Question Period Note: Indigenous Health

• The Government of Canada is working to close the gap in access to quality healthcare between Indigenous and non-Indigenous peoples in Canada, by:

• supporting 63 community-led mental wellness teams serving 344 communities;
• approving more than 828,000 requests for products and services under Jordan’s Principle since 2016; and
• providing coverage of health benefits to over 887,500 First Nations and Inuit in 2019-2020.

• The Government is also working to ensure that Indigenous peoples are in the driver’s seat when it comes to designing and delivering their healthcare programs and services.

Indigenous Services Canada (ISC) works collaboratively with partners to improve access to high quality services for First Nations, Inuit and Métis. Our vision is to support and empower Indigenous peoples to independently deliver services and address the socio-economic conditions in their communities.

The First Nations and Inuit Health Branch within ISC supports First Nations and Inuit in their aim to influence, manage, and control health programs and services that affect them.

The most advanced model of First Nations health transfer is in British Columbia where a tripartite Framework Agreement was signed in 2011 and led to the full devolution of the First Nations and Inuit Health Branch’s regional operations in 2013 to a newly established First Nations Health Authority.

If pressed on health services:

• The Government of Canada remains focused on supporting long-term investments that will improve the health and well-being of Indigenous communities.

• By listening to Indigenous communities, we have advanced shared priorities such as:

• Approximately 91% of mothers travelling for childbirth in 2019-20 were accompanied by at least one escort.
• Completing 197 of the 208 health-related infrastructure projects underway since 2016.

• The Department will continue working with partners towards improved health services and programs for Indigenous peoples.
Remote First Nation Communities – Access to Health Services

• The best success comes from Indigenous-led and delivered health systems.

• TheGovernment is working with provincial and First Nations partners to achieve system-wide health transformation in northern First Nation communities.

• The Government is advancing work with partners in Manitoba, Quebec, Ontario and Saskatchewan on health system transformation, with $71 million dedicated over three years to support this work.

Distinctions-based Indigenous Health Legislation

• In a country as prosperous as Canada, no one should go without the care they need, when and where they need it.

• Indigenous peoples have the right to high-quality health care and services that are adapted to their needs.

• The Government is committed to co-developing Indigenous Health legislation with First Nations, Inuit and Métis that responds to the realities of Indigenous communities and increases their control over the development and delivery of services.

If pressed on how distinctions-based Indigenous health legislation relates to COVID:

• The COVID-19 pandemic has underscored the need for strong mechanisms and adequate funding to ensure that First Nations, Inuit, and Métis have access to high-quality health and mental health services.

• Canada is committed to working with First Nations, Inuit, and Métis partners to co-develop distinctions-based Indigenous health legislation through an agreed upon, collaborative engagement process.

• Co-development provides an opportunity to advance shared health priorities post COVID-19.

• Improving the health and wellness of First Nations, Inuit, and Métis remains a priority for the Government of Canada.

Health services in the North:

• The Government is working with territorial and Indigenous partners to advance the health and safety of First Nations and Inuit in the North.

• While territorial governments are responsible for the delivery of health care in the territories, the Government works in partnership to ensure First Nations and Inuit have access to the culturally safe supports and services, including on the land activities.

• In 2020/21, we are allocating $47.5 million to support mental health programming and services in all 72 First Nations and Inuit communities in the three territories.

If Pressed on health services in the North during COVID-19:

• The Government is working with territorial and Indigenous partners to advance the health and safety of First Nations and Inuit in the North.

• The Government is supporting Indigenous communities to implement culturally relevant emergency measures to promote on the land physical distancing.

• To date, $65.9 million in distinctions-based funding has been announced through the Indigenous Community Support Fund to address the immediate needs in northern Indigenous communities, including urban and off-reserve.

• Recognizing the need for increased wellness supports, $10.6 million in funding has been provided to help northern Indigenous communities adapt and expand mental wellness services during the COVID-19 pandemic.

• These funds are in addition to the $35.1 million allocated in 2020-21 to support mental health programming and services in all 72 First Nations and Inuit communities in the three territories.

• In response to COVID-19, a pan-territorial Indigenous working group has been established and will continue to work with Indigenous partners to help them protect their health and safety during this pandemic.

Indigenous mental wellness and COVID-19

• Many Indigenous communities face unique challenges in addressing COVID-19, some of which can lead to increased stress.

• The funding announced for Indigenous communities as part of Canada’s COVID-19 response can be used to support access to mental wellness services while respecting physical distancing.

• The Government is working with partners to implement distance approaches to service delivery such as tele- and video-counselling for substance use services and other existing programs. The Hope for Wellness Help Line continues to offer crisis intervention services by telephone or chat.

If pressed on actions taken:

• The Government of Canada has seen success in supporting Indigenous-led approaches to mental wellness:

• 63 new community-led mental wellness teams serving 344 communities.

• Nishnawbe Aski Nation’s Choose Life Initiative, benefiting more than 22,000 high-risk youth and children, the 24/7 Hope for Wellness Help Line and the Inuit Tapiriit Kanatami’s National Inuit Suicide Prevention Strategy.

• However, the roots of suicide in Indigenous communities also derive from a range of social inequities, and we continue to work to include wellness in all policies.

Nunavut

• The Government of Canada is working in close partnership with the Government of Nunavut and Nunavut Tunngavik Incorporated to respond to the mental wellness needs of Inuit in the territory.

• Through this partnership, we are contributing $224.5 million over 10 years through the Nunavut Wellness Agreement for community wellness initiatives.

• In 2020/21, $19.9 million in funding is being allocated to the Government of Nunavut and community organizations for mental wellness teams and other mental wellness services.

Territories:

• The health and safety of First Nations and Inuit is one of
this Government’s highest priorities.

• In 2020/21, the Government is allocating $35.1 million to support mental health programming and services in all 72 First Nations and Inuit communities in the three territories.

• Territorial Governments are responsible for the delivery of health care in the territories. The department works in partnership to ensure First Nations and Inuit have access to the culturally safe supports and services, including on the land activities.

If pressed on COVID-19 and mental wellness in the territories:

• The Government of Canada is working closely with partners to ensure there is no gap in service in the territories during the COVID-19 crisis.

• In response to COVID-19, emotional and cultural supports, and mental health counselling for former students of residential schools, federal day schools, and their families, and those affected by the issue of Missing and Murdered Indigenous Women and Girls continue to be available virtually and in person, while respecting physical distancing guidelines.

• The Government is supporting Indigenous communities to implement culturally relevant emergency measures to promote on the land physical distancing.

Suicide Crisis:

• The Government is working with Indigenous communities, partners and experts to advance Indigenous-led approaches to mental wellness.

• At the last AFN Special Chiefs Assembly, the Minister committed to working with groups like NAN, FSIN, and AFN to support the strategies they bring forward.

• In December 2019, the Minister committed $2.5 million for community-driven mental wellness services and prevention programming in Saskatchewan.

• The Departemnt will continue to work in partnership to advance Indigenous-led approaches to address the social determinants of health.
AFN National Youth Suicide Strategy :

• The Government is deeply concerned about the tragic loss of life from suicide in many Indigenous communities, especially among youth.

• As the Minister said at the last AFN’s Special Chief’s Assembly, he shares their goal of addressing mental wellness as an urgent priority.

• The Department will work in partnership with Indigenous peoples to advance Indigenous-led approaches to mental wellness, as we did with NAN when they developed the successful Choose Life Initiative.