Community Mapping – Operational Review
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ACKNOWLEDGEMENTS Kahui Tautoko Consulting Ltd (KTCL) wishes to thank the management and staff of the participating First Nations communities including Chiefs and Council, Health Directors and their teams and the members of the First Nations community focus groups; tribal council members and other First Nations participants such as the National First Nations Health Technicians Network (NFNHTN) and members of the Non-Insured Health Benefit (NIHB) Navigators Network. We also thank and acknowledge the key stakeholders from provincial and territorial health services, private counsellors and practitioners; and Health Canada nursing personnel who participated. We acknowledge and appreciate the leadership, support and advice of the Assembly of First Nations (AFN), the First Nations and Inuit Health Branch (FNIHB) and members of the NIHB Joint Review Steering Committee (JRSC) who are undertaking this review. 2 TABLE OF CONTENTS ACKNOWLEDGEMENTS ......................................................................................................................................... 2 TABLE OF CONTENTS ............................................................................................................................................. 3 GLOSSARY ............................................................................................................................................................. 4 EXECUTIVE SUMMARY .......................................................................................................................................... 5 INTRODUCTION ................................................................................................................................................... 19 OVERVIEW................................................................................................................................................................. 19 DEFINING SHORT TERM CRISIS INTERVENTION MENTAL HEALTH COUNSELLING....................................................................... 19 SHORT-TERM MENTAL HEALTH CRISIS INTERVENTION IN A FIRST NATIONS CONTEXT ............................................................... 21 THE NATIONAL NON-INSURED HEALTH BENEFITS (NIHB) REVIEW ....................................................................................... 21 NIHB SHORT TERM CRISIS INTERVENTION MENTAL HEALTH COUNSELLING (STCIMHC) BENEFIT .............................................. 22 THE INDIAN RESIDENTIAL SCHOOL: RESOLUTION HEALTH SUPPORT PROGRAM (IRS: RHSP) ..................................................... 22 PROVINCIAL / TERRITORIAL SERVICES .............................................................................................................................. 23 THE FIRST NATIONS MENTAL WELLNESS CONTINUUM FRAMEWORK .................................................................................... 23 METHODOLOGY ................................................................................................................................................... 25 REVIEW OBJECTIVES .................................................................................................................................................... 25 REVIEW OUTPUT ........................................................................................................................................................ 25 REVIEW METHODS ...................................................................................................................................................... 25 LIMITATIONS OF THE REVIEW ........................................................................................................................................ 34 ANALYSIS OF FINDINGS ........................................................................................................................................ 36 HOW ACCESS TO THE STCIMHC IS EXPECTED TO WORK ..................................................................................................... 36 KNOWLEDGE OF – AND ACCESS TO - THE STCIMHC BENEFIT .............................................................................................. 38 CURRENT CRISIS INTERVENTION SERVICES AND MODELS ...................................................................................................... 41 CONCLUSIONS ..................................................................................................................................................... 45 RECOMMENDATIONS .......................................................................................................................................... 55 APPENDICES......................................................................................................................................................... 59 SITE REPORTS ......................................................................................................................................................... 59 NOVA SCOTIA / NEWFOUNDLAND REGION: WAYCOBAH FIRST NATION ......................................................... 60 NEW BRUNSWICK / PRINCE EDWARD ISLAND REGION: OROMOCTO FIRST NATION ....................................... 70 SASKATCHEWAN REGION: PIAPOT FIRST NATION ........................................................................................... 80 ONTARIO REGION: OJIBWAYS OF GARDEN RIVER FIRST NATION ..................................................................... 89 ALBERTA REGION: STONEY BEARSPAW FIRST NATION .................................................................................. 101 QUEBEC REGION: CONSEIL DES ATIKAMEKW DE WEMOTACI FIRST NATION ................................................ 111 NORTHWEST TERRITORY: LUTSEL K’E DENE BAND ........................................................................................ 128 MANITOBA REGION – PAUINGASSI FIRST NATION ......................................................................................... 139 YUKON TERRITORY: VUNTUT GWITCHIN FIRST NATION ................................................................................ 152 3 GLOSSARY AANDC Aboriginal Affairs and North Development Canada ADI Aboriginal Diabetes Initiative AFN Assembly of First Nations AHAC Aboriginal Health Access Centre AHP Aboriginal Health Program AHS Alberta Health Services BF Brighter Futures BHC Building Healthy Communities CBT Cognitive Behavior Therapy CEP Common Experience Payments CISM Critical Incident Stress Management [debriefing] CPNP Canada Prenatal Nutrition Program CSSSPNQL Commission de la santé et des Services Sociaux des Premières Nations du Quèbec et du Labrador CSU Crisis Stabilization Unit CYFN Council of Yukon First Nations EMS Emergency Management Services FASD Fetal Alcohol Stress Disorder FNIHB First Nations and Inuit Health Branch (Health Canada) FSIN Federation of Saskatchewan Indian Nations GNWT Government of the Northwest Territories HHN Horizon Health Network IAP Independent Assessment Process IERHA Interlake-Eastern Regional Health Authority IRS: RHSP Indian Residential School: Resolution Health Support Program (FNIHB Program) JRSC Joint Review Steering Committee KTCL Kahui Tautoko Consulting Limited LHIN Local Health Integration Network MCFD Ministry of Child and Family Development (or similar) MHMCT Mental Health Mobile Crisis Team NASYPS National Aboriginal Youth Suicide Prevention Strategy NFNHTN National First Nations Health Technician Network NGO Non-Government Organization NNADAP National Native Alcohol and Drug Addiction Program (FNIHB Program) NIHB Non-Insured Health Benefits NHS Native Health Service NSHA Nova Scotia Health Authority NPTP Northern Patient Transportation Program OTN Ontario Telemedicine Network PACT Program for Assertive Community Treatment PIP Prevention, Intervention, Postvention [suicide framework] RCMP Royal Canadian Mounted Police RHA Regional Health Authority STAR Success through Advocacy and Role modeling STCIMHC Short term crisis intervention mental health counselling (benefit) STHA Stanton Territorial Health Authority TRC Trust and Reconciliation Commission WHG Whitehorse General Hospital YHSS Yukon department of Health and Social Services YHSSA Yellowknife Health and Social Services Authority 4 EXECUTIVE SUMMARY Scope The Non-Insured Health Benefits (NIHB) Joint Review Steering Committee (JRSC) made up of Assembly of First Nations (AFN) appointees and First Nations and Inuit Health Branch (FNIHB) representatives has agreed on three pillars for their Joint Review Inquiry: 1. Process: Review of all components of NIHB policies, guidelines, etc; 2. Access: Analysis of access to include but not be limited to, access to services, information, choice, cultural appropriateness of the service. This will also be looked at through the Social Determinants of Health lens. It will include a survey of clients of NIHB with specific questions to obtain client input on their experience in accessing NIHB and the barriers they faced. Access flow charts will be developed to demonstrate the accessibility of services as compared to non-First Nations accessing the provincial system; 3. Cost: Cost analysis includes both prospective and retrospective costs, expenditures within the unique context of the population served including social and economic conditions. The JRSC agreed to review all six benefits of the NIHB program including medical transportation, vision, dental, pharmacy, medical supplies and equipment and short-term crisis intervention mental health counselling (STCIMHC).