Shkaabe Makwa Magazine | Summer 2023

Summer 2023

First Nations Wellness Initiative

24 Events & Training

In Conversation With... Kaitlyn Gilham

ON THE COVER

Drawing from his Mi’kmaq heritage, illustrator Greg Mitchell depicts a bear, the guide to the Spirit World, with a medicine bag around its neck and holding an abalone shell for smudging. The strawberries are for the feast to honour the bear. The inclusion of the human head and loon emphasize the joyous feeling of a community working together.

Artwork: Greg Mitchell Born in the North LTD.

CULTURE IS CENTRAL TO

BY RENEE LINKLATER

OUR STORY:

In 2000, a team of Indigenous social workers alongside Elder Vern Harper launched the Aboriginal Services program at CAMH. This was the first team at CAMH to support the unique needs of First Nations, Inuit, and Métis patients by providing culturally grounded, trauma-informed, patient and family-centred therapy, group work and individual sessions.

during treatment cycles and therapeutic sessions, including the burning of sage, which required a separate vent not attached to the main ventilation system.

In the years that followed, CAMH launched a number of additional initiatives in support of First Nations, Inuit, and Métis wellness. This included first renovating a clinical treatment room on the Queen Street campus in 2009 to ensure the team could use medicines

In 2013 the clinical room was transformed into a Ceremony Room with the renovations including the addition of cedar panels on the walls and a medicine wheel in the center of the room which was designed and painted by a group of Indigenous youth artists.

As CAMH was advancing the areas around patient care to better align with traditional healing, efforts to build better relationships with First Nations, Inuit and Métis political organizations, service providers and communities was well underway. With a

Chapin Asin - Elder Vern Harper with social work student

Aimee Wilson

Ceremony Room – CAMH, 60 White Squirrel Way

HEALING AND WELLNESS

LINKLATER

priority of community engagement, the Provincial System Support Program (PSSP) at CAMH established a new team in 2014 –Aboriginal Engagement and Outreach (AEO) which focused on engaging with Indigenous service providers around provincial initiatives, such as System Improvement through Service Collaborative, Staged Screening and Assessment and Improving Access to Structured Psychotherapies (now known as the Ontario Structured Psychotherapy Program), to name a few. Our team led the implementation of the Mobile Training Teams Initiative – an action item in Open Minds, Healthy Minds –Ontario’s Comprehensive Mental Health and Addictions Strategy (2011), which provided training and professional development to First Nations, Inuit and Métis mental health and addiction workers in northern Ontario. This initiative has evolved into Shkaabe Makwa’s Workforce Development - a provincial program. In these years, the team had the opportunity to convene Indigenous Elders and experts from service providers across Ontario to develop a new Trauma and Substance Use Assessment tool – which is currently going through a testing and validation process.

In 2016 CAMH opened Ceremony Grounds, including a Sweat Lodge, Sacred Fire and Medicine Gardens. That same year, CAMH published Guiding Directions, a five-year plan to strengthen CAMH’s practices and partnerships with First Nations, Inuit and, Métis.

After years of pondering our continued use of “Aboriginal” and not confident that we wanted to use “Indigenous” in our program name, in the spring 2018 a new name emerged that reflected how we seek help and guidance from the Spirit World: Shkaabe Makwa (pronounced SHKAW’-bay MUK’-wah), which translates to “Spirit Bear Helper” in Anishinaabemowin. For some, we acknowledge the Bear as “medicine,”

and others as a “knowledge keeper, protector and healer.”

After the name Shkaabe Makwa emerged, I approached CAMH’s then President and CEO Dr. Catherine Zahn about expanding the work of AEO and establishing Shkaabe Makwa as one of the new Centres at CAMH committed to promoting health system transformation grounded in First Nations, Inuit, and Métis knowledge and expertise. Dr. Zahn was ignited by the role Shkaabe Makwa could play not only within CAMH but across the hospital system as well.

In 2020, CAMH officially launched Shkaabe Makwa, the first hospital-based Centre in Canada designed to drive culturallyresponsive systems initiatives to achieve health justice and wellness for First Nations, Inuit, and Métis communities through the advancement of research, workforce development and innovative healing models that harmonize traditional knowledge and medical expertise.

We are firm believers that Indigenous health needs to be in Indigenous hands. The work of Shkaabe Makwa is grounded in the guidance of our external Leadership Circle comprised of 11 First Nations, Inuit, and Métis experts from across Ontario who are collectively connected across multiple systems of community health care, service providers agencies, mental health and wellness services, hospitals, child welfare, education, and research. We are grateful to Dr. Ed Connors, Melanie Goodchild, Joe Hester, Dr. Carol Hopkins, Amanda Kilabuk,

Dr. Darrel Manitowabi, James Morris, Kenn Richard, Ed Sackaney, Brenda Small and Dr. Pamela Williamson who continue to support, advise and guide us through our efforts at Shkaabe Makwa.

OUR INTENTIONS:

We hear all too often the extent of the racism and discrimination that Indigenous peoples face when they’re trying to access health care. We intend to make CAMH a safe place for First Nations, Inuit, and Métis. We believe people need to feel spiritually, culturally and psychologically safe, in order to engage with meaningful personal work. We are committed to building a hospital system that has the services and support to respond to the needs of our people and an environment that signals to First Nations, Inuit, and Métis that we care, that we understand the journey, and that we know that colonization has caused so much

Renee Linklater, Senior Director of Shkaabe Makwa

harm within our families and across our communities.

As a hospital-based Centre, we also understand our role in bringing together Indigenous service providers, community leaders, Elders, Knowledge Keepers, and Traditional Healers to collaborate on new treatment models, assessment tools, system initiatives and research methods. Additionally, we are dedicated to our roles as learners and educators and we are honoured to walk alongside so many others that share a vision of wellness.

Miigwech, Niá:wen, Nakurmiik, Marsee, Qujannamiik, Merci, Thank you!

Renee Linklater, PhD is a member of Rainy River First Nations in Northwestern Ontario. She has over 25 years of experience working with Indigenous healing agencies and First Nation communities. Renee has worked across the health and education sectors as a frontline worker, program evaluator, curriculum developer, educator/trainer, and researcher. She is an international speaker on trauma and healing and is the author of Decolonizing trauma work: Indigenous stories and strategies and editor of Connected in Creation: A Collection of Lived Experience through Cultural Expression. Renee is the Senior Director of Shkaabe Makwa - Centre for First Nations, Inuit and Métis Wellness at the Centre for Addiction and Mental Health (CAMH) and is actively involved in several system level initiatives across Ontario.

STAY CONNECTED

LEARN MORE

Shkaabe Makwa website

ECHO ONTARIO FIRST NATION, INUIT, & MÉTIS WELLNESS

BY WALTER LINDSTONE

Project ECHO (Extension for Community Healthcare Outcomes) was founded by Dr. Sanjeev Arora over 20 years ago with a mission to create an “all teach, all learn” approach for knowledge-sharing in rural and underserved communities. Today there are ECHO programs in 180 countries around the world including several here at CAMH .

In 2016, CAMH developed ECHO Ontario First Nation, Inuit, & Métis Wellness , a unique program specializing in servicing both rural/remote and urban Indigenous peoples and their communities. Offered during the fall and winter seasons, the 12-session program addresses mental and physical wellness from the perspective of wholism and supports community providers offering services to First Nations, Inuit, and Métis clients/patients in Ontario. Curriculum topics include: Post-traumatic Stress Disorder (PTSD), culturally informed suicide prevention, safety and healing in ceremony and much more. During each weekly session, Indigenous and non-Indigenous health professionals and helpers gather online over

a two-hour period to share knowledge and connect with a multidisciplinary community of practice.

Over the last six years, we have delivered 75 culturally designed and adapted didactic presentations to 365 unique community service providers. We have made tremendous strides with respect to our ECHO ON, and have incorporated evaluation feedback and comments from the participating community providers to continually evolve, adapt and strengthen our program. In 2022, we were honoured to receive the Fair and Just Award for Leadership in Promoting Equity, Diversity, and Inclusion through Education at CAMH, an award that recognizes people who are using meaningful and collaborative partnerships to change the way education is planned, developed, and implemented to create a connected CAMH.

Meet the ECHO Ontario First Nation, Inuit, & Métis Wellness Team

Our Path Ahead

I have virtually met so many like-minded individuals through this ECHO program and each of them have had significant impacts on my spiritual, mental, emotional, and physical wellness.

Looking ahead, we are collaborating with the Children’s Hospital of Eastern Ontario (CHEO) ECHO ON Team in the development of a specific 4-session cycle focused on providing cate to Indigenous children and youth to be delivered in the fall of 2023. Recently, we received more good news: we have been accepted to co-present on our collaboration in September at the Meta ECHO Conference. And of course, we’re all very excited and looking forward to starting our 7th Cycle this fall.

If you provide care to Indigenous patients/

community members and wish to join our unique ECHO, please reach out to Walter Lindstone , Implementation Specialist with Shkaabe Makwa or Leela-Emma Krishnan , Information Specialist.

Registration opens for ECHO Ontario First Nation, Inuit, & Métis Wellness in August 2023, click here for more information.

Walter Lindstone is Anishinaabe, from Batchewana First Nation. The spirit name he carries is ‘K’okomis Shkawbaywis’, which translates to ‘Your Grandmother’s Helper.’ He’s the proud father of six children and enjoys participating in and facilitating ceremonial work within his community. Walter is an Implementation Specialist with Shkaabe Makwa.

The Health Resource Team consists of two Indigenous co-hosts, Dr. Renee Linklater, PhD, Shkaabe Makwa, Senior Director & Dr. Victor Vien, MD FRCP; Cynthia White, Traditional Healer; Heidi Maracle, Host & Implementation Specialist; Psychiatrist, Dr. Jonathan Bertram, Addiction Medicine Physician; Dale Kuehl, Advanced Practice Clinical Leader; Walter Lindstone, Cultural Resource & Implementation Specialist and Leela-Emma Krishnan, Information Specialist

FIRST NATION, INUIT, & MÉTIS

Our model of care draws on diverse Indigenous frameworks, knowledges and teachings. The Circle encompasses many teachings including the Four Directions, four Sacred Colours of the original four Spirit Beings, and the four Sacred Medicines. The four sacred plants depicted in our Circle are important Traditional Medicines that are utilized by the First Nations, Inuit, and Métis that this ECHO serves. The traditions of our people are what has kept us alive through the trials and tribulations of colonialism and still do today. The Circle is also divided into two sections: Family and Community. These are also two very important aspects of this ECHO project. When you connect the medicines, the spiritual, mental, emotional, and physical along with family and community, it is the essence of what this ECHO project is all about. To serve our people by making connections deeply rooted in ancestral knowledge, epistemologies, and our Indigenous paradigm.

ONTARIO MÉTIS WELLNESS MODEL

Strawberry flower which is representative of our teachings on the sacredness and sanctity of love - the strawberry being the heart berry and reminds us about the sweetness of life. The next sacred plant medicine represented is Arctic Cotton which grows naturally across the tundra. This is a very important plant for Inuit and is call ‘Puallunnguat’ in Inuktitut. The seeds are used in seal oil lamps to light their homes and the plant is food for migrating geese and caribou which are also important for Inuit in helping them to sustain their livelihoods. Sage is the third plant on the medicine wheel and this is a very sacred medicine burned as an incense to assist with coping and grounding when one is feeling distraught or in need of a ‘pick me up’. The sage plant is used across Turtle Island in ceremonies to burn and offer as a smudge to cleanse the spiritual, mental, emotional, and physical being. Finally, the last medicine is cranberries, which are very important to Métis peoples as they added these berries to buffalo meat called ‘Pemmican’ to help with the preservation providing longer sustenance throughout the year.

Wiikwemkoong Community Visit (2022) Community leaders and staff at Wiikwemkoong Unceded Territory

Many existing services and supports designed to address mental health and substance use challenges do not meaningfully engage with the various communities they are designed to support. This creates an exclusive “created for” approach as opposed to an inclusive “created with” approach. Collaborative engagement and community-based approaches with First Nations peoples and communities are not often nurtured with this approach, potentially perpetuating culturally unsafe pathways that are not wholistic or responsive to communityspecific needs.

The First Nations Wellness Initiative (FNWI) is a collaborative model that guides the development of community-driven, evidence-informed, and community-based mental wellness strategies with First Nations communities. Led by researchers at the Institute for Mental Health Policy Research (IMHPR) and Shkaabe Makwa, the work is done in collaboration with various community members in a research-toaction process to build wellness strategies addressing mental health and substance use (MHS) challenges.

The FNWI is guided by a community-based research coordinator and a Community Advisory Circle through four phases:

1. LEARN

Quantitative and qualitative information is gathered on the needs and concerns of community members.

2. IDENTIFY

Local findings are shared and discussed to raise awareness regarding community strengths and challenges and to establish where to focus wellness efforts through selfdetermination.

3. IMPLEMENT

Participatory Action Research (PAR) is used to actively engage community members in developing, implementing and evaluating a sustainable and specific wellness strategy.

4. SHARE

The findings, recommendations, and lessons learned are broadly shared through various knowledge dissemination pathways.

The FNWI currently collaborates with Saugeen First Nation, Walpole Island First Nation, and most recently Wiikwemkoong Unceded Territory. Each community develops their own path through the FNWI by developing a Community Advisory Circle, ensuring that the approach is responding to the needs and concerns of the community.

LEARN MORE

Webinar: First Nations Mental Wellness Strategies Initiative: Acts of Reconciliation in Research at CAMH

Kahontakwas Diane Longboat, M.Ed., is the Senior Manager, Strategic Initiatives of Shkaabe Makwa, and also serves as the CAMH Elder. In these positions, Diane has played a key role in building culturally relevant systems at CAMH that support equity and community wellness for First Nations, Inuit, and Métis patients, families, and communities.

One of the primary initiatives Diane is involved with is the CAMH Reconciliation Working Group (RWG) where she served as co-chair from 2017 to 2020. In 2017, in response to the Truth and Reconciliation Commission report published by the Canadian government, staff from across CAMH came together to have a conversation about reconciliation and the role the

Kahontakwas Diane Longboat

hospital should play in addressing sections 18-24 which call upon health organizations to initiate change to improve services and partnerships with Indigenous peoples.

Following this initial gathering, Diane convened the first meeting of the RWG, an organization-wide group of Indigenous and non-Indigenous staff members. The group’s purpose is to support CAMH staff and physicians in all sectors of the organization in learning the history of First Nations, Inuit, and Métis, and how the history of colonialism and racism continues to impact mental health and substance use today. Resilience based on culture, language and rich ceremonial life contributes to well-being and balance of mind, body and spirit and is now part of the treatment options for First Nations, Inuit, and Métis patients.

In 2021, the RWG published the Truth & Reconciliation Action Plan containing 14 goals to foster a culturally safe work environment for CAMH staff and culturally safe services for patients and families, while

being publicly accountable for progress. That same year, the RWG was named a Leading Practice by the Health Standards Organization , an award that recognizes “an innovative, people-centred, evidenceinformed practice” that has “demonstrated a positive change related to safe and reliable care/service, accessible and appropriate care/service, and/or integrated care/service.”

Today, the RWG has 33 members from across CAMH and 367 staff members have signed a Pledge to Reconciliation to engage in learning, healing, and actionoriented endeavours. The RWG has been instrumental in many initiatives including the development of CAMH’s land acknowledgement guide and organizing various events to educate health care workers and the public about First Nations, Inuit, and Métis culture, history and healing.

In conversation with Laura Stanley (Communications Coordinator, Shkaabe Makwa), Diane discusses the evolution of the RWG and its impact on CAMH and beyond.

Laura Stanley: How has the Reconciliation Working Group evolved since its formation in 2017?

Diane Longboat: In December of 2017, I convened the very first meeting of the Reconciliation Working Group with five health leaders from inside CAMH and our conversations just took off from there. We decided to meet monthly since there was such an incredible need for opportunities to learn and to share together. Very few people had taken any kind of Indigenous

Sacred medicines in a Ceremony Room, 60 White Squirrel Way (CAMH)

history course, knew the Indigenous determinants of health, or had any knowledge of traditional healing, and its role in maintaining health and well-being. Few people understood that genocide was a direct result of colonization and that the intergenerational and historical impacts of genocide are still present in our DNA and they’re also present in all systems that purport to serve First Nations, Inuit, and Métis Nations within what is called Canada today. The first three years of function for the Reconciliation Working Group was purposefully laying a foundation for a knowledge base from ground zero and offering our colleagues the opportunity to learn together with Indigenous colleagues as a critical piece of our strategy.

It was in year three that we started to look at how we embed reconciliation into the system of CAMH in a way that our colleagues can, first of all, embrace it as their work and second of all, build on what we have laid down as the foundation. So that’s

where the Reconciliation Action Plan was born. Many people think that I wrote it, or a group of people within the Reconciliation Working Group wrote it but the truth is that Alexandra Wilkinson, who was a member of the RWG and non-Indigenous, was the architect of that Reconciliation Action Plan. She saw from her position in Public Affairs what could be possible in terms of embedding reconciliation within the organization. She developed the first draft of the Action Plan and we build it out to strengthen our position within the organization for a voice and place for First Nations, Inuit, and Métis mental health and addiction needs. I think that’s one of the beautiful things about the Reconciliation Working Group - it’s an invitation to all of our colleagues to join us in this work. Our membership is absolutely open to everybody and we welcome people from all areas of the organization. It’s been an amazing experience for me to witness how people work together for a common goal and it’s given me a lot of inspiration personally in my

Kahontakwas Diane Longboat at the opening of the CAMH Ceremony Grounds (2016) Every Child Matters flag raising ceremony on

life. I do believe that CAMH is a community, I believe that it has a very special culture, and I think with the Reconciliation Working Group, we are building a family within that community, and it’s very heartening to see that.

LS: What is some of the work that the Reconciliation Working Group has been involved in that you’re most proud of?

DL: I think Public Affairs really needs to be lifted up because they stand with us for all of our events, they do all of the event management. We’ve had a chance to work with many people in Public Affairs and that’s been very inspiring for me to meet more people who are willing to advance reconciliation at the organization. Sam Karami, Alexia Henriques, Kayan Yassine, Miguel Amante, Hayley Clark, Carley Lennox and so many others come to mind. The other organizational piece that I’m really proud of is our work with three policy committees.

Marika Bishop [Manager of Policy

Development and Special Projects] is the gateway to those policy committees and she’s spent so much time with me personally and the staff that I work with to introduce us to the world of policy at CAMH with its scheduling cycle for policy review, committee structures, and mandates along with the quality assurance and professional practice groups. She walks along with us in the policy process so that we can apply a lens of cultural safety, of anti-Indigenous

and Reconciliation (2022)

“It’s been an amazing experience for me to witness how people work together for a common goal and it’s given me a lot of inspiration personally in my life.”

Yo-Yo Ma and Kahontakwas Diane Longboat at the launch of the Art of Healing (2022)

racism, and reconciliation to the policies and practices that we have at CAMH.

I’m also proud of Indigenous cultural safety training opportunities that are available this year for the first time in greater numbers. We have 500 seats for San’yas’ Core Mental Health Training for our colleagues and physicians. It’s been really inspiring to see our colleagues say to us, “I took the Core Mental Health Training last year, I have added the knowledge to my skill level of core competencies and to my understanding of the clinical needs of First Nations, Inuit, and Métis in the system and I want to do a little bit more work in and around anti-racism.” So many of them have signed-on to Bystander to Ally online course which is another course that takes you into the realm of antiIndigenous racism in the healthcare setting.

LS: The Reconciliation Working Group will publish the 2022-2023 edition of the group’s annual report this month. Have any narratives emerged in the report?

DL: The narrative that I think is emerging is inspiration. People have expressed how much they have experienced personal change and growth as a result of being part of our learning activities and making the Pledge to Reconciliation. I think that pledge has gone a long, long way. We have 373 signatures from our staff who are committed to engaging in their own personal learning journey.

The other narrative is one of healing. Many, many people are engaged in healing. Healing on a personal level, whether that’s counselling, spending time with Elders, making a point of becoming friends with Indigenous peoples, attending events in Indigenous communities, and really healing from bias and old myths that no longer serve us. Many of our staff are healing into a very positive view of the contributions that Indigenous people have made to this country and the world. Staff have also taken action to bring their learnings into their clinical practice and into their family life. They’ve brought their families across a barrier. That barrier has been one of hesitation: “If I go to this Indigenous event, will I be welcomed?” “Can I attend this pow wow? Is it only for Indigenous people?”

“What if I make a mistake in a meeting, or use the wrong terminology or write the wrong terminology?” So people have crossed a barrier of self-doubt and hesitation and they’ve gained the confidence to embrace

“They’re no longer hesitant to make mistakes because they know that what’s lying ahead for them is a gift. That gift is one of respect, learning, and the ability to take action and to bring change into the world.”

Indigenous people and Indigenous worldviews. They’re no longer hesitant to make mistakes because they know that what’s lying ahead for them is a gift. That gift is one of respect, learning, and the ability to take action and to bring change into the world. True change starts with one individual and many have brought that knowledge into their families, which makes me really happy.

LS: What have been some of the other initiatives that you’ve been involved in that reflect reconciliation at CAMH?

DL: One of the things I’m really proud of is working with CAMH’s facilities and redevelopment group for the past couple of years. They’re overseeing the construction of new buildings, including the Secure Care & Recovery building and the new Research building, so I’ve been able to look at the plans of those buildings with our colleagues and ensure that there’s an Elders office and a Ceremony Room. We like to be close to Spiritual Care and they are our neighbours! There’s a kitchen that’s on site too so that we can prepare our offerings for ceremony and feast food. There’s medicine planters on the some of the outdoor balconies and there’s a sacred fire area for families to gather outside. Therapeutic art installations inside the buildings and outside in the green space create a welcoming healing message. We have had influence on the next generation

of the buildings that are coming up here at CAMH and it’s been a privilege for me to work with the facilities folks and to learn from them.

LEARN MORE Reconciliation at CAMH

CAMH Truth and Reconciliation Action Plan 2021-2024: Mid-way update

Laura Stanley is a Communications Coordinator with Shkaabe Makwa. She has a Master’s degree in Canadian & Indigenous Studies from Trent University. Laura spends a lot of her time knitting, crying about the Toronto Raptors, and reading books. She is a settler based in Tkaronto (Toronto).

CAMH’s Critical Care and Crisis Building | Installation: “All My Relations,” Rebecca Baird

Fall Learning Series:

Last fall, Shkaabe Makwa’s Workforce Development team hosted their annual virtual Fall Learning Series. The theme was Stories of Indigenous Resiliency and Healing and included insightful and moving presentations from Dr. Leona Makokis (“Calling Our Spirits Back: Finding Lost Voices in Circles of Trust”), Dr. Jennifer Wemigwans (“Digital Bundles in Healthcare”), and Dale Kuehl (“Suicide Risk Assessment in Clinical and Community Practice”).

If you missed any of these great talks, you can watch them here . We’ll announce details about the 2023 Fall Learning Series

soon so be sure to follow us on Facebook and sign-up for our newsletter to stay up to date!

The Art of Healing:

CAMH and the Toronto Symphony Orchestra (TSO) have partnered for The Art of Healing, an exciting new program that supports First Nations, Inuit, and Métis patients at CAMH. Métis composer Ian Cusson and members of the TSO worked with First Nations, Inuit, and Métis patients to support their healing through musical storytelling and composition, co-creating an original piece of music that the TSO will premier during their 2023/24 season. Click here to learn more

about the program and the special event celebrating the partnership featuring acclaimed cellist Yo-Yo Ma and Tobique First Nation performer and composer Jeremy Dutcher. To listen to Shkaabe Makwa’s Senior Director, Dr. Renee Linklater’s interview with Classical FM about The Art of Healing, click here . To hear a sample of the collaborative piece and read about the program’s impact, click here (via CBC).

Toronto Community Crisis Service Report:

In March 2022, the City of Toronto, in partnership with Toronto Police Service, Findhelp 211, and four community-based partners (Gerstein Crisis Centre, TAIBU Community Health Centre, Canadian Mental Health Association – Toronto, and 2-Spirited People of the 1st Nations) launched the Toronto Community Crisis Service , a Toronto-wide, non-policeled, alternative crisis response service. Shkaabe Makwa Manager, Evaluation and Performance Measurement, Yara Janes, alongside members of CAMH’s Provincial System Support Program (PSSP) have been leading the evaluation of the program’s

implementation and service delivery processes. Their findings from the first sixth months of the community crisis service are published in a report released earlier this year. Working closely with social service organization 2-Spirited People of the 1st Nations (2-Spirits) , Yara co-created the development of an Indigenous Evaluation Framework with program staff, partners, and 2-Spirits Advisory Group members, to ensure that the evaluation was communitydriven, and grounded in local context and Indigenous worldviews. To read the full report, click here .

Embracing Beautiful Differences:

Insights from the 2023 Gathering on Indigeneity, Neurodevelopmental Disabilities, & Mental Health

On May 11th and 12th at CAMH’s Queen Street campus, Elders, Knowledge Keepers, individuals with lived experience, caregivers, professionals, and researchers gathered to explore the intersection of Indigenous culture and neurodevelopmental disability at the first ever Gathering on Indigeneity, Neurodevelopmental Disabilities and Mental Health.

Gathering on Indigeneity, Neurodevelopmental Disabilities and Mental Health participants (2023)

Yo-Yo Ma and Jeremy Dutcher perform at CAMH (2022)

Over two days, attendees from Ontario, Saskatchewan, Alberta, and British Columbia shared their experiences, initiatives, and goals while touching on important themes, including the celebration of differences, the spiritual view of neurodevelopmental disabilities, and the integration of cultural elements in promoting wholistic wellbeing. Gathering on Indigeneity, Neurodevelopmental Disabilities and Mental Health centered the voices of Indigenous people living with neurodevelopmental disabilities, who were active participants, panel members, and presenters across both days. Visual artist Dakota Brant was on hand as a visual note-taker, summarizing the conversation topics in a beautiful graphic record. The gathering served as a platform for knowledge mobilization and underscored the pressing need for culturally sensitive and accessible services that honour the beautiful differences of Indigenous people living with neurodevelopmental disabilities.

In the coming months, a report will be published on the knowledge shared at the gathering with a focus on concrete calls to action that might enhance the lives of Indigenous peoples with neurodevelopmental differences.

For more information on Gathering on Indigeneity, Neurodevelopmental Disabilities and Mental Health, contact Dr. Kendra Thomson (Principal Investigator, Brock University/Azrieli Adult Neurodevelopmental Centre) or Louis Busch (Principal Knowledge User, Shkaabe Makwa).

This gathering was the result of a partnership between Brock University, CAMH’s Shkaabe Makwa, and the Azrieli Adult Neurodevelopmental Centre and made possible by a Canadian Institutes of Health Research (CIHR) Planning and Dissemination Grant.

Graphic Recording by Dakota Brant

Online | 12:00 PM - 1:00 PM EST

Join us for a special virtual event with Dr. Renee Linklater, Senior Director, Shkaabe Makwa, and author of Decolonizing Trauma Work. This event will be moderated by Dr. Amy Gajaria, Clinician Scientist, Margaret and Wallace McCain Centre for Child. The event will include a conversation with Renee about the book followed by a live Q&A.

Thunder Bay | 9:30 AM - 4:00 PM EST

Explore the principles of motivational interviewing, gain practical strategies to build and maintain motivation for change, learn effective techniques for identifying and address ambivalence, and acquire a deeper understanding of strategic tools beneficial for brief interventions.

Intended Audience: Ontario-based Indigenous helpers and workers who provide direct service to First Nations, Inuit, and/or

Métis peoples. Participants should engage in some form of counselling, guidance/ mentorship or support of community members within the role.

19 JULY

WELLNESS: BUILDING SKILLS FOR SELF-CARE

Online | 1:30 PM - 4:30 PM EST

This 3-hour virtual workshop will explore helper wellness in the context of working with Indigenous communities. Workshop participants will be able to: Recognize the signs of vicarious trauma, compassion fatigue, and burnout in yourself as a helper. Identify individual and shared values and effective strategies for nurturing healthy relationships at work and home. Apply mindfulness skills to support coping with the stressors associated with helping work. Build a plan to support wholistic well-being and to balance work/life responsibilities.

Intended Audience: First Nations, Inuit, Métis mental health professionals and community helpers in Ontario.

INTRODUCTION TO MOTIVATIONAL INTERVIEWING 14

Online | 9:30 AM - 4:00 PM EST

Explore the principles of motivational interviewing, gain practical strategies to build and maintain motivation for change, learn effective techniques for identifying and address ambivalence, and acquire a deeper understanding of strategic tools beneficial for brief interventions.

Intended Audience: Ontario-based Indigenous helpers and workers who provide direct service to First Nations, Inuit, and/or Métis peoples. Participants should engage in some form of counselling, guidance/ mentorship or support of community members within the role.

Indigenous Perspectives of Disability: A Primer on Fetal Alcohol Spectrum Disorder

Pivoting Towards the Good Life: Braiding Indigenous Wisdom with Acceptance and Commitment Therapy for Indigenous Helpers

Beautiful Difference: A Primer on Intellectual and Developmental Disabilities for Indigenous Helpers

Trauma-Informed Care for Helpers who Support First Nations, Inuit and Métis People

SIGN-UP FOR OUR MAILING LIST TO RECEIVE TRAINING REGISTRATION UPDATES!

COMING SOON:

Education Specialist

Evaluator (3 positions)

Manager, Workforce Development

Project Lead, System Initiatives

Project Lead, Provincial Indigenous Clinical Advisory Table

Research Coordinator

Join the dynamic Shkaabe Makwa team

Health Equity and Inclusion Framework for Education and Training

Recognized as a leading practice by the Health Standards Organization

Promotes learning environments and experiences that respect learner diversity

Integrates equity and inclusion in the planning, development and implementation of educational and training initiatives

Recognizes health inequities and considers the needs of vulnerable and marginalized populations

INTENDED AUDIENCE:

Learning environments and experiences should respect, relate to and reflect learners

Anyone involved in the design, development, and/or delivery of training and educational curricula for health professionals.

Applicable to online, blended, and classroom training.

We asked Shkaabe Makwa staff what they have been reading, listening to, and watching. This issue includes everything from our cover illustrator’s psychedelic rock band to a book on how Indigenous thinking can save the world.

#INDIGENOUS CONTENT CREATORS

After work I like to relax by scrolling through TikTok and watching the newest content by Indigenous creators. With many content creators working to dismantle anti-Indigenous racism, online spaces like TikTok make room for Indigenous voices and stories, creating a place where you can learn, laugh, cry and connect to other Indigenous peeps and allies. There are so many beautiful TikTok creators to mention including @Indigenous_ baddie (Michelle Chun, Swampy Cree) and @shinanova (Shina Nova, Inuk). Take a moment to search “Indigenous” and find some of these wonderful humans.

Remember though, you are what the algorithm gives you. The more you click on positive, educational, videos the more that content will be brought to you. Do the opposite and well, you may become overwhelmed with the negative.

Heidi Maracle (Implementation Specialist)

WAMPUMS - RAINBOW BEAM

When twins Chris and Greg Mitchell (Shkaabe Makwa Magazine illustrator) are not busy with their creative studio (Born in the North LTD. ), the Toronto-based duo make psychedelic garage-rock as Wampums. The Mitchell brothers describe their music as “the new age sound of spiritual enrichment” and, like in their visual arts practice, they draw from their Mi’kmaq heritage. Rainbow Beam , one of the two EPs they’ve released so far this year, is a prismatic collection of dreamy sounding lo-fi songs that would pair perfectly with a long weekend in the summer.

Laura Stanley (Communications Coordinator)

SAND TALK: HOW INDIGENOUS THINKING CAN SAVE THE WORLD

In his sharply written and witty book Sand Talk: How Indigenous Thinking Can Save the World , Tyson Yunkaporta (member of the Apalech Clan in Far North Queensland, Australia and academic, arts critic, researcher) brings an Indigenous perspective to historical and cultural issues and offers a new template for living. Narrated by Tyson, the audiobook version of Sand Talk amplifies the book’s playful tone making for a fantastic listen.

Laura Thibeault (Director of Wellness Innovation)

INDIGENOUS INSIGHTS: AN EVALUATION PODCAST

Hosted by Dr. Gladys Rowe (a Swampy Cree scholar and member of Fox Lake Cree Nation in Northern Manitoba), Indigenous Insights is a research and evaluation podcast that centres Indigenous knowledge and perspectives. Although I have really enjoyed all of the podcast episodes so far, episode three stands out for me the most. Gladys is joined by Dr. Michael Hart, a citizen of Fisher River Cree Nation in Manitoba and the vice-provost (Indigenous engagement) at the University of Calgary.

They discuss how the world of evaluation currently depends on funders, governments, and legislations and the importance of looking at power differentials in Indigenous evaluation: is it truly by, for, and with Indigenous people/communities/ nations? Through Cree teachings that were shared with him, Michael spoke about how important it is for those involved in Indigenous evaluation to understand who they are and where they come from in order to understand where they are going. He highlights how this approach greatly differs from a goal oriented method often found in mainstream or western practice. I am not an evaluator, but these same teachings of knowing who I am, and where I come from also helps to guide me where I am going including in the work I do as a helper.

Chrysta Wood (Community Support Specialist)

WOLF SAGA – WOLF SAGA

Wolf Saga is the electropop alter ego of Toronto-based musician Johnny Saga who released his self-titled debut LP in 2020. Featuring eight songs that blend pop sensibilities with lyrical themes of politics and injustice, Wolf Saga’s music is characterized by illusive synths and is heavily influenced by a blend of 80s pop and electroclash sounds. The contrast between the euphoric beats and socially conscious lyrics brings attention to important issues including Indigenous reparations and Black Lives Matter, inviting reflection and awareness among listeners of all backgrounds.

Olivia Keast (Education Specialist)

SHAME & GUILT, MASTERS OF DISGUISE

Shame & Guilt, Masters of Disguise by Jane MiddeltonMoz (a clinical psychologist, Director of the MiddeltonMoz Institute, and an assistant professor at the University of Toronto) provides readers with an excellent understanding of how feelings of shame and guilt can affect people’s lives from childhood into adulthood. She outlines how shame and guilt is transferred from parent to child (multi-generational trauma) and gives readers ways to understand and address shame, guilt, and trauma. Shame & Guilt is a great read for those willing to dig deep to find your true self.

Cora-Lee Simon (Manager, Operations)

IN CONVERSATION WITH...

Olivia Keast: What lead you to working with CAMH?

Meet Ron Linklater, a dedicated Knowledge Keeper who provides invaluable guidance, support, and advisory services for a variety of Workforce Development trainings at Shkaabe Makwa. Ron holds a Bachelor of Arts degree and a Certificate in Native Counselling from Lakehead University and has over 40 years of work experience in training, supporting addiction service providers, and counselling. Based in Thunder Bay, Ron currently serves as the chair of the Mikaaming Mino Pimatiziwin Healing Lodge (Sakgeeng First Nation) and is a member of the Lakehead University Elders Council.

In conversation with Olivia Keast (Education Specialist with Shkaabe Makwa), Ron reflects on his career in the addiction and mental health field and his role in contributing to the development, enhancement, and execution of the culturally relevant curriculums offered by Shkaabe Makwa.

Ron Linklater: I have a long history in the addictions field, particularly in the NNADAP [National Native Alcohol and Drug Abuse Program] community. I started as a worker in the National Native Alcohol Abuse Program in Geraldton, Ontario. I had this strong purpose in life by the 1980s and committed myself to help those struggling with drug and alcohol use. I was only 19 years old and I got hired to be a NNAAP student worker at the Geraldton Friendship Center by a NNAAP counsellor who is now an Elder. I credit him and another Indigenous man here in Thunder Bay for literally picking me up when I was down in my teenage years. I was suffering from the psychological conditions that permeate our people and I was into using alcohol, cannabis and other mood-altering drugs. I was getting really depressed and these two guys sensed that when they saw me, and they befriended me. There was something about them that was different than my other group of friends. My other group was the using group, but these two men would not participate in using mood altering substances. That was strange to me. I thought everybody did that. But in hindsight, they were already walking, as our people call it, the Red Road. Embracing their life of purpose of helping people and that is how it started.

They got me well physically, mentally, emotionally, and spiritually. I stopped using and stopped drinking. I started hanging around with them almost exclusively, stayed safe with them, and stayed in environments

that supported me, and today we see that as protective factors. So, I started to shed my risk factors and embrace my protective factors. I stopped drinking and drugging in the spring of 1980 and Elder Gene asked me that summer to be a NNAAP worker with him and I jumped at that opportunity. This eventually brought me into a lot of our communities across the province of Ontario then I went to Ottawa where I was hired as a consultant in the NNAAP program. After a while, I started realizing maybe I will bring my knowledge and my commitment back home. I ended up in Winnipeg, Manitoba and started to do consulting work for the provincial government. That work involved helping Indigenous communities, Indigenous organizations and other Indigenous people right in the province of Manitoba. And that’s how CAMH came along.

CAMH is a renowned resource and was offering programming like Gambling Awareness Training, but then the Indigenous workers knew of us Manitoba people who also did Gambling Training and that’s how I got involved and slowly got introduced to CAMH. As I started to work over the years, I did more and more work with CAMH until right before COVID. My wife and I decided to move from Winnipeg, Manitoba, back to Thunder Bay where I am today. I’ve come full circle because I started here as a young boy, got my sobriety here in the city and I carried it for over 43 years. I have 3 granddaughters

now and we are all healthy. I have friends that I left Thunder Bay in 1990s and 80s, and some of them have passed on. But the ones that are here, we have a shared vision that our people need and deserve to live the good life.

OK: What is your relationship with CAMH and Shkaabe Makwa today?

RL: I think the work I do with CAMH and Shkaabe Makwa is bringing Traditional Knowledge to the people that want a relationship with CAMH and the Shkaabe Makwa trainings. As a person with that knowledge, it would not be right be for me to hold onto it. That is one of the beliefs in our worldview, in fact. As we are aging, all these beautiful teachings, tools, instruments,

Ron Linklater begins a training in a good way

“As we are aging, all these beautiful teachings, tools, instruments, stories, songs and prayer can start to be given back in a good way. I used them to help me become who I am, but now I am aging, and I will give those back to our people.”

stories, songs and prayer can start to be given back in a good way. I used them to help me become who I am, but now I am aging, and I will give those back to our people. That is how it works. It is like reciprocity; they will need that. Some people that participate in Shkaabe Makwa training I can see how amazing what they just heard was. Maybe it is something from some other Elders or what someone else said, and they’ll chat about it how it literally tweaks their attitudes almost instantaneously because they see things perhaps how our ancestors would have interpreted things. I think that is the amazing gift we have as we get older. It is like we have a psychology. We know how people will think and they will appreciate it if we ourselves talk in a kind and gentle way. I think sometimes our people crave that. I think back to when I was a young child, I did not have that and perhaps I was in a lifestyle that was the opposite of those values.

Sometimes, we cannot reach our full potential because we are always being blocked by using, by negativity, by unbalanced lifestyles, and so our values get compromised. When I sit amongst the people, I think they sense that history with me, and so, they are ready to accept knowledge in a good way.

training on Acceptance and Commitment Therapy, I was part of the advisory committee, and we met with the founder of this therapy Dr. Steven Hayes. For him to say, “Yes I want to meet these people. I want to thank you, CAMH, Shkaabe Makwa. I’m so honoured.” We were honoured too! [Dr. Hayes and other clinical experts] sat in with the advisory committee on a couple of occasions just to share this amazing Western concept of how to help people with Acceptance and Commitment Therapy and to look at Indigenous nations’ ways of helping ourselves and about healing. We were not saying one was better than the other, but it is almost like they complement each other and that was amazing to see.

OK: What is one thing that you learned throughout the collaboration process with Shkaabe Makwa, as we are all learning from you?

OK: Do you have any favourite moments from your work with Shkaabe Makwa over the last few years?

RL: I like the way the people who work with Shkaabe Makwa they are open minded and they are so helpful to other individuals. For instance, when we were developing a

RL: The way the [training curricula] are developed is very unique because if you look at the original people that resided here, we didn’t have writing like the western settlers. We did have stories and we would tell them in rock etchings and other forms. We could arrange rocks and other objects to tell a story and that is a form of communication and writing for us, but a lot of us have lost the ability to interpret those things. One of the differences now is that we live in a society that is based on writing and being able to read write. But the Anishinaabe people and the Indigenous peoples, we have oral traditions, and I think Shkaabe Makwa does a good job of bringing the two together. I think that is something that we don’t see in

in other venues. For instance, with other [educational institutions], it is more writing focused. But there are other ways to learn, and these other ways of learning are based on our language, ceremonies, what we listen to, our songs and our pipe ceremonies. Shkaabe Makwa wants to incorporate that. I think that is something that we should be proud of. I have never been told I could not talk about certain things. In fact, I am encouraged to talk about it.

OK: What vision do you have for the future?

RL: There’s a beautiful woman I met many, many years ago. I used to watch her movies in 1977 when I was 17 years old in college in Thunder Bay, and her name was Alanis Obomsawin. She is citizen of the Abenaki Nation. She has produced hundreds of films for the National Film Board of Canada. She is 90 years old now. I attended one of her workshops in Winnipeg about ten years ago. The question posed to grandmother Obomsawin was, “are we in the prophecies that were shared by our people? Is this generation coming the ones that will change the world for the good?” And her answer basically was “yes, we are that generation.” She really, truly believes that. We call that the Eighth Fire Prophecy amongst our Anishinabek ceremonies. For her to say that, I left that evening just so full of hope, so happy that that this woman I admired all my life, finally said yes, we are the ones. My little fire lit in 1980, the Spring I sobered up. Now, it is a big bonfire. Other people have been lighting fires, and it is spreading. Fire is sacred to us and see worldview as a

powerful medicine. I think that is what the old one was saying. She saw a lot of little fires in the audience and I think that Earth will heal. Mother Earth will heal, because she is getting sick, and we cannot do that to her. We have to love and practice the ceremonies. She raised us, she brought us into this life as our mother, so we have to do the same thing for her. That is part of our role as human beings, is to remind the other two legged that there is this balanced way of living too. We should try to think of it like that. So that is what I do, we call this Mino Bimadiziwin - a good life.

Olivia Keast is a Marten Clan member of Hiawatha First Nation with English and Scottish relations. She is an Education Specialist with Shkaabe Makwa. Olivia aims to uplift and empower Indigenous peoples and promote a more wholistic health care system by providing culturally informed mental health and addiction training resources for First Nations, Inuit, and Métis direct service providers.

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KAITLYN GILHAM

CREATING RIPPLES THROUGH RELATIONSHIPS: ENGAGING INDIGENOUS YOUTH

Supported by the Provincial System Support Program (PSSP) at CAMH and the Ontario Centre of Excellence for Child and Youth Mental Health , Youth Wellness Hubs Ontario (YWHO) provides low-barrier access for young people (age 12 – 25 years old) seeking mental health and substance use support, primary care, social services, and more. Since forming in 2017, YWHO has grown to a network of 22 hubs that provide integrated services co-designed with youth for youth in communities across the province.

In 2021, YWHO, Indspire (an Indigenous national charity that invests in the education of First Nations, Inuit and Métis), and Shkaabe Makwa began collaborating with an advisory circle of Indigenous youth and an Elder to develop a series of resources for Indigenous youth that address substance use and harm reduction. In conversation with Krystine Abel (Manger, Implementation with Shkaabe Makwa), Kaitlyn Gilham (an Implementation Specialist with Youth

Wellness Hubs Ontario (YWHO) Provincial Office) details the collaborative approach to develop these resources, and the importance of Indigenous youth engagement. As Gilham explains, “We need to include as many perspectives as we can to make sure that services meet the needs of everyone accessing them.”

Krystine Abel: Tell me about yourself and your role with Youth Wellness Hubs Ontario (YWHO).

Kaitlyn Gilham: I am an Implementation Specialist in the YWHO Provincial Office, and the primary focus of my work is on Indigenous inclusion, engagement and health equity initiatives, such as the development of trainings, tools and resources. I also lead engagement with Indigenous youth and family members, Elders and Knowledge Keepers as key decision makers, and supporting local partnerships among hubs and Indigenousled organizations and communities.

KA: Tell me more about how Youth Wellness Hubs Ontario got involved with Indspire and Shkaabe Makwa?

KG: One of Indspire’s programs, called Rivers to Success, has a community of over 2000 First Nations, Inuit and Métis students, and provides tools, resources, mentorship and events to support Indigenous postsecondary students. The program exists to guide students through successful studies and education. The partnership with Indspire began with the Margaret and Wallace McCain Centre for Child Youth and Family Mental Health at CAMH, where the team collaborated and created the first round of Indigenous mental health resources by youth for youth in 2020. Then, in 2021 Indspire received funding that provided an opportunity to expand their reach with Indigenous youth and Indigenousfocused organizations across the country to create additional events and resources. Given YWHO’s youth focus and existing collaborative relationship with Shkaabe Makwa, it was a natural partnership.

KA: Can you tell me more about Indspire and the resources that were created?

KG: Indspire reaches youth from across the country from an enormous diversity of backgrounds and life experiences, and they decided to develop resources to support this. We need to include as many perspectives as we can in creating the resources or it’s not going to work. As a result, an advisory comprised of Indigenous youth and an Elder were central to the development of the resources. We started

by brainstorming as a group and talked about gaps they saw in conversations about wellness, mental health, and substance use, and listened to what resources would be helpful.

The group landed on resources that would address substance use and harm reduction. It was something that came up a lot and people were really passionate about.

We created two tip sheets (Supporting Our Well-being: Tips for a Balanced Life and Walking a Safe Path: Tools and Tips for Safer Substance Use ), an infographic (Many Directions, One Self: How Substance Use Can Impact Your Wellbeing ), and an animated video (Connection Carries Power: Montana’s Story ). We also hosted a virtual event with subject matter experts on Substance Use and Harm Reduction, specifically within the context of Indigenous mental health.

After the success of the 2021 resources, we brought the advisory together again to brainstorm for new resource topics and the group landed on healthy relationships.

Illustration provided by YWHO

We discussed what healthy relationships look like, building them, creating boundaries, the effects of colonization and how that impacts relationships in Indigenous communities, and more. We worked with a creative company to bring the youth perspectives on healthy relationships to life through new resources, which was also a truly collaborative process.

should be its own video, called Connection Carries Power: Montana’s Story. In the video, a youth advisor on our team, Montana, speaks candidly and beautifully about her experience with substance use and the importance of harm reduction and community in recovery. It was powerful because this resource was personal, youthled, and built from the ground up.

KA: What a gift to see the vision and needs of Indigenous youth come to life through the development of these resources. Was there a resource that had made an impact on you?

KG: Last year, we continued to work on an animated video that was from the previous year’s harm reduction resources. We had videos from community members discussing the importance of harm reduction, and what Indigenous mental health looks like. There was one story in particular that we thought

KA: Can you expand more on what that impact looks like, individually and collectively, in terms of community impact?

KG: It really creates like a ripple effect, right? We need to have meaningful engagement and good relationship building practices when we’re working with Indigenous youth. We’ve seen youth advisors who have worked with us over the years and start become involved in more opportunities in the mental health and substance use field, and have

Illustration provided by YWHO

turned into really confident leaders as a result. It’s amazing to see them grow into their gifts, and we’re grateful because we get to continue to work with these absolutely brilliant people. Then again, when we are able to create these sustainable andmeaningful relationships, and people enjoy being part of this group, they pull in more people from their own communities and networks. That’s another benefit for all because we get to work with more perspectives, and they get the opportunity to share their experiences and learn from other folks in the network. I really see it as a ripple of benefit for everybody when we make real, meaningful, reciprocal engagement a priority.

HOW TO MEANINGFULLY ENGAGE AND WORK WITH INDIGENOUS YOUTH

Kaitlyn Gilham

FOCUS ON CO-CREATION

Ensure that youth decide what the needs are and how to meet them, and that they are equal decision makers in the process. This gives them the opportunity to be more creative and involved, which creates better outcomes for everyone.

CREATE TIME TO BUILD RELATIONSHIPS

LEARN MORE Indspire Rivers to Success

Rivers to Success resources

Youth Wellness Hubs Ontario

Krystine Abel (kwe/she/her) is Anishinaabekwe and a member of M’Chigeeng First Nation. Krystine is the Manger, Implementation with Shkaabe Makwa.

Kaitlyn Gilham (she/her) is Métis (Georgian Bay) and Ukrainian. Kaitlyn is an Implementation Specialist with Youth Wellness Hubs Ontario (YWHO) Provincial Office.

Connect with folks you are working with, both in and outside of regular meetings. We ask youth, family members, Elders, and Knowledge Keepers to talk about personal experiences so trust is really important. If you don’t take that time to build relationships, people will feel uncomfortable or unsafe and will not share.

SUPPORT PEOPLE YOU’RE WORKING WITH

Reflect on what you’re doing outside of meetings to support the well-being of Indigenous youth, family members, Elders, and Knowledge

Keepers. Find and share personal, professional, and cultural growth opportunities and ensure that mental health resources are readily accessible. Honour people’s time by providing honoraria and gifts.

Although there is a lot of mental health research on Indigenous Peoples, there is surprisingly little evidence of the effectiveness of even the most robustly researched psychotherapeutic interventions when applied within Indigenous populations. But why? It may be that treatments that are deemed “evidence-based” (i.e., those that have been validated by randomized control trials, systematic reviews, and meta-analyses) are insensitive to cultural context or contain assumptions which are incongruent with the values of Indigenous

CONSTRUCTING A CULTURALLY-ADAPTED ACCEPTANCE AND COMMITMENT FOR FIRST NATIONS, INUIT,

In the spring of 2020, Shkaabe team set out to construct a training from the strengths of Acceptance reflecting the fundamental values Almost 1000 registrants later, Pivoting Indigenous Wisdom with Acceptance Indigenous Helpers has become one

BY LOUIS

Peoples. In his research on psychotherapy across cultures at McGill University, Dennis Wendt and colleagues argued that Westernbased psychotherapies may be inherently ethnocentric and subtly assimilative, while posing a risk of harm to culturally diverse populations.

The lack of research on psychotherapeutic interventions with Indigenous Peoples may also be a result of psychological researchers’ focus disproportionately on the description of certain issues (e.g., substance use) to the

Illustration: Tsista Kennedy

CULTURALLY-ADAPTED TRAINING ON COMMITMENT THERAPY INUIT, AND MÉTIS HELPERS

confidence and trust in practitioners, and drop-out of treatment at a much higher rate then the general population.

Through my interactions with both sides of Canada’s mental health system over the last two decades, I have become keenly aware of the limitations of its pathology model of mental disorder; especially when it comes to caring for the wellness of Indigenous Peoples. In my role as a Community Support Specialist on Shkaabe Makwa’s Workforce Development team, I have been given the great privilege of building relationships with Elders and helpers to gather knowledge that can be given back to the community in the form of culturally-relevant mental health trainings. The challenge of how to build a truly integrative program that went beyond surface-level adaptations and reflected the fundamental values of Indigenous helping work (relationality, wholism, contextualism, spirituality, etc.) was at the forefront of our minds while developing Pivoting Towards the Good Life, a five full-day culturally-adapted training for Indigenous helpers.

exclusion of outcome-based research on various treatments. Certainly, the lack of consistent funding for culturally-safe mental health services also makes it difficult to evaluate the short- and long-term effectiveness of any treatments that may show promise.

Whatever the case may be, it is clear that when Indigenous people do make use of mainstream mental health services, they experience considerable barriers, contend with bias and discrimination, have low

Shkaabe Makwa’s Workforce Development training curriculum that would draw Acceptance and Commitment Therapy while values of Indigenous helping work. Pivoting Towards the Good Life: Braiding Acceptance and Commitment Therapy for one of our most celebrated trainings.

When engaging with helpers from across the province to determine what they saw as training priorities for their agencies and communities, Workforce Development received a number of requests for training in culturally-adapted therapies.

In the spring of 2020, with the support of a dedicated team and strong leadership, we set out to construct a new training. In the past, community members responded favourable to training in Acceptance and

(tobacco) to Elders and Knowledge Keepers known for their wisdom on helping and healing work. We sought out people recognized by their communities for their gifts in teaching, healing and helping work. We were grateful to receive advisory support from Gloria Oshkabewisens-McGregor, Isaac Murdoch, Josh Eshkawkogan, Len Pierre, Pearl Gabona, Renée Thomas-Hill, Ron Linklater, and Vivian Recollet.

Over the next 10 months, we met virtually

Commitment Therapy (ACT), an actionoriented approach to psychotherapy. We also had some in-house expertise on the approach so we decided to start there. But we wanted it to be more than a workshop on another mainstream treatment modality with surface-level adaptations.

Luckily, there are protocols for seeking knowledge and support for complex problems. So, we started the way many knowledge gathering journeys start, by making an offering of asemaa/cistimaw

(at the height of the pandemic) with each of the Knowledge Keepers on many occasions to ask questions and receive teachings about what it means to be well, the nature and source of human suffering, the processes involved in helping and healing, the role of thought and language, and the importance of balance, spirit, and ceremony. Next, we asked the Knowledge Keepers for their perspectives on the six core concepts of ACT: acceptance, defusion, present moment awareness, self-as-context, committed action, and values. This work resulted in

The Good Life | Illustration: Tsista Kennedy

more than 50 hours of video interviews. This knowledge gathering phase was an incredible experience that I will be forever grateful for. There are teachings that I think of often, such as Ron’s reminder that the Anishinaabemowin word for tongue (de’nan) contains the word for heart (de’) or Isaac’s suggestion to put a pebble in your shoe when lost in the bush, or Vivian’s teachings on the flexible movement of water.

healing and helping journeys, and on some of the concepts discussed by the Knowledge Keepers.

Through this dialogue we observed and discussed the perspectives unique to ACT and an Indigenous wellness model and learned about the many points of correspondence, such as the importance of having a sense of self that is a connected to the world rather than separate from it. During one of our meetings, Dr. Hayes acknowledged that “the science of ACT has arrived at places that the ancient wisdom traditions have been at all along.” I will remember this as a great act of humility on his part.

While we learned from the Knowledge Keepers, we also engaged clinical experts from the ACT world to explore the intersections of ACT and Indigenous helping wisdom. We were honoured to have the creator of ACT, Dr. Steven Hayes, as one of the clinical advisors in this process. Additionally, we received invaluable support from seasoned clinicians Lesley Barreira, Benjamin Schoendorff, and Dr. Wanda Smith. We were able to bring the two groups together on two occasions for an open and organic discussion on our

In the fall of 2020 we started to build a curriculum around ACT’s core concepts while centering the teachings of the Knowledge Keepers. Specifically, the teachings that emphasize balance, interconnectivity, and a wholistic view of body, mind, heart, and spirit. The teachings of the Medicine Wheel and the foundational concept of Mino-Bimaadiziwin (meaning “living the good life” in Anishinaabemowin), amongst others, were referenced frequently by the Knowledge Keepers.

As the curriculum began to take form, we included video clips of Knowledge Keepers sharing teachings and ensured that learners would have opportunities to have in-depth discussions about the teachings, and the metaphors and narratives used by the Knowledge Keepers. We also incorporated frequent experiential activities, and repeated hands-on role plays of ACTinformed relational dialogue. This approach was important, as we had often heard community members say that they wanted skills and activities that they could take back and use in their helping work.

Shkaabe Makwa launched Pivoting Towards the Good Life in January of 2021. Since then, 1000 First Nations, Inuit, and Métis helpers have registered for the course. The development of this curriculum has been a great learning experience and it continues to be as we review and revise its content. The work to develop the training strengthened new and old relationships with Knowledge Keepers and consultants and has allowed us to connect with helpers across the province. Through integrating Indigenous values and perspectives on wellness with Acceptance and Commitment Therapy, Pivoting Towards the Good Life is a unique and innovative training and our hope is that it serves as a useful tool for the helpers who dedicate their lives to the health and wellness of our communities.

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Pivoting Towards the Good Life and all trainings offered by Shkaabe Makwa

Louis Busch is Bear Clan Member of the Nisichawayasihk Cree Nation and a Community Support Specialist with Shkaabe Makwa at the Centre for Addiction and Mental Health. Louis is a Registered Psychotherapist (qualifying) and Board Certified Behaviour Analyst with 15 years of experience working within the mental health and forensic mental health systems. Louis has a Master’s in Education from the University of Calgary and is currently completing doctoral studies at the University of Toronto.

Pivoting Towards the Good Life Participant

“I've been a social worker for 25 years, only 4 years in a First Nations community.

I realize there is a lot of "unlearning" to do, and I look for every opportunity to learn culturally relevant ways to provide counselling and hope. Thank you SO MUCH (both from myself and my current and future clients) for this amazing experience!”