Thank you, Mr. Chair.
First I would like to thank the committee as well for inviting me to discuss this critical issue of suicide prevention in first nations, Inuit, and Métis communities. As president of the Canadian Institutes of Health Research, or CIHR, I appreciate the opportunity to share with your committee the vital role that research is playing to address this tragedy.
As you may be aware, CIHR is the Government of Canada's granting agency responsible for supporting health research in universities, hospitals, research centres, and communities across Canada. CIHR's commitment to address the disproportionate health burden faced by indigenous people in Canada is steadfast. This is why we have made the health and wellness of indigenous communities and families one of four research priorities in our most recent five-year strategic plan.
When it comes to suicide, science has a critical role to play in helping us understand the root causes of this most complex and sensitive issue, and in developing evidence-based solutions for preventing it. The causes behind the unacceptably high incidence of suicide among indigenous people and how to design and evaluate interventions aimed at promoting mental wellness are at the heart of our research efforts.
It is important to understand that the research funded by CIHR on the topic of suicide and mental health covers a vast range of the health sciences, from basic to applied. It ranges from studies on the biological basis of depression to investigations of the cultural, social, and environmental risk factors linked to suicide ideation.
It includes, for example, research on the effects of the environment on genetic disposition to mental health disorders, research on intergenerational health impacts of residential schools, studies linking suicide to variance in exposure to daylight in the north, and the psychosocial impacts of housing conditions.
The research is happening at all levels, for it is critical to understand the etiology and the risk factors underpinning these high suicide rates if we want to be in a position to meaningfully address and prevent them. Indeed, research on suicide is not only meant to improve our understanding of the problem, but it is also meant to help develop evidence-informed interventions and programs, in other words, to translate knowledge into practice.
Appropriate interventions can be successful, as demonstrated by Quebec's preventative efforts, which led to a more than 50% reduction in suicide rates among its youth; this reduction was even more pronounced among young men.
It is imperative that research be leveraged in a similar way to help address suicide in first nations, Inuit, and Métis communities. We are talking about two very different sets of research questions and approaches here. The first, referred to as intervention or comparative effectiveness research, is about developing and testing the efficiency of interventions under tightly controlled conditions. The second, referred to as implementation research and delivery science, or IRDS, is about implementing and scaling up successful interventions in the real world. What works, for whom, and in which circumstances? How can successful prevention strategies be adapted and scaled up for different communities and settings?
Implementation science needs that research to be embedded into care and adapted to socioeconomic and cultural contexts to maximize efficiency and impact.
Implementation science and delivery research is a relatively new area of health research that we have embraced at CIHR to address a number of global health issues, including indigenous people's health. Thus, through a major strategic research initiative called “Pathways to Health Equity for Aboriginal Peoples”, we have supported a series of implementation science projects aimed at improving mental wellness and reducing the incidence of suicide in indigenous communities.
For instance, a project led by Dr. Claire Crooks from the Centre for Addiction and Mental Health in Toronto, took the mental health first aid program and adapted it to first nations communities across Canada. This original program had been demonstrated to increase individual skills and knowledge about how to respond in a mental health crisis.
It is currently used across Canada; however, previous evaluation studies found a critical need to culturally adapt the program to first nations communities. Using a combination of interviews, focus groups, implementation tracking, and surveys, the research studied the implementation of the adapted program in several first nations communities and confirmed its effectiveness.
Another example of the CIHR-funded research aimed at implementing research into practice is ACCESS open minds, a groundbreaking, national research network focused on youth mental health. Through this network, supported in partnership with the Graham Boeckh Foundation, researchers are taking existing mental health practices and treatments and making them age-appropriate for diverse youth populations. Through testing and evaluation of these tailored youth interventions at 12 sites across the country, including five that are working with indigenous communities, this network will help identify effective approaches for assessing and treating Canadian youth with mental illnesses.
A common feature of these two research initiatives is that they both involve multiple research sites and allow for learning across communities and between jurisdictions. Crossing jurisdictional boundaries also means developing international collaborations to address suicide prevention. The issue of indigenous suicide is not unique to Canada. Indigenous populations in other countries such as the U.S., Denmark, Sweden, and Australia are facing similar challenges.
While some of the causes and manifestations of suicide differ across countries, as they do across Canada's first nations, Inuit, and Métis communities, there are also important points of commonality and overlap. This shared problem presents an opportunity for joint research efforts and the sharing of best practices across borders. This is why since 2013 we've been involved in international research efforts to address suicide prevention in northern indigenous communities through the Arctic Council. Under the Canadian chairmanship of this international forum during 2013-15, CIHR spearheaded a research initiative involving researchers and community members from across four Arctic countries to identify promising practices in suicide prevention. These efforts culminated in an Arctic symposium in Iqaluit, held in March 2015, where researchers shared best practices in suicide prevention. The symposium was hosted jointly by the CIHR, the Government of Nunavut, and international partners.
As a second phase of this work, we are now partnering with a U.S. organization, the National Institutes of Health, in a follow-up project to further address suicide in Arctic regions. Through this follow-up initiative, called the RISING SUN, partners from across the Arctic states are coming together to identify common metrics to track suicidal behaviours, as well as key correlates and outcomes, so as to facilitate data sharing, evaluation, and interpretation of interventions for suicide prevention.
CIHR will soon be launching another major international research program on global mental health through the Global Alliance for Chronic Diseases or GACD, an international consortium of health research funders that Canada currently chairs. This program, with a combined international investment of over $60 million, will fund research into the prevention and management of mental disorders, with a focus on interventions in low- and middle-income countries, as well as vulnerable populations in high-income countries, including Canada's indigenous populations. Once again, through this opportunity, the CIHR will be able to leverage knowledge from international contexts that are relevant for Canada and will provide tools to tackle the issue of suicide in our communities.
These are just a few national and international examples of how CIHR is supporting research to address wellness and suicide prevention in indigenous communities. Through the science and applied research initiatives I described, CIHR is committed to continue supporting research to identify ways to promote resilience and positive mental health among indigenous peoples and to ensuring that research evidence is brought to bear on policy-making through knowledge translation.
In this regard, CIHR will look forward to continue working with Health Canada and other federal, provincial, and territorial partners to help inform policies and programs related to indigenous health.
Before closing, I would like to take a moment to underscore that all of the CIHR research projects in this area are designed and carried out in close collaboration with indigenous communities. Our ultimate objective over the long term is to develop and support a cadre of indigenous researchers as they are best positioned to understand from the inside the cultural determinants of mental wellness.
This is why strengthening research capacity within our indigenous population is at the heart of the CIHR agenda.
Finally, please allow me to acknowledge that research is only part of the solution to this very complex and challenging issue, but it is an important one for identifying the most effective path to achieving wellness.
Mr. Chair, thank you again for this opportunity to share our work with you in this critical area. I look forward to your questions.
Thank you.