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Breaking Point: the Suicide Crisis in Indigenous Communities

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Breaking Point: the Suicide Crisis in Indigenous Communities BREAKING POINT: THE SUICIDE CRISIS IN INDIGENOUS COMMUNITIES Report of the Standing Committee on Indigenous and Northern Affairs Hon. MaryAnn Mihychuk Chair JUNE 2017 42nd PARLIAMENT, 1st SESSION Published under the authority of the Speaker of the House of Commons SPEAKER’S PERMISSION Reproduction of the proceedings of the House of Commons and its Committees, in whole or in part and in any medium, is hereby permitted provided that the reproduction is accurate and is not presented as official. This permission does not extend to reproduction, distribution or use for commercial purpose of financial gain. Reproduction or use outside this permission or without authorization may be treated as copyright infringement in accordance with the Copyright Act. Authorization may be obtained on written application to the Office of the Speaker of the House of Commons. Reproduction in accordance with this permission does not constitute publication under the authority of the House of Commons. The absolute privilege that applies to the proceedings of the House of Commons does not extend to these permitted reproductions. Where a reproduction includes briefs to a Standing Committee of the House of Commons, authorization for reproduction may be required from the authors in accordance with the Copyright Act. Nothing in this permission abrogates or derogates from the privileges, powers, immunities and rights of the House of Commons and its Committees. For greater certainty, this permission does not affect the prohibition against impeaching or questioning the proceedings of the House of Commons in courts or otherwise. The House of Commons retains the right and privilege to find users in contempt of Parliament if a reproduction or use is not in accordance with this permission. Also available on the Parliament of Canada Web Site at the following address: http://www.parl.gc.ca BREAKING POINT: THE SUICIDE CRISIS IN INDIGENOUS COMMUNITIES Report of the Standing Committee on Indigenous and Northern Affairs Hon. MaryAnn Mihychuk Chair JUNE 2017 42nd PARLIAMENT, 1st SESSION STANDING COMMITTEE ON INDIGENOUS AND NORTHERN AFFAIRS CHAIR Hon. MaryAnn Mihychuk VICE-CHAIRS Romeo Saganash David Yurdiga MEMBERS Gary Anandasangaree Michael V. McLeod Mike Bossio Don Rusnak Rémi Massé Arnold Viersen Cathy McLeod OTHER MEMBERS OF PARLIAMENT WHO PARTICIPATED Ziad Aboultaif Kamal Khera Harold Albrecht Jenny Kwan Charlie Angus Joël Lightbound Niki Ashton Alaina Lockhart Rachel Blaney Elizabeth May Bob Bratina Alistair MacGregor Sukh Dhaliwal Jennifer O’Connell Matt DeCourcey Jean-Claude Poissant Neil R. Ellis Dan Ruimy Andy Fillmore Mark Strahl Hon. Hedy Fry Shannon Stubbs Georgina Jolibois Hon. Hunter Tootoo Yvonne Jones Yves Robillard iii CLERKS OF THE COMMITTEE Michelle Legault Grant McLaughlin LIBRARY OF PARLIAMENT Parliamentary Information and Research Service Sara Fryer, Analyst Norah Kielland, Analyst iv THE STANDING COMMITTEE ON INDIGENOUS AND NORTHERN AFFAIRS has the honour to present its NINTH REPORT Pursuant to its mandate under Standing Order 108(2) and the motion adopted by the Committee on Tuesday, April 12, 2016, the Committee has studied suicide among Indigenous peoples and communities and has agreed to report the following: v TABLE OF CONTENTS ACKNOWLEDGEMENTS ................................................................................................... ix BREAKING POINT: THE SUICIDE CRISIS IN INDIGENOUS COMMUNITIES ................. 1 EXECUTIVE SUMMARY ........................................................................................... 1 COMMITTEE MANDATE AND PROCESS ................................................................ 2 AN OVERVIEW OF MENTAL HEALTH IN INDIGENOUS COMMUNITIES .............. 3 A. Prevalence of Suicide among First Nations, Inuit and Métis people ................. 3 I. WHAT THE COMMITTEE HEARD ................................................................................... 7 HISTORIC AND INTERGENERATIONAL TRAUMA ................................................. 7 SELF-DETERMINATION, COMMUNITY-DRIVEN PRIORITIES AND LONG-TERM, STABLE FUNDING .................................................................................................. 11 A. Self-determination .......................................................................................... 11 B. Community Driven Priorities ........................................................................... 13 C. Stable, Predictable, Long-Term, Flexible Funding ......................................... 16 SOCIAL DETERMINANTS OF HEALTH ................................................................. 18 A. Housing .......................................................................................................... 19 B. Education ....................................................................................................... 22 C. Employment and Economic Development ..................................................... 24 D. Infrastructure .................................................................................................. 25 E. Childhood Adversity ....................................................................................... 26 MENTAL HEALTH AND SUBSTANCE USE ........................................................... 28 SUICIDE PREVENTION: CULTURAL CONTINUITY .............................................. 30 A. Cultural Continuity .......................................................................................... 31 B. Language ....................................................................................................... 31 C. Women........................................................................................................... 32 D. Cultural renewal and identity development .................................................... 32 E. Facilities for Healing, Sports, Recreation, Education ..................................... 34 MENTAL HEALTH SERVICES IN INDIGENOUS COMMUNITIES .......................... 36 A. Coordination ................................................................................................... 36 B. Existing Indigenous-Specific Suicide Prevention Strategies .......................... 38 C. Mental Health Services for First Nations and Inuit People ............................. 39 vii D. Survey Results: The Quality and Availability of Mental Health Services ........ 45 E. Urban ............................................................................................................. 47 F. Métis ............................................................................................................... 48 G. Health Professionals ...................................................................................... 49 H. Broadband Infrastructure And Social Media .................................................. 53 II. WHAT THE COMMITTEE FOUND: CONCLUSIONS AND RECOMMENDATIONS ... 55 CONCLUSIONS....................................................................................................... 55 A. Self-determination and reconciliation ............................................................. 55 B. Social Determinants of Health ........................................................................ 56 C. Mental Health Services .................................................................................. 61 LIST OF RECOMMENDATIONS ....................................................................................... 71 APPENDIX A: SURVEY: QUALITY AND AVAILABILITY OF MENTAL HEALTH SERVICES IN INDIGENOUS COMMUNITIES .................................................................. 77 APPENDIX B: LIST OF WITNESSES................................................................................ 89 APPENDIX C: LIST OF BRIEFS ........................................................................................ 95 REQUEST FOR GOVERNMENT RESPONSE ................................................................. 97 viii ACKNOWLEDGEMENTS The House of Commons Standing Committee on Indigenous and Northern Affairs (herein after “the Committee”) acknowledges those who bravely came before the Committee and shared their pain and losses due to suicide. We honour your powerful testimony and recognize your important contributions to this study. The Committee wishes to express its gratitude to all those who appeared before it during the course of its study of Suicide among Indigenous Peoples and Communities. The Committee is deeply appreciative of the personal experiences shared by community members, leaders and youth representatives which provided us with a deeper understanding of the issues that affect suicide and the provision of mental health services in communities. The Committee is thankful for the gracious hospitality of First Nations, Inuit and Métis individuals and organizations who welcomed us warmly during youth roundtables and community site visits. Finally, the Chair wishes to extend her appreciation to her colleagues and staff on the Committee for their dedicated efforts to deal with these important issues. ix BREAKING POINT: THE SUICIDE CRISIS IN INDIGENOUS COMMUNITIES EXECUTIVE SUMMARY The House of Commons Standing Committee on Indigenous and Northern Affairs adopted a motion in 2016 to examine and prepare a report on suicide among Indigenous peoples and communities. Over the course of the study, the Committee heard from over 50 Indigenous youth representatives, First Nations, Inuit and Métis leaders, leading Indigenous academics and health professional organizations,
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