Evidence of meeting #16 for Indigenous and Northern Affairs in the 42nd Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was research.
A video is available from Parliament.
Conservative
Arnold Viersen Conservative Peace River—Westlock, AB
Is there some study that you could table that has those?
President, Canadian Institutes of Health Research
We can send you some articles, absolutely.
Liberal
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
Thank you, Mr. Chair.
I want to thank all of you for joining us today.
I want to distinguish between the short-term solution and a longer-term solution. I want to leave the longer term out and just talk about the short term, recognizing that a number of social determinants in health will have a significant impact on the longer term, as well as the TRC and a lot of the things Dr. Wong outlined.
In terms of the short term, and let's say a year or a two-year timeline, do we have a dashboard? Is there somebody with a dashboard or a screen where we can see, of the 600 communities that INAC serves, these 30 have a high likelihood of suicide, or they're highly susceptible to suicide, or there's an increased risk in a certain period of time, the second group has a lower risk, and the third group has effectively no risk?
Are there any metrics of that sort that are available, which somebody's looking at continuously and deploying resources accordingly?
Executive Director, Office of Population and Public Health, Department of Health
Yes, we do have a dashboard precisely to look at that. To us, it's really an issue of equity. You start by addressing the areas where there are lots of needs first, and then with time, you start going to the second tier and the third tier. The short answer is yes.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
With respect to that first tier, what kinds of supports are being offered proactively? Given the limitations that exist right now, what supports do you provide? How do you bring the provinces in? How do you bring the different agencies in to ensure that they are supported—let's say the top 30 communities or the top-tier communities—in that timeline that we're talking about?
Executive Director, Office of Population and Public Health, Department of Health
For those in the top-tier, high-need communities, we are working with partners, the communities, first nations communities, Inuit communities as well as with universities, hospitals, professionals, and professional groups to try to see how we can find ways to expedite services as well as to maximize the use of telemedicine in order to provide those mental health services.
In addition, we also work with our partners, other government departments as well as provinces and territories where appropriate, to find ways to address some of the other issues that are beyond health. We want to bring in other partners to look at recreation, traditional activities, how to reinvigorate the language and culture, and so on.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
For that top tier, are those numbers static or do they move around?
Executive Director, Office of Population and Public Health, Department of Health
Unfortunately that top tier is not static. It's dynamic and it changes with time. Therefore, our response is also dynamic.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
What are your greatest challenges in re-evaluating and fulfilling those needs as they arise?
Executive Director, Office of Population and Public Health, Department of Health
Resources.
Executive Director, Office of Population and Public Health, Department of Health
Both human resources at every single level as well as financial resources.
Liberal
Gary Anandasangaree Liberal Scarborough—Rouge Park, ON
How do we start addressing the human resources? I know that for financial resources there is a commitment right now from our government for $8.4 billion over the next five years. It will go to some of these things, but really, a lot of it is for infrastructure. How do we address the resource deficit? I'm assuming it's professionals, doctors, psychiatrists, nurse practitioners, and so on. How do we address that in the short term? Are there locums? Are the medical associations involved? Are there nurses associations involved in supporting this right now?
Executive Director, Office of Population and Public Health, Department of Health
On the professional resources front, we are in discussion with medical schools, professional organizations, and nursing schools, in order to see whether there are ways that professionals can be mobilized to offer services, whether regularly or periodically, through a collaboration with the communities. We are trying to facilitate that, working of course with provinces and territories.
Already, we have a number of institutions very interested in trying to work in that capacity. Some of the medical schools and nursing schools have training programs as well. We also facilitate the encouragement of training more nurses and doctors, in order for them to eventually work in those remote and isolated areas on reserves.
Liberal
The Chair Liberal Andy Fillmore
Thank you, Dr. Wong.
The next question is from David Yurdiga, please.
Conservative
David Yurdiga Conservative Fort McMurray—Cold Lake, AB
Thank you, Mr. Chair. I'd like to thank the witnesses for being here today and presenting. It's very informative.
Some first nations experience virtually no suicides in their communities, while others experience three, four, or seven times the national average. What are the factors that contribute to the higher suicide rates? Is there a magic thing when you compare communities to communities?
I open up the question to any of the witnesses.
Executive Director, Office of Population and Public Health, Department of Health
If I understand your question correctly, you're interested in looking at the factors that determine why one community has a high risk for suicide, and another, a low risk for suicide. Is that correct?
Conservative
David Yurdiga Conservative Fort McMurray—Cold Lake, AB
That's correct. You have two communities in proximity, and you have one that has a substantially lower suicide rate. Then you go 100 kilometres and that other one has a high suicide rate. Geographically, they're in the same region but the suicide rates are much different.
Executive Director, Office of Population and Public Health, Department of Health
Chandler and Lalonde have done a remarkable study looking at that exact question. To sum up, what they found is that there is a list of factors that are important, but the most important factor is that services and governance have to be determined and controlled by the community, including mental wellness services, other health services, education services, police services, etc. They found that was very important in reducing the rate of suicide and increasing mental wellness.
It gives the control and the leadership to the community, for the community. Other people can assist, such as governments, but they are there to support. The leadership and the control needs to be by the community and for the community. This is in addition to all the social determinants of health that Paul and I spoke about earlier, as well as the reconciliation part.
Conservative
David Yurdiga Conservative Fort McMurray—Cold Lake, AB
What I found in my riding is that one community is very active in other communities, whether it’s sports, hockey…. It seems that the one that’s very aggressive as far as being a participant with other communities, they have role models. The community rallies behind their teams. Have you found that in other regions?
Executive Director, Office of Population and Public Health, Department of Health
Yes, indeed. Having recreational activities, sports activities where there is a network to promote the youth, gives them a vision, a purpose in life, that's very helpful.
How can you live in a community where there's absolutely nothing to do? There are no sports. When you look to your left, look to your right, you see the suicide of your friends. There's no future. When there's a vibrant community where the leadership controls the education services, the recreational services, and the health services, it gives the young people a goal in life. They participate in those activities. They excel in life, and they see role models that they can emulate. Those are some of the key factors for success in those communities.
Conservative
David Yurdiga Conservative Fort McMurray—Cold Lake, AB
Many indigenous people on reserves have difficulty finding good long-term jobs. Having a job for one month here and two months there is not really a job. Have there been any studies that correlate employment and suicide? Are there any studies out there that say that's one of the contributing factors?
Executive Director, Office of Population and Public Health, Department of Health
Yes, there is a correlation between those.
Conservative
David Yurdiga Conservative Fort McMurray—Cold Lake, AB
What are some of the interjurisdictional challenges that affect access to health services by first nations and Inuit individuals?