Indigenous and Northern Affairs Committee on May 31st, 2016

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

Thank you.

We have a myriad of programs, and I am glad to see that CIHR is starting to really focus, because I think that is going to be critical. Aboriginal head start has been around forever, as well as the NNADAP program. Programs have been around, and if they are not working, I think we need to start to refocus support. Obviously, the biggest issue is the upstream.

Again, hopefully my next question is a quick one. In the headlines this morning, in the Ottawa Citizen, was a young indigenous person who was clearly having challenges. The doctor was so horrified that she felt she had to speak out. You talked about the mandate of working with the provinces and territories. When those sorts of things happen, do you ever take an incident like this and give that doctor a call to say, what the heck is going on? Do you have a system in place with the provinces where you can use a case study like that to improve things? Did you pick up the phone, or did anyone in your department pick up the phone? Apparently, it sounded very horrific in terms of a local case.

[Dr. Tom Wong]

Yes. In a situation like that, what our department does is liaise with the province and have discussions about that. That particular example is something that can be of major concern to all Canadians, if all the facts that are described in the newspapers are there. The reason is that we need to think about the circumstances where an aboriginal youth who is very scared ends up in a facility. What is the most welcoming way to help this youth? Of course, we don't know the circumstances, and we don't want to comment on the individual circumstance.

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

I understand that.

I know, as well as many, that not everything reported has all the facts. Is there a system in place where you can immediately take action?

[Dr. Tom Wong]

Yes.

[Keith Conn, Assistant Deputy Minister, Regional Operations, Department of Health]

I will try to support my colleague. It's Keith Conn.

To answer your question, yes, the phone is picked up. I am not sure about this particular case, but for example, when there are disturbing prescription patterns for an individual client—we do have a tracking system—there is a call from our head office to that prescriber or pharmacist. We work closely with the various provinces and territories. I wouldn't say a hotline, but we have a direct line to senior officials to say that we have an issue, for example, “This person is in Toronto, they are stranded, and they are going through a crisis. How do we work co-operatively together?” We have navigators as well, who are out in the field working for first nation communities to champion or to help clients who are in a distressing situation that could be leading to some high-risk situation. Yes, we pick up the phone. We call pharmacists, doctors, or our connections within various ministries of health to resolve the issue.

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

My next question is for Dr. Beaudet.

You alluded briefly to two things. You said that you share best practices at the Arctic Council meetings. Is there a public document that could be ultimately tabled?

[Dr. Alain Beaudet]

There are several documents, and we will be happy.... The report of the project, the outcome of the project during the two years of Canada's chairmanship is out, and we will certainly be happy to send this report to you.

As I said, we are pursuing now.... It is great that under the chairmanship of the United States, they have decided to maintain the project and build on it. We saw what the gaps were from our first study. One of the problems we realized was that.... We all started with wanting not only to look at the interventions that had been successful in Canada, but also to learn from interventions that had been successful in Greenland, Alaska, northern Sweden, and northern Norway, where, as you know, there are also extremely high suicide rates among aboriginal youth.

We realized that we had a difficulty in actually comparing the studies because of the lack of standardized metrics. It is one thing to measure suicide rates, but there are all sorts of other metrics in the interim that could inform whether an intervention is successful or not, and whether we are actually changing the mental health core. This is what we are doing now. Canada will be hosting a major end-of-term symposium on this case in Iqaluit.

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

They have me down to my last minute. You talked about a very successful Quebec project, their preventative initiative, with a 50% reduction in suicide rates. If that could be tabled—

[Dr. Alain Beaudet]

Absolutely. It's been a major program launched in Quebec for preventing suicide. The results have been amazing, actually. As you know, Quebec had, among the provinces, the highest rate of suicide among youth. The effect of a systematic approach to prevention has massively decreased the rate of suicide among youth. We'll be happy to send you this information.

[The Chair, Liberal, Andy Fillmore]

Thank you for that.

The next question is from Charlie Angus, please.

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

Thank you very much for participating in what I think could be a very important study, with all our members of Parliament trying to deal with some of these issues. I hope we will see you again as more evidence comes forward.

Certainly, the issue of suicide is very complicated, but in some ways it's also very simple, in that the agencies, the adults, the institutions whose job it is to protect children are failing them. That's what we need to look at.

I bring forward the case of 14-year-old Azraya Kokopenace, who died a horrific death in Lake of the Woods. She was involved with child welfare. She was involved with police. She was brought to a hospital, walked out of that hospital in the middle of the night, and her body was found two days later. The family is asking for an inquest. I don't want to deal with the individual case, but what was raised in that tragedy was that she tried to get mental health services and mental health services were not available. In fact, in Queen's Park today, in calling for the inquest, MPP Sarah Campbell said, “To be clear, these services don't exist.”

Do you keep records, statistics, of the number of requests for mental health services for youth at risk? Do you keep records of how many are denied? Do you have records of what the delay rate for treatment is?

[Dr. Tom Wong]

Thank you very much for the question.

Yes, indeed, we are very concerned about the state of mental health services in Canada in general. This is both on reserve and off reserve for indigenous people and for non-indigenous people as well. Specifically, in remote and isolated areas, there's a particular challenge.

Yes, to answer the question, our department does have records of people requesting mental health services, and the department does actually provide those services by contracting with professionals to provide those services, both in person as well as through telehealth arrangements.

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

Thank you. I only have seven minutes, that's why I'm being curt here.

In our communities that I represent, I hear all the time that people are denied service, or they wait so long the young people go to ground and we've lost young people. Would you share those statistics with us so that we have a sense of what the delay rates are, because if we're being told that mental health services simply do not exist in parts of the country, then what else can we expect but that these young people are going to fall through the cracks? Would we be able to get those statistics?

[Dr. Tom Wong]

Yes, we'd be happy to provide those statistics. It is really important to us that anybody who wants and needs mental health services actually gets those services, because they want those services to get help.

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

Thank you. That's excellent.

You'd said that we have 10 mental health wellness teams in the country and you say they represent between two and 10 communities that they service. There are 634 first nations, so that's between about 3% and maximum 20%. The AFN said we need 80. Have you costed out what it will take to get us to have a full complement of mental health wellness teams?

[Dr. Tom Wong]

If we wanted to look at a utopian situation, yes, we want to go up to—

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

It's not utopian. This is about making sure that every community has a mental health wellness team so their kids aren't killing themselves. You say you have 10. They say they need 80, so have you costed out what it would take to get us there?

[Dr. Tom Wong]

Right now, we are actually doing the calculation on how much that would cost, yes, and we would very much like to expand those mental health wellness team services.

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

That would be great.

[Dr. Tom Wong]

Those mental health wellness team services are not just providing the services when there's a crisis, but they also to try to prevent the crisis from occurring. Then when a crisis happens they help the community deal with the crisis and mobilize other teams into the community.

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

We're 70 short, so could we get the numbers on what it would take to get us there?

I notice on the mental wellness continuum that only $350,000 was allocated. We asked Health Canada about this the last time they were here. How much would you need to get the full implementation of the mental health wellness continuum framework?

[Dr. Tom Wong]

The implementation of the first nations mental wellness continuum framework is much more than the $350,000 because everything that was done up to the point when the framework was developed, was compatible with—

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

But without your framework, there's only $350,000.

[Dr. Tom Wong]

Yes, but the $350,000 was purely the first tiny step to do the pilot studies.

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

What will it take to fully implement?