A program meant to fund care for Indigenous patients is instead failing them by endorsing therapists with spotted histories, critics charge.
By Wendy-Ann Clarke, Declan Keogh and Owen Thompson / Investigative Journalism Bureau and Robert Cribb, Staff Reporter
Toronto Star: Dr. Oren Amitay has posted online an article defending Indian Residential Schools.
The Toronto psychologist has publicly lauded “the facts” of a social media post that claimed reports of Indigenous children’s bodies being buried in unmarked graves were “all a hoax.”
He is also approved by the federal government to provide counselling to vulnerable Indigenous patients.
The Non-Insured Health Benefits (NIHB) program is designed to fund care to First Nations and Inuit people, who face some of the highest rates of suicidality in the world. The federal program is failing those very patients, critics charge, by endorsing therapists with troubling professional and personal histories.
They include counsellors with serious professional disciplinary or criminal record histories for offences including murder, having sex with a former client and abandoning a vulnerable patient who became suicidal as a result, a joint investigation by the Toronto Star, Investigative Journalism Bureau and TVO has found. Amitay has twice faced discipline, including one case where the regulator found problems with a parental capacity assessment he made in a child custody case. In both cases, he was ordered to undergo further training, most recently in June.
“How can NIHB continue to have these people on their list knowing the character of these people are high-risk for harm to First Nations people?” asks Dr. Carol Hopkins, an Indigenous therapist who has worked in addiction and mental health in First Nation communities for more than 20 years.
Asked about the comments, Amitay said he acknowledges the injustices committed against First Nations people in Canada but defends his public criticism of allegations of mass graves. He said he has previously had Indigenous patients, and currently supervises a team of therapists who treat patients in the NIHB but does not himself counsel those patients.
“No mass graves have been discovered,” he said in an interview. “We can acknowledge these horrors (against First Nations people) while also saying that we have to be responsible.”
NIHB-approved therapists include some with troubling histories
The NIHB maintains a list of more than 5,000 licensed mental health care providers who can bill the program directly. NIHB-approved therapists and counsellors are required to be in good standing with a provincial or territorial regulatory college and be practicing under the regulations of their licensing body.
But the federal government’s reliance on provincial regulatory colleges to vet therapists has made eligible those with spotted histories, while simultaneously excluding many experienced Indigenous counsellors who want to serve their communities.
Concerns over Canada’s mental healthcare program for Indigenous people sparked an investigation by the Star, IJB and the Star.
Federal Indigenous Services Canada officials who run the NIHB program declined interview requests.
But in a written statement, they said the program is “not responsible for the licensing and regulation of health professionals,” and that such questions “fall to the respective regulatory body … We invite anyone who has concerns regarding the competence of a health provider to file a complaint with the relevant provincial/territorial regulatory body.”
First Nations mental health practitioners and advocates say passing the responsibility for quality Indigenous mental health care to provincial colleges is indefensible.
“The (provincial regulatory) colleges don’t provide that oversight the way NIHB thinks they do because the colleges don’t have any Indigenization or reconciliation strategies in place,” says Angela Grier, an Indigenous mental health counsellor in Alberta with more than 20 years experience who says she has treated many First Nations clients who suffered negative — even racist — experiences with NIHB therapists.
“There’s not a lot of checks and balances in NIHB.”
Indigenous community’s trust ‘was broken again’
The NIHB mental health program was designed to give Inuit and First Nations people health coverage not provided by the provinces. It is administered by Indigenous Services Canada (ISC) through a contract with U.S. benefits firm Express Scripts. Health Canada awarded this $117-million, five-year contract in 2018 with renewal options up to 11 years.
Provincially licensed therapists apply for NIHB approval by filling out an enrolment form in which they self-report areas of expertise such as residential schools, Missing and Murdered Indigenous Women, addiction and sexual, physical and emotional abuse.
The NIHB profile for Kelley Bird-Naytowhow, a registered social worker, listed crisis intervention, grief and loss as areas of expertise. What it didn’t mention was his criminal record for murder.
In September 2022, he was counselling grieving patients in James Smith Cree Nation following a stabbing massacre that killed 11 people.
A 2022 vigil for the victims of a mass stabbing at James Smith Cree Nation.Heywood Yu / The Canadian Press
A year later, as the community struggled to cope with the lingering impact, Deborah McLean, a band councillor at the time, was sent a news story detailing Bird-Naytowhow’s second degree murder conviction nearly two decades earlier for fatally stabbing a taxi driver in 2001.A 2022 vigil for the victims of a mass stabbing at James Smith Cree Nation.Heywood Yu / The Canadian Press
“We’re already going through enough here. Trust (in the system) was broken again,” she says. “For all we know, there could have been (other therapists approved by NIHB) with abuse backgrounds. She says “it really didn’t sit right” with her to learn that his crime involved a stabbing.
Bird-Naytowhow was released on full parole in 2014, according to parole board records.
Bird-Naytowhow said he is deeply regretful for his crime to which he pleaded guilty and served his time, and that he could have been more proactive in telling members of the James Smith Cree Nation community about his past. He noted that a professional association of social workers says individuals with criminal records may be able to draw on life experiences to help others, “something that I work to do in my practice.” He said he has been open and transparent about his past to his provincial regulatory body, the Saskatchewan Association of Social Workers (SASW).
“As part of my registration, I have always provided vulnerable sector checks and criminal background checks when requested, which highlight my past,” he said. “The SASW is aware of my history through these checks, and the NIHB had every opportunity to be thorough with SASW or by asking directly for either a vulnerable sector check or a criminal background check.”
The written statement from ISC says officials were unaware of any concerns with Bird-Naytowhow and has since suspended his approval to provide service in the community and terminated his NIHB billing privileges.
“We are committed to our continued work together with First Nations and Inuit partners … with the goal of continually improving client access to benefits, including mental health counselling.”
Joe Hestor, executive director of Anishnawbe Health Toronto, a non-profit agency that helps First Nations people access health care services, says a lack of vigilance over mental health care providers amounts to a breach of responsibility.
“It’s unfortunate, but that’s the state of trust in terms of our people with the health system,” he said. “Anything that’s there to assist has really failed. And our people now have an innate fear to go to those medicine chests as were written in the treaties.”
Therapist sought out sex with former patient
There is a growing demand for therapists and access to therapy, especially among underserved Indigenous populations.
That is why Thunder Bay therapist Paul Johnston still has his license after pleading guilty to professional misconduct before a disciplinary panel of the College of Psychologists of Ontario in 2009. He had sex with a former client who said she was sexually abused by her stepfather.
TRUTH AND RECONCILIATION: OPINION
Click on the following link to view the video:
Health care for Indigenous people in Canada is failing. It’s time to give us the power back
The college decision says that after treatment ended, Johnston approached her about having sex with him “as soon as two years had passed … when he should have reasonably believed that she was susceptible to his influence as her former psychologist.”
The disciplinary panel suspended his licence but did not revoke it, in part because doing so would have a negative impact on a community with scarce services in the area.
Johnston still practices psychology in Thunder Bay. As he is a licensee in good standing with his provincial regulator, he is on the federal NIHB list of approved counsellors.
Johnston said in a written statement: “The matter was closed 15 years ago. … I am truthfully dedicated to ensuring the highest quality care and safety for clients.” He said that he has one NIHB patient, a male he has treated for several years.
The relationship between therapist and patient is inherently uneven. The therapist has knowledge and skills the patient defers to, as well as access to some of the patient’s most intimate information.
Social worker Gerlinde Goodwin remains on the NIHB list of approved therapists despite allegedly abusing that power over a client who came to her with mental health issues and a distrust of therapists.
Goodwin, who worked at the Assiginack Family Health Team in Manitowaning, Manitoulin District Ont., where 40 per cent of the population is First Nation, now faces disciplinary allegations from the Ontario College of Social Workers based on a client complaint.
As their relationship grew closer, the client provided Goodwin with cannabis, and the therapist would open up about her own life, college disciplinary documents allege. In some cases “the entire session with [the Client] was spent discussing (Goodwin’s) family circumstances,” the allegations before the college say.
The client’s mental state worsened and Goodwin was aware, the allegations also say.
Goodwin went on an extended vacation and left the already mentally vulnerable client without any counselling. After returning from an eight-week vacation, Goodwin abruptly terminated her relationship with the client through a text message four days before their next scheduled appointment, the client alleged.
The client then attempted to contact Goodwin but never received a response. She finally confronted Goodwin in the parking lot of the clinic and Goodwin allegedly responded by saying, “kind of creepy don’t you think.” This made the client feel suicidal, the records allege.
Goodwin has not yet received any official disciplinary finding from the college. Repeated attempts to reach her were unsuccessful. The NIHB list states her areas of expertise are treating emotional abuse and crisis intervention.
Controversial psychologist has run afoul of his professional regulator
Before Toronto psychologist Amitay drew the ire of Indigenous patients and mental health advocates for his online posts, he ran afoul of his profession’s regulator.
Following complaints about a parenting capacity assessment Amitay conducted in a court case, the College of Psychologists ordered he undergo a remedial program in which he’d routinely check in with a peer mentor.
The college’s disciplinary committee had concluded Amitay’s assessment, particularly around allegations of sexual abuse, was not supported by “adequate and reliable information” and warned him to avoid “the appearance of bias.” He also faced criticism for continuing to conduct further assessments without informing children’s aid societies he had been ordered by the college to be mentored.
Amitay resisted, repeatedly expressing that there was nothing to be gained from such frequent mentorship sessions, which he denounced as punitive “babysitting,” according to an agreed statement of facts. In 2020, he was found guilty of professional misconduct for his “ “disgraceful, dishonourable, or unprofessional” conduct in not complying with the mentorship program.
Amitay faced new allegations of professional misconduct before the college related to “conflicts of interest, appearance of bias, record-keeping, and consent,” according to a June 2024 finding. Although unable to reveal the specifics of the case, Amitay described it as an “exceptional situation.” In June, Amitay agreed to undergo peer coaching.
“I fully accept the college’s findings.”
‘He’s got no business being in mental health’
Beyond his professional disciplinary record, Amitay’s public views on Indigenous issues have angered First Nations’ patients and mental health advocates who reviewed them at the request of reporters.
Following news reports of unmarked graves at former residential schools across Canada, he made a Facebook post acknowledging “horrors” had been perpetrated against Indigenous people. But the post also linked to an article that said “much harm resulted” but also appeared to defend residential schools’ “intent of educating children, assimilating them into the broader Canadian population, and ultimately lifting them out of poverty.”
In May of this year, he urged his followers on social media platform X not to ignore a post he shared saying reports of the bodies of Indigenous children in unmarked graves were “all a hoax” that has created national sympathy for the “fake dead.”
A recently-published federal Independent Special Interlocutor report notes the “well-documented historical reality that thousands of children died and were buried in cemeteries or unmarked graves at Indian Residential Schools, or at other institutions to which they were forcibly transferred.” It also calls out the “small but vocal group of denialists” who “use media and manipulate historical evidence to influence bystanders and sway public opinion.”
Cheyanne Halcrow, a 36-year old from Kapawe’no First Nation in Alberta who suffers from depression and anxiety from the intergenerational trauma of residential schools, calls it unacceptable that therapists holding views like Amitay are approved to serve First Nation clients.
“Fire’ em,” she says. “ You go see those people where these residential schools are. All those babies that didn’t make it home or all the people that lived through the rape and the torment — You tell those people that ‘Oh we were helping you.’ Helping us what?
“As far as I’m concerned he’s got no business trying to help. He’s got no business being in mental health.”
In response to those comments, Amitay, whose areas of expertise on his NIHB profile include trauma-informed care and grief counselling, said: “Anyone who takes umbrage or offence or is hurt by any of these kinds of comments, I can understand that …. They are suffering. They’re going through pain that most people can’t imagine.”
Asked whether NIHB providers treating vulnerable First Nations clients should be held to a higher standard of vetting and training than is provided by self-regulatory colleges, he agreed.
“That makes perfect sense to me because … it’s a very unique population with different needs from others. And you want to make sure that whoever is working with them is sensitive to those needs.”
Many Indigenous counsellors denied NIHB enrolment
Despite a national shortage of culturally sensitive therapists, many experienced Indigenous counsellors are denied NIHB enrolment, the investigation found.
In 2015, ISC delisted counselling and psychotherapy designations in all provinces and territories that do not have a provincially regulated college.
As a result, thousands of counsellors and psychotherapists in Alberta, Manitoba, Saskatchewan, Newfoundland, Yukon, Northwest Territories and Nunavut no longer qualify to become registered providers under NIHB.
Even if clients can afford to pay out of pocket to see those providers, they are typically not eligible for reimbursement through NIHB, despite their specialized training and work in the community.
ISC said that eligibility exceptions can be made at their discretion in situations where the provider has obtained certification from a self-regulatory body and if there is an insufficient number of available providers in a region.
The program would not make an exception for Dee Bremner, who completed a master’s degree in counselling psychology in 2016 with the dream of helping women from First Nations communities in southern Alberta.
With less than a handful of Indigenous therapists in private practice where she is, Bremner says her understanding of Indigenous clients facing intergenerational trauma and loss is being wasted.
“I have a sister who is a murdered Indigenous woman. I have lived. I have done those journeys so I had insight. A non-Indigenous therapist couldn’t do that,” she says. “I really am rare and still, in spite of that, (NIHB) would not make an exception.”
Traditional practices are integral to the mental health healing of many First Nations people. In 2017, ISC entered into separate agreements with some First Nation and Inuit communities to help facilitate traditional services, such as covering the costs of travel for practitioners.
But as traditional healers don’t meet ISC’s criteria as being part of a regulatory college, they cannot bill NIHB as providers for their work.
Dr. Elisa Lacerda-Vandenborn, a professor of psychology at the University of Calgary who specializes in Indigenous studies, says the system pushes patients into Western medicine and eliminates choice.
“What the community wants doesn’t make it onto the list of what is (considered) legitimate (by the government),” she says. “The vetting system for someone to work with the community should be determined by the community.”
The Investigative Journalism Bureau is a non-profit newsroom based at the University of Toronto’s Dalla Lana School of Public Health
With files from Max Loslo and Norma Hilton from the Investigative Journalism Bureau
Robert Cribb is a Toronto-based investigative reporter for the Star. Reach him via email: rcribb@thestar.ca.