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In 2018/19 the Ministry of Health and Long-Term Care provided one-time Mental Health and Addictions (MHA) funding to the Indigenous Primary Health Care Council (IPHCC) to support the collection and analysis of data to provide a better understanding of Indigenous community-governed MHA programs and services in Ontario.
These programs and services are provided across Ontario at ten Aboriginal Health Access Centres (AHACs) and three Indigenous-governed Community Health Centres (CHCs). At least fifteen additional Indigenous Interprofessional Primary Care Teams (IIPCTs) are in development or have recently opened their doors (Appendix 1). As of 2016, AHACs and Indigenous-governed CHCs provided care to 66,000 individuals, encompassing more than 25% of the First Nations, Inuit, and Metis population in Ontario. This number is expected to more than double once the IIPCTs are fully established.
Indigenous health centres share a common Model of Wholistic Health and Wellbeing. This model focuses on the restoration and rebalancing of the physical, mental, emotional and spiritual wellbeing of Indigenous peoples, families, communities and nations. Consequently, Indigenous health organizations do not see themselves as providing stand-alone mental health and addictions services. Instead, MHA services are part of an integrated model of care in which all programs and services promote wellbeing across all aspects of the self. For the purpose of this report, a western construct of a ‘continuum of care’ is used to explore the range of services Indigenous health centres provide to clients with MHA challenges. Although this construct greatly simplifies the complexity inherent in the Model of Wholistic Health and Wellbeing, it is useful because it can be used to identify critical service gaps.
Evidence gathered for this report indicate that programs and services rooted in Indigenous cultures and ways of healing are the most effective way to support Indigenous clients with MHA challenges. Indigenous health centres are ideally positioned to provide these programs and services. However, they currently do not receive sufficient funding to provide a full continuum of care for clients with MHA challenges. This causes clients with severe MHA challenges to go without necessary care. Indigenous health centres need to be funded in a manner that enables them to provide a complete continuum of culturally safe, culture-based MHA care.
A substantial number of Indigenous people with MHA challenges still need to seek care from mainstream healthcare institutions—places where anti-Indigenous racism is endemic (Matthews, 2017; Wylie & McConkey, 2019). Leadership teams and front-line service providers of all publicly-funded organizations that provide MHA programs and services need to be trained on how to address and eliminate anti-Indigenous racism.
The Indigenous Primary Health Care Council (IPHCC) is an Indigenous-governed, culture-based and Indigenous-informed organization. It supports the advancement of Indigenous primary health care provision and planning throughout Ontario through partnerships, education, and advocacy. The IPHCC takes a coordinated approach to enhance Indigenous health care by ensuring the delivery of culturally safe, effective health services in a manner that respects the diversity, languages, and strengths of Indigenous peoples. This population-level, needsbased approach to health care planning, evaluation, and scaling-up leading practices drives excellence in Indigenous health.