Indigenous and Northern Affairs Committee on Oct. 5th, 2016

[The Chair, Liberal, Andy Fillmore]

That brings us to a close, Dr. DeGagné and Dr. McCormick.

Thank you very much for your testimony. It will be reflected in the record and ultimately in the report, which we hope will be completed some time early in the new year. We'll look forward to sharing it when it's ready to be shared.

Thanks again for your time.

[Dr. Rod McCormick]

Thank you.

[The Chair, Liberal, Andy Fillmore]

We'll have a brief suspension while we switch to the next panel.

Thank you.

[The Chair, Liberal, Andy Fillmore]

Okay, we're back.

This second panel today is composed of three witnesses, and we're offering 10 minutes to each of them.

The first witness is Gwen Healey, who's going to be joining us strictly by teleconference, no video today.

[Dr. Gwen Healey, Executive and Scientific Director, Qaujigiartiit Health Research Centre]

Thank you to the chair for the invitation to address the committee today.

I'm Dr. Gwen Healey, and I was born and raised in Iqaluit, Nunavut. It's in this community that I continue to live and work. I'm the executive and scientific director of the Qaujigiartiit Health Research Centre. I co-founded Qaujigiartiit in 2006 with the late Andrew Tagak, Sr. I am also an assistant professor of human sciences at the Northern Ontario School of Medicine. My formal training is in epidemiology and public health.

Our centre is an independent, non-profit community research centre. We exist to answer the health questions of our communities. This may take the form of community-based research, territorial and systems-level research, or circumpolar international projects across the Arctic. We develop evidence-based interventions, conduct surveys, collect narratives, and explore community-identified health questions. We are contributing to scholarship and academia by sharing our evidence nationally and internationally, and by developing and sharing health research approaches that are developed from an Inuit epistemology.

Health research studies are usually developed from a deficit-based model. There is an issue, a medicine or treatment is created and applied, and then presumably an individual gets better. However, this is not the only way to examine a topic. This method often treats contextual information as confounding or biased. Occasionally it is ignored altogether. However, sometimes the contextual information can be the essence of the issue.

We know that the context of Nunavut's suicide crisis is extremely important but rarely openly discussed. There is a marked difference between Canada and Nunavut when it comes to such social determinants of health as poverty, housing, and education. From the Nunavut portion of the Inuit health survey, we know that 11% of adult respondents were verbally abused as children; 31% of adults reported experiencing severe physical abuse in childhood; 52% of women and 22% of men reported experiencing severe sexual abuse in childhood; 43% reported feeling depressed some or little of the time, and 9% all or most of the time; feelings of depression were more commonly reported among women and youth; 48% of respondents reported having thought seriously about suicide; and 29% of respondents reported a non-fatal suicide attempt in their lives.

These are heartbreaking statistics, and the context of this information is extremely important. Nunavut settlement history is relatively new compared with other indigenous communities in Canada. The federal settlement program, the tuberculosis outbreak, the dog slaughter, and the residential school system events all occurred in roughly the same time period, in the 1950s and 1960s.

At this time, families were severed, children were taken away from their parents, and a complex series of events unfolded that had an immediate and long-lasting impact on Inuit society. What is particularly damaging about this series of events is the fact that Inuit society is relational, founded on a system of kinship relations. These relations form the basis of a unique attachment philosophy. When parents were separated from their children during the settlement and separation events, the development of family attachments was disrupted, threatening the foundation of Inuit kinship society, ways of knowing, language, transfer of skills, and knowledge about wellness and what one needs to be well. It severed the very threads that wove the fabric of many families together.

The deficits are important to understand, but so are the strengths. Rather than a purely deficit-based model, at Qaujigiartiit we often apply a strengths-based model to our work. We know that we have certain strengths in our communities and our way of life. We know that certain aspects of our lives are very good as a result of celebrating and building on these strengths. How can we help others to tap into their strengths and ensure that our communities are well, now and for future generations?

Between 2006 and 2008, we held a series of public engagement sessions across Nunavut to identify health priorities from the perspective of community members. Mental health and wellness of our communities was the most important priority. Our board focused on the mental health and wellness of children and youth in particular after these consultations. At that time, we knew there was a dearth of programs or supports for children or youth or their parents in Nunavut. We knew what our strengths were. Our relationship with the land, our connections and relationships with each other, our willingness and readiness to help each other, our arts and music and stories, our absolute undying love for our children—all are our collective strengths and core societal values.

From this place, we set out to design a program to help young people realize these strengths in themselves. Our belief was that from this position, we could, as a community, contribute to the building of such strengths in our youth to help them be well, especially if their home environment included trauma or neglect, or if for any other reason they were not learning about these strengths at home.

Through this pathway, we believe we can prevent death by suicide. This program would be something that any community member could deliver if they also saw these strengths in themselves. We worked with elders, youth, parents, youth workers, and community members from across Nunavut to develop the content for the program that one of the parents named Makimautiksat, which means “building a foundation within oneself.” The program was designed to take place on the land and in the community. We spent the next four years piloting and evaluating the program in Nunavut.

The model for Makimautiksat comes from Inuit perspectives on what it means for a young person to be well, as well as the western scientific literature. For example, we know from neuroscience literature that in an adolescent's developing brain, a very important time to develop coping skills is between the ages of nine and twelve years. By focusing on this age group, there is a greater likelihood of retention; hopefully, these skills can be retained during tough life events and transitions that lie ahead in the teen and early adulthood years.

The model for Makimautiksat is developed around eight core concepts or foundational pillars. We envision them as rocks in a tent ring, which provides the stabilization for a tent or qammaq. The first concept is the strengthening of coping skills. The second is Inuuqatigiitiarniq, which is being respectful of others and building healthy and supportive relationships. The third is Timiga, my body, promoting awareness of the body, movement and nutrition. The fourth is Sananiq, which is crafting and exploring creativity. The fifth is Nunalivut, which is our community, and is about fostering personal and community wellness. Saqqatujuqis the sixth concept, which is the distant horizon and it's about self-discovery and future planning. The seventh is understanding informed choices, substance use and peer pressure. The eight concept is Avatittinik Kamatsiarniq, stewards of the land and connecting knowledge and skills with experience on the land.

From our research findings, as we evaluated the program, we found that activities fostered physical, mental, emotional, and spiritual wellness and supported a holistic perspective among youth. Campers reported feeling more happy, cheerful, and energetic, with a decrease in feeling sad or miserable, and felt more comfortable expressing themselves. Lessons that they were glad to have learned included being physically active, to have respect for themselves, the importance of going on the land to Inuit culture and values, self-empowerment skills, and healthy relationships.

Six months after the program, one youth was reported saying, “I am smart”, and others reported feelings of confidence in their ability to complete tasks, like going to school on time, and were more aware of problems that they now had control over. They reported realizing that they were capable of helping others and offering advice.

Facilitators felt youth were more confident after attending Makimautiksat and that the land component was vital for skill building and for revitalizing the importance of stewardship for the land among youth. Parents also described that their children had more confidence.

After the conclusion of the funding we had received to develop Makimautiksat, we tried for two years to find more funding to sustain ongoing delivery and expansion. We submitted a number of proposals, to the territorial government in particular, and nothing came through, so the project stagnated. This year, we have received six months of funding from the Government of Nunavut, to train new facilitators and support the delivery of Makimautiksat as an after-school program, which will culminate in a land camp in the late winter and early spring. We continue to struggle to find opportunities for sustainability and scale-up.

Inuit societal values and pathways to wellness are key to moving forward. Rebuilding and strengthening the relational aspects of society, fostering the relationships between youth, their families, their communities, the land and the spirit world and the ancestors, will take time but is essential. We are thinking about the seven generations to come.

Seven people in my life have died by suicide. This issue affects all of us. I have young children, and when I look at them I think it's unacceptable that our children should have to grieve the way we grieve for the loss of our peers, our loved ones, and our fellow community members. Our generation must do something about this. It's imperative that we act. I believe we know many of the pathways forward, and what we need are sustained support, leadership, and opportunities to act on them.

Thank you for your time. That's the end of my statement.

[The Chair, Liberal, Andy Fillmore]

Thank you very much for that, Dr. Healey; we very much appreciate it.

We're going to move right on to the next statements and then we'll come back and do questions all at once, so I hope you're able to stay on the line with us.

The next witness is Jakob Gearheard, the executive director of Ilisaqsivik.

Please have the floor for 10 minutes.

[Jakob Gearheard, Executive Director, Ilisaqsivik Society]

Ladies and gentlemen of the committee, on behalf of Ilisaqsivik's board of directors and staff, thank you for this invitation to appear before you today for this important discussion. My name is Jakob Gearheard, and I'm executive director of Ilisaqsivik Society.

Ilisaqsivik was established in 1997 by community members in Clyde River, a community of about a thousand people on the northeast coast of Baffin island. Ilisaqsivik was founded because the community was not happy with the existing mental health and social services and other wellness-related programs that were provided by the government. These services were not culturally relevant, they were not provided in Inuktitut, and they did not reflect Inuit values. In many instances throughout Nunavut this is still the case today.

Ilisaqsivik is a true grassroots, community-based Inuit organization. It is a Canadian registered charity and a Nunavut registered society. At Ilisaqsivik our mission is to encourage and support community wellness by providing safe spaces, resources, and programming that empower families and individuals to find healing and develop their strengths.

Ilisaqsivik was started by just a few people, but it has grown until today and strengthened over the years. Today we are the largest employer in our community, with more than 50 people in part-time and full-time positions. We are also the first employer for many community members. We offer employment training in many types of job skills.

In addition to our wellness centre, we operate the Ittaq heritage and research centre, which also houses a digital media centre. Last year we opened a hotel whose profits go to support Ilisaqsivik, one of the few examples of social entrepreneurship in Nunavut.

This last point is important, and I want to highlight it here. Ilisaqsivik has branched into social entrepreneurship because it needs to find ways to mitigate a serious funding struggle. Despite winning national awards for our work—including from the prime minister of Canada—and being held as a positive example of quality care closer to home by different government and Inuit organizations, nobody has stepped up to ensure our financial security. We survive project to project and year to year. We are always at risk of not securing the resources we need. So, while I tell you about the successes of our organization over the next few minutes—successes thanks to the dedication and hard work of our board and our staff and our community—you must understand that our funding security is a critical issue. We are constantly addressing an ongoing risk to our existence.

To fulfill our mission of supporting community wellness, we provide a wide range of programs. Last year we offered more than 80 programs. Our programs support all of our community members from pregnant women to children, teens, families, and elders. We provide programs related to education, culture, language, nutrition, land skills, health, wellness, and more. I cannot mention all of our programs as it would take too much time. But just to give you a few examples, we offer pre-school parents and tots, prenatal nutrition, land-based healing, cultural and hunting programs, youth drop-in, parenting programs, diabetes prevention, Inuktitut literacy, etc.

Land-based programs are the most important and successful programs we offer. We offer a variety of land-based programs including elder-youth camps and hunter training programs for youth. Local youth regularly have the opportunity to learn to hunt, fish, and practise on-the-land skills through our programming. They share their catch with the community. These programs contribute to food security by providing fresh meat to households and also passing knowledge and experience on to the next generation of hunters. Just last month, we held a three-week-long summer land program whereby more than 50 community members camped on the land and participated in facilitated cultural and healing activities. Our land programs are held in all seasons, for all ages, and everyone is welcome.

There is one other key area of Ilisaqsivik's services that I would like to highlight for you today, and it is our counselling services. One of our key achievements is providing culturally relevant counselling and counsellor training grounded in Inuit values and knowledge and provided in Inuktitut, for Inuit and by Inuit.

All across Nunavut, Inuit struggle to access appropriate mental health counselling and social services. In most cases the mental health services available to Inuit are from fly-in, southern-based counsellors and social workers who have minimal to no knowledge and experience with Inuit culture, do not speak Inuktitut, and do not understand the historical and cultural context of where they are working.

Inuit have always had counsellors who were recognized as trusted and respected people who had life experience, to whom others could talk when they needed to talk. These recognized people are in all of our communities. At Ilisaqsivik we decided that we needed to organize and empower these community-based counsellors. Our local counsellors wanted more training, but there were no training programs available to them. All available training was in English, based on southern-style counselling and based on southern approaches and values, so we built our own counsellors' training and mentorship program at Ilisaqsivik called Our Life's Journey.

The program started in 2007, and since then we have grown tremendously in our counsellor training. We offer a one-year program that has five modules to be completed. The program offers counselling and addictions training to people working in the health and social service fields in Inuit communities. The training is based on Inuit knowledge and values combined with useful approaches from many other sources, and it is delivered in Inuktitut. Training Inuit is our priority, but we also make exceptions for other front-line non-Inuit workers. We are inclusive. We want to collaborate with our mental health professionals, but we only provide training in Inuktitut and in the Inuit way.

Since 2007 over 110 people have participated in our training. The age of participants has ranged from 20 to 83 years old. To date, we have had participants from all 13 Qikiqtani communities, and also from several communities in the Kivalliq and Kitikmeot regions. In 2016 our counsellor training program became accredited by the Indigenous Certification Board of Canada, and as of now we have 38 graduates who have completed our full program.

The result of our counsellor training program is a network of professional counsellors with specialized Inuit-appropriate training available to clients in Inuktitut. Ilisaqsivik counsellors know the language. They know the culture and they know what clients need.

At Ilisaqsivik, as part of this program, we have a mobile trauma team. In the past, if there were a traumatic event in a community, southern-based workers would be flown in. Now communities are calling Ilisaqsivik to send assistance. We are responding with trained counsellors across Baffin. We can quickly send people to communities and to families to help in their own language, counsellors who understand the context, the culture, and the people they're helping. Based on our experience, we feel strongly that there should be mandatory training for any caregiver working in Nunavut, training that educates them about Inuit culture and history, but that is only the beginning.

The Government of Nunavut should hire more graduates from the Inuit counsellors and mentorship program and put these people in positions to help Inuit communities and families. They should also invest in programs like this to train more Inuit counsellors and caregivers and provide more culturally relevant services.

We are proud of our work at Ilisaqsivik and we wish more communities could have centres like Ilisaqsivik. In Nunavut, Ilisaqsivik is very unique. It is run by Inuit for Inuit and it is truly community based. We are exceptionally strong even though we struggle with funding and recognition for Inuit ways.

I am grateful for the opportunity to share experiences with this committee and truly believe that the only way to build stronger, more resilient, and healthier communities is by all of us working together, listening to and respecting one another.

Thank you.

[The Chair, Liberal, Andy Fillmore]

Thanks so much, Jakob. It is much appreciated.

We are pleased to welcome now Dr. Margo Greenwood from the National Collaborating Centre for Aboriginal Health.

You have 10 minutes, please.

[Dr. Margo Greenwood, Academic Leader, National Collaborating Centre for Aboriginal Health]

Good afternoon. I'd like to begin by thanking the organizers and the committee for inviting me. It's a real privilege to be here. As you can probably tell, it's the first time I've been here, so I'll do my best.

I actually prepared some slides for you but then quickly realized that you don't have those here. I'm going to do my best to talk from them. If I sound a little disconnected, please forgive me.

I'm a Cree, from Treaty 6 area, in central Alberta, but I've lived most of my life in northern British Columbia, in Prince George. That's where the National Collaborating Centre for Aboriginal Health is located, at the University of Northern British Columbia, in Prince George. Most of my adult life has been in the north. My children were born and raised in the north, not the far north as Jake and Gwen talked about it, but in the northern part of the province.

The National Collaborating Centre is a knowledge translation centre. I've prepared for you today five slides that contain key elements or points taken from the literature. Mike, Rod, Jake, and Gwen have already spoken to a number of the points I have, so I'm affirming them as I present this to you.

I'd like to start by really looking at the principles of some of the best practices that we're hearing about. What underlying elements are common to them? I have heard many of them already.

One of the first ones we think and talk about is that any practice, program, or policy needs to be anchored in indigenous knowledge and the right to self-determination. I heard people talking about self-governance, but self-determination is not the same as self-governance. I think that's an important distinction. I think one leads to the other. It's really important that we have the right to determine our own health and well-being and the right to determine our children's health and well-being in this country.

Another element with regard to practice or policy is that they are rooted in the land, in their indigenous cultures, in their languages, in their values, and in their beliefs. We've heard examples of that already today.

There is the concept of holism. We talk a lot about that. That is a concept anchored in, I dare say, indigenous spirituality. It's very deeply rooted in the understanding—as it is in other cultures as well—of the interconnectedness of all beings and the understanding that we are connected to the land. I think that's really important. We often hear about holism especially when we're talking about children's development. We often hear about the developmental domains: the physical, the social, emotional, cognitive, spiritual, and cultural. We also talk about these within the context of family and community. These don't happen independently; they're interrelated and they are situated within the context of family and community. I'm going to talk more about that a little bit later.

I have heard lots of the presenters talk about programs and practices that are locally initiated, owned, and accountable. I think that's a really important word—accountability. I don't mean accountability just to funders, but accountability to the people we serve, to ourselves, and to our communities. I think those are really important concepts in that they are determined by community. What that looks like is determined by them.

Many of these best practices are seen to be population-based. We're not just talking about individuals. I think I've made that point.

The other point that came out in the literature is strengths based. I think that's really important, in any issue.

How do we build on the existing strengths that we have? We have strengths that we probably haven't even tapped into yet. How do we bring those together?

This is—

[The Chair, Liberal, Andy Fillmore]

Dr. Greenwood, I just want to check in with you and let you know that we're at just over half the time. I'm getting some signals from you that you maybe have more to get through.

[Dr. Margo Greenwood]

I'll get going, because I can talk on and on.

These are probably some really important points, but I think strengths based is a really important piece. When we're talking about cultures and about knowledge, we're talking about different systems of knowledge. How do we draw from those systems, in partnerships, in collaborations, to realize the kinds of things we need to do to move forward together to address a lot of these social challenges that we're facing?

The literature also talks about protective factors, ensuring individual identity and personal skills, engagement of youth in the strategies that are being developed for them or with them—it should be with them—and really thinking about intersectoral collaborations, so that it doesn't just sit in health or in education, that there are multiple players here. There needs to be intersectoral solutions.

I'm going to skip some, because I probably have three minutes left now.

I'm going to talk about my last slide. I have a number of others in here. One I will say is on some of the protective factors. I think Rod and Mike mentioned about the seminal work of Chandler and Lalonde. They looked at communities that were more self-determining, and that indeed those communities had insignificant, if any, rates of youth suicide. That's a seminal piece of work in this country, in my opinion, and there are many others.

I want to go right to my last slide. I wish you could see it. It's a graphic. You'll maybe be able to see it in your mind. In the centre, there are nested circles. In the centre, we have “Restoring and Revitalizing Individuals and Families”, so that there's the healing. All of the programs we heard about are absolutely essential to the healing of individuals and families. Those constitute the community.

Sitting within that, though.... That circle is nested within systems and structures. Those systems and structures need to be enabling those direct services to individuals and families. They need to be enabling those to happen. If we have a lack of funding, or we have a policy that won't allow certain things, then we're not enabling those good practices that the community will develop. I think that's really important.

I see those as the enablers of all of this. Being in a lot of these discussions, I don't hear us talk about that. It's hard. It's not easy to make those changes. However, if we're going to see these practices at the community level—and we've heard about sustainability and all of that—we need to be looking at and moving simultaneously, at multiple levels, to ensure that what's happening at that one-on-one level will be successful.

I'm going to stop there. I made it through two slides.

Thank you very much.

[The Chair, Liberal, Andy Fillmore]

Thank you very much for that.

I will let you know that we do have one or two copies of your slides here, and your notes. We will duplicate them and distribute them to the committee.

[Dr. Margo Greenwood]

There's a larger document that goes with that.

[The Chair, Liberal, Andy Fillmore]

We have that as well. We'll distribute both.

Thank you, Gwen, Jakob, and Margo.

Jakob, I want to mention that we had hoped to see you in Iqaluit two weeks ago at our public hearing, but understand that the flights didn't allow it. We're very grateful that you were able to fly in today.

[Jakob Gearheard]

Thank you.

It would have been even better because then it wouldn't have been me; it would have been our chair and one of our councillors.

Sorry, I apologize that it had to be me this time.

[The Chair, Liberal, Andy Fillmore]

That's okay. We're happy to have you. I can tell you, just about every other guest that we had at our panel mentioned your work, so it's great to have you.

Thank you all.

We're going to move right into questions. We have time for a few questions. They're for seven minutes.

The first question is from Don Rusnak, please.

[Don Rusnak, Liberal, Thunder Bay—Rainy River, ON]

Thank you for your presentation. We probably do have the technology to get it up on the board, but we didn't today. I apologize for that.

We're hearing over and over again of the problem with funds to do the work, the great work, I'm hearing, that you guys are doing in the community. I'll ask you a question that comes from the analysts, because it was exactly what I was thinking in terms of testimony that was heard at the public hearing in Iqaluit. A witness noted that the federal program funding criteria were too narrow for some Inuit-specific initiatives. When program funding did arrive, partway through the fiscal year, it left only 20 weeks to deliver the program. A representative from Leave Out Violence Nova Scotia stated that she does not apply for federal funding, as the funding arrives too late in the year and only provides very short-term funding. To my understanding, they can do very little with it. They'll either have to return it or, in this case, she doesn't apply for it. It was recommended that funding be extended for multi-year initiatives.

First, how responsive have federal program criteria been to your community-based initiatives, right now and in the past, and what would be your recommendation for the future?

[Jakob Gearheard]

I would start by saying that, first of all, the federal government doesn't need to own the short-term funding problem. It's across the board. It's with all funders, or a lot of the funders—territorial funders, even non-governmental funders. There's this tendency to fund short term.

Funders always want to fund the new project, something that's never been done before. They often don't want to fund this ongoing project that we've been doing for 10 years and works. They want to fund a new part of that. That's another part of that problem.

We love federal funding. We apply for it all the time. We receive federal funding. We're funded right now by Health Canada. We're one of the Indian residential school programs. We represent Baffin Island for that program. That funding partially funds the counsellor training program that I'm talking about. It's awesome. I wish it were for more than one year at a time. We have to apply for it every year. Every year they say they don't know if we'll get it next year: maybe we'll get it next year. They'll tell us later if we're going to get it once we get the application in.

It makes my job really difficult. Instead of figuring out how we're going to make our program better, I'm scrambling around trying to figure out if we'll be funded next year. Our counsellors also have a really difficult time. They're asking me all time if they're working here next year or if they need to start looking for another job. It makes it so.... But I won't go down that rabbit hole.

In terms of the criteria being too narrow, I can't think of a specific example of when that stopped us. I think we may have a higher capacity in our organization to write proposals, so I would only be able to speak for our organization on that. I think sometimes it might be too narrow. Sometimes it might be too bureaucratic to get through that. Sometimes we have to hire consultants to help us walk through the application process.

[Don Rusnak, Liberal, Thunder Bay—Rainy River, ON]

Gwen, in terms of funding coming from funders, can you identify any problem for us so that hopefully at the federal level we can make a recommendation to government to fix that? As well, are there positives that you see? I don't know if you heard the previous presentation from the other two gentlemen who were talking about the Aboriginal Healing Foundation. Would an organization like that, with perhaps not as rigorous funding models or categories, be beneficial to organizations like yours?

[Dr. Gwen Healey]

Our organization has the same challenge as Ilisaqsivik. We are also only project-based funded. We don't have core funding, although we try continuously to find it. We also rely on proposal driven funding. We also love federal funding. We've been fortunate in being able to apply for it and to receive multi-year funding through the Public Health Agency, but it's usually through a research or innovation focused initiative.

Makimautiksat is a good example of this where we received a five-year grant to develop, pilot, and implement the program. Unfortunately, when we finished that, and we had this wonderful program, it was impossible to try and find the funding to fund the program delivery now that the innovation part has been concluded. That part has been a challenge, as well as trying to navigate the different streams of funding through Health Canada and the Public Health Agency. We were shimmied between different departments, and then it ended up just being no one's responsibility to help us find the right pathway. That was a challenge at our end.

When we do get that multi-year funding, then it's perfect, and it's great, and it works well in being able to work with the different departments. All of that is very smooth. We do appreciate that.

When it comes to the question of narrow criteria, I don't think I can comment on that. In my experience, the criteria have been broad enough to capture a wide variety of proposals, and in our experience we haven't had that problem necessarily.

[The Chair, Liberal, Andy Fillmore]

Thanks, Dr. Healey, we're just out of time there.

[Dr. Gwen Healey]

Thanks, okay.

[The Chair, Liberal, Andy Fillmore]

The next question—and we only have time for two more questions I'm afraid—is from David Yurdiga.

[David Yurdiga, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair, and I'd like to thank Dr. Healey, Jakob, and Margo for joining us here today. Your input is very valuable, and it will be an important part of our report.

One of the concerns we heard in our committee trip to northern Quebec and Nunavut was the cost and turnover of mental health professionals. What challenges do the youth experience with this constant turnover? I'd like to hear from all the witnesses, if possible.

[Jakob Gearheard]

I'll start.

It's a huge challenge. Somebody comes into the community, and it takes them.... They might come in on a contract that's six weeks long, or they might come in on a contract that's two weeks long. They fly in. They spend most of their time trying to figure out where they are. Flying into a community on Baffin Island is not like driving down the road. It's really different. There are all kinds of trauma you're going to see and hear about because you're in a small community. There is a lot of trauma. We have mental health workers who leave. They fly in, they get traumatized, and they leave.

If you're a client—and this happens all the time—people will come over to our office and they'll complain about the mental health worker who just flew in. They'll say things like, “I went in there and I had to spend the first 30 minutes explaining to them Inuit history, and about residential schools, and what is the dog slaughter, and how all this stuff is impacted. I even had to tell him why it's super expensive to live up here. I couldn't speak Inuktitut to him, and the mental health worker wanted to bring in a translator, or he is related to me, or he's my ex-boyfriend.”

It's a small community. There are 1,000 people. If you're a fly-in mental health worker it's tough, and it's not fair for the clients. I would go as far as to say that it's not ethical for a mental health worker to fly in and pretend they're counselling when they don't speak the language, or when they are not sure of the capacity of their interpreter, or how the interpreter is even related to the situation they're talking about. They don't know enough about the community to know the basic history.

I've had clients say they felt like they should have been paid to provide the mental health worker with an orientation to the north, and they didn't feel like they got anything out of it.

Then what happens is that the mental health worker leaves. They're there for six weeks, and you finally you get to trust them and you're working on a plan. Maybe you're going to go for residential treatment somewhere or something, and then someone else comes in and you start all over.