Indigenous and Northern Affairs Committee on Oct. 19th, 2016

[The Chair, Liberal, Andy Fillmore]

Good afternoon, everyone. We'll come to order.

This is the House of Commons Standing Committee on Indigenous and Northern Affairs. We're continuing our study of suicide among indigenous peoples and communities.

Welcome, everyone. We're meeting today on Algonquin territory, for which we're very grateful.

We have two panels. In the first panel in the first hour from 3:30 to 4:30, we have the Mental Health Commission of Canada and the Canadian Association for Suicide Prevention. I think we've arranged that each organization will have 10 minutes to present. We thank you very much.

Getting right into it, I'd like to invite Louise Bradley, president and CEO of the Mental Health Commission of Canada, and Ed Mantler, VP for programs and priorities, to take the floor for 10 minutes.

[Louise Bradley, President and Chief Executive Officer, Mental Health Commission of Canada]

Thank you very much for inviting us here today. It's really a privilege to appear before this committee.

I think it's doubly important to acknowledge the Algonquin people, who are the traditional custodians of this land. I'd also like to pay respect to their elders past and present and recognize the strength, resilience, and capacity of indigenous peoples in this land. I think this is particularly important, given the recent tragedy in northern Saskatchewan. I'd like to acknowledge that today.

I want to begin first by stating very clearly that I am not an expert in this area. I am not an indigenous person. You've heard from Dr. Rod McCormick and Dr. Mike DeGagné and other indigenous thought leaders. They've talked to you about restoring families and providing healing. You've heard that the answers lie in communities, something that the Mental Health Commission of Canada very much agrees with.

I can attest to this, having learned a great deal in visiting the Esketemc First Nation in June. I had the privilege of meeting Chief Charlene Belleau, who has initiated healing within her community that is very impressive.

I have with me today a commitment stick that I was honoured to be presented with. It was part of my reconciliation journey. Having spent time with her and also listening to the stories of elders within her community, I think the sweeping transformation that has taken place under her leadership is an inspiring example of reconciliation. As I said, I learned a tremendous amount. The community was very generous and gracious in welcoming us. It isn't an exaggeration to say that my experience was nothing short of life-changing. I spent a couple of days there, and it really was very enlightening.

I took away from that visit three key understandings that have really reshaped my world view, both personally and as a leader of a national organization.

Firstly, my commitment to reconciliation has been strengthened. Like all Canadians, I bear a responsibility to play a role in the healing of our country. As the leader of the Mental Health Commission of Canada, I'm learning what it means to be a partner in this unique context. I've come to understand that being invited to the table is a privilege and that the best thing we can bring is an open mind and a willing spirit. We've set aside our past attempts in favour of a nuanced understanding, born very much from humility.

Secondly, I recognize that the work that lies ahead must be undertaken by indigenous peoples, and they have the capacity, regionally and nationally, to lead this effort. Research tells us that intergenerational trauma and its effects are the legacy of residential schools and the relocation of Inuit in our northern communities, and it means generations affected by poorer health outcomes.

I often liken the stigma associated with mental illness to an iceberg—being from Newfoundland, I'm quite familiar with those—and what we see is really only the very tip of the problem. I think it might be fair to say that the same is true when it comes to assessing the damage incurred by indigenous peoples through decades of colonialism and cultural subordination.

There are ways and means to support indigenous peoples as they action their own solutions to the crisis they now face. Layers and layers of research and evidence support this work, and, as an external entity, the commission, for example, waits to be invited to align and partner with indigenous organizations, as we were privileged to do with the ITK this past summer around the Inuit suicide prevention strategy, in the launch of that strategy in northern Labrador. Our knowledge as an organization was enriched by this experience. We understand that it can take years to build a foundation of trust and that this foundation will likely remain delicate for quite some time.

Finally, I recognize that chronic underfunding has ill-served indigenous peoples and harmed Canada's overall health and reputation. That is why the federal government should support sustained, long-term funding of non-political indigenous organizations like the former Aboriginal Healing Foundation, organizations that deliver evidence-based, strength-based community development and culturally based initiatives.

I specify non-political, because any efforts must be undertaken with a view to a long-term solution. Critical health outcomes cannot be dictated by the political will at the time. To echo my colleagues, Dr. McCormick and Dr. DeGagné, direct service provision should never be politicized.

To conclude, I would like you to consider some of the small successes of which the commission is very proud. We are working on implementing the Truth and Reconciliation Commission's calls to action. One step we are taking—this very week, as a matter of fact—is implementing reconciliation dialogue workshops, which are now mandatory for every staff member in the commission, and our board of directors is also undergoing that training.

As part of our commitment, and in our role as a convener, we have invited HealthCareCAN and the Canadian Centre on Substance Abuse to join us on our journey.

Finally, I would be remiss if I didn't take a moment to personally thank Senator Murray Sinclair; Chief Charlene Belleau; Natan Obed, president of ITK; and Joe Gallagher, CEO of the First Nations Health Authority, all of whom have become trusted advisers to me and everybody at the commission on this journey.

Thank you very much.

[The Chair, Liberal, Andy Fillmore]

Thank you very much for that.

Mr. Mantler, are you adding anything at this time?

[Ed Mantler, Vice-President, Programs and Priorities, Mental Health Commission of Canada]

Not at this time.

[The Chair, Liberal, Andy Fillmore]

Thank you.

We'll move right along to the Canadian Association for Suicide Prevention. We'll hear from Jennifer Ward, who is director and survivors chair, along with Ed Connors, director.

You have 10 minutes to divide as you see fit.

[Jennifer Ward, Director and Survivors Chair, Canadian Association for Suicide Prevention]

Thank you very much for having me here today.

In April, May, and June of this past spring, I was humbled to be a part of Ontario's emergency medical assistance team, EMAT. The EMAT deployed to Attawapiskat, Ontario, in the wake of its youth suicide crisis. It was the only time in history that the team had been deployed to a first nations community and the deployment of almost 60 days was the longest in the team's history.

As a psychosocial member of the EMAT, I provided risk assessments, safety planning, clinical supports, psychoeducation, and resources to the existing community staff and community members.

I will speak today about some the experiences and knowledge that are informed by what I refer to as the “survivor's lens”. As a survivor of suicide loss myself—I am the survivors chair for the Canadian Association for Suicide Prevention—my focus is always on postvention.

At CASP when we use the term “suicide prevention” we inherently mean suicide prevention, intervention, and postvention. We have made significant strides in raising awareness and public dialogue about suicide prevention and education, but clearly much work lies ahead.

In Attawapiskat, I learned a great many things. Namely I learned that although the media at times may have suggested otherwise, that community and its people have a great many strengths, strengths that in the context of suicide prevention deserve our focus and deserve to be celebrated.

On many occasions in Attawapiskat, I was aware that I was not the best person to be providing support to that community. Although I am an ally and I embrace first nations' learning, I am not from them. I am an outsider. There were many occasions when in working with an individual or family we would make every effort to bring in a local resource or a person to provide additional support and continuity, knowing that our team would be leaving. It was more often the case than not that we learned that the resource person was profoundly impacted themselves. So I am reminded that we must not forget that the caregivers are also hurting.

From the literature we know that each suicide death leaves in its wake a number of survivors who are deeply impacted following a suicide death. Traditionally we have reported that number to be between seven and 10 survivors for each suicide loss. New research tells us that it is much more likely to be 25 people per suicide death who are profoundly impacted. In smaller and remote communities when a suicide occurs, virtually everyone is impacted, including the first responders and the emergency personnel.

We also know that suicide-related grief and loss is a significant risk factor in suicidality for those survivors who are bereaved by a suicide loss. However, clinically or on the front line, we often fail to recognize or address the suicide-related grief, which may have been the very experience that brought somebody to thoughts of suicide or suicidality in the first place. We must not forget the healing that must occur after a suicide has happened. Postvention is prevention.

During my time in Attawapiskat, I was lucky enough to have been included in several experiences that promoted not only healing, but life promotion and a celebration of culture: arts-based workshops including painting, drum making, and a gathering of youth in a music recording session. The youth of Attawapiskat are truly amazing. Although these types of gatherings are not not traditionally viewed as suicide prevention interventions, we have to make room for this to be so.

In Attawapiskat and all of Canada the focus is on youth. There was also much involvement and concern for the elders and older adults in that community. But what about that generation in between, those who are mothers and fathers and also daughters and sons? We know that the middle-age demographic is among the highest risk demographic across Canada, although not specifically for first nations communities. We do know that all individuals and entire communities must be engaged in reconciliation and holistic life promotion practices. This critical age group are most often caregivers for aging parents and for children and youth. How then are we reaching and engaging them in life promotion? This is an important question that begs our attention.

Since 1985, the Canadian Association for Suicide Prevention has attended to the critical public health issue of suicide across our nation. As an unfunded volunteer organization, we rely on the strength of our partnerships with national partners such as the Mental Health Commission of Canada and the First Peoples Wellness Circle.

In addition, we also work closely with many community-based organizations, and many successes in the field of suicide prevention are both community driven and innovative.

I have some more to say about that, but I'm going to leave some space for my colleague.

[Dr. Ed Connors, Director, Canadian Association for Suicide Prevention]

Thank you.

I'm Dr. Ed Connors. I'm of Mohawk-Irish ancestry. I'm a band member of Kahnawake Mohawk Territory.

As a psychologist, I've worked across the country in our first nations communities for the past 35 years. In those 35 years I have been intimately involved with the experiences of suicide in our communities.

I'm going to share with you now a synopsis of what I've shared with you in the form of a document that you'll find in your package. I apologize to the French members of the committee that I did not have time to have this fully translated for you because we were just recently notified of the invitation. We will ensure that it will come to you in full translation, as required.

I'm going to make a few comments here with regard to this paper. I'm going to begin with an acknowledgement. Thank you, Louise, for acknowledging the first nations indigenous peoples of this territory and their lands. I will also acknowledge that these are in our territories as well in more, what we call, modern time.

I will begin by giving a comment as an opening, which we do when we open any gathering and when we come together. It's the opening of the thanksgiving prayer. When we begin, we begin in this way, and I think it's significant as an opening to my remarks. What we say when we open in the thanksgiving prayer is that we are now gathered and we see as we gather the cycles of life that continue. As we see those cycles of life as they continue, we recognize that we've been given the duty to live in balance and harmony with each other in all of life. As we do this, we bring our minds together as one, and we give greetings and thanks to each other. Now, as we have done so, we acknowledge that our minds are as one.

I am going to make comments regarding not just our indigenous populations of Canada, because my involvement has been worldwide. I've acknowledged and recognized the similarities in the patterns of suicide globally. The indigenous populations worldwide are at the highest risk of suicide. While indigenous communities worldwide generally present the highest rates of suicide, there are many examples of indigenous populations, such as the Sami people of Norway, and communities in Canada, the B.C. first nations that have been reported by Chandler and Lalonde as having extremely low suicide rates, and in many cases no suicide.

In Canada, high suicide rates range from five to seven times that of suicides among non-indigenous populations. In extreme cases, suicide rates have exceeded over 800 times those of non-indigenous communities. Suicides in indigenous communities globally are overwhelmingly overrepresented among our youth. I draw that to your attention because I think it's an important question and a focus that we need to have about why our youth have such high suicide rates, not just in Canada, but indigenous populations globally.

There are no-to-low suicide rates in many of our communities, and that has been accounted for in many of the studies that have been done. Some of the most recent works show that in those communities we can account largely for the low suicide rates to no suicide rates as being connected to strong self-governance and strong cultural renewal.

Elevated rates of suicide in indigenous communities have also been linked globally to colonization, colonialism, and acculturation. Indigenous world views as expressed through languages, cultures, beliefs, values, and lifestyles have been disrespected, suppressed, and oppressed through the process of colonization.

I share with you at this moment a wampum belt. It is the way that we made treaties in the past, and we made treaties with my ancestors. As I pointed out to you, I am both of indigenous ancestry, Mohawk, and Irish ancestry.

My ancestors came together in the formation of this treaty. This treaty was made in 1613, with the Dutch and the Haudenosaunee, or the Mohawk people. When this treaty was made, it was made to identify the fact that we were of two different world views, two different cultures, two different languages, and different ways of understanding ourselves, the world around us, and all of creation.

It said that we will live together in peace and harmony on this land, but to do so we need to be able to respect each other's cultures, each other's ways of knowing, understanding, and believing, and that we need not only to respect each other's ways, but to recognize that they are equal, that they are not one greater than the other. I believe today that we are faced at this time.... There are many things that tell us today that we're at at time in our history where we can actually come back full circle to this treaty. We can fulfill the vision of our ancestors, of my ancestors and yours.

We talk about today as a time of reconciliation. What is reconciliation? Reconciliation, in many ways, has to do with re-establishing this vision, re-establishing the true relationship of equality and respect.

In our communities today, indigenous world views that have been repressed are now being expressed again and being renewed. As they are being renewed in our communities, and I've seen this happen in many of our communities—as is now being shown within the research—and as that renewal occurs, the rates of self-harm...and the process of healing is taking shape.

The renewal of indigenous world views and associated lifestyles serves to protect against the negative effects stemming from the trauma and losses associated with colonialism. Cultural renewal enables our youth to answer four questions known to be important for healthy development, especially during the period of childhood to early adulthood: Where do I come from? Who am I? Why am I here? Where am I going? This knowledge also relates to recent insights provided through the First Nations Mental Wellness Continuum Framework. It identifies meaning, purpose, belonging, and hope as core concepts underlying the state of wellness or health within our people.

First nations communities have known that cultural renewal is primary to the recovery of healthy indigenous people's families and communities. This has been the core of our effective healing programs for many years. Twenty-seven years ago, I was part of the development of the sacred circle, providing a way of life within the Ojibway Tribal Family Services in Treaty 3, northwestern Ontario.

This was one of the earliest examples of cultural renewal within our communities as a process of healing. It was the first time that we really spoke to the experiences of life promotion, as opposed to suicide prevention. It was the first time that we supported cultural renewal and healthy community development. It was discontinued, and this is an important point, and I'll close on this note. That work that was done, and many of the pieces of work that we've done in the past that we've proven to be effective, were discontinued across the nation. Programs that were focusing on this at one point in time, which were once federally funded, moved from federal funding to provincial funding. When that happened, there was a change from what we called family support programs and cultural renewal to a process of child protection and child welfare agencies. When that happened, we moved from the process of cultural renewal and the healing of our communities to where we are today.

I challenge you in your thinking about this to consider that we know what works. We have seen what works, and we have had many example of that. We know this within our communities.

I hope that we are able to gain the support of your committee as we continue to come together in the process of reconciliation and of healing within our communities.

Thank you.

[The Chair, Liberal, Andy Fillmore]

Thank you to both organizations and all panel members for their testimony.

We'll move right into questions now. The first round of questions is seven minutes in duration, and I'll use the cards again. That seven minutes will allow both questions and answers.

The first question is coming from Michael McLeod, please.

[Michael McLeod, Liberal, Northwest Territories, NT]

Thank you to all of you for your presentations. I'm the member of Parliament for Northwest Territories.

Since the study was undertaken, we've experienced quite a few suicides. In under five months, we've had four. When you start adding the people who are passing from drug overdoses, because drugs have hit the north too and are in the small communities, we're really seeing the impact on our communities. I find it really interesting when you say 25 people per suicide death are impacted, and maybe that number is even a little low. I know in our communities that people are all pretty much connected. People are related, and when somebody passes away, it's significant and it takes a long time to recover. Some people never recover.

We have had a chance to study this issue for a while now. We've gone to several communities and a lot of the facts that you've raised here today we've heard in most places.

I represent 33 communities and in some of our smaller communities, especially the ones that are made up of larger aboriginal populations or predominately aboriginal, we have real issues with trusting and using the health centres or the RCMP. We have limited capacity and we have very few programs that address some of the issues that need to be dealt with as a result of the residential schools or trauma or how they've been impacted. We virtually have no infrastructure to house programs or offices.

We heard in some of our testimony, mostly by the youth, that there should be a recommendation that investment be made in community-based youth facilities to be used for recreation, for reconciliation, for healing, for hunting, and for sports. We do have some facilities such as friendship centres or cultural centres, but I haven't heard anybody speak to actual infrastructure, so I'd like to ask that question.

We also heard lots about the issue of housing and how that's impacting people in the communities and causing a feeling of despair, because there's no place to stay. There's no place for people who are homeless. It's a growing issue.

Maybe I could ask the two organizations to touch on those two areas.

[Louise Bradley]

I'll start off with some general remarks. I think you're absolutely right when you look at the issue of housing, which is a huge social determinant of health. The Mental Health Commission of Canada did a five-year research demonstration project on homelessness and the mentally ill, but it did not do that in any northern communities. However, I think what we learned from that research can apply. We studied a housing-first approach, which means housing along with a basket of services. It doesn't mean housing only; it means housing first. Certainly, it can have a huge impact in terms of the mental health outcomes of people in general. That's what our research told us.

I don't think I'm an expert in terms of speaking about the infrastructure part of it. I do know that the Aboriginal Healing Foundation certainly had community programs, if you want to refer to those as infrastructure, and I understand that they were very successful. When that funding was removed and the supports were taken away, things reverted back and the numbers increased.

Do you want to add anything?

[Jennifer Ward]

Certainly I can only speak to my experience in Attawapiskat, and infrastructure was an absolutely glaring issue in my time there. My full-time job is on a police-based crisis team in Peel Region, Ontario. I have a natural inclination to find the officers in whatever community I'm in. I spent a lot of time with the police in Attawapiskat as well.

I said to them, “What's one simple thing that we could do to make it easier for you to do your job and serve this community?” They gave a simple example that had never even occurred to me. They don't have street names, addresses, or numbers on any of the homes. So they get a report that there's a suicide in progress or somebody is at risk of suicide, and they're trying to respond, and they cannot locate the house. That's a very simple infrastructure issue that had real and profound consequences in the daily duties of the officers. That's one point I can make.

The other is, again around the youth, not having a youth centre, not having a dedicated space where they could gather. Then, some of the spaces that did exist in the community were unsafe, condemned really. The arcade in particular was one building that was not available. Then when some of the buildings did exist, it was difficult or challenging for the youth to have access to them on a regular basis or to find adult volunteers who were able to regularly contribute to safe practices and safe gatherings for them.

[The Chair, Liberal, Andy Fillmore]

There are 30 seconds remaining, Michael, if you can make use of it.

[Dr. Ed Connors]

I think you're correct. You're identifying the basic needs. We know already that in the north, for example in many of our communities now, the infrastructure of our housing is collapsing. As we have global warming, and the changes are occurring, we're basically losing housing.

When we start to think about health, we have to start with the basic needs. That's what you're pointing to, I think.

A lot of these other things that we're recognizing are factors that add in to the complex picture of creating a healthier life. We have to start at the beginning, which is the basic needs. Housing is only one of those. We can talk about the social determinants of health. What about the food issues?

[The Chair, Liberal, Andy Fillmore]

I'm sorry, we'll have to leave it there and move on. I'm sure you will have an opportunity to get the remainder out.

The next question is from Cathy McLeod.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you, witnesses.

I think everyone on this committee, with the recent very tragic suicides in Saskatchewan, is feeling a very heavy burden in terms of where we're going to go with this particular initiative and how we're going to actually make this matter. It was all the more powerfully brought home in the last week.

I can understand, Dr. Connors, the picture that you talked about.

I'm going to start by focusing on Jennifer. I've always sort of wondered how effective these deployment teams can be as a response. Of course, we have another crisis. Tell me a little bit more about who was on your deployment team, what you did, how you did it, and if you think it made a difference.

[Jennifer Ward]

The EMAT team consists largely of critical-care paramedics, nurses, nurse practitioners, and the psychosocial team, primarily graduate-level social workers, which is my profession.

We did also have a number of individuals on our team who were first nations identified, aboriginal social work practitioners. We were lucky to have them. I would say they were the most valuable members of our team because of course they were able to connect with community.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

So the group goes into the community that already doesn't have housing. Keep going, but I'm wondering about some of these technical details.

[Jennifer Ward]

We stayed in a hunting lodge, and it took time to develop a rapport with community members. We weren't certain if we would be welcomed. Initially it was a 30-day deployment and those 30 days were exclusively hospital-based. We were providing respite relief to the clinical staff in that community who were simply burned out from responding to this crisis in the week prior to our arrival, and many of them left the community to go and attend to their self-care elsewhere.

We were brought in for respite services originally. The second phase of our deployment was much more community-based, and we participated in some of the practices that I mentioned around arts-based healing and drum making that we had done with some local elders. We had brought in music sound recording artists to work with the youth, as well, and then we worked with many of the clinical care providers within the community around community crisis response models and some things that we know have worked elsewhere. It was really a delivery of resources and ideas, and saying, “These are some things that we know have worked, some of them perhaps will work for you”, and then we would learn as well from that group.

Did it work? Was that your question? Was it effective over time? I would say there have been many good outcomes from that deployment. One in particular that Ed and I had the privilege of being a part of was the Sounding Echo Youth council in Attawapiskat that had been overwhelmed with a response that was media-led. Many organizations reached out to this youth council, and one in particular was the Jays Care Foundation from the Toronto Blue Jays.

The Jays Care Foundation is still involved in that community, so many of the outreach efforts are long term. They have now created—Ed and I have been involved a bit in the creation of it—a three-year program in co-operation with the Ontario Ministry of Child and Youth, called Girls at Bat. It's for the eight first nations around the James Bay coast, and it specifically targets young females in that community. It is a life promotion program, and I do think that it will have a longer-term and positive impact.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Dr. Connors.

[Dr. Ed Connors]

Just adding to that, I think what you're concerned about, which I've been concerned about, is the fact that many of our crisis responses are just that. They're just crisis only, and then we pull out. The experience I've seen in our communities quite consistently is that we continue to get the message that people care at the moment, but once they leave we get the message that people don't care, because why did you come and then disappear?

What's happened now, and what is happening, as Jennifer was talking about...the difference is we're keying in on that now and saying that it's not enough. We have to have consistent long-term responses. When she went in and they started to identify children who were at high risk and needing more services, the question became not only what are we going to do while we are here, but how are we going to help these young people to get services beyond this?

That is one of the responses, but there are other issues that need to be attended to in order to ensure that consistency of care is followed through. What is happening is that we have now identified through other programs that they connected with...for example, in the Enaahtig Healing Lodge and Learning Centre we did work with the kids from Attawapiskat. We began, and worked with them for a month. Then after that month we went back to the community and we've begun a relationship working with the community.

We now have an ongoing...and the youth who were in that program now connect with art workers through the Internet, and they've started to develop relationships. In addition to the program they're talking about there, we're starting to evolve other forms of relationships with the community to ensure there is a long-term response and not just a crisis response.

[The Chair, Liberal, Andy Fillmore]

Thank you.

We're just about out of time. Thank you very much for that.

The next question is from Charlie Angus, please.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Thank you very much for coming here. I have enormous respect for your work, and I want to thank you for your work with EMAT. I don't know if we met at the emergency ward, but I went there a couple of times to see the work.

I want to talk about suicide contagion and clusters, because when we had the Attawapiskat state of emergency and we had to fly in an emergency team, across Canada that same month, there were states of emergency declared in Neskantaga and Cross Lake, and three in Saskatchewan. Imagine three non-native communities declaring a state of emergency because their kids were killing themselves. The government would turn itself upside-down, but we get an emergency response.

No offence to the great work that was done, but this crisis didn't just happen. None of these crises happened accidentally. They are clusters.

I just want to walk you through this. In 2008-09, we lost 13 kids in James Bay in a winter, and they were laying off the front-line staff. The government was going to come in with a program to get kids to play, but they were cutting off the front-line workers. In 2012, they cut them off. When Sheridan Hookimaw died, we couldn't get her home for four or five months. The contagion started then. They were surprised that all of these children were starting to self-harm? I find that shocking.

I want to ask you this. If we know that suicide is a contagion, and if we know that we have to move in, and if we know that we have to have those supports, then why now when a 10-year-old girl has killed herself in Saskatchewan are we still scratching our heads at the federal level and saying, “Oh, my God, what are we going to do? Maybe if we got a program. Maybe if we got them to fill out a form to get some of kind of youth thing happening, they'd be better off”?

It's a band-aid after a band-aid.

I would like to hear what you, given your experience on the ground at Attawapiskat, see as a long-term solution so we don't have to fly in emergency teams anymore.

[Jennifer Ward]

I think that one of the most critical things we're missing in Canada is a national response around postvention. We know that suicide is going to occur. With Sheridan Hookimaw, many of the individuals I was able to meet when I was in Attawapiskat were profoundly affected by her death personally, and they had little or no formalized supports around that. When I say “formalized”, I don't mean in my traditional clinical sense, but even on a community level.

Many communities, including Ottawa, have a post-suicide support team. As soon as a suicide occurs, that team goes in. It's local, on the ground, and connected to resources. That is something I think we need in Canada. It exists in the United States, Ireland, Scotland, and many other countries.

I think we need to understand that suicide is a circle There are prevention, postvention, and intervention, and they all work together. One way I think we could get in front of that would be to recognize that the risk is going to go right through the roof as soon as that occurs.

[Charlie Angus, NDP, Timmins—James Bay, ON]

With Sheridan, we had the warning bells going off, but we couldn't get youth out to get treatment. We have been told that treatment, in a lot of the areas, just doesn't happen. I got an email from a young girl in the James Bay region who said that she was so glad that all the emergency teams were flying in, and she asked if we could drop one of them off in her community. So that's the issue.

In the time I have left, I want to talk about the trauma of the front-line workers.

You talked about the NAPS police. The work that EMAT did in just giving them a break was enormous. These are front-line battle statistics in terms of what they were dealing with on a nightly basis, and they're dealing with those among their own family members. Then people leave, and our front-line workers are dealing with severe trauma, not just with the children but in their own families. How do we ensure a national support so that the communities are not left on their own to deal with this trauma?

NAPS officers say that they're the ones who have to go in and cut the children down; they're the ones who are expected to get up the next day and go to work; and they're the ones who end up killing themselves as well. How do we deal with trauma for the front-line workers?

[Dr. Ed Connors]

That's what Jen was talking about in terms of providing the services that are necessary to help them with grieving and bereavement. That's the initial service that needs to be provided to them. I do a lot of that work with a lot of the police services that are serving our northern communities. That's happening, and we are trying to do that, but we don't have a sufficient amount of resources to respond to the need. Part of it is actually a funding issue in terms of ensuring we can provide those services to those people.

There's another point, Charlie, that is important to recognize in terms of your question about how we change the system. You're right. These figures that I quoted have been the same for 35 years. The same conditions have continued to repeat themselves. What can we do differently, though? We have learned over that time, but we haven't been utilizing a lot of what we've been learning. That's particularly the knowledge that Louise was referring to, saying that we do have the knowledge within our first nations communities about what can work.

I gave you an example of one that was working really well, but then it was gone. We had 12 communities that we were working with, and huge change was occurring. We were addressing the true needs, and then all of a sudden the funding changed. Priorities change and the resources and the services that are needed, that you're looking for and that you're asking about, are gone. I did that work over 25 years ago. We do learn, but sometimes we don't pay attention to what we have learned that works. I say that first nations people know what has been working.

The other point that I think is really important is the systemic point, and that has to do with the borders. In this country, we've created borders that are not first nations borders; they're the provincial borders and the federal borders. Then, as you know, the politics of it all becomes wrapped up in how children are treated, or how they're not treated. I've got an example of one of the young people from Attawapiskat. We identified the need for that child's services as being immediate and extremely high-risk. A lot of those children were at extremely high risk. She was the highest. We identified where those services were that were culturally appropriate, but they were across the border. They were in Manitoba, so what happened? We couldn't access those services for her. They ended up placing her into a southern Ontario psychiatric facility for adults, where they had virtually no understanding of that child's cultural background, what her needs were, or what was happening in the community.

How do we help? We think we're helping, but we're not. As first nations people, we recognize that. We know that's happening, and we try to educate people and share that. This is where we need to bring together and start sharing that knowledge, listening to each other, and giving some credence to the knowledge that's there within our communities.