Indigenous and Northern Affairs Committee on May 13th, 2022

[Lori Idlout, NDP, Nunavut, NU]

[Member spoke in Inuktitut as follows:]

ᖁᔭᓐᓇᒦᒃ, ᓯᕗᓪᓕᕐᒥᒃ ᖁᔭᓕᒍᒪᕙᔅᓯ ᐃᓘᓐᓇᓯ ᐊᒃᓱᐊᓗᒃ ᑐᓴᕐᓂᖅᑐᐃᓐᓇᐅᓵᕋᔅᓯ ᐅᓂᒃᑳᑦᑎᐊᖅᖢᓯ ᑐᑭᓯᓇᑦᑎᐊᖅᑐᓂᒃ ᐊᒻᒪᓗ ᐅᓂᒃᑳᒐᐅᑎᒋᔭᔅᓯ ᓄᓇᕗᒻᒥᐅᓄᑦ ᐊᑐᖅᑕᐅᓯᒪᒻᒥᒪᑕ ᐃᑉᐱᓐᓇᑦᑎᐊᖅᑐᑦ ᖃᐅᔨᒪᑦᑎᐊᖅᑕᒃᑲ ᐅᓂᒃᑲᐅᓯᕆᔭᔅᓯ. ᐊᐱᖅᑯᑎᖃᕈᒪᓪᓗᐊᖅᑕᕋᒪ ᐃᓅᓯᓕᕆᓂᐅᑉ ᒥᒃᓵᓄᑦ mental health-ᖑᓂᕋᖅᑕᐅᔪᖅ, ᖃᓄᕐᓕ ᑲᑎᖅᓱᐃᖃᑦᑕᕆᐊᖃᖅᐱᓯ ᓄᓇᖃᖅᑳᖅᓯᒪᔪᐃᑦ ᐃᑲᔪᖅᑎᐅᒑᖓᒥᒃ ᐊᒻᒪᓗ ᖃᓄᖅ ᓄᓇᖃᖅᑳᖅᓯᒪᔪᓄᑦ ᐋᓐᓂᐊᖅᑕᖃᙱᓕᕆᓂᕐᒧᑦ ᓇᓪᓕᐅᒃᑯᒫᖏᓐᓄᑦ ᐃᑲᔫᓯᐊᓄᑦ ᐊᑭᓕᖅᑐᐃᓂᕐᒧᑦ ᐱᑕᖃᕐᒪᖔᑦ? ᐃᓘᓐᓇᓯ ᑭᐅᔪᓐᓇᕈᔅᓯ.

[Inuktitut text interpreted as follows:]

First, I'd like to thank you for your wonderful presentation. It was very informative. It gives a better picture of what's going on in the field. We know that the situations you talked about affect everyone in the communities. We have all encountered similar problems.

My question is this. When it comes to mental health counsellors and healers, how are you keeping track of aboriginal and indigenous healers? What is the current approach to tracking mental health outcomes for first nations and Inuit who use the counselling benefit under the NIHB program? How are those results being reported to the indigenous communities and the government?

If you could all respond to this, I would appreciate it. Thank you.

[The Chair, Liberal, Marc Garneau]

If you are ready to respond, Grand Chief, go ahead, please.

[Grand Chief Ken Kyikavichik]

Thank you, Mr. Chair and other members of the committee, and thank you to MP Idlout for her question.

At the current time, there isn't a very formalized process for the tracking or the listing of our healers and mental health counsellors with our organization. We do have what are known as “resolution" health support workers in each of our communities who are providing part-time support. Especially when we're encountering tragedies or deaths in the community, they provide immediate support. On an ongoing basis, they provide that localized community support.

What we are finding the most effective, however, is on-the-land programming. To that end, the Gwich'in Tribal Council is investing significantly, in partnership with the Government of Canada, in retrofitting a wellness facility about 15 kilometres south of the town of Inuvik on the east branch of the Mackenzie River. It's so that we can offer mental health and wellness programming in our communities. They're not treatment centres, per se, but maybe detoxification. We may be able to offer aftercare services in addition to other services locally that allow our people to reconnect with the land, which we find is incredibly powerful to restoring their mental health.

In terms of how it is reported, I don't have that data directly in front of me. However, I can say that we do have the workers and the staff within our health and wellness department who are able to provide that vital service at the community level.

[The Chair, Liberal, Marc Garneau]

Ms. Wallace, do you want to answer that question?

[Isabelle Wallace]

Unfortunately, we don't have a tracking system for mental health services. We do have three social workers. We sometimes will send people to neighbour communities, such as Tobique First Nation, for land-based healing. Unfortunately, we don't have that in our community.

We have the detox centre, but oftentimes people in our region are reluctant to even go there for that type of service due to the fear of stigma. We all know each other. Even having their car seen at the social worker's office is something they avoid. There is a big gap in mental health services in our region.

[Lori Idlout, NDP, Nunavut, NU]

[Member spoke in Inuktitut as follows:]

ᖁᔭᓐᓇᒦᒃ. ᑖᓐᓇ ᐃᑲᔪᖅᓯᒻᒪᑦᑕᐅᖅ ᐱᖁᔨᕗᖔᕈᑎᖃᕋᔭᖅᐱᖅᑲᐃ ᑖᓐᓇ ᖃᓄᖅ ᐋᖅᑭᒋᐊᖅᑕᐅᒃᑲᓐᓂᕈᓐᓇᕐᒪᖔᑦ ᓲᖃᐃᒻᒪ ᑖᒃᑯᐊ ᓄᓇᖃᖅᑳᖅᓯᒪᔪᐃᑦ ᓇᒻᒥᓂᑦ ᐃᑲᔪᖅᑎᒌᒋᐊᖃᕋᓗᐊᕐᒪᑕ ᐱᖁᔨᕗᖔᕈᑎᓂᒃ ᐱᖃᕐᒪᖔᔅᓯ, ᐊᐱᕆᕙᔅᓯ ᐃᓘᓐᓇᓯ.

[Inuktitut text interpreted as follows:]

Thank you.

Would you have a resolution or a recommendation as to how we can improve the recognition of traditional mental health workers who are community-based? Do you have any recommendations on how we can bring that up to par with other counsellors?

[The Chair, Liberal, Marc Garneau]

Do you want to start, Grand Chief?

[Grand Chief Ken Kyikavichik]

Sure, Mr. Chair.

My recommendation would be to look at it in a manner that is well removed from western science, if you want to call it that. We are finding that the traditional approach to mental health counselling has been to provide a counsellor from outside of a community into the community. We are firm believers that our counsellors exist and that they interact on a less formal basis, on a day-to-day basis. What we are finding most effective is providing people who will listen to our people and not judge them for their particular situations.

In terms of improving the recognition of mental health workers at the community level, it's removing all of the credentials, if you will, all of the very high levels of post-secondary education. It's recognizing and placing value on the social awareness and the knowledge of our culture, our language and our protocols, and understanding how people are provided with that counselling in the Gwich'in way, as we would say, which is a lot of listening and not much talking.

[The Chair, Liberal, Marc Garneau]

Thank you very much, Ms. Idlout.

We are running up against the clock, but we can have a quick second round like we did the first time, if committee members are willing.

We could start with Mr. Schmale for three minutes.

[Jamie Schmale, Conservative, Haliburton—Kawartha Lakes—Brock, ON]

Thank you, Chair.

Thank you, witnesses, for this great testimony.

I'll continue with you, Ms. Wallace. We were talking about mental health just a little while ago. In previous testimony in this meeting and in prior meetings, we heard about the bureaucracy being a barrier to care, especially on the preventative side, in terms of bureaucratic red tape and issues with communication and reimbursement, etc. I know that you talked about it earlier on in your testimony and in questioning, but maybe you could expand on that in terms of the mental health side of it.

Are you noticing, or have you experienced, mental health situations where, especially on the preventative side, extreme delays in getting access to treatment then led to an even worse case, where individuals, perhaps for a whole variety of reasons, were being taken to a hospital emergency room—or worse?

[Isabelle Wallace]

Thank you for the question.

Yes, in many instances where we probably would have cases of overdoses, we knew that they would have been preventable, but we didn't have the connectivity or even the staff to run the programs to connect them virtually with a mental health professional, even if it was a psychiatrist or, if we remove all credentials, if we wanted to provide land-based healing or traditional healing. I've seen many overdoses.

It's very frustrating because we know that these would have been preventable. As nurses, we don't have the time to even sit down with our patients and have a conversation. That would often happen when they are on their hospital bed and the action has already happened. Then we would try to be briefly with them.

It happened that over the weekends I had instances where I couldn't connect with a social worker or a professional, and I was told by a doctor who was sitting in his apartment in Toronto, “We won't be dealing with a mental health crisis on a Friday night. This has to wait until Monday morning.” That was unacceptable.

I tried to advocate for the patient, but I had to send her back to her home. She was at a high risk of committing suicide, and that's very heartbreaking. We worked very hard over the weekend to make sure that she was safe and that as nurses we were too, but that's what we were told. The doctor is often the one who will decide who will be sent down south, if they can justify it. That's one example.

[The Chair, Liberal, Marc Garneau]

Thank you, Mr. Schmale.

We'll go to Ms. Atwin for three minutes.

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you, Mr. Chair.

Thanks so much to our witnesses today for joining us and for your testimony.

With my short time, I'd love to ask Ms. Wallace some questions.

Thank you for being with us today, Ms. Wallace. It's always a pleasure to cross paths with you.

You talked a bit about overt instances of racism and the systemic racism that's part of the system. I'm wondering as well about whether there are significant language barriers to accessing services through the NIHB and if you could speak to that.

[Isabelle Wallace]

Absolutely.

It's a majority francophone community. In fact, it's the only one. The other communities in New Brunswick have access to funds and services, but those services are very often offered in English only.

We are often told that our community is in a remote corner of the province. Because we are isolated, I have to turn to Quebec to find resources and materials. For services, we rely only on the Edmundston Regional Hospital and the Vitalité Health Network.

Regarding the NIHB program, when my colleagues and the other health professionals try to contact the call centre staff, the person who takes the call often can't speak French or, when they can, they don't have the answers to their questions. They simply weren't given the information. So there are delays, and that causes a lot of frustration.

I know that professionals were unable to enrol in the program because they were unable to communicate with someone who speaks French. I find that unacceptable. The program exists and staff want to collaborate. However, there is a language barrier. So that aspect has to be looked at more closely. As well, the call centre employees automatically think we're coming from Quebec, when the Quebec health care system is different from New Brunswick's. There is a lot of confusion and a lot of time gets wasted.

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you.

Do I have any speaking time left, Mr. Chair?

[The Chair, Liberal, Marc Garneau]

You have less than a minute left.

[Jenica Atwin, Liberal, Fredericton, NB]

Would there perhaps be additional barriers for women and members of the 2SLGBTQ+ community as well?

[Isabelle Wallace]

Absolutely. My brother is transgender—two-spirit—and we ran out of options for them. Essentially, what I had to tell them was, “Move to Montreal and seek private services, because I don't have the answers for you.” Our community doctor couldn't provide the care, and it just came to that point where they moved to Montreal, unfortunately.

[The Chair, Liberal, Marc Garneau]

Thank you very much.

We'll go to Madame Gill.

Ms. Gill, the floor is yours for about a minute and a half.

[Marilène Gill, Bloc, Manicouagan, QC]

Thank you, Mr. Chair.

I will ask Ms. Wallace one last question relating to the language issue. I know it came up during the last meetings, particularly in connection with Indigenous languages. The issue was that there were problems, particularly for seniors, in accessing services in their language.

Ms. Wallace, you referred to French and the fact that the community seems to have lost its language, Wolastoqey. I'm not certain.

What can we do to help you and for people to be able to get care in their language?

[Isabelle Wallace]

I have thought about it this week, and I have tried to find solutions. We talked about the possibility of getting funding to have an Indigenous navigator to help us with NIHBs, but our population doesn't meet the criteria required. Our community having help from a francophone would be important. We are working to revitalize the Wolastoqey language in our community, but we are a long way from seeing it come back to life there. In the nation, there are still people who speak that language, but it is very threatened.

On the other hand, I'd like to have the help of a francophone Indigenous navigator to support people in New Brunswick, which is a bilingual province. We aren't the only francophone First Nation; there are others in other communities. Being able to get this in ours would be important.

[The Chair, Liberal, Marc Garneau]

Thank you very much.

Ms. Idlout, you have time for a quick question. You have about 90 seconds.

[Lori Idlout, NDP, Nunavut, NU]

[Member spoke in Inuktitut as follows:]

ᖁᔭᓐᓇᒦᒃ ᐃᓘᓐᓇᓯ. ᐊᐱᕆᑲᐅᖅᑐᐃᓐᓇᕈᒪᔪᖓ ᑕᐃᒃᑯᐊ ᑭᒡᓕᓯᓂᐊᖅᑏᑦ ᓈᒻᒪᒃᓯᖃᑎᒌᓕᓂᕐᒧᑦ ᐱᖁᔨᕗᖔᕈᑎᓂᒃ ᓴᖅᑭᑎᑦᑎᓚᐅᖅᓯᒪᒻᒪᑕ Truth and Reconciliation Commission-ᑯᑦ, ᑖᒃᑯᐊ ᐱᖁᔨᕗᖔᕈᑎᖏᑦ 18-ᒥᑦ 24-ᒧᑦ ᓈᓴᐅᑎᐅᓚᐅᕐᒪᑕ ᐃᑉᐱᒍᓱᒻᒪᖔᔅᓰ ᑖᒃᑯᐊ ᐊᑐᖅᑕᐅᒑᓂᒃᐸᓪᓕᐊᒻᒪᖔᑦᑕ ᐅᖃᐅᓯᕆᔪᓐᓇᖅᐱᓯᐅᖅᑲᐃ?

[Inuktitut text interpreted as follows:]

Thank you.

Very quickly, the Truth and Reconciliation Commission produced recommendations on health, recommendations 18 to 24. Have you worked with and implemented those truth and reconciliation recommendations in your work?

[English]

Are they being implemented? Do you feel that the federal government is doing an adequate job in implementing the calls to action?

[The Chair, Liberal, Marc Garneau]

Madam Idlout, did you direct that at a particular witness?

[Lori Idlout, NDP, Nunavut, NU]

I'm sorry. That was to both.