Health services aren't meeting needs of Nova Scotia's Mi'kmaw communities, committee hears

Health services are not meeting the needs of Mi'kmaw communities in the province.

That's the message a legislative committee heard Thursday from those trying to design a system that's better suited to the needs of First Nations in Nova Scotia.

"The current mental health and addictions system is not working," said Juliana Julian, health director for the Paqtnkek First Nation. "Mi'kmaw in Nova Scotia need mental health and addictions services and supports that are accessible and available in the community."

That includes services "that are culturally safe and trauma-informed, and include land-based healing, ceremony and language," she said.

Although the focus of the meeting was on mental health care, Julian's colleague Sharon Rudderham went even further in her critique.

"The current health and wellness system is not working for our people and a different approach is needed," said Rudderham, who is the director of health transformation at Tajikeimɨk, the province's new Mi'kmaw health authority.

Rudderham's organization, which is funded by Ottawa and the province, recently signed a memorandum of understanding with the federal and provincial governments to accept responsibility for federal health services.

It's part of a process that will ultimately transform the design and delivery of health services for Mi'kmaq throughout the province.

The health committee heard from nine people, including officials from Nova Scotia Health, IWK Health and the Office of Addictions and Mental Health. All of them agreed on the need to change the system to better serve Mi'kmaw communities.

Rudderham suggested the first step should be to address "anti-Indigenous racism" within the health system.

She said many people refuse to seek help, especially for a mental illness, until they reach the breaking point.

"Mental health needs to move out of emergency rooms," she said. "ERs are not safe spaces for our community members. And then they are discharged back into [the] community, with no transitions in care or service."

'Services need to  come to community'

Instead, the care should be provided in Mi'kmaw communities, according to Rudderham.

Julian echoed that sentiment.

"At the end of the day, services need to come to community because community [members are] already feeling like they are not accepted in those settings so bring them to the setting where they do feel comfortable," she said.

Elaine Allison, health director of the Wagmatcook First Nation, suggested that care should not be provided in a hospital-like setting, nor should it always be delivered in a conventional manner.

"Sometimes we just go for a drive and we talk to the clients," said Allison. 

"We go to Tim Hortons and we have a coffee. Lots of providers will not do that, but we need to do that in our community."

Francine Vezina, the executive director at the Office of Addictions and Mental Health, said what she heard at the meeting was neither a surprise nor was the assessment of the health system wrong.

"It's true, it's not working," she said. "The safety is not there, the trust is not there. Those are things we continue to have to work on."