NationTalk: CAMH’s commitment to truth and reconciliation will continue to evolve following the implementation of this three-year plan, and future work will aim to further dismantle the intransigent oppressive systems that continuously exclude and harm Indigenous peoples.

In May 2021, CAMH launched the CAMH Truth and Reconciliation Action Plan, a three-year plan that includes 14 commitments to build stronger relationships between Indigenous and non-Indigenous people at CAMH by the end of fiscal year 2023/24. CAMH has a legacy as a colonial institution and our hospital is part of a system tainted with racism and oppression. This means that First Nations, Inuit and Métis patients and their families experience barriers to health care and do not have access to the best care we can offer. Systemic racism, conscious and unconscious bias and oppression also harms First Nations, Inuit, and Métis employees at CAMH.

The CAMH Truth and Reconciliation Action Plan invites everyone to take up the work with detailed actions to:

• create a safe work environment for First Nations, Inuit and Métis staff and physicians;
• create an environment where First Nations, Inuit and Métis patients and families feel safe to receive CAMH services; and,
• ensure accountability for meeting targets associated with CAMH’s reconciliation agenda.

The plan was developed by CAMH’s Reconciliation Working Group (RWG) and unanimously endorsed by CAMH’s Board of Trustees and Executive Leadership Team. Over 530 CAMH staff attended the virtual CEO Town Hall to launch the Action Plan led by former President and CEO of CAMH, Dr. Catherine Zahn. Since that time, hundreds of CAMH staff have taken part in learning opportunities and signed the CAMH Pledge to Reconciliation, committing themselves to learn more, engage in personal healing and take meaningful action in furthering truth and reconciliation efforts as civic duty and to increase their professional competency.

Importantly, the CAMH Truth and Reconciliation Action Plan is aligned with the strategic directions from One CAMH. We strive to:

• foster hope through care, innovation and advocacy;
• consider all voices and push ourselves to find those who are missing; and,
• enact positive, tangible and measurable change for our communities.

This work does not rest with only one area of our organization – it requires all leaders, teams and individuals at CAMH to be actively engaged and use their special skills to advance truth and reconciliation.

The plan establishes reconciliation as an organizational priority for which progress is continuously conveyed in quarterly and annual reports. Thank you to the members of CAMH’s RWG for spearheading this important work and to the Elders, First Nations, Inuit and Métis health care leaders and community members who have guided CAMH on its journey to advance truth and reconciliation.

CAMH acknowledges that, although a lot of important work is being done, our shared journey towards truth and reconciliation has just begun. CAMH’s commitment to truth and reconciliation will continue to evolve following the implementation of this three-year plan, and future work will aim to further dismantle the intransigent oppressive systems that continuously exclude and harm Indigenous peoples.

We are happy to report that progress has been made on all 14 action items now that we are at the half-way point of this living document. Click here for a full list of actions

Result 1
Create an environment where all First Nations, Inuit and Métis staff and physicians feel safe at work, and where all CAMH staff and physicians have a clear understanding of how the legacy of colonialism, as well as resiliency, impacts mental health and substance use, and recognize their duty to actively and daily carry out the work of reconciliation (Actions 1.1 to 1.7)
Key Partners: Public Affairs, Education, People & Experience, Shkaabe Makwa, the Executive Leadership Team, Fair & Just Steering Committee.

• The plan was released in May 2021 at a well-attended virtual CEO Town Hall.
• The CAMH Land Acknowledgement
•  is posted in buildings and can be viewed on digital screens
• The RWG developed and released “Guidance for Honouring the Land and Ancestors through Land Acknowledgements 
• Orientation materials for new staff members have been updated to reflect CAMH’s history as a colonial institution and describe the programs underway to advance truth and reconciliation as well as provide culturally specific support for First Nations, Inuit and Métis patients.
• 200 new staff including CAMH physicians and the Executive Leadership Team are registered to complete San’yas Indigenous Cultural Safety Training – Core Mental Health 
• Most of the Executive Leadership Team have completed the training. Prior to the launch of the Action Plan, just over 300 CAMH staff had completed this course.
• A new internal learning module that outlines current programs, services, and policy reforms intended to create a safe environment for First Nations, Inuit and Métis staff, patients and families at the hospital is being developed through the support of the CAMH Organizational Development team.
• Healing Circles were held in 2021 for Indigenous and non-Indigenous staff to grieve and discuss the unmarked graves found at former residential school sites.
• A new intranet hub provides easily accessible resources to support staff in their truth and reconciliation journey. It features a Pledge to Reconciliation with 373 pledges made, including those that renewed their pledge for a second time.
• Aboriginal Caucus, 40 First Nations, Inuit and Métis staff from various programs and services across CAMH, meet five times a year and actively support the National Day for Truth and Reconciliation during the month of September and National Indigenous History Month in June each year by creating learning opportunities for staff members and the public. The Aboriginal Caucus serves as a support for one another as work continues to bring change into CAMH for a healthy work environment free of racism.

Result 2
Create an environment where First Nations, Inuit and Métis patients and families feel safe to receive CAMH services (Actions 2.1 to 2.3) Key Partners: Fair & Just Steering Committee, People & Experience, Office of Health Equity, Shkaabe Makwa, Performance & Analytics, Clinical Services

• The review process of all CAMH policies is underway. Policies are being reviewed and revised currently by Indigenous content experts at Shkaabe Makwa to improve the experience and well-being of Indigenous patients, staff, physicians, families and visitors. The hiring of A Senior Health Policy Analyst, Shkaabe Makwa was hired in February 2022 to support the review of policies with a lens of cultural safety, anti-Indigenous racism and reconciliation. The Policy Analyst will also lead the development of a new policy review tool and training for all members of the three policy committees.
• The Faith Based Meals and Food Practices procedure has been updated to include an Indigenous dinner option. This is an important part of providing culturally appropriate care for First Nations, Inuit and Métis patients.
• Exemptions to CAMH’s Tobacco-Free Initiative have been made to grant access for traditional use of tobacco for prayers, guidance, ceremonies and participation in research.
• An Indigenous Navigator has been placed in the Emergency Department by Aboriginal Services to support First Nations, Inuit and Métis patients in their care pathway at CAMH.
• The Ontario Structured Psychotherapy program now includes a stream of Cognitive Behavioural Therapy geared towards First Nations, Inuit and Métis patients with mild to moderate depression and anxiety-related concerns.
• In collaboration with the ECHO Ontario Mental Health Team, Shkaabe Makwa launched its sixth cycle of responsive programming intended to enhance training for mental health service providers across the province who care for First Nations, Inuit and Métis patients 
• Indigenous therapeutic art is visible in both the McCain Complex Care & Recovery Building and the Crisis & Critical Care building that will promote an environment of healing and recovery.
• New spaces are planned for the next phase of CAMH’s historic Phase 1D Redevelopment. Discussions have included spaces that will enable smudging ceremonies indoors, planters of sacred medicines on specific balconies, a Ceremony Room, an Elder’s office, and an outdoor Sacred Fire area for patients and families.
• Therapeutic art installations developed by Indigenous artists are being planned for the new Secure Care and Recovery building, and Research and Discovery Centre.
• Indigenous plants and gardens, an outdoor Indigenous art installation, an Indigenous water art installation, and a marker noting the lands of CAMH as Council Grounds for the Mississaugas of the Credit are planned near the TD Commons and Adelaide Street area.
• A partnership between Aboriginal Services, Shkaabe Makwa, and Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health has formed to support the development of a new training manual for group facilitators implementing Healing Pathways, a trauma-informed, culturally grounded coping skills group for First Nations, Inuit and Métis patients who are struggling with substance use challenges.
• CAMH and Toronto Symphony Orchestra (TSO) have come together to form a multi-year partnership and launch “Art of Healing”—a new program that supports First Nations, Inuit, and Métis patients at CAMH through storytelling and musical composition, co-creating an original piece of music that will be premièred by the TSO in their 2023/24 season. The launch of this program was celebrated through a live performance by award winning cellist Yo Yo Ma and TSO artists at CAMH.
• VIBE Arts 
• sponsored activities were offered to CAMH patients that included lessons in drum making, singing, and sewing traditional gloves.

Result 3
Ensure accountability for meeting targets associated with CAMH’s reconciliation agenda (Actions 3.1 to 3.4)
Key Partners: Fair & Just Steering Committee, Performance & Analytics, RWG, Horizontal Violence, Anti-Racism and Anti-Oppression (HVARAO) Working Group, Safe & Well Committee, Public Affairs

• A Reconciliation Review Committee was formed in Fall 2021 to guide the implementation of this work. It was intended to report annually to CAMH’s Board of Trustees and the Executive Leadership Team on progress toward reconciliation. CAMH has integrated reporting mechanisms to track progress of the Action Plan into its foundational structures of updating both the Executive Leadership Team and the Board of Trustees on progress against One CAMH and other key initiatives. As a result, the mandate and role of the Committee has recently shifted and will now serve to be more advisory.
• The action items related to this plan and other reconciliation metrics are included in the internal CAMH GOAL tracker, Fair and Just Dashboard, and Quality Improvement Plan
• The Indigenous Health Action Network (IHAN), comprised of Indigenous Leadership from the Toronto Academic Health Science Network (TAHSN) hospitals, has been established. The IHAN will report directly to the CEO Committee of TAHSN on system wide changes for improving First Nations, Inuit and Métis care in the hospital setting with a focus on data collection and analytics, incident reporting instances of racism, and cultural safety training. IHAN supports the reconciliation efforts of CAMH by sharing our progress across the 14 member hospitals in the system to inspire systemic transformation.
• All organization-wide committees have a minimum of one RWG member as part of their membership.

Other highlights across the hospital over the last 18 months include:

• The RWG was awarded a Leading Practice by Accreditation Canada and the Health Standards Organization in Spring 2021 for its exciting and innovative work. A Leading Practice is a practice carried out by a health and/or social service organization that has demonstrated a positive change, is people-centered, safe and efficient.
• The RWG received an award on Safe and Well CAMH Day in Fall 2021 as a CAMH group creating a safer and more inclusive work environment.
• The RWG hosted over a dozen educational activities and events including the REDress Campaign with multidisciplinary artist Jaime Black that spotlighted the issue of Missing and Murdered Indigenous Women, Girls and Two-Spirit Peoples. This campaign included an outdoor red dress art installation at the Queen Site campus and a virtual panel discussion.

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