The main obstacle is access to services. When you're in a first nations community, the health services that are provided do not reflect the same services that are available in the off-reserve community. Mental health off reserve has counsellors and therapists. On reserve, those services are not mirrored, so they're not as accessible.
Also, funding around mental health prevention.... Provide mental health prevention that's culturally appropriate and community mandated and developed, all the way from prevention along the continuum to treatment, and then also treatment including.... Suicide is very high in our communities. Once community members leave a mental health facility, if they go off reserve, they're going to have a community health nurse who makes sure they're following up on their care. If they go on reserve, they literally almost fall off the grid.
There are different privacy acts that each jurisdiction is bound to. My colleague mentioned Jordan's principle and the jurisdictional barriers. Those barriers appear everywhere. If people were to go off reserve, they would have access to mental health supports. In the community, those are limited.
Access to equitable services would be my answer.