Staggering mental health, addiction stats push northern First Nations to call for emergency declaration

Chiefs of First Nations in northern Ontario are calling for a public emergency and social crisis to be declared, emphasizing the disproportionate mental health and addictions issues facing their communities compared to the rest of the province.

The Sioux Lookout First Nations Health Authority's (SLFNHA) held its two-day annual general meeting last week. It serves 33 First Nations — 28 of them are considered remote as they have no highway access.

Those who attended the meeting in Thunder Bay heard jarring preliminary figures from a report on mental health and substance use that's underway in the communities. The figures show band members are hospitalized for mental health and addictions issues at six times the provincial rate.

From 2011 to 2021, emergency department visits for intentional self-injury nearly doubled and ambulatory visits in the communities tripled.

Chiefs at the meeting passed a resolution to direct the SLFNHA to:

• Develop a media and advocacy strategy based on the mental health and substance use report.
• Develop a joint task force by March 2024.
• Seek funding from Indigenous Services Canada to host a mental health forum.
• Call on the Ontario and federal governments to implement several solutions, from resource allocation to policy changes, and an agreement from the solicitor general to respond to the crisis.

'Each number is a person'

The steering committee involved in SLFNHA's mental health report has been listening to stories from community members to integrate Indigenous knowledge into its findings, Dr. Lloyd Douglas, SLFNHA's public health physician, told CBC News.

"When you hear the storytellers sharing their experiences, you quickly realize that each statistic, each number, is a person, is a mom, is a dad, is an aunt, an uncle, a cousin," Douglas said. "This is not something that's historical — this is extremely current."

While much of the data gathered goes up to 2021, he suspects the numbers have worsened since then.

Each statistic, each number, is a person, is a mom, is a dad, is an aunt, an uncle, a cousin.- Dr. Lloyd Douglas, public health physician with SLFNHA

It's hoped the final report will be completed by November, in time to be presented at a special meeting of chiefs. The goal of the report is to provide First Nations people with quantitative evidence that can be used to push for more resources.

"It will validate their stories," Douglas said. "Their voices will be amplified through this report."

Investments, initiatives in Sioux Lookout

Several new projects have been implemented in Sioux Lookout, which acts as a hub for surrounding First Nations to access health care and social services to meet people's mental health and addictions needs.

These include the opening of safe rooms at the Meno Ya Win Health Centre, a new walk-in addictions clinic at both the hospital and emergency shelter, and new supportive treatment beds. SLFNHA also purchased a third hostel this spring to help accommodate some of the thousands of people who go to the town for medical appointments.

"From the perspective of a co-ordinated continuum of care, it's important to have a suite of services," said Sonia Isaac-Mann, the SLFNHA's chief executive officer and president.  

"Those wraparound services that are needed so [they] don't just go into treatment — there's more to it than that, and it's looking at: how do we support them on their journey to healing and wellness?" she said.

Isaac-Mann said she sees SLFNHA's role as helping to co-ordinate different partners. She supports the chiefs' mental health resolution, and hopes to work closely with communities and organizations to help them achieve their goals.

"[The resolution] is very timely and it really puts everybody who has a role to play in this system on alert that we need to do this work, we need to do it now, it's not three years from now." 

New mental-health care model

SLFNHA is finalizing a new mental health model for the First Nations it serves.

Chief operating officer Janet Gordon said the framework takes into consideration a comprehensive mental health and addictions review, and community consultations.

During SLFNHA's meeting last week, she said these core principles must be in place to make mental health and addictions services more accessible:

• Land-based, traditional practices.
• Language revitalization.
• Better access to electronic medical records and data.
• The physical space for specialized services to be offered.

But that's all contingent on flexible, sustainable funding, she said.

"We need a long-term solution and we need … infrastructure to support that at the community level," Gordon told CBC News. "It's developing those business plans, developing work plans with the communities, with different groups, and putting some timelines around it."

It's hoped that work will be done in the next four to five months, she added.

"We have identified a model that could address some of those areas in terms of being able to better respond to individual needs so that they can have access to service," she said. "Doing more prevention and promotion so we're not waiting for people to be in crisis or that they are not taking their own lives."

Another key focus is providing care to youth, and ensuring they have safe spaces in their communities and are empowered to lead the next generations, Gordon said.

Leaders seek Indigenous-led health care

Also at the SLFNHA meeting, the chiefs passed a position statement affirming they will no longer accept a health-care system that is controlled by the provincial and federal governments and offloads responsibility to First Nations.

Kitchenuhmaykoosib Inninuwug Chief Donny Morris, a member of the Chiefs Council on Health (CCOH), has been a driving force in what is known as the health transformation project, which aims for an Indigenous-led, Indigenous-owned health-care system for the region's First Nations.

The passing of the position statement has triggered the start of a trilateral negotiation process to:

• Recognize and support First Nations' jurisdiction over public health in SLFNHA communities.
• Access immediate, sustainable resources to address long-standing gaps in health care.
• Explore interim models for care.
• Support a culturally-based and informed process that prioritizes community engagement and expertise.

"We signed [a] treaty to be partners with Ontario and Canada, and only two are benefiting in that scenario, and that's why we want to develop our own health system," Morris told CBC News.

"Better service, better care and better facilities ... that needs to happen now," he said. "We need to be at the table to meet with the provincial and federal government because, like I said, they are our partners. It cannot exclude us when we're treaty partners."

Passing the position statement means the provincial and federal governments must sit down with First Nations leaders to discuss next steps.

Morris said the plan is to reach out to all parties, including tribal councils and provincial territorial organizations, in the next month.

"It's gonna involve everybody to make this thing work — [not just] us trying to make the change."