Indigenous and Northern Affairs Committee on April 9th, 2019

[The Chair, Liberal, MaryAnn Mihychuk]

Then we still have a long way to go.

[Janet Gordon]

Yes.

Out of the physicians we have in our practice, maybe three are first nations people.

[The Chair, Liberal, MaryAnn Mihychuk]

Three out of...?

[Janet Gordon]

The rest are mostly from the Toronto area.

[The Chair, Liberal, MaryAnn Mihychuk]

How many physicians would serve your regional area? You have three indigenous....

[Janet Gordon]

We have enough funding to recruit about 50 physicians. Some physicians chose not to work full-time or they work away or from home and will only work a quarter of the time, so we probably have about 40 physicians who work for us. When you calculate how much that is equivalent to in full-time positions, I believe it's about 22 physicians.

[The Chair, Liberal, MaryAnn Mihychuk]

Okay.

[Janet Gordon]

So we're not where we should be. We're trying to stretch people—

[The Chair, Liberal, MaryAnn Mihychuk]

Yes, I hear you.

[Janet Gordon]

—as far as we can.

[The Chair, Liberal, MaryAnn Mihychuk]

We have a bit of time for MP Will Amos, if he chooses.

[William Amos, Liberal, Pontiac, QC]

Thank you, Madam Chair.

My thanks to both of our witnesses. I think your testimony and the questions asked by member Blaney make it clear that you have a really challenging set of issues, all of which compound the problems. If you don't have adequate housing, if you don't have the investments necessary on the education side, if you don't have the investments on the health side, then all of those end up creating a vicious circle. Your testimony is coming across very clearly, and I thank you for that.

I wonder, if one were to try to look as far upstream as possible towards future solutions, what is it you would need with regard to your youth and the education of your young community members to address these issues related to capacity-building going forward? It seems to me that what you're really asking for is a way of solving the root problems, so I wonder if you'd like to go in that direction and advise on what you need done to address the capacity issues from a youth perspective.

[James Morris]

The first problem that has to be dealt with—and the health authority itself doesn't play a key role in this—is educating the young people. We had a high school in Thunder Bay that used to accommodate about 200 students, but because of the problems that Thunder Bay has been having with students turning up dead, when I was there last spring, I learned that there were only about 60 students at the high school. That happened because parents were reluctant to send their kids to high school in Thunder Bay because of the death rate among students. I don't know who's working to improve that, but I know it's going to take some time.

One solution I've heard many people suggest is that these kids shouldn't have to leave home to go to high school. We need to find some way to provide high school education to all these kids in their own home. I don't know how that's going to be done yet. Some communities have a form of high school, but it doesn't have the same standards as the high schools in Thunder Bay. That needs to be dealt with.

Once that's done, then we need to have a policy and a program that will train these young people to do health care work that makes sense. It's not training them to be doctors the way we train normal doctors; that's too long and too difficult for them right now. We need to adapt training programs to the work needed in the communities. It may involve some things that doctors do, but not everything, because that's not what's really needed. It's better than waiting three weeks for a doctor to come in and taking a chance on whether they're going to see you or not. We need to put a lot of effort into designing programs that work for remote native communities.

I'll see if Janet has anything to offer on that.

[Janet Gordon]

One of the models we were looking at is the Nuka model that trains community health aides in Alaska. They don't have physicians or nurses living in their communities, but they have their own people who have been trained, and it's pretty aggressive training. At the end of it they have the skills and knowledge to provide emergency or primary care.

Those are some of the models we've been looking at to see how we can build capacity in our communities so that people feel they are safe and have access to service as quickly as possible.

One of the other things I wanted to mention is that in Saskatchewan, they have a first nations university. Models like that support people who want to go to college and university. It's hard to integrate into systems when you're just coming out of remote communities, so a more supportive environment needs to be there for people who come out of our communities.

[The Chair, Liberal, MaryAnn Mihychuk]

We have to move on.

[William Amos, Liberal, Pontiac, QC]

Thank you.

[The Chair, Liberal, MaryAnn Mihychuk]

Questioning now moves to Kevin Waugh.

For the information of the committee, it seems that the vote has been moved to 11:30, so we will be able to complete the full amount of time allocated.

Do we want to continue with five-minute rounds? How do members want to proceed? I've been very generous with our time.

Okay. I see one person in agreement.

MP Kevin Waugh.

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

Janet and James, thank you for being here this morning.

You've both talked about suicide. Janet, you mentioned a number—500. James, you talked about the school situation.

What are we doing?

This community of Thunder Bay has been in the national news for the last two to three weeks. Obviously, no one's listening, because we haven't seen anything. Both of you have touched on this here this morning, the suicides and the attempted suicides. It's an epidemic in your area.

Where do you reach out? Obviously, there's an issue in your area.

[James Morris]

Yes. Actually, the suicide crisis in our area began in 1986. If you look at the statistics before that, there were suicides, but there was no pattern to them. In 1986 a pattern started to develop, beginning with young men between the ages of 15 and 21. It peaked in 2000, when we had 26 suicides in the region in one year. That's more than two suicides a month. In small communities, that has had a devastating effect.

There's no one reason why these suicides happen; there are many reasons. You have to take the environment that these kids live in together with the things that have happened to them personally to come up with some semblance of why they died. None of them can tell us: they're dead. We can only look at their backgrounds and realize that everything a reserve life represents has conspired to kill these young people. I don't know if any of you have ever lived in reservations. It's a very poor way of life. Many of these kids grow up hungry all the time. They have poor clothing. They experience a lot of family violence from the time they are little babies. Some of them just get tired. They just walk off and hang themselves. Kids do that. There's nothing; the systems that are in place are not enough to look after all these kids adequately. Some of them just give up. They can't go on.

What are we doing about it? There is no policy and therefore no mental health program for first nations people in Canada. That's the number one problem. When I went to Ottawa back in the late eighties, when I was told we had a crisis, I was told that the federal government doesn't have a policy for mental health; the province does that. I went to the province, and they said, “Yes, we have a whole series of mental health programs—except for status Indians living on reserve.” So we were nowhere.

There is still no policy for these kids who live on reserve to get mental health help. All we have is a patchwork of mental health programs from both the federal level and the province. There is no comprehensive program to deal with these suicides. That's the first thing. We have to take whatever we can, from wherever we can, to deal with this issue. There are many issues. We have had pedophiles in our region, we have poverty—you name it. These kids just can't deal with it without—

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

I am on your website. You show 43 openings for jobs. A mental health counsellor makes $76,767 a year. This was posted four months ago. Have you filled that position?

[James Morris]

No. We're still looking.

[Kevin Waugh, Conservative, Saskatoon—Grasswood, SK]

See, here's the issue; you have 43 jobs, ranging from mental health to privacy officer. I mean, that's 43 jobs. Some of these go on for months. Like I said, this one was posted four months ago. Have you had any leads to bring people to your community?

[James Morris]

We are constantly looking for people to come in. First of all, we don't have our own people. I just finished telling you that because of the educational system, we don't have people from our region who can do that. We have to look everywhere. Recruiting and training professionals to come to work in a remote area is very difficult. We struggle with that. We are very lucky when we do find people who are committed to helping people.

[Janet Gordon]

Yes.

[James Morris]

We have a lot of those people, and we're very lucky to have them, but it's hard to find people like that all the time. Some people will come and stay for one month, and then they're gone.