Trigger warning: This press contains sensitive subject matter, including suicide and self-harm, that could be triggering for some readers. Resources are available below.
NationTalk: Toronto, Ont. – The federal Non-Insured Health Benefits (NIHB) mental health program is harming First Nations people, according to another damning media report published last week by the Toronto Star and the Investigative Journalism Bureau.
The report alleges that the NIHB’s archaic and inaccessible bureaucracy, culturally insensitive care, a lack of First Nations therapists and painfully long wait times are leaving vulnerable First Nations people suffering. Some quoted in the report say these failures have even led to suicide.
“The Chiefs of Ontario demand the federal government address the grievous flaws that have been identified in the NIHB program,” said Ontario Regional Chief Abram Benedict.
The federal government has vowed to investigate some of the recent revelations, according to a Toronto Star article published last week. The NIHB program is administered by Indigenous Services Canada and is designed to provide First Nations and Inuit people access to health care that is not covered by provinces and territories, including mental health counselling.
There are about 5,000 government-approved mental health counsellors enrolled in the program. But only about a quarter of them have submitted any evidence that they have cultural competency or have experience working with First Nations people. And only a fraction self-identified as Indigenous. Meanwhile, the First Nations Health Authority (FNHA) in B.C. requires therapists to take an eight-week cultural competency course to register as an approved provider. Previous reporting on the NIHB system showed that some approved providers have lengthy disciplinary, legal and moral records, including murder, having sex with a former client and appearing to defend residential schools.
“It’s unacceptable that a program specifically designed to provide mental health care for First Nations is filled with people who don’t understand who we are, our histories, or the unique challenges we face,” said Regional Chief Benedict. “At the very least, these providers must be trained in fundamental knowledge about First Nations, so our people can walk into an office with confidence that they’ll receive relevant, safe care—not care that risks causing harm.”
Clients and providers interviewed by reporters describe troubling accounts of racism and discrimination faced in the offices of those who are meant to support their mental healing. Others recount mental health providers who did not understand or denied the ongoing impacts of Canadian colonialism. Some clients felt dismissed, with their experiences being questioned or minimized.
“As a former NIHB navigator for several years at the Chiefs of Ontario, I witnessed firsthand how the system can harm our people. There were many times that medically required health care needs were denied and then the person would stop seeking help. The system was broken, and while we tried to work to reform, it did not change and made it feel like our people’s lives didn’t matter—but they did and do matter. We can and must do better,” said Hiawatha First Nation Chief Laurie Carr.
“When you go somewhere for care, you expect to be treated with respect and dignity, and get your required health care needs met. You don’t expect to have to justify your entire existence or educate someone on basic facts. We can’t expect people to heal if we can’t give them what they need.”
The reporting also highlighted significant barriers that people face when trying to access the program. When someone is in crisis they need help urgently. However, the federal system is cumbersome and requires people to call and wait for a list of approved mental health providers. Then they must begin the lengthy process of calling each provider to see if they are even accepting patients. In contrast, the FNHA in B.C. maintains a list of approved providers that anyone can find on its website, making it accessible for anyone in need
While the national average wait for community mental health counselling is 31 days, people trying to access care through the NIHB program can wait up to six months or a year, according to the reporting.
“We’ve all seen the stories about what happens when people don’t receive the care they need. It’s life or death. We call on the government to immediately come to the table to begin working with First Nations to achieve meaningful and long-term reforms,” said Regional Chief Benedict. “We cannot wait for tragedy to strike again. We must act now.”
The investigation also revealed that the federal government contracts a private, for-profit U.S.-based health care company to administer the NIHB program on its behalf to the tune of billions of dollars.
“We know what is best for our people. It’s astonishing that the federal government appears to be giving hundreds of millions of dollars to a private, for-profit company in the United States instead of working to build capacity in First Nations,” said Mushkegowuk Council Deputy Grand Chief Natasha Martin, who co-chairs the Ontario Chiefs Committee on Health.
Despite decades of calls for reforms from First Nations Leadership, advocates and mental health experts, little has been done to improve the NIHB program. In 2014, the AFN and the federal government initiated a joint review of the NIHB program. But a decade later, the status and progress of the process remain unclear. This lack of action resulted in the Chiefs-in-Assembly passing a resolution telling COO to withdraw from the process in 2018.
Resources are available online at https://988.ca/ or you can connect to the national suicide prevention helpline at 1-833-456-4566, or the Kids Help Phone at 1-800-668-6868.The Hope for Wellness Help Line is available 24/7 to all Indigenous peoples across Canada at 1-855-242-3310 online at www.hopeforwellness.ca. You can the national 24-hour crisis line for residential school survivors and their families at 1-866-925-4419.
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The Chiefs of Ontario supports all First Nations in Ontario as they assert their sovereignty, jurisdiction, and their chosen expression of nationhood. Follow Chiefs of Ontario on Facebook, X, Instagram, or LinkedIn @ChiefsOfOntario
Media Contact:
Isak Vaillancourt
Communications Manager
Chiefs of Ontario
Telephone: 416-819-8184
Email: isak.vaillancourt@coo.org
Kallie Diabo
Communications Officer
Email: Kallie.Diabo@coo.org
Phone: (416) 597-1266
Mobile: (647) 553-4761