Cree community forced to pause suicide-prevention program due to Jordan's Principle changes

Though a disruption could be dangerous, even deadly, a health organization in a northern Ontario First Nation says it has no choice but to pause a youth suicide prevention initiative due to the federal government's recent changes to Jordan's Principle.

Christopher Thind, executive director of the health services board in Kashechewan First Nation, says people are upset and fearful of the potential impacts in the fly-in Cree community on the James Bay coast.

"Genuinely, it's terrifying to know what is possibly to come from not having access to the resources," Thind said.

Indigenous Services Canada announced the sweeping changes on Feb. 10, calling them necessary to ensure the First Nations children's program is sustainable long term, amid a backlog of funding applications most recently assessed at 135,000.

But the new directives will force the health services board to pause its Choose Life programming temporarily on April 1, said Thind, meaning about 1,000 youth would lose access to care and resources — with potentially devastating consequences.

"The scariest would be death, in all honesty. Just recognize we have a lot of youth that are on a mental health caseload," he said.

"They're developing skills to cope for themselves, to deal with the situations, whether household, family or other [risk] exposures. It's tough."

Choose Life aims to bridge gaps in services by providing mental health and wellness supports. Launched in 2017, the initiative is specific to the 49 communities in northern Ontario that comprise Nishnawbe Aski Nation (NAN), a regional advocacy organization.

Jordan's Principle is named after Jordan River Anderson, a Cree boy born with multiple disabilities in 1999, who died in hospital at age five. He never got to live at home because Ottawa and Manitoba couldn't agree on who should pay for his home care.

The principle is now a legal rule enforced by the Canadian Human Rights Tribunal to prevent racial discrimination in the provision of government-funded services.

Despite efforts to secure sustainable funding, Choose Life has been funded entirely through Jordan's Principle, and communities must file separate group-based funding applications on their own or through a tribal council.

In a news release, Kashechewan Health Services said the disruptions are a common issue that have plagued communities in the western part of the NAN region, with some having to suspend services as early as summer 2024.

"We are beyond devastated that the changes from ISC and Jordan's Principle has resulted in us having to pursue this path, but we've exercised all possible options at this time, the state of the program all lies within the hands of Indigenous Services Canada," the release says.

In the past, Ottawa would reimburse communities for expenses incurred before receiving official approval but officials "are now reversing this directive entirely," telling the health organization to stop all unapproved spending, the release said.

Pediatric society concerned

ISC did not respond to a request for comment by publishing time.

Dr. Daniel Bierstone, a Toronto-based pediatrician who is visiting Kashechewan this week, reacted to the news of the program's suspension with shock and outrage.

"There are no words to describe the depths of injustice this is perpetuating against Indigenous kids and youth here," said Bierstone, who visits the James Bay region three times a year.

"This would not be acceptable in any other community in Canada."

Kashechewan has already been hit by overlapping crises, the doctor said, including annual spring flood evacuations, a tainted water crisis causing horrible skin infections, an invasive Group A strep outbreak and the suicide crises that led to Choose Life in the first place.

Service disruptions would likely amplify feelings of abandonment and despair, and raise risks by separating youth from one particular mental health worker who has built a trusting relationship with many, Bierstone said.

"If if she is not there, this will increase the risk of suicide in the community. That's not an understatement," Bierstone said.

The situation is already raising alarm at a national pediatricians' association.

"I'm quite concerned," said Toronto-based general pediatrician Dr. Ryan Giroux, co-chair of the Canadian Paediatric Society's First Nations, Inuit and Métis Health Committee.

Giroux, a citizen of the Métis Nation of Alberta, wrote to Indigenous Services Minister Patty Hajdu on March 10 to express concerns with the narrowing of coverage.

"I'm concerned with how quickly it has happened and what is being lost in the crosshairs, particularly with programming that prevents suicide, for example," Giroux said.

The Assembly of First Nations is similarly concerned about wider service disruptions starting April 1, the first day of the new fiscal year in the federal funding cycle, a letter obtained by CBC Indigenous reveals.

"The lack of information is causing stress and is fuelling misinformation about what levels of funding are available, if any," wrote National Chief Cindy Woodhouse Nepinak in a March 5 letter to Hajdu.

In an interview earlier this month, Hajdu would only say Jordan's Principle requests will still be approved, adding that her department has a contingency plan to ensure that Jordan's Principle continues to provide care.

In a follow-up statement, Woodhouse Nepinak said the assembly understands some funding is earmarked for the upcoming year, but that the scope of that funding remains unclear.