Dr. Erika Mundel Strategic Policy FNHA Mental Health and Wellness Promotion: A Policy Perspective from the First Nations Health Authority in BC Dr. Erika Mundel Strategic Policy FNHA

Declaration of real or potential conflicts of interest Presenter: Erika Mundel I have no real or potential conflict of interest related to the material that is being presented today. Ce webinaire est accrédité par l'École de santé publique de l'Université de Montréal. De ce fait, je dois déclarer mes conflits d’intérêt.

Health & Wellness (interrupted) www.fnha.ca Health & Wellness (interrupted) BC First Nations Perspective on Wellness – holistic Our vision of health and wellness comes from the ancestors and is relational Colonization interrupted this worldview • Context: The First Nations Perspective on Health and Wellness articulates a holistic vision of wellness. First Nations recognize that good health and wellness starts with every human being and extends outward to include broader social, economic, cultural and environmental determinants of health and wellness. Colonization interrupted this worldview and a Western European perspective of health became the dominant lens on which our current health care system is based.

FNHA: A Unique Place in the Health System In some ways, the FNHA is like the Ministry of Health and Health Canada: FNHA undertakes strategic policy and planning. In some ways, the FNHA is like the Provincial Health Services Authority: FNHA delivers some services to the entire First Nations population across the province, and can provide certain shared services across BC First Nations health centres. In some ways, the FNHA is like Regional Health Authorities: FNHA undertakes local and regional health services planning and delivery Ministry of Health/ Health Canada Provincial Health Services Authority FNHA FNHA Context Regional Health Authorities FNHA is working at all levels of the health system simultaneously to advance system-wide priorities in the spirit of reciprocal accountability.

Policy Statement on Mental Health and Wellness Our common vision sees the mental health and wellness of all First Nations promoted and nurtured in the places where they live their lives—including in homes, families, communities, territories, work, and school. Equitable and stigma-free access to a culturally-safe, comprehensive, coordinated continuum of care further affirms, enables and restores mental health and wellness of individuals, families and communities. Implementation of this vision by First Nations and our partners contributes to reconciliation and Nation rebuilding. When services are needed, a full continuum is equitably available and includes: culture and traditional healing; promotion, prevention, capacity-building, education; early identification and intervention; wrap-around supports, including aftercare; harm reduction; crisis response; trauma-specific services; withdrawal management/detox; trauma-informed in-patient and out-patient treatment/services; coordination of care and care planning Principles: Person-and family-centred Wellness-focused and Recovery-oriented Trauma informed and responsive Cultural safety & humility Culture and community centred Foundational elements: Principles Developed at Joint FNHA, MoH, MCFD workshop August 2016 Are included in province’s Primary and Community Care transformation policy papers (informing patient medical homes, primary care networks and Mental Health and Substance Use specialized services) Next steps include developing service standards and other tools to support operationalization

Directions for Collaborative Actions Key Action Areas 1. Increased access to and quality of services 2. Traditional healing and wellness approaches as foundation 3. Facilitate wellness across the continuum, and focus on supportive environments and addressing root causes 4. Community ownership through nation- based and nation rebuilding approaches 5. Integrative system design and service delivery Commitments /recommendations 1. E.g. Invest in and operationalize shared service principles 2. E.g., ensure traditional healing approaches are central to any new First Nations serving mental health and wellness services 3. E.g., increase investments in mental wellness promotion activities (culture, language, land-based healing), focus on children and youth 4. E.g., ensure new investments build capacity to enhance community and nation designed service models 5. E.g., build partnerships and coordinate action across sector siloes; develop holistic and integrated service models. SHARED SERVICE PRINCIPLES ~Person-and family-centred ~Wellness-focused and Recovery-oriented ~Trauma informed and responsive ~Cultural safety & humility ~Culture and community centred Discuss key roles for public health actors here. Work happens at level of: individuals and families; communities; reorienting health services to mental health and wellness; removing structural barriers (eg through policy).