reports is that people have their own framework. It is difficult for them to understand what the issues are at the community level. For example, I talked about the model review, the Jicarilla Apache, which has been listed as the number one recommended program in Acting on What We Know and this other report. When we went to meet with them, we found out that they have sovereignty and they are also one of the five richest communities, reservations, in the United States.
They have a strong economic base and a mental health unit of 50 people. They have their own detox centre. They have a tribal code that says if you are at risk of hurting yourself, they will put you under surveillance, and if you choose not to abide by that, you have to leave the community.
Therefore, I felt it had not been explored or researched properly, and this is the number one recommended program. Okay, give us sovereignty, give us a strong economic base, give us a staff of 40 in every community and give us the ability to put protocols in place that say people have no confidentiality once they enter the behavioural health unit.
Those things are not possible in Canada. That is the type of problem I felt non-native researchers have in looking at our health issues, as an example.
Senator Johnson: I just want to talk to the youth because I know them and I worked with them. They were very helpful to us in our study on urban Aboriginal youth in the cities across Canada, which was the first study of that topic.
How have you been doing over the last couple of years with your program, and you have described it somewhat, but in terms of the mental health side, of youth suicide?
Mr. Whitford: I think we have come a long way in the five years that the youth secretariat has operated. However, each year continues to be a financial struggle for us.
Senator Johnson: You are getting more kids coming in?
Mr. Whitford: The Keewatin Winnipeg Youth Initiative was recognized as a best practice and is funded by the Urban Multipurpose Youth Centres Initiative out of Heritage Canada. We are waiting for funding once again for the year. We will probably end up losing about five months out of the year. However, based on past experience, we intend to just continue to deliver programs and services for urban Aboriginal youth and convince the management of AMC to support us in operating that project.
Initially, it was intended to be a one-time project. However, due to the need for that program in the north end of Winnipeg, where there is a high number of Aboriginal youth who are out of school and unemployed, we have a vested interest in seeing that program continue to operate for the youth.
Senator Johnson: How is Brian McKinnon's program working at the Y? I am talking about the fitness program. Do you know about that?
Mr. Whitford: No.
Senator Johnson: At R.B. Russell.
Mr. Whitford: I understand it is working quite well. They have outside sponsorship to enrol some of the students there in the downtown YM/YWCA, which is a very nice facility.
Senator Johnson: How would you describe the mental health of your friends and the young people in Manitoba now of Aboriginal origin?
Mr. Whitford: I think in some cases, they are reluctant to get the help that they need. They are more likely to seek support for the issues that they have from their peers. We need to build the capacity among people that the youth interact with on a daily basis.
In addition to our role as coordinators, we are almost therapists or counsellors to our fellow youth, who come to us with different addictions and we make referrals. However, for one reason or another, they are reluctant to seek the professional services they need.
Senator Johnson: Are any of them taking advantage of that?
Mr. Whitford: I know a couple of our youth do take advantage of the mental health services out there, but very few.
Senator Johnson: So you would prefer to have your own?
Mr. Whitford: Yes. One of our long-term plans is to have our own resource centre.
Senator Johnson: Would that be in conjunction with the wellness centre that Tina was mentioning?
Mr. Whitford: Yes. We want it to be staffed by young people and to have our own library, resource centre and training facility.
Senator Johnson: We have no wellness resource centre here in Manitoba that I know of. We have our centres. You have Thunderbird House.
Mr. Whitford: Yes, but none specifically for First Nations or Aboriginal youth.
Senator Pépin: We had some representation that there is a link between mental health or mental disability and substance abuse; would you agree with that?
Ms. Meawasige: I am looking at First Nations and why they have a higher incidence of mental illness. I think we should look back to the government policy of assimilation of First Nations people. That caused First Nations people to become separated from the values that give them meaning in life. People lost touch with traditional family, community and culture. Not knowing how to reconnect with that, not having the strength to reconnect causes the anxiety, and I think that anxiety often leads to substance abuse. Continued substance abuse leads to mental illness.
Therefore, we need to examine the history of First Nations. We consulted with youth. We asked them to identify meaningful things in their lives. They often state culture, language. We need to realize that it is those very things that give the youth meaning that we were forcibly separated from by assimilation policies.
Also, I think a lot of young people do not access resources right now because it is Western-based therapy, which is believed to have universal application. You think that approach will work for everybody and can be used with any culture. However, these approaches are specific to the culture in which they are developed and do not translate well across cultures. There is a high rate of turnover in young people accessing services. They see a counsellor once, it does not work and that is it.
For example, nature and spirituality play a prominent role in First Nation healing practices, yet they are non-existent in mainstream therapies. Mainstream therapy focuses on the individual, while First Nation healing considers the individual within the context of the family or the community. There is an interconnection about Aboriginal people.
Senator Pépin: That is why you say that revitalization of your culture is so important.
Ms. Meawasige: Definitely.
Senator Pépin: Also, you mentioned a 20-day model program. I was wondering about that?
Ms. McKay: I was talking about the youth leadership development training that we developed with the national youth council. That was just recently piloted, so a lot of recommendations came out of that. It is five days for each of the four components. It is meant to be delivered in four separate five-day sessions. However, we delivered it all at once to get feedback, identify gaps and see how well it worked.
Senator Pépin: Jason, you said that there was a need for more recreation. Could you elaborate a little on that?
Mr. Whitford: I do not know if many of you have been in First Nation communities, but I myself grew up in the city of Winnipeg. My family has lived in the same area for 32 years, in the south end of the city. There is a community centre within about six blocks in each direction from the home that we live in.
However, I know, for example, in Sandy Bay First Nation, once school is out, the youth pretty much have to fend for themselves. One thing leads to another, and then we have A, B, C, all of the numerous issues you hear about. This is probably the same situation in every First Nation across Canada. We have presented resolutions to the Assembly of Manitoba Chiefs leadership to push that forward.
However, in communities, Indian Affairs funding is the capital budget and recreation is not seen as a priority area. The roads, the schools, the band offices, the housing are priorities, and it is a huge gap.
We would like to see something like that piloted in Manitoba to see the impact. A couple of communities that do have the treaty land entitlement funding are listening and responding to the needs of the youth, and they are doing so on their own. However, it is just not consistent.
Senator Pépin: Do you know if there are more young women or more young men committing suicide?
Mr. Whitford: I know that in the report from a few years ago the rates among young men were higher. The methods of suicide are more violent, more final among men.
The Deputy Chairman: I would like to make a general comment for the panel to respond to and see whether we can do something useful for you in our report.
We have been hearing over and over from every sector that we have interviewed across the country that there is a tremendous need for community resources and for the integration of social services, primary health care, mental health teams, et cetera, but at the community level, where they can get to the people who need the resources. It seems to me you have been saying the very same thing; however, you have one degree of complexity that the other people did not. The rest of the people in the country have to wrestle with the federal/provincial health relationship, whereas you have a triumvirate. You have the federal/provincial health relationship and social service relationship and social infrastructure relationship. In addition, you have the First Nations being treated in a different way by the federal government.
When I have tried to think about this in my own solitude, I have wondered whether, when it comes to health and mental health services, you have to contract services. The expertise is in the provincial resources when it comes to delivery systems. I can understand completely that you do not want to sacrifice any of your autonomy.
Therefore, as the funding flows to make the system work, it would have to flow to your community centres, to your community organizations that contain all of these things from the federal government. Then you could, in turn, buy from the Manitoba health department the resources you need to make your system work.
Now I have no idea whether I am saying something absurd or not. I am just trying to grope through this issue and frame it in some way that gets you out of this terrible conundrum you are in now, where you are bounced from federal to Aboriginal health to First Nations to provincial resources and there is a lack of autonomy in your community organizations.
I would ask you now to think about that and try to address it. If you were king of the world and could design the best system, how would you see it?
Ms. Keeper: The best answer I could probably give is that the funding would flow through AMC and would be in First Nations' control. I understand what you are saying about services in the provincial jurisdiction that we should be accessing or could be accessing and that could possibly help us. However, on the matter of suicide in Manitoba, it is not true. Under the provincial jurisdiction there are no resources in suicide prevention, even for the mainstream. There is a severe lack of resources in this region.
In fact, the visioning committee is probably at the front of the train. We have had calls from almost every regional health authority, including the Winnipeg Regional Health Authority. We have participated with the provincial health department in developing suicide prevention strategies. We do not have adequate resources even under the provincial jurisdiction.
Further to that, one of the things that we are saying is that we have to reframe the resources that we believe will help our people with mental health issues. We believe that the mental health framework for the general population really does not work that well for them and does not work for us. We have a context in terms of who we are traditionally. We are a people of the land, we are people of community and extended family, and that continues today. Often, a mental health framework means people working one on one, but you go back to your family. You go back to a whole community.
We have communities of people. We are people who have been traumatized by the shutdown of our ability to make choices about our lives. The breakup of our families has had an enormous impact.
I believe that we cannot look at the mainstream mental health framework model as an answer. We have to start looking at putting resources into developing our own models or working together in a true partnership where we have a voice that says, "This is not working for us, let's look at how we can alter and enhance it."
The Deputy Chairman: My perception was you have to be in control. You have to have your community resources and be in control of them. However, the situation with mental health, addiction, suicide and so on is an enormously complex problem across the country. You are quite right that it is not handled appropriately anywhere, so you have nobody to learn from.
Nonetheless, when you get down to the pragmatic point of application of a system, I do not think you would ever have enough resources within your own community, so you will somehow have to be able to purchase them. The way I see it, that is the big move that has to be made, is to give you the clout to organize what you need and go out and buy it, rather than having Big Brother in Ottawa telling you how to do it.
Senator Pépin: Everything has to be central.
The Deputy Chairman: If it is to achieve a result, it has to be in the hands of people who know what they are doing.
Senator Gill: We look at what is going on right now, but do not forget, the situation now is not the situation that used to be. For example, there are nations. The Aboriginal nation was almost destroyed. Now people are living on band by band. The band comes from the Indian Act. You have to consider that. If you provide services on a national basis it is different, because a nation is a group of communities, sometimes lots of communities, like the Cree Nation, for example. There are lots of people. Instead of looking at people band by band, it is a different picture. You have more resources, more talents and things like that if we come back to what was there before, the real situation.
This is not a question, it is a comment. We are acting in that way today, but we have to rebuild lots of things amongst the First Nations.
Ms. Gwen Wasicuna, Community Wellness Worker, Assembly of Manitoba Chiefs: I am from Sioux Valley, Dakota Nation. I was asked to come here to represent the program that I work in, mental health and wellness. I sent an outline of the program. You can take a look to see if you have any questions, or did you want me to read it out?
The Deputy Chairman: I would prefer if you just briefly summarized what you have here. Tell us what you are trying to do and what your problems are.
Ms. Wasicuna: In our community of Sioux Valley, one of the main goals that we have achieved is to have a community help line for members of our community who are suicidal and linking them up to other resources. Often, we use resources within the community and not the professionals from outside because a lot of our members are used to speaking in their own language and are comfortable talking with male or female, depending on their gender. There are cultural differences in how you talk to one another, whether you are male or female. They have a hard time connecting with the professionals, whether they are therapists or crisis intervention workers, if they do not know what the protocol is or what gender they are. Therefore, it is often linkage to community resources, whether it is Elders or extended family. This helps them when they are suicidal or having suicidal thoughts.
We found though that with our volunteer wellness team we need to continuously, month to month, year to year, train them so that they can work within the community, plus know some of the language, some of the mental health issues that the therapists ask about when they use outside resources. It is continuously updating that. We are always short of funds to do that for our community volunteers, who are out there helping us 24/7 sometimes.
We need continuous training for our community members to be able to help and use them as a resource, more so than some of the professional resources in mental health, the counselling that is available to us. People are only allowed maybe six to eight sessions to deal with whatever past issues that they have to deal with. Often, it takes that long just to get connected with the person, and then it is chopped off. You have used up all your sessions.
We are hoping to be able to extend that somehow, because addictions and the suicidal behaviour go hand in hand. We have to be able to provide the professional resources when needed, plus the community resources on a continuous basis.
We just started our program. I would say it has been in the works for about five years. The help line has been available to our community for nine years. That is purely a volunteer service for our community members and it is an after-hours support service.
There are some growing pains once in a while, but we need to continue that. We are hoping to extend it to our neighbouring communities within a 50-mile radius, Birdtail Sioux and Canupawakpa Dakota Nation, and help them to link up with that resource, but there are just not enough funds to do that.
That is what we have done so far and what we wish to have happen.
Senator Johnson: If I am following your earlier comments, how do they get the funding that they need to develop the programs they want in their communities? I think this study and the community has to look at just where the money is going in terms of health. There is a lot of money allocated, over $13 billion, in terms of just Aboriginal programs from five departments of the federal government through the provinces, and that does not include residential schools, land claims or anything else.
I think it would be a good idea to look at that so we could know where the money would be available and make it more hands-on, because I do not know where it is going. I am frustrated after all the years I have been on the Aboriginal Committee and in the Senate. Where is it, what happens; where does it evaporate?
Ms. Meawasige: Could I just say something with regards to where money goes? As I said, the mandate for First Nations mental health lies with these BFI and BHC coordinators, who work under FNIHB. I think maybe there should be something done to look at the wage comparison between those workers who promote mental health on reserve versus the same type of program FNIHB offers in mental health services. I think you will see a wage disparity there. There is some money right there that should be looked at.
Senator Johnson: Well, I totally agree, and I would like the rest of you to comment because the rubber hits the road when it comes to this discussion.
Ms. Keeper: I do know that there will be further presentations by the Assembly of Manitoba Chiefs that will, I am sure, clarify this. The Acting Grand Chief and Irene Linklater are presenting.
Also, there is $65 million in the National Aboriginal Youth Suicide Prevention Strategy that is supposed to flow over the summer and through to the fall. For example, you would believe that money is to support the youth, and yet we were informed that we would not be receiving any dollars from that fund initially and not to expect it. In fact, we had a meeting with the assistant deputy minister of FNIHB and presented it to them. We had to go outside the region, because the region was not intending to flow that money to First Nations or to the youth.
It is a difficult relationship that has to be addressed.
This is not about asking for further funding for communities, it is about accessing quality resources that are available in mainstream society but not currently available to First Nations.
The Deputy Chairman: Thank you all very much.
I would like now to welcome Chief Norman Bone and Chief Ron Evans. We would appreciate if each of you would give us a brief presentation and then we would like to ask questions. As you know, we are trying to address how we can improve the mental health of the First Nations people and what can be done to lower suicide rates and treat mental illness when it occurs.
Mr. Ron Evans, Chief of Norway House Cree Nation, Assembly of Manitoba Chiefs: I am delighted to have Chief Norman Bone here with me, a colleague of mine on the health portfolio.
I want to take the time to welcome you to the territory of the Anishinabeg of Treaty #1, signed in 1871. Manitoba is the Anishinabe and Ininiw word for "where the Creator sits." It is the original homeland to the Ininiw — the Cree — the Assiniboine and Dakota, the Anishinabeg and Dene peoples. Together with the OjiCree of Island Lakes and the Dene of the far North, we welcome you to this land.
The Assembly of Manitoba Chiefs was founded in 1989 as the most recent successor to political organizations our First Nations leadership established through the years to strengthen our peoples and promote and defend our treaty and inherent rights.
On May 26, 2005, the chiefs and the Government of Canada announced the establishment of the first ever treaty relations commission in Manitoba to undertake research, promote public education and understanding of the treaties and to mediate disputes based on our treaties and our inherent right to govern our own people, our lands and our resources. We are proud to say that our Grand Chief until this week, Dennis White Bird, has just been appointed the Treaty Relations Commissioner in our Province of Manitoba.
We put our treaties front and centre today because that is where we believe the change must come to improve the health of our peoples. The recognition and the affirmation of our treaty and inherent rights that the Constitution speaks to must include implementation of our treaty rights and respect for our inherent right to self-determination.
In any discussion of mental health, mental illness and addiction with regard to Manitoba First Nations people, it is essential to know that our peoples are unique. We are Cree, Dakota, Dene, Ojibway, OjiCree, and we have languages, cultural ways, traditions and ceremonies that make us who we are. Our people have lived in what is now called Canada since long before written records. The oral traditions of our different peoples document our history and our continuing relationship with the lands and waters of our territories.
You may have heard this before. Today, we ask you to consider the connection between mental illness and addiction that our peoples experience and the dramatic upheaval in our lives due to the imposition of new ways and laws by newcomers, including the imposition of the Crown. This devastating effect has been most directly felt since the late 19th century through successive Indian Acts that control all aspects of our lives from the cradle to the grave and through residential schools. These two weapons tore apart our families, denied us their love and nurturing, and undermined our traditional livelihood and any inroads our entrepreneurs made in the newer economies.
Into the 20th century, this was a period of dispossession of our families, our lands and waters, our livelihood, our way of life. A concerted campaign was waged to take the Indian out of the child in residential schools and to take the Indians off the lands by enforcement of both federal and provincial laws.
We do not wish to recite the devastation visited upon our peoples. We do wish you to understand that our peoples continue to suffer from what our Elders and healers say is unresolved grief over the generations. Some refer to this situation or condition as historic trauma or collective grief, and it manifests itself in the high proportion of our people addicted to alcohol, drugs, gambling or other forms of addiction and in high suicide rates, especially among our young people.
This collective grief and the need to heal from this historic trauma is a complex situation that requires layers of understanding by the people affected and by those who seek to help, whether health professionals, policy-makers or private investors.
We understand that some of our people suffer from mental illness of many causes, and some illnesses we share with mainstream Canadians. For example, the Aboriginal autism society of Turtle Island held a two-day conference in Winnipeg this past weekend.
However, for the most part, the skyrocketing rates of addictions and suicide and the identification of stress influencing the onset and acute stages of chronic diseases are directly traceable to our collective history. These underlying causes of mental illness can only be addressed through acting on our treaty and inherent rights to self-determination and establishing a new relationship with the Crown. Such a relationship and partnership needs to be specific to First Nations in recognition of our place as original peoples and the diversity of our cultures. Thus, we are here today to explain that any laws, policies, programs and services for First Nations health must come from our peoples and our leadership in order to be effective.
This January 2005, the Chiefs-in-Assembly in Manitoba adopted a 10-year action plan called the Manitoba First Nations Health and Wellness Strategy. We built upon the 1998 Assembly of Manitoba Chiefs' vision for action in health: All life comes from our Creator. Life is therefore sacred and must be preserved, protected and respected. Paramount to life is health. Thus, it is recognized and asserted that health is the total well-being and balance of our physical, mental, emotional and spiritual natures. In a collective and cooperative spirit and respectful of each First Nation's autonomy, it is our vision that total health be restored and maintained in the lives of all First Nations people in Manitoba.
Our 2005 10-year action plan is being further considered by forums last week and this to more fully involve First Nations representatives and health workers from the front lines. This will be our plan and we will bring forward our views to the Prime Minister's blueprint process. However, make no mistake, this is the plan that the Manitoba First Nations will pursue. We will continue to lobby, network, develop partnerships and seek support and funding whenever necessary to carry out our strategies to achieve our goal of restoring total health to our peoples.
Our goals are to increase life expectancy to a level comparable with non-First Nations in Manitoba; to reduce the prevalence of illness and disease rates across all ages; to improve health to a level comparable to or better than the provincial and national rates; to strengthen the service infrastructure essential to improving access by First Nations people to the health services, especially off-reserve citizens.
Our priorities are designing and implementing a First Nations health system delivery framework, strengthening comprehensive primary health care, supporting emotional and social well-being, addressing the social determinants of health, and pursuing health information and research.
Within each of these priorities, we have detailed targets and action plans for how to achieve them.
We recognize that working with federal and provincial governments and partners such as regional health authorities is essential. However, we will be true partners. This is our inherent right to self-determination and we must act upon our treaty right to health care.
You may be aware of significant research findings from Harvard University on socio-economic development and from the 14-year research study in B.C. on suicide prevention in First Nations. The Harvard project on Native American tribes found, through several years of onsite work with First Nations in the U.S. and Canada, that business success in First Nations in Canada and tribes in the United States depended upon a few factors such as a stable government and regulations, adequate funding, and, importantly, the cultural match of the business to the community. Similarly, the ongoing 14-year study of Chandler and Lalonde, "Cultural Continuity as a Hedge against Suicide," found that First Nations who had control of essentially government functions such as education, health, community services, who worked to resolve land claims and actively practised their cultural traditions, had little to no suicide. Thus, culture is a major contributing factor to the well-being of our people and to the success and stability of community initiatives to provide opportunity and hope.
It can be noted that Manitoba First Nations will be working with Dr. Lalonde on an expanded population health/ indigenous methodologies study of cultural continuity with Manitoba First Nations perspectives — the Cree, the Dakota, the Dene, the Ojibway and the OjiCree.
The foundation of our cultures is the relationship we have with the Creator. We believe in a spiritual connection to healing and good health. For this reason, we honour and respect traditional healers, traditional medicines from the earth and the healing ceremonies of our peoples. We will work to ensure that there will always be a respected place for our medicines, our healers and our ways within an effective health system for our people. Yet presently, health care services for First Nations people are not based on holistic and spiritual health. Our people cannot be well unless our spirits are well. The very concepts of health in our own languages speak of walking in balance, and thus we must build new health systems that are infused with spiritual care.
All life is interconnected, and this is the way health services and programs need to be, from prevention, education and treatment to healing to palliative care. We believe that integration of services means building strong interconnections to enable an ongoing, supportive delivery of those services. We are pleased that this committee has cited the social determinants of health, as our First Nations communities need adequate housing, high quality education and access to employment and training opportunities.
The demographics in Manitoba and Saskatchewan point to the reality that within a decade, more than a third of the workforce will be primarily First Nations as well as other Aboriginal peoples. The future economy of the Prairies depends a great deal on our peoples obtaining the education and employment opportunities needed and building the future for all of us.
Finally, our languages hold thousands of years of knowledge of our lands and waters. Our values and teachings are based upon our people's intimate knowledge of our lands. Our Elders tell us that everything we need to make us well is in our own territory. It is essential that we care for the environment to ensure that the nurturance and healing of the lands and waters continue and our treaties and inherent rights are respected so that we have continued access to our lands, medicines and ceremonial places.
Our role as chiefs is multifaceted. We work with our council, Elders and all our people to ensure that our First Nations are healthy, viable communities in which to live and grow as individuals and families. Moreover, our role is to protect and strengthen our treaty and inherent rights to ensure that the Anishinabe, Ininiw, the Dakota, the Dene and OjiCree people continue as diverse, unique peoples for endless generations to come.
In conclusion, we wish to address your specific questions. What should be the top priorities for the federal government as it starts the process of changing the way it delivers mental health services and addiction treatment to First Nations? — to address the intergenerational impact of the Indian Act and residential schools, that is, colonization and assimilation; and the lack of implementation of the treaties and recognition of our inherent right to self-determination. What would be the most appropriate structures and processes to ensure that First Nations have adequate input into the design of services they need? The answer we seek is bilateral arrangements, First Nations to federal government. How can the federal government organize itself to deliver those services most efficiently and effectively? It can fund First Nations health planning and delivery as demonstrated by and will be implemented through our coordinated efforts in the Manitoba First Nations health and wellness strategy, a 10-year plan for action, 2005 to 2015. Who should take responsibility for carrying out an environmental scan to determine what programs exist, identify duplication among government departments and organizations, significant gaps in programming and how best to maximize the effective use of available resources? The Assembly of Manitoba Chiefs and Manitoba First Nations, along with government and university partners, have taken a lead in divining the state of First Nations health, health care usage and access and the particular barriers First Nations face in interjurisdictional disputes over health care. We would be glad to send you a listing of these resources.
Honourable senators, we wish you good deliberations. We hope we have furthered your understanding and we look forward to your recommendations, your questions. With that, I conclude, and I say ekosi, miigwech, mahsi cho, wopida, merci, and thank you. I will turn it over to my fellow chief.
Mr. Norman Bone, Chief of Keeseekoowenin First Nation, Assembly of Manitoba Chiefs: Thank you very much. I just echo and support the statements that Chief Ron Evans made and I would like to, in numerous nutshells, request more quality money for the work we have to do.
I am just echoing Chief Evans and supporting what he has presented for us. Hopefully, the message that we can give to you and you can pass on to the people you work with is what has happened to us is, overnight, our lifestyle had changed. When the reserves were created, basically it did not take very long for that change to happen. This created what was referred to as the historical trauma, but it was a traumatic experience for many of our people.
At one time, the First Nations people of this area roamed and worked the entire countryside to maintain their lifestyles. It was changed basically overnight by having to, in our case, live on a reserve that is 5,000 acres. That changed things for us drastically.
The way this affected us mentally, if you take a look at the stats, the numbers tell those stories for us. In 100 years we have had all kinds of things happen to us, aside from the strategy here, the residential schools, the children's aid society system, how it did not serve us very well in the early part of the last century.
I can keep on giving more examples of that, but I tried to put this into a nutshell, in about three points. One is assisting us in reviewing and understanding our situation, the work that we have to do as a result of that. We need resources for our communities off and on the reserves to work on awareness, prevention and treatment programs. We need to be in control of those resources for ongoing program development and implementation.
What has happened to us in 100 years will not change, unfortunately, overnight and we hope that our presentation here today will assist you in taking that message on to where you have to take it so that we can look at doing the damage control ourselves, working with our Elders, our youth, the women, the men and our children to correct the harm that was caused over the past 100-odd years.
Just to give you an example of 30 years ago in my community. We did not have any money for counsellors or for mental health workers. We had a volunteer alcohol worker or person who ran the AA program and was seeing anywhere from one to nine people throughout the course of the year, trying to assist them in gaining their stability and sobriety.
Roll it up to 30 years now, we have been able to access — which is okay but still not enough — through the transfer control programs a mental health worker and a NADAP worker. With a community our size on 5,000 acres, between 400 and 500 people, those workers are seeing anywhere up to 120 people. We need more work to help those individuals who come to the health centre looking for assistance with their own stability. We do not have a professional counsellor on staff, but one of the workers who comes to our community is seeing anywhere from 60 to 120 people, with the help of the mental health worker, the BFI worker and the NADAP worker. Therefore, there is a lot of work to be done there.
That is just on reserve. We still have many people we need to reach out to who are within areas like Winnipeg or Brandon, where our community peoples live.
I thought I would just add that to try to give a picture of what is happening with our community. The last presenters were giving some of those pictures. One made a joke as well — we need more quality money. We need enough money to be able to pay the workers properly to carry out the work that needs to be done in relation to the mental health services. Thank you very much.
Senator Kirby: I wonder if I can ask a broad question. When the committee did its previous study, we were appalled at all the health statistics from the on-reserve Aboriginal community. They are truly third world and outrageous. Forgetting just for the moment about mental health — I will come back to that in a second — how do we begin to deal with that? I think it was Chief Evans who talked about a partnership with the regional health authorities, the province, the federal government, and so on. The federal government basically does not provide on-the-ground services in any event, other than airplanes, so would you be better off if, effectively, the federal government signed a contract to pay for all of the services with the provincial government, which has the resources on the ground? The federal government would get out of the day-to-day picture because, as best as I can tell across the country, that does not help anybody. With federal funding, you people would negotiate directly with the provincial government, with the on-the-ground community services. I understand the federal government has to pay for it. This is not an attempt to save money, this is an attempt to get somebody out of the picture who, it seems, is not contributing anything to help solve your problems.
Mr. Bone: That is one possibility. We have been struggling with that in trying to access some services that way already. I am not sure that we have been that successful. I will talk about one situation in our community.
Senator Kirby: Where is your community?
Mr. Bone: Elphinstone is the name of the town and Keeseekoowenin First Nation is the name of the reserve. We are just north of Brandon. We assisted the local municipalities and two other First Nations in trying to save the local hospital in terms of maintaining the doctors there. We were not successful.
Even when we and the municipal people jointly are trying to work at initiatives to provide or maintain services within our area, we are not succeeding, so what you are suggesting may not necessarily work.
Senator Kirby: Just so we are clear, there are lots of stories in Northern Ontario and elsewhere that have nothing to do with an on-reserve situation, whereas there was a story in the paper recently about how five of the six doctors in a Northern Ontario town left. It is not First Nations versus non-First Nations.
Mr. Bone: That is what I am getting at. What you are recommending is that the feds give the money for the services. We are trying that already, but it has not been that successful, not when initiatives are taken, for instance, to shut down hospitals right next to our communities. It is not working in that sense.
Senator Kirby: Who shut down the hospital? Was that a provincial or a federal decision?
Mr. Bone: A provincial decision. If you are transferring the money that way, then there are definitely some problems with the way that will be set up. The one option that I would look at is — I would not mind if you were to present it that way — why not have a contract directly with the First Nations of Manitoba so that we could create and deliver those services for ourselves.
Senator Kirby: So in a sense, the federal government would contract with the chiefs?
Mr. Bone: With a mechanism like that. That is one point.
Senator Kirby: All right. Could I ask one other question? I could not believe your numbers. You said one counsellor or NADAP worker was responsible for 120?
Mr. Bone: Up to 120. I had asked the health director in my community how many people the one counsellor who is coming to our community is seeing. The response that the health director gave was, at a minimum, 60 people. The kind of work that he does is simply awareness and prevention and some minimal treatment work. This is a worker who is shared between a couple of the reserves in our area. We also have a mental health worker.
Senator Kirby: Full time?
Mr. Bone: Full time, yes, but again, we have to work at training that individual to become, let us say, a qualified counsellor, and if she came back to work for us, we would not be able to afford her according to the agreement. We have a bit of a problem that way.
Senator Kirby: What is a reasonable number of people for a single worker to see? I do not have a feel for that. My instinct says up to 120 is really high.
Mr. Bone: Yes, it is high.
Senator Kirby: We can find that out. Can I just ask you one last thing? In the very last paragraph of Chief Evans's presentation, you talk about how you could give us information. Specifically, you refer to the particular barriers First Nations face in interjurisdictional disputes over health care, and we would love to see that information, the references to that or whatever you have. If you can send that to us, it is the last bullet point on page 7. I would like to understand that better. You also say there you would be glad to send us a listing. That would be really helpful.
Senator Gill: Thank you very much for your briefing. It is a good one. I like this one very much. Just in your briefing notes, you mentioned Anishinabe, Assiniboine, Dakota, OjiCree and Dene. These are all the nations, not bands.
Mr. Evans: These are different nations.
Senator Gill: I see a difference between the bands and nations. I like this way to express that because people used to see bands as First Nations. It is a part of one of our First Nations. I think it is very important that this point be made. Just before you came we had some youth here and there was a question about that. People feel that it is very difficult for First Nations to have the services because there are not enough human resources. However, when you take the nation, the picture is quite different. That is why I think it is very important to make this distinction and good for our committee to read that because we will lead others in the national capital on that. Usually, they talk about 600 nations across the country, or more, which is not the case. There are approximately 50 nations with whom the government should deal. I think it is very important.
Senator Kirby: Senator Gill, because the witnesses would find this interesting, you live on an Ojibway reserve?
Senator Gill: No, Innu reserve. I used to be chief.
I would like to know something because I was aware, at the time that Phil Fontaine was your Grand Chief here in Manitoba you started something here to take over from Indian Affairs. Did you succeed?
Mr. Evans: No. We started pursuing our FAI, Manitoba Framework Agreement Initiative. We have not kept to the time span that was predicted. It is taking much longer than that.
Senator Gill: However, you are still working on it?
Mr. Evans: We are still working towards that, yes.
Senator Gill: And the goal is still the same, or have you changed your mind?
Mr. Evans: No. The goal is always the same, towards self-determination and self-government; that was the whole purpose of the FAI, so we could manage our own affairs. This morning there is a signing at the Manitoba Legislature for us to take over our probation services. We have taken over our child and family services. It is no different when we seek to take over some of our own health services so we can start to manage those. Once we begin to manage those, then that allows our people to start acquiring the skills, taking responsibility for ourselves. Not only that, but once we have acquired the skills to manage our own responsibilities, we can transfer those to our children and our grandchildren. That is how we begin to address the problems that we are encountering at this time.
Senator Gill: Coming back the financial resources, since you started to get organized and to manage services for your people, you want to have the resources from Ottawa identified for the Aboriginal First Nations come to you instead of to the provincial government?
Mr. Evans: They should come to our organization, because when it is done through another entity, we are still not given that full responsibility, that full trust that we are able to manage. We have people now who have the education and the experience that can help the organization, help the communities begin to move forward. It is just that we do not have a vehicle; we do not have the resources to demonstrate what we are capable of at this time.
Senator Johnson: What resources do you have?
Mr. Bone: We do not have very much, other than what we get through the government, because some of it goes through the province. Not all of it comes directly to us. It is never adequate for us to successfully deliver some of the services that we assume responsibility for.
An example is transportation and medical transportation. We always seem to be running a deficit because no one can determine what the expense will be, so right away, the majority of us are seen as not competent to deliver that. At the same time, it is not something that we have total control over. There are other players at the table, yet we are the ones who have to try to deal with at the community level.
I wanted to respond to your earlier question about the nations. There are nine reserves or bands within our Ojibway Nation around Riding Mountain National Park. We view ourselves as the Ojibway Nation and we are spread over nine separate reserves.
I would just like to make some other comments in reference to the initiatives that were undertaken here a few years back. Of course, not all of us agree with some of the approaches, but the intent is for us to get control of as much of the resources as possible so we can correct the problems ourselves. If we continue to allow other jurisdictions to try to assist with or take on the work of correcting our problems, it will not work. The entire approach to taking over from Indian Affairs was based on that kind of foundation. Let us control all of those funds within that department, that organization. Give it in to our control so we can look at carrying out the work that is needed.
Senator Gill: You have been working on that for 10 years, I think.
Mr. Bone: Actually, about 30 years.
Senator Gill: I would like to say it is short term compared to the country, dealing with the provincial government. Sometimes, when Indian people try to do something, it seems to take time, but it is not the case, because provincial and federal governments are still fighting over the Constitution and things like that; it is short.
The issue has always been around of people who are saying that the Aboriginal people do not have the competence or they are not able to manage their own affairs, usually the money is just thrown away, things like that. How would you answer those people? I have been hearing that quite often, and probably it is the same with you. How would you answer?
Mr. Bone: I would say, "Just have patience, because we can create our own stability, given time." Sometimes the time frames that are imposed upon us are too short. For example, to fix a community that has a third party or co-management situation in two years would not necessarily work. You have to look at the systems, at how long those leaders have been there in terms of being able to correct those kinds of problems. It may take four years to correct a third-party co-management system.
Senator Gill: What about the confidence?
Mr. Bone: I think that once a community can see that it has a timetable to correct its own problems, it will develop the confidence. I am certainly seeing that in my experience of the areas that I come from.
Senator Johnson: I wanted further clarification on how the provincial government should turn things over to you. That is what you want. What about the urban areas?
Mr. Bone: We have some diversions on our side of the table too at times, but I am not sure if we want the province to just do as you suggested there.
Senator Johnson: That is what I understood, that you wanted direct control.
Mr. Bone: We are trying to look at how would we do if we had a stand-alone system where the resources would be made available to us to correct our own problems in combination with the provincial system that is involved, and it will assist. There are some areas where you might have to do some things jointly, for example, hospitals. I know my community could not build or run a hospital; we could not afford a hospital. If I worked jointly with the municipalities in our areas, maybe the whole southwest region of Manitoba would end up with one hospital.
Senator Johnson: What about the Aboriginals in the urban centres, in Winnipeg, for example?
Mr. Evans: My community has 500. My membership is 6,000, and just in the city alone, 500 of our citizens reside here. We have an office here in the city. They come there for any kind of support that they seeking. We do not turn them away, we assume responsibility for them. I think that is what we are saying as leaders in this province, that we want to be able to support all our citizens, whether they live on reserve or off reserve. We are able as a community to do that at this point.
I believe that if we were given the resources we would be able to do that for all the First Nations who live in the urban areas. It is just that right now, we do not have the resources to develop the kinds of services and programs that are needed because we are focused on trying to address the poverty and hopelessness that exists in many First Nation communities. Sometimes we are forced to take some of those resources to try to assist those living in the urban areas.
Senator Johnson: Well, as we discussed with the last witnesses — we had a very good discussion about this as well — where does the money go? Where does all the money go, the $13 billion for Aboriginal issues or programs in Canada through five departments and the provincial governments? Is it always just money, or is it the way the money is being sent through the provinces and into either reserves or the urban programs or whatever?
We have some very good programs in Manitoba, you know that, and in the city, especially in terms of healing people — Thunderbird House, other things at the Aboriginal Centre, further things happening on a number of fronts. I just want to know where the money goes now, because you want more quality money.
Mr. Evans: In the area of health, I believe we are in a position to provide just a number system, how that money is not helping our communities, especially those communities in the north of this province. The cost of providing treatment needs to be visited, how we can begin to provide more cost-saving treatment as opposed to what is there now. There are a lot of expenses that work towards that.
When you ask where the money goes, most of it goes to the service providers. We are just a kind of flow-through, the First Nation communities, and it is not really assisting in the way that it should. It is not providing the kind of services and treatment that it should, so that needs to be looked at.
Senator Gill: You have to work on the condition that when you give money to those organizations, you are fixing the problem. Somebody else is doing that, though, the band council.
Mr. Evans: It is not just in one area, it is a vicious circle. You spend money to treat people here, for example, one individual coming out of an overcrowded home. He comes out for treatment and then goes back to the overcrowded home. It does not change. Nothing really changes because now the people living in that same household will follow the same pattern. Unless the conditions change right in the communities and the environment, then we are not achieving what we need to, which is to bring health and healing to our people. If we do not find new or creative ways to spend money to provide treatment, then it is just an uphill battle.
At the same time, this is where we need to be given that confidence and that trust so that we can perhaps see what is wrong, because we are not given that opportunity to change things for ourselves. To do that, we need the resources.
The Deputy Chairman: We were discussing this earlier today, as Senator Johnson just mentioned. One of the reasons for the failure of the mental health system in Canada nationwide has been lack of organization at the community level. Now, it seems to me that, from what I have heard so far and the little I know about your predicament compared to what you know, there are layers of services that could be handled very well at the community level. If you had an emphasis on community care for mental health, addiction and suicide, et cetera, there are many communities where that could be organized quite well, I think, at the community clinic, primary care, social services level.
Of course, I think it would be a colossal mistake to try to organize hospital services, tertiary or quaternary mental health services; you can buy those. They exist, and for the few people who need them you can buy them. However, the masses would be treated in your community centre.
It is a question of breaking it down to a realistic model. We get the message loud and clear, both from you and the people from your communities, you want to maintain control of your resources at the community levels, and you could still do that.
Mr. Bone: I would like to make two comments. One is in response to the question where does the money go? The money is given according to population or membership. We have a membership of, let us say, 900, but our on-reserve population is 600. What happens there is that through all the agreements and all the stats that we provide to the various departments, our funding is calculated on just the on-reserve population.
We have never — and I have not seen it — received any of the money for the 300 who are living, let us say, in Winnipeg or Brandon. We will never get those funds. Whatever the program, announcement, whatever you want to call it, we would never get the urban portion.
One of the approaches that some of us are looking at is having access to all of that funding so we can provide those services directly ourselves. That may not be enough, so we would have to go back to the partnership system and work with a municipal or a provincial jurisdiction in order to deliver a service. That is one possibility.
The story that I always tell is you get groups of us chiefs together, we succeed in creating an awareness of a specific problem we are having and we go to Ottawa and succeed in getting, let us say, $100. On my way home, I have to give some to the AFN, some to the province, some to the municipality, some to the city and some to the Indian organizations that function in the urban areas. When I get home, maybe I will have $50 of that $100 that we succeeded in getting as a group of chiefs.
Senator Kirby: Why do you have to give it to other people?
Mr. Bone: Systems are set up. It goes back to the system. Funding is given to us through contribution agreements based on that line, on-reserve or off-reserve population, and that is where we get shot in the foot.
Senator Kirby: I still do not understand why you have to give it. I understand how the funding is arranged, but you say you have to give to, for example, the AFN.
Mr. Bone: Maybe our terms are wrong, "have to." We share it basically with all of these other organizations that are claiming it, let us say, for advocacy or delivery of a particular service to our First Nation, members from our community.
Senator Johnson: I am from Manitoba, from Gimli, and I have watched this process for years. I have been on reserves. I have been in Norway House. I have not been in yours. I am more curious after 15 years in the Senate and 11 years on the Aboriginal Peoples Committee. I am still asking the same question. It never seems to be in the hands of the grassroots community.
Mr. Bone: It is never directly in our hands, correct.
Senator Gill: I think we have to be very clear on that. I agree with you there. Money has been given only for the people living on the reserve. Even if your tribe or your nation or your band is 5,000, if you have 600 people living on the reserve, the money is given just for those people.
When you are talking about the services here in town, you are talking about services for your people living on the reserve, because you do not receive any financing for people living here in Winnipeg. You are receiving money for your people living on the reserve but receiving services here. You have to pay for that because people are going back to your reserves.
Mr. Evans: Yes.
Senator Gill: Maybe it was a little confused. The money has been given for the people living on the reserve. I think it is very important to know that.
I just want to mention that I am pushing my band, my reserve, to spend money in better ways and things like that. The answer they give me is they would like to see the money being spent the best way possible because there is not too much money. The answer was always that we have so many reports to do for the government and conditions we have to answer, so the money does not mean too much at the end. Norman was talking about when you have $100,000 for certain things, when you come home, you do not have much money left. This is the case.
I think we have to consider that and see what kind of report the band council has to produce, how many employees they need to produce that. You have to serve the structures of the federal government. In my area, this is the case. People are saying "We have to answer. We have to fulfil the conditions. We have to spend lots of money on employing people to do that."
Senator Kirby: Frankly, I have been trying to find a way around that problem, because I think it is in large measure a waste of money, at least from a health care standpoint. Get rid of the First Nations and Inuit Health Branch, just blow it up and replace it. No, I do not mean put a bomb under it, but get rid of it and have the federal government conclude there are 5,000 people, whatever the number is.
The reason for contracting with the province is that a lot of the services are in any event provided by the province, like hospitals. In that sense it is like any remote community, whether it is on a reserve or not. Have the province contract with the local band councils or the Manitoba chiefs or whoever to provide the services.
Other than providing money, the impression I have is that the federal government, frankly, is just a hindrance. Other than providing money, I have yet to have anybody tell me what they do that contributes positively to improving the health of First Nations people, so let's get them out of it. Have them contribute the money but nothing else. I know that sounds rather crude, but that is really where my head is at. Do either of you want to comment on that?
Mr. Bone: Well, I ought to agree with you, crude or not. If we had an exercise like that, where First Nations could access the money directly, then I would support that. Crude or not, you need to cut out all the red tape — exactly.
Senator Gill: I think I understand what you said. Correct me if I am wrong, but I think most of the First Nations would like to have the money from the federal government. Then it is up to the First Nation to deal with the provincial government or with any other organization to get the services they want if they cannot provide them themselves. You see, it is reversed, Senator Kirby.
Senator Kirby: I hear you.
The Deputy Chairman: That came through loud and clear this afternoon from your young people who appeared before you did. They said "Let us organize the services at the community level, let us buy what we cannot provide. Let the money flow to us so we can get what we need."
Mr. Bone: Exactly.
The Deputy Chairman: Ladies and gentlemen, it has been a very productive afternoon. I thank you both for coming here and sharing your expertise with us, helping us along with this report, and hopefully we can do something useful for you.
Mr. Bone: Thank you very much.
Mr. Evans: Thank you for the opportunity. It has been an honour.
The committee adjourned.