Indigenous and Northern Affairs Committee on May 31st, 2016

[The Chair, Liberal, Andy Fillmore]

Sorry, Mr. Bossio.

We're moving to a three-minute question now from Charlie Angus, please.

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

Thank you very much.

I was looking at the Pikangikum coroner's recommendations from the horrific suicide crisis of 2006 to 2009. There were 100 recommendations. We will be having the Thunder Bay inquest recommendations. We've had the TRC recommendations.

Can AANDC tell us, in a case like that, how many recommendations are followed up on?

[Paula Isaak]

We're currently working right now to implement the calls to action of the TRC. That process has started.

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

But in the case of Pikangikum...?

[Paula Isaak]

I can't tell you off the top of my head, so I'd have to get back to you.

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

One of the key recommendations from Dr. Bert Lauwers, who did the Pikangikum report—and it strikes me as something to be learned in Attawapiskat—was to establish a steering committee with health professionals, law enforcement, and government in the community so that we could actually move forward. That doesn't seem to have taken place. It seems to have been a bit ad hoc. But a coherent steering committee.... This is what we're hearing in Attawapiskat as well with the youth, about giving them something.

We see that there are partners stepping up. In Pikangikum, Project Journey with the OPP is doing incredible work with young people. When Mr. Conn and I walked into Attawapiskat we were met by the Canadian Rangers, who were on the ground. We have an enormous amount of goodwill. We have an enormous amount of expertise in providing services, but in some of these communities we need a framework. We need to have, especially in troubled communities of crisis, the federal government or the provincial partner playing a role to support the efforts of organizations that want to help.

Mr. Conn, the clock is ticking on the EMAT team in Attawapiskat. People in our community have seen this movie before, where once all the attention is gone, one by one so are all the workers, and we're back to square one. What's the post 30-day plan with EMAT and making sure that we can get the best out of all these organizations that want to help?

[Keith Conn]

Thank you for the question.

The EMAT team along with some of the federal resources—we have a senior executive from Health Canada as well as representatives from the North East LHIN, Local Health Integration Network—have been working with the community itself. The EMAT has been doing some knowledge transfer and training within the community, including for the health director and other staff, to develop a transition plan so that as the EMAT dissipates, there will be a plan in place in terms of medium-term supports, coordination.

They've been doing some community mapping of all the agencies, the workers that are in place on a continual basis but also what is going to be augmented shortly between the collaboration and input of the North East LHIN and the WAHA hospital, so those are being solidified. We're going to have some discussion hopefully with the chief on Thursday. I think there's a reasonable plan. It's been a lot of hard work, but I think there's some light.

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

Is it applicable to other...? I mean, it seems to me we're always reinventing the wheel in the middle of—

[The Chair, Liberal, Andy Fillmore]

Charlie, I'm afraid we're out of time, but your name is coming back up again.

We're moving through the list. We're going to start again with seven-minute questions, and the first one comes from Rémi Massé.

[Rémi Massé, Liberal, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you, Mr. Chair.

I'd like to thank the witnesses for contributing to this important exercise of trying to shed light on the causes of high suicide rates and potential solutions to prevent them.

My first question is for Dr. Beaudet. Our colleague, Cathy McLeod, touched on this earlier, but unfortunately, we ran out of time.

I'd like you to speak at greater length about the solutions Quebec put in place, solutions you described as successful. They, in fact, led to a 50% reduction in the youth suicide rate. Please take your time because I think it's important we hear what those solutions are.

[Dr. Alain Beaudet]

I can give you some details on that. It's a program-based government approach that relies on structured prevention policies.

As is always the case when it comes to research, we are in the situation your colleague referred to earlier. We want to find out which policies had an impact and to what extent the impact of those new policies was positive. Can we establish any correlations? Without question, Quebec is currently experiencing a lower suicide rate, and it is holding steady. Year after year, we've seen an absolutely phenomenal drop in Quebec's suicide rate. Which programming elements and which preventative measures were applied, specifically? Establishing the cause-and-effect relationship—not just the correlation—is still a challenge. I would certainly be happy to send you the relevant documentation.

One thing is clear, however, and it was certainly noticeable when we looked at the various interventions used in the U.S., Australia, Greenland, and Canada. To be effective in preventing suicide, the interventions must be heavily adapted to local socioeconomic conditions and local communities and, as my colleague said, rely on community engagement. Of course, youth-focused models are paramount, and they will vary tremendously from one community to another and grow based on the level of remoteness.

Unfortunately, it won't work to simply take Quebec's prevention policies, lock stock and barrel, and apply them to Nunavut. I can't stress enough how important that is to understand.

It's equally important to understand which elements can be imported and how they can be tailored. I gave you the example of a researcher who took prevention programs that had been successful elsewhere and, working hand-in-hand with the communities, adapted them to first nations. These tailored programs have been met with tremendous success. Clearly, that's one solution that is worth a much closer look.

[Rémi Massé, Liberal, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you.

That's important because, even though, as you say, the number of deaths by suicide has dropped significantly, our statistics show that the number of suicide deaths in the province of Quebec still sits at 753 among men and at 219 among women. That's still a lot, so there's a long way to go yet.

[Dr. Alain Beaudet]

The situation was alarming because the suicide rate was one of the highest in the world not that long ago. Today, that is still true in Canada, but for Inuit populations, as you know. Unfortunately, we still hold the sad distinction of having the world's highest suicide rate among young men.

[Rémi Massé, Liberal, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you.

I have another question for the Health Canada officials responsible for implementing the aboriginal health programs.

In July 2015, the federal government announced its commitment to ongoing funding for aboriginal health programs, including $13.5 million per year for the national aboriginal youth suicide prevention strategy. How many suicide prevention projects have been funded under the strategy, and what have the outcomes been?

[Dr. Tom Wong]

Thank you for the question.

Indeed, the strategy has funded more than 130 projects. For me, that is just a start because many more projects could be funded with additional resources in the future, but we are already seeing some of the outcomes. In some of the projects, some of the participants are reporting that they are seeing more hope. They are seeing a future for themselves, and they are actually starting to attend school more. Those are all elements that predict a better future, and therefore less propensity for mental diseases and suicide as well.

[Rémi Massé, Liberal, Avignon—La Mitis—Matane—Matapédia, QC]

Thank you.

Could you describe some of the projects that were put in place? What tangible measures were taken under the 130 projects being funded? That may help to partly answer the question asked by my colleague, Michael McLeod. I'd like to know what solutions were adopted, concretely speaking, under those projects.

[Dr. Tom Wong]

Yes, that's very much so.

For example, I was talking earlier about a project in the Northwest Territories where there was a camp for adolescent teen girls, and through the camp activities they've learned to have self-confidence and they've learned about the linkage to culture. As a result of that they are reporting all of those factors that I talked about, the feeling of hope, the feeling of the future, and as a result of that, their connection to schools and all of those things have increased.

Another project is through the development of community, working together with the local police to try to help the young people understand their strengths and help them to do physical activities. As a result of that, they are finding that they will no longer be complaining that there is nothing to do in life. They now seem to look to there being a place for them in the future.

[The Chair, Liberal, Andy Fillmore]

Thank you very much for that.

The next questioner is Cathy McLeod, please.

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

Thank you, Chair.

I do want to pick up on my namesake in terms of the fact that it doesn't appear to be one lead in this, so the sense I'm getting is a scattering of services and programs across a whole host of departments. Some have been evaluated; some haven't. I think there are certainly ways it can be brought together with a little more clarity, but you've been embedded in the system and perhaps you see it more clearly than I do.

I do want to also pick up on this. I think if you had the money tomorrow you would never be able to fill 70 teams of mental health workers. I've delivered health care and been responsible for getting services in rural and remote communities, and I think it is really tough in terms of HR manpower and getting people with the right skills. I always believed that to some degree the money is better spent in terms of recreation and capacity building.

To that end, first of all, I know that Dr. Beaudet talked about the mental health first aid program being adapted to first nations communities and rolled out. Is it being rolled out in 600 communities across the country, or 20 communities? To what degree has it been evaluated, and to what degree is it showing any kinds of results?

[Dr. Alain Beaudet]

The answer is no, not to the 600 communities.

We are funding research, so our role is to demonstrate that an intervention is effective. Then our role is to work with our colleagues to ensure that the effective interventions are scaled up in a way that is appropriate for the various communities where they are being scaled up.

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

How many communities are you researching? The program was adapted—

[Dr. Alain Beaudet]

It depends on the program, but I am thinking about one where there are—

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

This is the mental health first aid one.

[Dr. Alain Beaudet]

—12 communities in one program, the same number. There are relatively small numbers of communities where the research is carried out.

Don't forget that, again, we support the research so we cannot support care, which often goes with implementation science to a very large scale.

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

Okay. My next question will to go Health Canada.

I've seen demonstration project, after research project, after primary health care project that is shown to be effective. Do you have a system whereby you can reallocate resources from things that aren't effective to.... Let's say, for example, this mental health first aid kit was showing amazing results. What kind of nimbleness and flexibility do you have to scale that kind of thing up?