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Indigenous children and youth in care


Overarching

Recommendation 1: That the Ministry of Mental Health and Addictions work with the Ministry of Health and the Ministry of Children and Family Development to conduct a review, after consulting with health authorities, First Nations, Métis Nation and urban Indigenous communities and leadership and other appropriate bodies, into the use of involuntary mental health care for children and youth to identify the conditions that are contributing to its increased use, and identify immediate opportunities to provide voluntary interventions or improve practices that would reduce involuntary admissions. Review to be complete by Jan. 1, 2022.


Overarching

Recommendation 2: That the Ministry of Health require health authorities to collect and report key information pertaining to children and youth admitted under the Mental Health Act in a way that is standardized across the province and reported regularly, including but not limited to:

  • identity factors (ethnicity, gender identity);
  • Indigeneity – First Nations, Métis and Inuit identity;
  • standardized length of stay data across all hospital settings; admissions of children on a voluntary basis at the request of their parents;
  • requests for, and outcomes of, second medical opinions;
  • detailed seclusion and restraint data; data related to extended leave;
  • outcomes related to quality of care, effectiveness and patient satisfaction.
This work to be completed by June 1, 2022.


Admission

Recommendation 4: That the Ministry of Health, and the Ministry of Mental Health and Addictions actively engage and consult with First Nations, Métis Nation and urban Indigenous health bodies and leadership to develop a process to enable a child or youth to notify their community or Nation of their involuntary admission. To be complete by Sept. 1, 2021.


Rights

Recommendation 7: That the Ministry of Health work with the health authorities to develop a process to ensure that First Nations, Métis or Inuit children or youth who are either detained under the Mental Health Act or are under 16 and admitted by their parent/legal guardian are offered services by hospital staff who assist Indigenous patients such as navigators, liaison nurses, nurse practitioners and Elders in residence. Process to be developed and operational by Jan. 1, 2022.


Rights

Recommendation 8: That the Ministry of Health and the Ministry of Mental Health and Addictions put forward amendments to the Mental Health Act after actively engaging and consulting with health authorities, First Nations, Métis Nation and urban Indigenous communities and leadership and other appropriate bodies, that will ensure children and youth who are detained under the Mental Health Act have the right to retain personal items that do not pose a risk to their safety or the safety of others and continue practices that support their physical, emotional, mental, spiritual and relational wellbeing and their sense of identity. Amendments to be put forward by May 1, 2022.


Treatment

Recommendation 9: That the Ministry of Health, the Ministry of Mental Health and Addictions and the First Nations Health Authority actively engage and consult with First Nations, Métis Nation and urban Indigenous leadership and communities to identify changes needed in order to ensure that First Nations, Métis, Inuit and urban Indigenous children and youth are provided with trauma-informed, culturally safe and attuned mental health services, including a diversity of treatment modalities specific to their unique culture, when detained under the Mental Health Act. Changes to be identified by Sept. 1, 2021 and implemented in full by Sept. 1, 2022.


Treatment

Recommendation 11: That the Ministry of Health and the Ministry of Mental Health and Addictions put forward amendments to the Mental Health Act after actively engaging and consulting with health authorities, First Nations, Métis Nation and urban Indigenous communities and leadership and other appropriate bodies to ensure that, for children and youth who are detained under the Mental Health Act, isolation and restraint are:

  • only used as a last resort when all other interventions have been exhausted, and
  • only used in accordance with specific legislative or regulatory criteria including assessment, time limits, reviews, documentation and reporting requirements.
Amendments to be put forward by May 1, 2022.


Reviews

Recommendation 14: That the Mental Health Review Board pilot a new Review Board hearing process for children and youth that centres the young person and is trauma-informed and culturally attuned after actively engaging and consulting with health authorities, First Nations, Métis Nation and urban Indigenous communities and leadership and other appropriate bodies. Pilot to be operational by Oct. 1, 2022.


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