First Nations Mental Wellness Continuum Framework Policy Hackathon

First Nations Mental Wellness Continuum Framework Policy Hackathon Final Wrap-Up Report September 2022

Centre for Indigenous Policy and Research

Megan Lewis, Director of Indigenous Policy and Research megan@canadianroots.ca

Section 1: Introduction.............................................................................................................................. 3 1.1 Who Is CRE.................................................................................................................................... 3 CRE’s Guiding Principles .............................................................................................................. 3 Impact of Budget 2019 ................................................................................................................. 3 Section 2: Hackathon Overview & Demographic Data ......................................................................... 4 2.1 Hackathon Overview.................................................................................................................... 4 2.2 Participant Demographic Summary .......................................................................................... 4 Section 3: Hackathon Summary & Policy Briefs................................................................................... 5 3.1 Hackathon Summary ................................................................................................................... 5 Theme 1: Access to Services & Service Availability ................................................................ 6 Theme 2: Indigenous Youth Awareness of Existing Services ................................................ 6 Theme 3: Quality, Safety, and Inclusiveness of Services ....................................................... 6 3.2 Closing Engagement ................................................................................................................... 7 Theme 1 - Youth Perspectives on Mental Health: Key Considerations ................................ 8 Theme 2 – Youth- Driven Solutions: Coming Together to Create Systems Change .......... 8 Section 4: Analysis & Next Steps ............................................................................................................ 8

Section 1: Introduction 1.1 Who Is CRE

Founded in 2008, Canadian Roots Exchange is a national Indigenous youth-led non-profit and registered charity ((832296602RR0001). We envision a future where Indigenous youth are empowered and connected as dynamic leaders in vibrant and thriving communities. We collaborate with communities to provide programs, grants and opportunities that are grounded in Indigenous ways of knowing and being and designed to strengthen and amplify the voices of Indigenous youth.

In the 2019 federal budget, the Government of Canada named CRE as a leading Indigenous Youth organization to take up TRC Call to Action 66 for reconciliation and committed federal funding for a pilot project of $15.2 million over three years (2019/2020 - 2022/2023). Budget 2019 set the goal of the pilot project as ensuring that “the voices of First Nations, Inuit and Métis are heard and to support Indigenous youth reconciliation initiatives.” Funding supports the establishment of a distinctions-based national network of Indigenous youth, helps ensure that Government of Canada policies and programs are informed by the diverse voices of Indigenous youth, and provides support to community events, gatherings for Indigenous youth and reconciliation-focused community-based Indigenous youth activities, etc. Since that time CRE has grown exponentially with offices in Toronto and Ottawa, ON and over 50 staff members (80% self-identify as Indigenous) working remotely from coast to coast.

CRE’s Guiding Principles Centering Indigenous youth perspectives, we have 7 deeply held principles that guide us in our work and in the way in which we relate to each other: • • • • • • •

Reciprocity Innovation Accountability Reclamation Advocacy Resurgence Solidarity

Impact of Budget 2019 Budget 2019 set the goal of the pilot project as ensuring that “the voices of First Nations, Inuit and Métis are heard and to support Indigenous youth reconciliation initiatives.” Funding will support the establishment of a distinctions-based national network of Indigenous youth, help ensure that Government of Canada policies and programs are informed by the diverse voices of Indigenous youth, and provide support to community events, gatherings for Indigenous youth and reconciliation-focused community-based Indigenous youth activities. Here are just some of the impacts Budget 2019 had between April 2019- March 2022, and across 23 unique programs: • • •

1,769 Primary Participants 29,003 Program Beneficiaries Over 34,000 Digital Engagements

CRE In Fall 2020, CRE had a total national economic impact of $13.7 million.

Section 2: Hackathon Overview & Demographic Data 2.1 Hackathon Overview CRE was approached to support in the enhanced involvement of Indigenous youth in the ongoing analysis and development of the First Nations Mental Wellness Continuum Framework (the Framework), led by the FNMWCF Secretariat. Supported by Indigenous Services Canada, CRE began planning for the event in early 2022.

By their nature, policy hackathons present an opportunity to empower and educate all in the same space, while fostering connections with other like-minded youth. Held over the course of two weekends, 24 youth came together guided by their mentors to write policy proposals and prepare for their presentations to judges on the final day. Participants were supported by an introductory learners package, subject matter expert sessions throughout, and Elder Ed Connors who present throughout the event to ground the space in ceremony, and to provide ongoing support.

The aim of the hackathon was to explore and understand youth priorities in mental health, intersections between youth priorities and the FNMWCF, and youth needs for orientation to the FNMWCF. Participants were asked to answer those questions in the form of a policy brief and presentation that also notes any strengths, opportunities, and gaps they saw in the framework and any resources or tools they would create to enable the framework to be applied in various contexts.

2.2 Participant Demographic Summary Of the 24 participants in the hackathon, the overwhelming majority identified as First Nations, while 12.5% identified as Métis.

Unfortunately, the hackathon had no Inuit participants, and CRE continues to work to improve relationships with Inuit youth wherever they live.

Half of participants were between the ages of 26-29, with the next largest age bracket being 22-25 (41.6%). Finally, 8.4% of participants were aged between 18-21. Participants hailed from 9 provinces and territories, with the largest groups from Ontario (41.6%) or Manitoba (12.5%).

Nearly half of participants identified as cis women (45.8%), while 29.2% included Two-Spirit as part or all of their gender identity.

Notably, over half (58.7%) of all participants identified as falling under the Two-spirit and LGBTQ+ umbrella. Lastly, participants were relatively evenly split between those living with disabilities and those without at 42% each, while 16% were unsure about the question or preferred not to say.

Section 3: Hackathon Summary & Policy Briefs 3.1 Hackathon Summary One of the most crucial components of the hackathon focuses on capacity building sessions hosted by a variety of subject matter experts. These sessions seek to provide youth with the tools they need to collaborate with their teams to achieve the goals of the hackathon. For this hackathon, we kicked off our sessions with Dr. Brenda Restoule who spoke to youth about the Framework itself, in order to provide participants with an understanding of the Framework, which was necessary in order to respond to the case study. Next, Diana Prosser, a manager within the Strategic Policy, Planning and Results Directorate, Child and Family Services Reform with Indigenous Services Canada joined us to provide a presentation on tips and tricks to writing a policy brief. We closed off these sessions with Elder Perry McLeod who spoke to the importance of mental wellness from a cultural perspective.

For the hackathon itself, participants were asked to write a policy brief and prepare a presentation exploring youth priorities in mental health, intersections between youth priorities and the FNMWCF, and youth needs for orientation to the FNMWCF. The case study suggested that the youth use the background section of their brief to speak to youth priorities in relation to mental health, and to note any strengths, opportunities, and gaps in the framework. With the rest of their policy briefs, youth were asked to outline what resource(s) or tool(s) their team would create to enable the framework to be applied in various contexts.

Participants were also advised that they could propose a broader recommendation as a starting place, or could propose a recommendation related to a specific institutional context (such as government, schools, hospitals, evaluation etc.) This could include exploring what agencies/organizations are providing current supports and services, whether they are working, and who might do a better job. The case study also prompted participants to consider what

community dynamics facilitate change, how they might use the framework at the individual or community levels, and what it would take to explain the framework at the community level.

Most importantly, these asks were meant to uncover concrete tools and strategies for ensuring that the Framework is useful to Indigenous youth and their service providers.

Below, recommendations from the four teams have been grouped into three clusters that 1) reflect the diverse priorities of the youth when it comes to policy-making about their mental wellness, and 2) provide an indication of what gaps the FNMWCF could highlight from an advocacy perspective.

Theme 1: Access to Services & Service Availability • Allocate more funding for mental health services for youth transitioning from reserve settings to off-reserve settings. Indigenous youth have been forced to be strong, resilient, resourceful when leaving home communities and seeking access to services in new, urban settings. In addition to increasing the availability of more mainstream mental health services (such as therapy/counselling), this funding should include streams dedicated to bringing sweats, powwows to the city (even through universities) so the onus isn’t always on the youth to travel to access traditional healing practices and ceremony.

• Allocate more funding for 2SLGBTQ+-specific youth mental health services, services in rural areas, more funding for traditional modes of healing and to pay traditional healers • Advocate for health services to be less dependent on provincial jurisdictional funding, needs, and political climates. With the Framework as a guide, the federal government could set national standards and expectations when it comes to the availability of mental health services for Indigenous youth.

• Create a digital platform for Indigenous youth to receive culturally appropriate, traumainformed mental wellness supports in an accessible format.

Theme 2: Indigenous Youth Awareness of Existing Services • Create one directory listing all currently available Indigenous youth mental health services, with a wide range of filters and tags that indicate the type of service being offered (such as whether the service costs money, whether there is funding available to access it, whether pit relates to food or housing, whether it is a form of counselling counseling, ceremony, recreational, social groups, education) as well as the option to filter by age restrictions, First Nations, Métis, or Inuit services, and status vs. Non-status services. This effort should also be capacitated with adequate staff and dollars to maintain the directory and to carry out a rigorous social media campaign with targeted advertising to ensure Indigenous youth are aware of what services exist to access in their area(s) and should be evaluated regularly after the launch for accuracy and effectiveness.

• Build partnerships with existing, trusted partners in Indigenous youth mental health on the development marketing, and monitoring of the directory.

Theme 3: Quality, Safety, and Inclusiveness of Services • Allocate more funds to 2SLGBTQ+ -inclusive mental health services, especially for those in rural areas. This should include improving access to safe traditional healing circles and Two-spirited sweetheart dances at Pow Wows, more access for traditional healers, and more community resources directed to Two Spirited youth.

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Provide more culturally specific mental health first aid training for Indigenous youth to providers, community members, and Indigenous youth themselves.

Improve communication between mental health service providers to streamline and improve quality of services and avoid duplication or overstepping. This should include setting national standards for follow up times with Indigenous youth in mental health crises.

Allocate funds for the creation of Indigenous youth mental health navigator positions across the country, to be made available in schools, hospitals, online Create an Indigenous youth council that centers Indigenous youth mental health priorities in a way that is inclusive of First Nations, Métis, and Inuit-specific needs. The council should serve not only as a hub of information for youth seeking supports but also as a platform from which Indigenous youth can lead and advocate for reform at the policy/decision-making level. The funding of this council should include honoraria for the time and emotional labor of the Indigenous youth, and for the inclusion of a peer mentorship program to provide hope and build connections between youth on a regional, provincial, and/or territorial basis.

3.2 Closing Engagement

At the end of the program, CRE hosted a closing engagement so that the youth could debrief and share their feelings about how the hackathon unfolded, what impacted them the most, and what we can improve on for next time. The session included graphic recording by Michelle Buchholz, which can be found below.

Theme 1 - Youth Perspectives on Mental Health: Key Considerations When asked what gaps youth saw in existing mental health and wellness services, participants identified the need to improve consistent access to services when youth are moving between provinces and/or transitioning from living on-reserve to living off-reserve. This conversation spoke to realities of urban Indigenous youth, as well as youth coming from their communities, and rural and remote areas alike. Specifically, a lack of communication between health care jurisdictions and health care service providers (such as walk-in clinics or clinics located within educational institutions) create situations where youth are being denied care or having to go long stretches without care of any kind. Some participants also spoke about the harms of forcing youth into western mental health services when they are struggling with self-harm or suicidal ideation. Such practices separate them from their Elders and community, causing further deterioration of their mental, emotional, and spiritual wellness, while also engendering a feeling of powerlessness and mistrust of the mainstream mental health system.

In terms of quality of services, participants spoke to negative experiences with child services, and to the lack of education when it comes to concrete strategies for de-escalation and selfcare (such as Dialectical Behaviour Therapy). One participant relayed a story about seeking crisis intervention through a helpline and being denied service and redirected to an emergency room (where no crisis workers were present) due to being Indigenous. Overall, participants reiterated the need for safety and consistency to be applied across services and highlighted the ongoing systemic racism and discrimination present in all systems of health care.

Participants expressed positive experiences frequently being tied to services or resources that were grounded in culture and community wellness and explored avenues for prevention and sustainable care. Many participants said that the Framework itself demonstrated significant potential to be an impactful resource in this area since it is grounded in culture, and Indigenous perspectives.

Theme 2 – Youth- Driven Solutions: Coming Together to Create Systems Change When asked how they came to their recommendations, youth spoke to the importance of addressing the mental health crisis at the root and outlined the importance of cultural reclamation, identity, and land-based healing to that fight. They also spoke further to the need for more work to include Two-Spirit, LGBTQ+, and disability-specific needs in that work, and agreed that in order for the Framework to be more reflect their needs, it needs to be broadened to include Métis and Inuit realities, as well as create more space for disability advocacy.

Section 4: Analysis & Next Steps "For this Framework to be an effective guide, it needs to be inclusive and represent the diverse needs of First Nations, Inuit, and Métis and Two-Spirit youth in both rural/remote, Northern, urban and on reserve to center youth priorities, needs and ensure a panIndigenous approach to healing is avoided." (Hackathon Policy Brief) "The biggest opportunity arising from the First Nations Mental Wellness Continuum Framework is to focus on improving access for Indigenous youth [in the social determinants of health areas identified by the framework]." (Hackathon Policy Brief) “Let’s use [the Framework] to highlight the fact that provinces shouldn’t be in charge of all the health services. That’s why we have to move towards parliament and ministers to support a bill to set national minimum standards.” (Hackathon Policy Brief)

Despite the education material provided in advance, a facilitated information session about the framework, and a case study that provided many points of entry to dissecting the framework, participants were unable to meaningfully engage with the content of the framework itself. This is evident in the fact that nearly all the recommendations youth provided were more general to mental wellness needs and less specific to the substance of the framework. CRE takes this as a clear indication that the Framework's current form is too dense for anything beyond a surface level engagement. Further barriers include the framework's specificity to First Nations mental wellness, immediately excluding Métis, Inuit, and participants with mixed Indigenous backgrounds. Two-Spirit and LGBTQ+ participants similarly stated that they didn't immediately feel included by the framework.

At the surface level, a few key elements of the framework resonated with participants: 1. Its holistic nature and emphasis on balancing the physical, spiritual, mental, and emotional; 2. Its responsiveness to colonization's impacts, which they frequently identified as missing from their health care experiences, and 3. Its centering of culture & cultural identity to mental wellness.

The most important takeaway shared was that participants were largely unable to identify what to do with the valuable information presented within the framework.

As such, CRE has provided the following recommendations based on inference and observation of the participants' attempts to grapple with the framework. Long-term, much of this work will require relationship-building with Inuit and Métis mental health experts; securing additional funding to significantly expand the resources accompanying the framework; and potentially having a call for place-specific resource-development. Funding could also be secured to establish an advisory circle of voices that are missing, including but not limited to youth. This circle, if and when established, should include coordination with existing circles that may exist doing important work in this area. Moreover, there’s a need for a clear workplan, with defined action items, and clear timelines. The Secretariat’s vision, goals, and purpose need to be clearly articulated and shared with the people who are meant to be served by this framework. We hope these recommendations will help elevate the framework and be more relevant for youth and others.

Framework Format & Accessibility To ensure that youth understand the Framework itself, it needs to be broken down in plainlanguage and adapted into complimentary formats (such as explanatory videos, TikTok's, audio clips, etc.). It is crucial to create a single online hub as a “one-stop-shop" for the framework that clearly lays out what the framework is, and how it can be used. This hub should include: •

User-specific toolkits that outline how they can apply the framework in their respective sectors (i.e., how to use the framework in schools, universities, hospitals, justice systems, life promotion programs, and/or for evaluators, urban planners, policy makers, etc.) The Secretariat needs to create these dynamic place-based scenarios for using the framework to help make the framework's application clearer. Part of this can also be the creation of baseline knowledge tools and guides and sharing them widely. For people

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who don’t see a toolkit for their sector, clear instructions and guidance should be visible to allow people to apply for funding to make a tool for their sector.

Clear descriptions of who is on the secretariat, how it is governed, how it started, and any external partners as well.

A contact page for anyone with questions about the framework, with clear info about who they are contacting and why.

A feedback tool for folks to suggest things and ask questions.

An extensive and organized resource library with clear ties back to the framework – while the current resource library provides useful information, it does not all clearly tie back to the framework.

An engaging informational video about the framework, and/or a workshop folks can watch to gain a deeper understanding of it. This could take the form of a 101-style course, with follow-ups describing exactly how to use it. The course could also include micro sessions about diverse ways to apply the framework that then direct to the relevant place in the online hub with tools for different sectors.

The hub should also include examples of how the framework is currently being applied, and link to active social media feeds that highlight real-life examples of the framework in use. The hub should create an archive of case studies, and reports from partners/places and people who are using it, leveraging, and highlighting existing practices and successes. Sharing these stories, best practices, and tools can coincide with relevant awareness weeks to support in driving traffic and knowledge sharing.

Fostering Inclusivity The name and its specificity of the framework to First Nations made it difficult for our Inuit and Métis participants to find an entry point without already coming from a place of exclusion. It’s unfair to expect them to do the work of seeing themselves in the framework from that starting point.

If the framework is meant to specifically apply to First Nations (as the name would imply), the Secretariat needs to connect the framework to equivalent Inuit and Métis work/frameworks/initiatives. Meaningful consultation and relationship-building with Inuit, Métis, and 2SLGBTQIA+ youth and trusted organizations that work with and for them can create a foundation on which to amend the framework or create new frameworks that are more reflective of each nation's unique needs and priorities. In this way, there is also opportunity for the framework to highlight broader best practices and set the stage for more collaboration among and between First Nations, Métis, and Inuit agencies and organizations that are focused on mental wellness.

Bringing Youth In The Framework could be treated as one of many advocacy tools that can be used to highlight gaps, in much the same way that UNDRIP, the TRC, RCAP, and the MMIWG Calls to Justice do.

Availability and accessibility of services were two of the most commonly identified challenges for youth and are key areas of focus in the above-listed tools. To continue pursuing the goal of increasing accessibility and safety of mental health services for Indigenous youth, the secretariat could create a youth council responsible for accountability and providing

opportunities for them to use the framework as an advocacy tool to voice their concerns to government.

As noted, youth are confident that the Framework has incredibly valuable information that could be applied in many ways, however, are seeking direction on how to go about that application.

Taking into consideration their recommendations, and the analysis, we look forward to the future of the Framework and the many ways in which it will be utilized to support Indigenous mental wellness for generations to come.