INAN Committee Report

GOVERNMENT OF CANADA RESPONSE TO THE STANDING COMMITTEE ON INDIGENOUS AND NORTHERN AFFAIRS:

BREAKING POINT: THE SUICIDE CRISIS IN INDIGENOUS COMMUNITIES

INTRODUCTION

The Government of Canada thanks the Standing Committee on Indigenous and Northern Affairs for the report and agrees with the spirit and intent of the recommendations.

As a Government, we are deeply concerned with the disproportionately high rates of suicide in some Indigenous communities.  We agree that more needs to be done to support communities experiencing high rates of suicide and mental distress.  Our Government is committed to working in partnership with Indigenous organizations and communities as well as provinces and territories to ensure that individuals, families, and communities can access a continuum of effective, sustainable, trauma-informed, and culturally appropriate mental health supports and services.

The report highlights that the root causes of the high rates of suicide among Indigenous people in Canada are complex, with links to intergenerational trauma, the social determinants of health, and access to culturally appropriate mental wellness supports and services. In this vein, the Government recognizes that a commitment to reducing rates of suicide in Indigenous communities in the long term will involve coordination with partners across sectors and at all levels to sustainably support community-led healing. We recognize that each Indigenous community is unique, and that supporting communities in their community wellness planning, including identification of priorities, strengths, and needs, is critical in our efforts toward a renewed relationship and reconciliation. We recognize that suicide is a symptom of profound individual, family, and community distress and understand that the policies and practices of the past are among the significant factors contributing to the distress and its intergenerational impacts. There are no quick fixes to long standing issues but Canada is advancing efforts with Indigenous partners and other stakeholders to bring about change and hope in Indigenous communities.

Many of the recommendations included in the report reflect what the Government is hearing from Indigenous partners. The Government recognizes that fundamental and transformative changes need to continue to be made. The recent August 28, 2017 announcement by the Prime Minister to split the Department of Indigenous and Northern Affairs into two departments: one responsible for Crown-Indigenous Relations and Northern Affairs and the other responsible for Indigenous services exemplifies how committed our Government is to better serving Indigenous peoples. Transforming how we structure ourselves, share information and work with our partners and clients will allow us to build stronger and better ways of delivering services to Indigenous peoples and to advance the nation-to-nation, Inuit-Crown and government-to-government relationships, helping to make our national journey of reconciliation a reality.

The most responsible thing we can do as a Government to support Indigenous wellness, is to follow and support Indigenous partners.  We already have the roadmaps of how social and health systems need to be changed, how services need to be re-oriented, how gaps can be filled and programs and services can be enhanced.  These roadmaps are the First Nations Mental Wellness Continuum Framework and the National Inuit Suicide Prevention Strategy. Our job as government is to work with partners to bring together available resources and that those align with strategies developed with Indigenous partners, to remove barriers to their implementation, and to work in partnership with Indigenous organizations and communities to ensure that they are fully realized, as determined by communities.

With respect to the specific recommendations set out in the Committee’s report, we will describe how we are collectively working towards implementing the recommendations. The Committee’s recommendations fall under three broad themes:  a) Self-determination and reconciliation; b) Social Determinants of Health; and c) Mental health Services; and the Government Response aligns with those themes.  Without being an exhaustive list of all actions and initiatives undertaken by Canada, the Government Response introduces specific examples of what Canada is doing to address the recommendations raised by the Committee.

A. Self-determination and Reconciliation (recommendations 1, 2, 3, 18, 21)

The Committee and the witnesses who appeared before it rightly pointed to the connections between self-determination, reconciliation, and language and culture as a way to address the effects of trauma.

The Government of Canada believes in the need to advance self-determination and reconciliation with Indigenous peoples. Canada is of the view that community capacity and control is a key component of a healthy community and that the implementation of programs and services (mental wellness and others) must be driven by the priorities, needs, culture and strengths of communities. All new investments will be implemented through engagement processes where Indigenous partners provide government the direction. Control can be achieved through many ways, but must always start with open and transparent engagement processes.

Canada has committed to advancing reconciliation and renewing the Indigenous-Crown relationship based on recognition of rights, respect, cooperation, and partnership. As part of  a reconciliation framework, several approaches have been established to continue the journey of reconciliation. For example, on December 15, 2015, the Prime Minister announced in partnership with Indigenous communities, the provinces, territories and other partners that Canada would implement all of the recommendations of the Truth and Reconciliation Commission. Progress has been made on more than two-thirds of the ninety four Calls to Action under federal and shared responsibility in collaboration with partners to advance all Calls to Action.

Canada has also established permanent bilateral mechanisms with the Assembly of First Nations (AFN), the Inuit Tapiriit Kanatami and the four Inuit Nunangat Regions, and the Métis National Council and its governing members. Through this distinctions-based process, Canada continues to work with Indigenous groups on mutual priorities and interests. Canada is also in the process of establishing a National Council for Reconciliation. In addition, Canada has entered into Recognition of Indigenous Rights and Self-Determination discussions with Indigenous groups across the country. This work with Indigenous partners has allowed us to establish processes to advance joint policy development. The goal is to achieve a fundamental and profound shift in the relationship between the Crown and Indigenous peoples, and to move forward together as true partners.

In May 2016, Canada announced its full and unqualified endorsement of the United Nations Declaration on the Rights of Indigenous Peoples, and committed to adopt and implement the Declaration in accordance with the Canadian Constitution. Implementation requires full participation of Indigenous communities to ensure that measures reflect the priorities and solutions identified by the communities. The implementation of the United Nations Declaration on the Rights of Indigenous Peoples requires transformative change in the Government’s relationship with Indigenous peoples.

Canada is fulfilling its commitment to implementing the Declaration through the review of laws and policies, as well as other collaborative initiatives and actions. In July 2017, the Department of Justice released a set of Principles Respecting the Government of Canada’s Relationship with Indigenous Peoples that will guide the review of laws and policies. These Principles are rooted in Canada’s Constitution, guided by the United Nations Declaration, and informed by the Report of the Royal Commission on Aboriginal Peoples and the Truth and Reconciliation Commission’s Calls to Action. In addition, they reflect a commitment to good faith, the rule of law, democracy, equality, non-discrimination, and respect for human rights. They will guide the work required to fulfill the Government’s commitment to a renewed nation-to-nation, government-to-government, and Inuit-Crown relationships.

The Government of Canada is committed to the renewed nation-to-nation relationship. Within that context, it is working with Indigenous partners and other stakeholders to advance a number of key initiatives, which include:

• First Nations, Inuit and Métis groups have advised the Government that reconciliation is about having more flexible tools to address their rights, interests and needs. Since 2015, we have taken steps to address concerns through a new approach called Recognition of Indigenous Rights and Self-Determination tables. These interest-based discussions are about actualizing self-determination through dialogue and partnership.
• There are currently 46 tables underway to explore the rights, needs and interests which are most important to increase self-determination and improve socio-economic outcomes.  To date, there are 13 co-developed agreements that were signed with Indigenous partners through these discussions, including three with the Métis. These discussions involve more than 300 Indigenous communities, with a total population of over 500,000 people.
• The Government believes that its policy suite is not accessible or flexible enough to allow Indigenous partners to advance their self-determination aspirations in ways that work for them, or to address the key socio-economic needs and priorities of their communities. Rights Recognition discussions are a starting point to bring about change. The Government will continue to work with Indigenous partners to develop necessary policy reforms to enable faster achievement of better outcomes. This work will be guided by the Department of Justice’s Principles respecting the Government of Canada’s relationship with Indigenous peoples.
• Canada has been working to support self-determination directly in relation to education. A formal self-government agreement on education jurisdiction was reached with the Anishinabek Nation in Ontario, which was successfully ratified by 23 First Nations and signed by Minister Bennett and the respective chiefs on August 16, 2017. Canada is currently co-developing the legislation giving effect to the Agreement, and is targeting an effective date of April 1, 2018.
• The launch of a joint fiscal policy development process in 2016 in collaboration with signatories to modern treaties and self-government arrangements in Canada to ensure Canada’s fiscal policy framework reflects the desire for a renewed nation-to nation relationship with Indigenous people. A similar process was launched with the AFN to fully examine existing financial arrangements and jointly produce proposals for developing a new fiscal relationship for Indian Act First Nations.
• The eleven self-governing Yukon First Nations have decided to assume responsibility, including financial resources, for HC’s targeted programs in addition to having jurisdiction in health (i.e. the ability to enact legislation) as part of their modern treaties. 

Our current policy framework for self-government and self-determination negotiations must be reformed in order to bring it in line with a recognition of rights approach. We recognize that to do this, a new section 35 policy suite is needed to renew key policies, including the Comprehensive Lands claim policy, Inherent Right policy, and also the Consultation and Accommodation guidelines. We will continue to work with Indigenous partners to identify and co-develop necessary policy reforms to enable faster achievement of better outcomes.

Canada has also taken steps to increase First Nations and Inuit control over health programs and services.  Beginning in 2005, a tripartite collaborative process began between British Columbia First Nations, Canada, and the province of British Columbia.

This collaboration led to the British Columbia Tripartite Framework Agreement on First Nation Health Governance (2011). Through this agreement, a province-wide First Nations Health Authority (FNHA) has taken over First Nations health programs, services, and staff in British Columbia. The FNHA is governed by First Nations and works with the province to coordinate health services.  HC remains a funder and governance partner, but has ceased its program delivery role (as of October 2013). This initiative has enabled greater self-determination in health for British Columbia First Nations as they now have full control, through the FNHA, over the design, management, and delivery of health programs and services for approximately 150,000 British Columbia First Nations in over 200 communities. Since 2005, the gaps in the health status between First Nations and other British Columbia residents in key areas have already been achieved, including: the incidence of youth suicide reduced by 50%, and the prevalence of diabetes reduced by 33%. The FNHA has also expanded tele-health access to over 15,000 First Nations and virtual service delivery for 45 communities which is increasing access to quality care. The Government is committed to continue working towards increased First Nations and Inuit control over Health Services.

In July 2017, the Government signed the Charter of Relationship Principles Governing Health System Transformation in Nishnawbe Aski Nation (NAN) Territory, which sets out common objectives and commits the Federal and Ontario Governments to working together with the Nishnawbe Aski Nation to transform the delivery of healthcare to First Nations communities.   This system-wide change would see First Nations have equitable access to quality care delivered within their community, in NAN territory, as a priority. 

B. Social Determinants of Health

High rates of suicide are a symptom of social and economic inequalities and historical trauma.  Budget 2016 provided an unprecedented investment to support Indigenous peoples and make a positive impact on the social determinants of health, including investments in primary and secondary education, child and family services, clean drinking water, and infrastructure on reserve.  Budget 2017 is building on those investments with an additional $4 billion for improved housing, water treatment, health facilities and community infrastructure and will support the co-development of Housing Strategies with Indigenous leaders to improve housing outcomes for Indigenous communities.

Language and Culture (recommendation 6, 27)

The Government agrees with the Committee on the importance of revitalizing Indigenous languages to ensure they remain present and vibrant for future generations. On December 6, 2016, the Prime Minister announced that the Government will enact an Indigenous Languages Act, co-developed with Indigenous peoples, with the goal of ensuring the preservation, protection, and revitalization of First Nations, Métis, and Inuit languages in Canada. On June 15, 2017, the Department of Canadian Heritage, the Assembly of First Nations, Inuit Tapiriit Kanatami and the Métis Nation made a

Declaration of Intent to collaborate with the Government of Canada on the co-development of First Nations, Inuit and Métis Nation languages legislation. Engagement will include grassroots organizations, urban populations and experts, and the intent of the partners is to have the legislation adopted in the current parliament. Budget 2017 provided $90 million over three years towards federal Indigenous language support initiatives. During those three years, engagement and consultations with Indigenous partners will also explore how best to structure the future delivery of Indigenous language support, for and by Indigenous peoples and communities.

Canada supports language and culture activities across the elementary and secondary education program suite, including through the core Elementary and Secondary Education Program for First Nations students, which supports instructional services and students support services, as well as through several proposal-based programs. Together, these programs support First Nations, Inuit and their organizations to develop culturally-relevant curricula and activities, such as the development of language courses, specialist engagement, and language and cultural camps. Budget 2016 invested a total of $275 million over five years for expanded language and cultural programming in First Nation primary and secondary education on reserve. This is in recognition of the unique circumstance and needs of First Nations children, and that language and culture can enrich the classroom experience. 

Canada also supports First Nations and Inuit communities to help preserve and strengthen unique First Nation and Inuit cultures, traditions and languages through the First Nation and Inuit Cultural Education Centres Program (CECP) and provides funding to approximately 100 First Nation and eight to 10 Inuit centres on an annual basis.

With respect to training of public servants on Indigenous history, rights and cultures, the Canada School of Public Service (CSPS) is currently developing the Indigenous Learning Series.  These series will be part of the CSPS common curriculum.  As such, the objectives of the Series are to enable public servants to: understand their duties and obligations; understand Indigenous peoples’ histories, contemporary experiences and legal rights; and foster the creation of respectful relationships and effective collaboration with Indigenous Peoples in delivering relevant programs, policies and services.

HC is working with Indigenous partners, educational institutions, professional regulatory bodies and provinces/territories to facilitate the advancement of Indigenous Health Human Resources and cultural competency within health systems, working in partnership toward the development of strategies for increasing the recruitment and retention of Indigenous health human resources, and supporting cultural competence training for all health care professionals. 

The Government also recently announced that the Canadian Institutes of Health Research (CIHR) are investing $8 million to form a cross-country mentorship network for First Nations, Inuit and Métis peoples considering a career in health research. The Indigenous Mentorship Network Program aims to support the next generation of Indigenous health researchers by providing distinctive learning opportunities and specially tailored mentoring activities to Indigenous students at the undergraduate, master’s, doctoral and post-doctoral levels, as well as Indigenous researchers in the beginning phase of their careers.

Mothers and Children (Recommendations 5, 13, 19, 25)

Canada recognizes that supporting mothers and children in early stages of life, has beneficial effects on the development and well-being of Indigenous children and families over time. In support of First Nation communities’ efforts to strengthen parental capacity, Canada invests over $100 million annually in culturally relevant programming that improves the pre- and post-natal health of pregnant women and infants as well as the physical, emotional, and mental health of children and families.  For example, the Maternal Child Health Program screens for child abuse and family violence; the Fetal Alcohol Spectrum Disorder program supports abstinence from alcohol during pregnancy; and the Canada Prenatal Nutrition Program supports women's efforts to breastfeed, which is known to increase parental attachment. Budget 2017 invested a further $83.2 million, over five years to expand maternal and child health services for First Nations and Inuit families with children under six.

Budget 2017 proposed to provide new funding to expand the medical transportation benefit to ensure that expecting mothers do not have to travel alone if they require medical transportation outside the community to deliver their babies.

As part of the Government of Canada’s commitment to work with Indigenous partners to support innovative and transformative health care solutions, an investment of $6 million over five years was announced in Budget 2017 for demonstration projects to increase access to culturally-safe, healthy pregnancy-oriented midwifery services in First Nations and Inuit communities. Going forward in 2017-18, this investment will support engagement and planning processes to bring Indigenous birthing practices closer to communities.

The Government of Canada provides $29.1 million annually in funding for the Aboriginal Head Start in Urban and Northern Communities (AHSUNC) Program, which is a national community-based early intervention program that focuses on early childhood development for First Nations, Inuit and Métis children and their families living off reserve.  On average, the program reaches from 4600-4800 children annually at 134 sites.

Budget 2016 provided $29.4 million for the urgent repair and renovations of existing First Nations and Inuit Child Care Initiative and Aboriginal Head Start on reserve facilities. Budget 2016 provided $100 million in 2017-18 towards Early Learning and Child Care on and off-reserve. The Government has been engaging with Indigenous organizations and parents to determine the best approach to delivering high quality early learning and child care as part of a new Indigenous Early Learning and Child Care Framework.

On the issue of child welfare, Canada is committed to overhauling the First Nation Child and Family Services Program on reserve with the ultimate goal to reduce the number of children taken into care. Budget 2016 invested an additional $634.8 million over five years and $176.8 million ongoing in the Program to address funding gaps, and to support strengthened prevention and front-line services.  The program is part of a broader continuum of programs and services that help address the many challenges faced by First Nations children and families living on reserve. Canada is currently working with First Nation partners, agencies and provincial/Yukon government and other partners on how to reform the Program. Through its engagement process, Canada heard from First Nations leadership, communities and families and youth about the need for communities to have jurisdiction over what happens to children in their communities. Canada also heard about the importance of supporting community-based prevention efforts. In response, some of the funding announced in Budget 2016 for First Nations Child and Family Services is going directly to communities, specifically in Ontario so that they can do prevention work that meets their needs. Canada is also supporting community well-being initiatives in other regions to better support children and families, including models that focus on (re)connecting children to their language and culture.

Canada continues to work with First Nations partners and communities, as well as provinces and territories, to meet the specific needs of First Nations children in all regions of Canada. In 2016, up to $382.5 million over three years was committed to implement Jordan’s Principle which is a child-first principle that applies to all First Nations children and aims to ensure there are no gaps and delay in services. To the end of July 2017, the Government of Canada approved over 13,348 requests for health, social, and education services, supports and products for First Nations children. These have included many types of services, supports and products including mental health supports, speech therapy, addiction treatment, educational supports, and more. Canada is committed to continuing to engage with First Nations partners, provinces and territories and other stakeholders to help ensure that all First Nation children get the care and services they need.  The Government of Canada is working with the provinces and territories, and First Nations partners including the Assembly of First Nations (AFN) and individual communities on long-term options to better meet the needs of First Nation children.

Canada also funds a network of 41 shelters for victims of family violence in Indigenous communities that offer opportunities for young people to disclose adverse childhood events, particularly when they are related to family violence. Shelters offer a range options to support and promote healing, such as referrals to culturally appropriate professional supports. The Shelter Enhancement Program provides funding to build new or repair existing shelters in First Nation communities for women and their children, youth, or men who are victims of family violence. Budget 2016 announced additional funding of $10.4 million over three years towards this program to build five additional shelters for victims of family violence on-reserve.

In addition, in June 2017, the Government launched It’s Time: Canada’s Strategy to prevent and Address Gender-based Violence. The Strategy builds on federal initiatives already underway and lays the foundation for greater action. It is based on three pillars that will improve Canada’s overall response to gender-based violence: prevention, support for survivors and their families, and promotion of responsive legal and justice systems. Importantly – and in the spirit of reconciliation – the Strategy also puts forward a range of actions to specifically address violence against Indigenous women and girls. These include:

• new funding to respond to the unique needs of Indigenous survivors; and
• working with Indigenous organizations to undertake research initiatives.

Education and Skills Development (recommendation 4, 7, 8, 9, 11, 28)

Education is critical to the economic and skills development of Indigenous peoples and their communities. Budget 2016 invested a total investment of $2.6 billion over five years to strengthen First Nations education on reserve. These resources are being used to address immediate needs and make new investments in areas critical to First Nations student success, such as language and culture, programming, literacy and numeracy, and special education. These investments include $824.1 million over five years to support the transformation of the current on reserve K-12 education system, and engagement with First Nations education stakeholders on broader options to strengthen First Nations education. This funding is also being used to support those First Nations that are ready to move now to create new education systems that strengthen First Nations control of First Nations education and support strong student outcomes, such as the creation of Manitoba First Nations School System (a First Nations-controlled school board in Manitoba that began operations this school year.) 

An essential component of a student’s education is having a safe and healthy place in which to learn. Building on ongoing education infrastructure investments, Budget 2016 invested another $969.4 million over five years. Currently 135 projects are underway at various stages with 67 new on reserve schools and 56 renovations/expansions.

Additionally, Canada is encouraging lifelong learning and increasing the participation of Indigenous peoples in post-secondary education and skills development to improve the employability of Indigenous peoples, especially in health related professions.  

As part of Budget 2017 the Government has committed to undertake a comprehensive and collaborative review with Indigenous partners of all current federal programs that support Indigenous students who wish to pursue post-secondary education. The purpose of the review will be to ensure that these programs meet the needs of individual students while supporting attendance at, and completion of, a post-secondary degree or credential. In conjunction with this review, to address immediate need, Budget 2017 committed:

• an additional $90 million over two years provided to increase access to the Post- Secondary Student Support Program;
• an additional $25 million over five years to support scholarships and bursaries offered by Indspire;
• $38 million over four years, starting in 2018-19; with this renewed funding, Pathways to Education will provide vulnerable youth, including Indigenous students, with the supports they need to succeed in school, including tutoring, career mentoring and financial help, such as scholarships and internships; and
• $50 million in 2017-18 to provide added capacity to meet the growing demand from Indigenous Peoples for skills development and job training. 

In addition, Student Grant amounts for low and middle income students as well as part-time students under the Canada Student Grant Program were increased by 50% in academic year 2016-17, and eligibility for these grants will be expanded starting in 2017-18. Also, as part of the fixed student contribution starting in 2017-18, Indigenous learners will be exempted from making a fixed student contribution. This will increase their access to Canada Student Grants and Loans, providing more financial support for post-secondary education (PSE). This exemption will apply to all students who self-identify as First Nation (Status and non-Status), Métis, or Inuit. The federal budget also committed to making PSE more accessible for Indigenous students.

The Aboriginal Skills and Employment Training Strategy (ASETS)  supports a full continuum of job training and skills development services – from essential skills acquisition to more advanced skills for jobs in high demand industries – in over 600 points of service across Canada.  ASETS is funded at approximately $345 million per year, and is open to all Indigenous people in Canada.  Budget 2016 invested $15 million over two years, beginning in 2016-17, to enhance training that aligns with community needs as a first phase of a renewed strategy beyond 2018. To inform this renewal, extensive engagement with Indigenous partners took place over 2016, with discussions continuing into 2017. This commitment to renew and improve ASETS was reiterated in Budget 2017.Budget 2017 also invested $50 million in 2017-18 in the strategy, which includes new funding, the investment made in Budget 2016, as well as additional reallocated resources from other programming that support skills and training more generally.

Housing and Infrastructure (recommendations 4, 15, 17, 25, 26)

Budget 2016 was an important first step in addressing infrastructure needs in First Nation communities. The Government committed to making strategic investments in a wide range of infrastructure categories, including broadband and connectivity, and to ensuring that funding responds to the needs and priorities of communities across Canada.

Budgets 2016 and 2017 invested approximately $8.5 billion in programs and initiatives that aim to provide affordable housing, water treatment centre systems, health facilities and other community infrastructure.

Since Budget 2016 announcements, Indigenous and Northern Affairs has allocated $406.6 million in targeted funding to support 1,061 housing projects. Of this total, 471 projects have been completed resulting in the construction or renovation of 1,610 homes for Indigenous peoples.

These investments are a first step. The Government will be working with First Nations communities to further develop an effective long-term approach to supporting the construction and maintenance of an adequate supply of housing on reserve as part of a broader National Housing Framework. Progress toward this goal includes constructing, planning or renovating nearly 6,400 housing units on reserve.

Economic Development (recommendation 10)

The Government acknowledges that economic development and job creation play an important role in advancing youth suicide prevention interventions. The Government is committed to improving economic opportunities for Indigenous peoples in Canada.  It manages an integrated suite of economic development programs that assists Indigenous businesses, communities and entrepreneurs in establishing and expanding their access to business and economic opportunities. Key partners include the Canadian Council for Aboriginal Business, the Council for the Advancement of Native Development Officers, the National Economic Development Board as well as the National Aboriginal Capital Corporations Association and the national network of Aboriginal Financial Institutions.

The Indigenous Entrepreneurship and Business Development program is an example of an initiative that includes support to Indigenous youth employment and entrepreneurship amongst its range of economic development and job creation support activities. This program seeks to increase the number of viable businesses in Canada owned and controlled by Indigenous peoples, provide a supportive business environment for Indigenous peoples and advocate and inform employers about the hiring of Indigenous peoples. The program has two components: Access to Capital and Access to Business Opportunities. Within these components, the Indigenous Entrepreneurship and Business Development program provides funding that focuses on reducing vulnerability through economic security and job creation (entrepreneurship strategies, financial planning) and on promoting participation in leadership and decision-making roles.

Support for Indigenous Youth (recommendations 5, 15) 

Through Budget 2017, Canada invested $18.9 million over five years, with ongoing funding of $5.5 million every year thereafter to support Indigenous youth and sport. This investment will increase support for culturally relevant sport programming for Indigenous youth and children at the community level. It will also help to strengthen Indigenous leadership and ensure the national sport system is more inclusive of Indigenous peoples through training and collaboration with National Sports Organizations. This investment will also establish stable, ongoing funding for the North American Indigenous Games.

Through the First Nations Infrastructure Fund, Canada helps First Nation communities improve and increase public infrastructure by funding community projects including cultural and recreational facilities such as community centres and halls, arenas, museums or other infrastructure that reflect the First Nations heritage or that encourages community members to adopt more active and healthier lifestyles. Budget 2016 provided $76.9 million over a two year period specifically for cultural and recreational facilities.

Urban Indigenous (recommendations 14)

The Committee also recognized that Friendship Centres offer important services to Indigenous peoples in urban areas. The Government recently announced Urban Programming for Indigenous Peoples (UPIP), which took effect as of April 1, 2017. Budget 2017 invested $118.5 million over five years in UPIP, which when combined with previously allocated funds, brings its total annual contribution to $53 million. The Urban Programming for Indigenous Peoples seeks to support and build on the existing network of Friendship Centres, which are on the front line of working to address the numerous and often critical issues faced by Indigenous peoples in urban environments. This new programming is designed to assist First Nations, Inuit and Métis living in or transitioning to urban centres through four approaches: core funding for Indigenous organizations serving urban Indigenous peoples; funding to organizations to offer programs and services; support for existing and new coalitions that bring together all levels of government and stakeholders to address local coordination and solve issues; as well as research and innovation funding to academics, researchers and organizations for  innovative pilots projects. The new programming adopts a distinctions-based approach by providing specific allocations to the Métis and Inuit to address their specific needs and priorities.

C. Mental Health Services (12, 16, 20, 22, 21, 23, 24)

Canada is committed to working with Indigenous communities and organizations, provinces and territories to improve health care, including mental health services to communities. Canada invests $2.7 billion annually to support First Nations and Inuit health, including over $341 million annually to support First Nations and Inuit mental wellness. This investment funds community based programs and services that provide culturally-relevant mental health promotion, suicide prevention, addictions prevention and treatment, crisis response, and after care. Community-based suicide prevention approaches are considered part of the broad continuum of mental wellness and may include youth leadership opportunities, on-the-land programming, and youth-elder linkages.

Additionally, medical transportation to access health services outside the client’s community of residence is an eligible benefit under the Non-Insured Health Benefits (NIHB) Program. Medical transportation can be covered to access mental health services provided as an insured service (psychiatry, physician or hospital) and mental health counselling provided as a benefit under the NIHB Program. 

The Government agrees with the Committee that a continuum of mental wellness care includes seamless access to services that span federal, provincial, territorial jurisdictions.  The Government also recognizes that there have been challenges responding to the increased demand for mental health services resulting in unmet needs.

In June 2016, a three year interim investment of $69 million was announced to introduce immediate measures to support First Nations and Inuit mental wellness.  This investment supports the expansion of mental wellness teams, a community-driven approach that enhances access to mental health services for individuals, families, and communities, in culturally grounded ways, and that promotes collaboration and coordination among service providers and all levels of government. This funding provided enhanced support for community capacity building, and the establishment of the toll-free, 24-hour First Nations and Inuit Hope for Wellness Help Line.  Since the launch in October 2016, the Hope for Wellness Help Line has provided immediate mental health counselling to over 2,300 callers and provided over 725 referrals for additional services, when requested.

Budget 2017 provided $828.2 million over five years to improve health outcomes of First Nations and Inuit through new investments in: mental wellness; primary care; maternal and child health; home and community care; and, infectious diseases and non-insured health benefits.  This includes $118.2 million for mental health programming for First Nations and Inuit; $86 million for the Non-Insured Health Benefits Program to expand access to mental health professionals and—for the first time—make available the services of traditional healers to address mental health needs; and $15 million for harm reduction.  The investment also includes increased support for youth suicide prevention through an emphasis on youth engagement. These investments provide an opportunity to expand First Nations and Inuit health programs and services into communities that do not have access, address existing gaps in services and training currently offered; and, improve the responsiveness of programs to local community needs. HC is engaging with First Nations and Inuit partners at the national and regional levels to prioritize and plan for implementation of these new funds. Additionally, the Government of Canada announced in June 2017, $465,000 for Wunnumin Lake’s Choose Life Project, a two-year project designed to expedite access to mental health services and supports. The project supports First Nations children and youth in Nishnawbe Aski Nation communities who are at risk of suicide.

Investments are guided by the First Nations Mental Wellness Continuum Framework and the National Inuit Suicide Prevention Strategy.  Developed by and with partners, both strategies highlight community capacity and control and access to a continuum of mental health services, as key components of a healthy community and underscore that implementation of programs and services must be driven by the priorities, needs, and strengths of communities, as identified by community health planning.

The Government agrees with the Committee that improved broadband services are an important part of improving access to mental health services, particularly for those living in remote communities.  HC’s eHealth Infostructure Program (eHIP) is working closely with First Nation organizations to align common health information technology projects such as telehealth and broadband connectivity.  It supports 227 active telehealth sites at the community level offering a wide range of services including tele-mental health, tele-visitation for family members, and tele-diabetes. In 2015-16, there were over 14,000 successful telehealth sessions in First Nation communities and mental health was one of the most common types of sessions.  Mobile health technologies such as tablets and hand-held devices are being more commonly used in health centres in First Nation communities to increase access to a range of health professional for remote and isolated communities.

Canada is committed to continue to work with Indigenous partners to support community approaches that are culturally grounded and flexible so that communities can tailor them to meet their unique needs and cultural contexts.  This Government is also committed to moving toward self-determination and First Nations and Inuit control over health systems.  Supporting community self-determination will empower communities to create health systems that meet their needs. 

CONCLUSION

Again, we would like to thank the Standing Committee on Indigenous and Northern Affairs for their work on this issue. The current response is by no means an exhaustive list of what is being undertaken at the National, regional nor provincial-territorial levels to address the suicide crisis in Indigenous communities. It represents an overview of the Governments’ efforts since 2015 to improve the wellness and well-being of Indigenous peoples in Canada and an ongoing commitment to continue these efforts.  As mentioned in the introduction and as recognized by witnesses who appeared before the Standing Committee, there is no easy solution to such a complex issue.  It is only by continuing to work in true partnership with Indigenous peoples, leaders and organizations that we will be able to address the root causes of suicide, reduce the risk factors, and raise hope for Indigenous peoples in Canada. 

The recent transformative change to create two departments for Indigenous services and relationships announced by the Government builds on the recommendations of the Royal Commission on Aboriginal Peoples, and is an important step in order to better integrate services and collaborate to find innovative solutions to complex issues, and ultimately improve the lives of Indigenous peoples.