Good morning.
[Witness spoke in Ojibwa as follows:]
Aanii boozhoo. Waabzhe kwens’dizhnikaaz. Mgizi ndodem dokis ndo jibaa. Anishnaabe ndi yaaw.
[Ojibwa text translated as follows:]
Hello. My name is White-skinned woman. My clan is Eagle. I am from Dokis. I am Anishinabe.
[English]
First Peoples Wellness Circle is pleased to be a witness before the standing committee today.
As an indigenous-led organization dedicated to advocating for mental wellness in indigenous communities and supporting a segment of the mental wellness workforce, we would like to focus our comments around the first nations mental wellness continuum framework, where we get our mandate, to talk about mental wellness during COVID-19.
A recent workforce survey completed by the implementation team of the first nations mental wellness continuum framework found reports of noticeable or significant increase in rates of stress and anxiety related to COVID-19 and public health measures, including depression, substance use, violence, financial stress and stress in meeting basic needs. This matches the June 2020 Stats Canada report data on indigenous peoples mental health impacts during COVID-19, which saw fair or poor mental health, with stress and anxiety particularly noticeable for indigenous women.
Children and youth are experiencing higher rates of loneliness, stress and anxiety as a result of public health measures, and although there's a lack of indigenous-specific data, past evidence suggests that negative impacts are exacerbated by family and community challenges, such as intergenerational trauma; difficulty meeting basic needs related to housing, clean water and food security; financial insecurity and poverty; violence, substance misuse and mental illness; and inequitable access to health, community and social supports. Informal reports have also indicated that the public health measures have also retriggered memories of colonial trauma and are negatively affecting the well-being of families and communities.
This same workforce survey noted there was a noticeable decrease in access to health and social support services, although there is a noticeable increase in need for information around mental wellness and for better and more reliable connectivity and access to technology. This same survey highlighted how nimble the mental wellness workforce in our communities has been in meeting needs by increasing their partnerships to support families and communities; continuing to provide access to mental wellness services, including increased access through virtual care; being innovative in their approaches; and ensuring access to land-based activities and cultural events. However, there is concern around the capacity to meet the increased demand for services and supports for children, youth, families, elders and populations at greater risk of mental health issues as this pandemic continues.
It's expected that the mental wellness pandemic will last far beyond this pandemic and requires a thoughtful and planned approach. We offer the following suggestions.
Number one is access to culturally relevant mental wellness supports and services across the lifespan. Mental wellness supports and services in indigenous communities have been consistently underfunded compared to Canadians, resulting in a patchwork of supports and services that vary across the country. The pandemic has exacerbated pre-existing inequities in mental wellness services, as noted by higher levels of crisis, violence and overdose deaths. Services have not been funded in ways that support the world view of indigenous people.
The first nations mental wellness continuum framework identifies the need to invest in community-defined and community-led programs and services across the lifespan that lead to collective outcomes for families and communities. They must be accessible in the home, schools, workplaces and community. Programs and services must be grounded in cultural practices, values and knowledge, including enhanced access and funding for cultural practitioners. We have seen many creative efforts by first nations to virtually share cultural teachings, engage in cultural practices, access land-based learning and activities, and access cultural practitioners to address negative impacts of COVID-19. These efforts support indigenous citizens to feel connected and give hope during these unprecedented times.
Number two is equitable access to virtual care for mental wellness. The public health measures required many mental wellness services to pivot to virtual care so that services could still be accessible to those in need. Wellness workers in indigenous communities have also pivoted to provide virtual care; however, there are challenges in accessibility and competency in using virtual care. Connectivity, access to reliable Internet services and the cost of services and technology are primary reasons that indigenous communities experience significant difficulty with shifting and accessing virtual care. These challenges are more pronounced in remote, isolated and northern communities. Canada has committed to digital health for first nations by 2030, but this is much too late.
Mental wellness teams and NNADAP treatment centres have already shifted services to virtual platforms, but the shift is hampered by poor connectivity and accessibility to technology as well as limitations in workforce capacity related to both reliable and culturally relevant information on ethics, privacy and liability, and access to supervision and IT support. Investments in connectivity, infrastructure, technology, sustained access to virtual care and human resources must happen more immediately. Otherwise, the gap in health inequity for indigenous people will continue to grow.
Number three is support for the mental wellness workforce. A needs assessment of mental wellness teams completed in 2019 identified that human resources did not match the need in communities to address the complex issues stemming from colonial traumas. Recommendations called for additional funding to meet the health human resource demand and to provide wellness services to the workforce to minimize effects of burnout, compassion fatigue and retention issues.
The heightened pressures on the workforce during COVID-19 to do more—to respond in creative and innovative ways, often with limited resources and tools; to provide advice to leadership; and to address the mounting crisis of violence, substance misuse, overdose deaths and mental health challenges occurring in communities—is taxing an already overburdened workforce. The workforce survey highlights the noticeable efforts by the workforce to respond, and initiatives spearheaded by indigenous health organizations have provided some level of support to the workforce, but it's not enough.
Investments to increase the mental wellness workforce are part of a solution to alleviate the pressures. However, investments should also consider strategies, such as debriefing, supervision and workforce wellness programs, including access to elders, healers and ceremonies, as being critical to maintaining and retaining the workforce.
Finally, investments to define evidence from an indigenous knowledge perspective on workplace mental wellness are required. Production of indigenous evidence-based materials on workplace mental wellness strategies, support for people to return to work, mental wellness training for supervisors and managers, and setting up—