First Nations family says culturally sensitive mental health care difficult to find

This story is Part 4 of a five-part series looking at the state of youth mental health resources in Calgary.

A First Nations mom says accessing mental health care for herself and her children would be better if more culturally sensitive care were available in Calgary.

Alycia Two Bears has spent a lot of time in the Alberta Children's Hospital emergency room seeking emergency mental health care for her children.

Her first visit was nearly a decade ago, with her now 16-year-old daughter.

"Our introduction with the mental health system actually involved taking my oldest to Children's Hospital for their mental health unit for particularly violent behaviours," she said.

WATCH | Alycia Two Bears on how mental health supports can be better for Indigenous children, in the video at the top of this story

We got involved a lot with community counselling, and then it shifted into my fourth kiddo, who's now 10, also including hospital stays at the mental health unit and more."

As a First Nations family, it's been particularly difficult to access the care she and her children need, Two Bears says.

"I've had to talk to the doctors about what intergenerational trauma means and how it impacts our family," said the mom, who is a member of the Mistawasis Nêhiyawak First Nation in Saskatchewan but now calls Calgary home.

"I don't feel that I should be doing that in a time of distress and crisis — to have to sit down and put on my teacher's hat to educate."

In a written statement, Alberta Health Services (AHS) said it understands the province's Indigenous population has specific needs, and it has dedicated Indigenous staff available through the province.

"AHS takes into consideration culturally appropriate health-care services for First Nations, Métis and Inuit peoples throughout the province," it said.

"All AHS staff are required to complete Indigenous awareness training to increase awareness of the unique health-care needs of Indigenous peoples in Alberta."

When Two Bears has accessed the emergency room at the Alberta Children's Hospital for any of her kids, the mother of five says she's never had or been offered culturally informed care.

"Within most mental health services, you don't receive somebody who necessarily always has that trauma informed lens, who knows about ceremony, who knows about tradition, and then also knows that they're complex and different," she said.

"We're [a] Nêhiyawak family, so we don't need Niitsitapi values or necessarily a knowledge keeper, because they're not all the same. To find somebody who's a registered psychologist, understands the complex history that we have with Canada, is difficult."

Natalie St-Denis is an assistant professor and director of the Indigenous Social Work Circle at the University of Calgary.

She says any mental health professionals who work with Indigenous youth and families need to understand the effects of the complex and cumulative trauma they're experiencing.

"I'm still always surprised at the number of people, even professionals — be it either social workers, psychologists, nurses and doctors — who still don't know or understand the impact of those challenges that many of our community members experienced throughout their lifetime," she said.

When looking at the province's sensitivity and competency training, St-Denis, who has mixed ancestry with Mi'kmaq and Acadian heritage, has been disappointed.

AHS says the training is a one-time thing, for four hours total.

"What do you learn in four hours about another culture? About history? I would say not very much," she said. 

St-Denis says improving Indigenous care in health services settings is something that's been called for by the Truth and Reconciliation Commission of Canada.

"It clearly identifies very specific steps for health-care centres and education it should include in the work that we do within and not only on reserves, but in urban settings as well," she said. 

Two Bears says she and each of her five children have needed to access mental health services at some point.

"Whether it be directly for them for personal care, but also realizing we're a whole family unit that's all impacted by mental health," she said.

Two Bears says her family also deals with the same struggles as any other family looking for mental health care for their children — which means lots of wait lists and short-term programming.

"As the mom, it's frustrating. You get hope that you're gonna get help and then you realize this is only going to last for six months, and your family dynamic is still ongoing and then the issues still arise, they still come up," she said.

"Then you have to go back into the waiting line to get potentially up to six months of a waiting list to get the same help that you had already asked for a year ago."

But she feels that if there was more availability of culturally appropriate care for Indigenous youth and families in Alberta, it would have made her family's mental health journey better.

"In the system, your parenting is critiqued, why you're there is critiqued, and while they are absolutely there to help your entire family dynamic, it can feel like a very lonely process as a single parent," she said.

"If I had an elder or somebody to sort of be present with me, I think it would have reduced a lot of anxiety or the perception of 'this is a struggle I have to do all alone.'"

St-Denis said the reality is that many Indigenous peoples won't seek help at hospitals because they fear their children might be apprehended.

"Even a mom taking their youth in, they might feel, 'Oh, well, they'll blame me and so they'll apprehend my kid.' So there's all of these barriers and fears in place, because of how systems are interacting with our community members," she said.

AHS says it's working on improving access to culturally safe health care for Indigenous patients and their families.

It says there are a few programs already established, including Indigenous mental health programs that help families navigate services for their Indigenous children within AHS and the community and the Honouring Life program.

"[It] addresses risk and protective factors and builds community capacity to support Indigenous youth resiliency and suicide prevention through community-based holistic wellness programming," said AHS.

St-Denis says it's important to understand that not all Indigenous youth will be ready to connect with someone like an elder or Indigenous liaison person.

"But having those people on site is really important," she said.

Ultimately, it's about creating a safe space for Indigenous youth and families, she said.

"If there was a smudge room where the youth can go to, if that's something that they practise," she said. "But [also] having someone who understands it, maybe a knowledge keeper or indigenous liaison person within the hospital system or even elders."

• Want to learn more about this project? On Tuesday, Jan. 11, CBC Calgary reporter Lucie Edwardson will answer your questions live about her five-part series Kids in Crisis. You can submit any questions you have here or comment below.

Two Bears says that while her family hasn't been provided culturally sensitive care through AHS, they have recently had some success through a national program, Non-Insured Health Benefits (NIHB).

"There is coverage for a therapist or a registered psychologist now directly through NIHB, [which] is fantastic," she said, adding there is an option to speak with an Indigenous service provider if desired.

In a statement, Indigenous Services Canada said the program has been around for nearly two decades. It means that every 12 months, an eligible client (Canadian resident who is First Nations or Inuit) can receive up to 22 hours of counselling from an approved provider.

"That we have the option of having ongoing care that renews every single year is tremendously useful, and that makes a direct impact on me personally, and then as a mom," she said.

If you or someone you love is struggling, AHS recommends the following resources:

• Call the Distress Centre at 403-266-HELP (4357)
• Call ConnecTeen at 403-264-TEEN or text 587-333-2724
• Call the Kids Help Phone at 1-800-668-6868 or text CONNECT to 686868.
• Bullying Helpline at 1-888-456-2323
• Call the Mental Health Helpline at 1-877-303-2642 or the addiction line at 1-866-332-2322.
• Visit the Help in Tough Times website for more resources.
• If in crisis call 911 or visit the closest emergency department.

Indigenous mental health resources:

• The Hope for Wellness Chat at 1-855-242-3310
• The National Indian Residential School Crisis Line at 1-866-925-4419

Read more stories from the Kids in Crisis series: