1. First Nations and Inuit Mental Wellness Strategic Action Plan Kathy Langlois Director General Community Programs Directorate First Nations and Inuit Health Branch Health Canada

2. Context - Mental Wellness Issues Facing First Nations and Inuit  Suicide Rates: –3-6 times higher in First Nations communities compared to non-Aboriginal Canadians –11 times higher among Inuit youth  Addictions: –Higher rates of binge drinking & alcohol- related hospitalization –Almost double the number of alcohol- related deaths  Violence: –Rates of domestic violence are up to 5 times higher than average on First Nations reserves –Rates of sexual assault are estimated to be triple the Canadian average

3. Current FNIHB Mental Health and Addictions Programming National Native Alcohol & Drug Abuse Program and National Youth Solvent Abuse Program ($70M/year): –Network of 62 treatment centres; more than 550 community based prevention programs; more than 1,000 workers. Brighter Futures and Building Healthy Communities ($89M/year): –BF supports a range of health promotion and illness prevention activities, including community-based mental health, child development, parenting skills, healthy babies, and injury prevention. –BHC assists First Nations and Inuit communities to provide mental health crisis intervention and aftercare.

4. Current Programming (cont’d) The National Aboriginal Youth Suicide Prevention Strategy ($15M/year): –Launched in 2005-06 to reduce risk factors and promote protective factors against Aboriginal youth suicide. The Indian Residential Schools Resolution Health Support Program ($19M/year; ramping down): –Provides mental, emotional, and cultural supports to former Indian Residential School students and their families. The Mental Health Crisis Counseling benefit ($14M/year): –Covers the cost of short-term, professional mental health crisis counseling for eligible First Nations and Inuit.

5. National Anti-Drug Strategy Modernize the National Native Alcohol and Drug Abuse Program (NNADAP) –Increase service effectiveness through cultural and clinical models (regional needs assessments, experts panel, evidence- based program framework, accreditation) –Increase service quality (training, certification, recruitment and retention) –Increase access through innovations in service delivery (outreach, outpatient, mobile mental wellness teams)

6. Kirby Report on Mental Health, Mental Illness and Addictions  The Senate Standing Committee on Social Affairs, Science and Technology (chaired by Senator Kirby) was mandated to examine issues concerning mental health and mental illness in the Canadian population –Final Report - May 9, 2006 –Recommendations on services for all Aboriginals (First Nations/Inuit/Métis):  Stronger links to Aboriginal perspectives  Aboriginal Advisory Committee for the Mental Health Commission  Strategy for mental wellness & healing  “A dramatic change is needed to ensure that FN and Inuit receive an inclusive range of programs and services related to health determinants and linked to positive outcomes”

7. The Mental Wellness Advisory Committee (MWAC) Mandate: Development of a Strategic Action Plan to improve the mental wellness outcomes of First Nations and Inuit and guide mental wellness policy and program development over the next 3-5 years Lead members: AFN, ITK, FNIHB Key members: Federal/Provincial/ Territorial networks; National Native Addictions Partnership Foundation; Native Mental Health Association of Canada; Aboriginal Healing Foundation; Canadian Mental Health Association; Canadian Centre for Substance Abuse; Centre for Addictions and Mental Health; Public Health Agency Canada; Indian and Northern Affairs Canada

8. Strategic Action Plan – Vision “First Nations and Inuit embrace the achievement of whole health (physical, mental, emotional, spiritual, social and economic well-being) through a comprehensive and coordinated approach that respects, values and utilizes traditional and cultural knowledge, methodologies, languages and ways of knowing.”

9. Strategic Action Plan – 5 Goals 1.Ensure a Continuum of Services 2.Enhance traditional, cultural and western Knowledge Development and Sharing 3.Support Community Development 4.Health Human Resources 5.Federal/Provincial/Territorial/Aborigin al Roles & Responsibilities

10. Strategic Action Plan – Themes  Community leadership  Community resources (natural caregivers)  Traditional and cultural ways of healing  Improved communication, sharing of information  Coordinated continuum of services  Increase number of workers with appropriate mental health and addictions and cultural awareness training  Reduce burnout and support existing staff (clinical supervision)

11. Alianait - The Inuit-Specific Mental Wellness Task Group Mandate: to create an Inuit-specific national strategy that reflects Inuit mental wellness priorities and circumstances Inuit-specific plan and goals complement the MWAC Strategic Action Plan, while addressing unique Inuit needs and issues Inuit approach to mental wellness is holistic, positive and inclusive of all stakeholders: “Everyone has a role to play”

12. Alianait – A Phased Approach to Mental Wellness Four-phased approach to implementation: –Phase I: develop regional community wellness plans (4) and an urban Inuit plan; –Phase II-IV: implement short, medium and long-term goals Focus on community development and partnerships

13. Applying a Public Health Perspective Contributing to a long-term public health vision –Importance of prevention and promotion –Understanding and building links between mental and physical health Injury prevention; chronic disease; physical activity –Building capacity and improving community wellness Collaborative, community-based approaches offer best chance of success

14. Promoting Healthy Communities Community development approach to health promotion –Developing community capacity to improve mental wellness –Improving mental wellness to develop community capacity Mental wellness as a measure of community health –A range of determinants impact wellness Multiple players involved (federal departments, provincial/territorial governments, NGOs, etc) Co-existing cultural and mainstream approaches to program delivery –Respecting, valuing, and utilizing traditional and cultural knowledge, methodologies, languages, and ways of knowing Role of women –Engage and empower – international examples of healthy indigenous communities with vibrant women leaders

15. Lessons Learned To be relevant, programs and services must respect the importance of: –Community development and decision making –Cultural relevance –A coordinated continuum of services

16. Future Directions Mental Wellness Advisory Committee –Collaborate with the Mental Health Commission of Canada Health Canada – Continue to support the work of MWAC – Use MWAC Strategic Action Plan (SAP) to guide existing/new program investments – Implement NADS – including new NNADAP (framework) and mental wellness teams –Explore opportunities for collaboration with NDPHS partners