The Recuperative Process

In the new South Africa, following apartheid, Nelson Mandela realized that in addition to political reconstruction and empowerment for the indigenous black population, there needed to be a healing process for all citizens. The result was The Truth and Reconciliation Commission.

How can trust and respect be restored after great injustice and pain has been inflicted? This is an important question in considering solutions to aboriginal mental health problems.
In Canada in the last 10 years, there have also been attempts to promote healing on all levels (national, local, individual).
In 1993, The Anglican Church of Canada made a formal apology for the tremendous wrongs that were committed in the name of Christian conversion.

In 1995, Elijah Harper brought Aboriginal and non-Aboriginal peoples together from across Canada to find a spiritual basis for healing and understanding.

From this Sacred Assembly, people developed a
Reconciliation Proclamation and a Statement of Principles and Priorities.

In 1998, George Erasmus headed a new
organization entitled the Aboriginal Healing Foundation whose purpose was to oversee a $350 million fund to address the legacy of physical and sexual abuse in the Residential School system. This fund, secured after a contribution agreement with the Government of Canada, constituted a significant element of ‘Gathering Strength – Canada’s Aboriginal Action Plan’, announced on January 7, 1998. As part of that announcement, the Government of Canada offered a Statement of Reconciliation acknowledging the government’s role in the development and administration of the Residential School system, and said it was deeply sorry to those victims who suffered physical and sexual abuse.

Government Health Services Intervention

In a recent report from Health Canada, the problem of access to health services was seen as related to (a) geography and,
(b) culture and knowledge issues.

(a) Problems of access to health services because of geography

With respect to geography, the government formulated two strategies.

These were:
-to set up a video-conferencing ‘telehealth’ system to allow specialized medical assistance to be delivered electronically over great distances. In the area of renal medicine, a National Telehealth Community Care Pilot Project was set up in New Brunswick, and a project entitled the First Nations National Telehealth Research Project was launched in Western Canada. The results of these video-conferencing experiments have been mixed. They were expensive to implement and participants reported being frustrated with both the new technology and its unreliability.

-to develop local capacity. The second strategy of developing local health services has had more success. The Régie régionale de la santé et des services sociaux de Nunavik has been particularly successful with its program entitled ‘Putting in Place An Integrated System for People with Severe or Persistent Mental Problems’. A re-integration centre was set up in Inukjuak which provided 24-hour care in a structured milieu. The service was for individuals in need of short-term or long-term residential care and respite care. It also offered crisis intervention, day programs and community follow-up. The Centre was staffed by Inuit, which further enhanced local skills while addressing concerns about cultural sensitivity.

Health Canada has a new approach to the provision of health services known as the New Public Health. This is the practice of promoting health holistically through social and community development. The Inukjuak centre is a good example of the New Public Health in practice. The RCAP addressed the need for a holistic approach when it suggested that many of the problems now confronting Aboriginal communities could be
addressed more effectively in a health promotion framework rather than with a curative approach.

(b) Problems of access to health services because of culture and knowledge issues

Even if services do exist, people are often hesitant to use them if they feel that the staff are strangers when it comes to local language and culture. To combat this problem, several ‘outreach’ programs have been set up. In these programs, medical services have been provided in storefront centres that are easily accessible and set amongst other familiar buildings like the local bank or post office. Another approach has been to hire liaison workers who are able to play the role of facilitators, i.e. helping clients to negotiate the health and social services system. It has been found that as a result of these workers, there have been fewer missed appointments, and improved cooperation with respect to treatment programs. At the same time, health professionals have been able to develop a better
understanding of the health needs of their Aboriginal clients.

In general, there has been a shift in government policy in the last 10 years towards what has been called ‘Native solutions for Native problems’. This policy shift has been encouraged for the autonomy it has given some Aboriginal groups to deal with mental and social health issues in a manner appropriate to their own culture. However, the problem remains that too often government policy is a scrambled response to a crisis (e.g. an increase in the occurrence of suicides) rather than a gradual and ongoing development of local services and expertise as part of a coordinated program of constructive change.

We, the delegates to Sacred Assembly ‘95, gathered together in Hull, Quebec on December 6-9, 1995, having come from the four corners of this land—East, West, North, and South—and having brought with us diverse spiritual backgrounds, and having listened to and prayed with Elders, spiritual leaders and with each other, are now able to assert the following:

We share, as part of our common spiritual foundation, the belief that: the Creator, God reigns supreme over all things; the land on which we live was created for the benefit of all;
as the original inhabitants of this land, Aboriginal peoples have a special right and responsibility to ensure the continuing integrity of the land and the unity and well-being of its inhabitants; and non-Aboriginal Canadians also share in these responsibilities.

We share the recognition that reconciliation between Aboriginal and non-Aboriginal Canadians must be rooted in a spiritual understanding of land as a gift from the Creator, God; the sins and injustices which have historically divided Aboriginal and non-Aboriginal peoples remain active in our society today; concrete actions must be taken by Aboriginal and non-Aboriginal peoples alike to overcome these injustices and to bind up the wounds of those who have suffered.

We share an understanding that the starting point for healing and reconciliation lies in a personal communion with the Creator, God; while change must take place at all levels of society, it must be rooted most firmly in the communities; and relations based on justice will require respect for past treaties, a fair settlement of land rights disputes, the implementation of the inherent right of self-government and the creation of economic development opportunities and other institutions to support it.

We share a commitment as individuals to seek the personal guidance and counsel of Elders and spiritual leaders in order to walk more closely with the Creator, God; to return to our communities and develop ways to continue the process of healing and reconciliation that has begun at Sacred Assembly ‘95; to continue to explore with each other our sacred foundations, in order to bring about spiritual reconciliation, Aboriginal justice and the fulfillment of political responsibilities in this country; to continue to respect the differences in our spiritual journeys, even as we seek to discover the common spiritual link between us. As churches and faith communities: to continue the process of healing and reconciliation with Aboriginal peoples by providing the forums and supports needed to heal the wounds created in the past; to become stronger advocates for justice and reconciliation in the current and future public affairs, and to hold our governments accountable for their implementation of just policies; to recommit ourselves to a program of education and action on issues relating to land rights, self-government, economic development and racism.

As First Nations and Aboriginal communities and organizations: to work towards healing and reconciliation within our communities; to accept the challenge issued by Youth to create an environment in our communities that encourages a healthy view of oneself and respect for others, and addresses community conflict that prevents Youth from finding their path.