Possibilities for Culturally Responsive Programming: Reimagining My Role

Possibilities for Culturally Responsive Programming: Reimagining My Role February 1, 2016 Pylypchuk Hall, St. Paul s Hospital & Telehealth 12:00 5:00pm Research Chair in Substance Abuse Saskatoon Health Region, Representative Workforce, First Nations and Métis Health

12:00 1:00 THEME: Networking Lunch AIM: Share about your addictions and mental health work related to First Nations and Métis health over lunch (share program materials if you brought them with you!) & meet with a Regional Health Authority or local agency Elder/ cultural knowledge keeper if they were able to attend.

From Stilettos to Moccasins https://www.youtube.com/watch?v=1qrb8wa2ihs Step By Step https://www.youtube.com/watch?v=1qrb8wa2ihs

Possibilities for Culturally Responsive Programming: Reimagining My Role February 1, 2016 Pylypchuk Hall, St. Paul s Hospital & Telehealth 12:00 5:00pm Research Chair in Substance Abuse www.addictionresearchchair.ca Saskatoon Health Region, Representative Workforce, First Nations and Métis Health https://www.saskatoonhealthregion.ca/locations_servi ces/services/fnmh/representativeworkforce/pages/home.aspx

Elders Maria Linklater (SHR) Norma-Jean Byrd (RQHR) Betty McKenna (Five Hills) Abraham Garidner (KY) Marie Favel (KY) Julie Pitzel (PAPHR) Speakers Sharon Clarke (co-host) Colleen Anne Dell (co-host) Mary Deleary Barb Fornssler Fern Stockdale Winder Dori Cook Saskatchewan Ministry of Health, Community Care Branch Martina Matthewson Nicolle Poirier Kathy Willerth Local Organizing Champions Judy Pelly, Saskatoon Health Region Dave McDonald, Mamawetan Churchill River Health Region Karen Floyd, Sun Country Health Region Colette Beaubein, Five Hills Health Region Brenda Dubois, Regina Qu Appelle Health Region Nicole Miller, Heartland Health Region Sandra Hansen, Athabasca Health Region Sharon Kish, Cody, Prairie North Health Region Teresa Kosmas, Cypress Health Region Candace Rogers, Kelsey Trail Health Region Beverly Whitehawk, Sunrise Health Region Shawna Materi, Saskatoon Health Region Christa Petit, Keewatin Yatthe Regional Health Authority Maria Lloyd, Prince Albert Parkland Health Region Telehealth Sites Rosetown- Heartland Health Region Kindersley- Heartland Health Region Weyburn- Sun Country Health Region Estevan- Sun Country Health Region Kipling- Sun Country Health Region Tisdale- Kelsey Trail Health Region Yorkton- Sunrise Health Region Prince Albert- Prince Albert Parkland Swift Current- Cypress Health Region North Battleford- Prairie North Health Region Lloydminster- Prairie North Health Region Meadow Lake- Prairie North Health Region Moose Jaw- Five Hills Health Region Ile a la Crosse- Keewatin Yatthe Regional Health Authority La Ronge- Mamaweta Churchill River Health Region Regina- Regina Qu Appelle Health Region Grenfell- Regina Qu Appelle Health Region Organization Alicia Husband Carrie Opalko-Windecke Barb Fornssler

WELCOME! Saskatoon Health Region, Representative Workforce, First Nations and Métis Health VISION: To be diverse, culturally competent organization: with a workforce that is representative of the community we serve That provides quality client centred experiences to patients, clients, residents and families within Saskatoon Health Region MANDATE: To increase Saskatchewan s substance abuse research capacity, strengthen the training of addiction workers, and increase the effective use of research resources in substance abuse prevention and treatment.

"Reconciliation is about forging and maintaining respectful relationships. There are no shortcuts." -Justice Murray Sinclair The mandate of the Truth and Reconciliation Commission of Canada is to inform all Canadians about what happened in Indian Residential Schools (IRS). The Commission documented the truth of survivors, families, communities and anyone personally affected by the IRS experience. This includes First Nations, Inuit and Métis former Indian Residential School students, their families, communities, the Churches, former school employees, Government and other Canadians. The aim of the TRC is that it hopes to guide and inspire Aboriginal peoples and Canadians in a process of reconciliation and renewed relationships that are based on mutual understanding and respect. (http://www.trc.ca/websites/trcinstitution/index.php?p=3)

Calls to Action: http://www.trc.ca/websites/trcinstitution/file/2015/findings/calls_to_a ction_english2.pdf 57. Professional Development and Training for Public Servants We call upon federal, provincial, territorial, and municipal governments to provide education to public servants on the history of Aboriginal peoples, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, Indigenous law, and Aboriginal Crown relations. This will require skills based training in intercultural competency, conflict resolution, human rights, and antiracism.

1:00 2:00 THEME: Knowledge Creation AIM: Introduce the concept of culturally responsive care in the work and lives of service providers involved in mental health and addictions care delivery in SK. Hear from Elder Maria Linklater, Fern Stockdale Winder & Barbara Fornssler.

Cultural Humility Is not about achieving awareness or knowledge, but rather self-humility. It is a process, and cannot be achieved. Cultural humility is the ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the [person] (Hook, J.N. (2013). Cultural Humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology). It is a lifelong process of self-reflection and selfcritique (rather than only learning about the culture of the other/cultural competency) - Dr. Melanie Tervalon and Jann Murray-Garcia. Cultural humility incorporates a lifelong commitment to self-evaluation and critique, to redressing the power imbalances in the physician-patient dynamic, and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individual defined populations. (Tervalon, M., Murray- Garcia, J. (1998). Cultural Humility Versus Cultural Competence: A Critical Distinction Journal of Health Care for the Poor and Underserved). Cultural Humility video: https://www.youtube.com/watch?v=_mbu8bvkb_u

2:00 2:45 THEME: Knowledge Translation AIM: Review the challenges and strengths in culturally responsive care delivery via two case studies from individuals with lived experience in Saskatoon.

Can you please share a time when the mental health and addictions services provided in your health region acknowledged that a client was First Nations or Métis and worked well? Please identify why you think the service delivery worked well. THEMES 1. Client-centred 2. Culture-informed 3. Collaborative

Can you please share a time when the mental health and addictions services provided in your health region did or did not acknowledge that a client was First Nations or Métis and did not work well? Please identify why you think the service delivery did not work well. THEMES 1. Not client-centred 2. Not culture-informed 3. Not collaborative 4. Systemic Barriers

To recognize and share your achievements with other RHAs in service delivery with First Nations and Metis, can you please share any programming, practices or resources offered by your RHA. THEMES 1. Client-centred 2. Culture-informed 3. Collaborative

Cultural Humility Is not about achieving awareness or knowledge, but rather self-humility. It is a process, and cannot be achieved. Cultural humility is the ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the [person] (Hook, J.N. (2013). Cultural Humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology). It is a lifelong process of self-reflection and selfcritique (rather than only learning about the culture of the other/cultural competency) - Dr. Melanie Tervalon and Jann Murray-Garcia. Cultural humility incorporates a lifelong commitment to self-evaluation and critique, to redressing the power imbalances in the physician-patient dynamic, and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individual defined populations. (Tervalon, M., Murray- Garcia, J. (1998). Cultural Humility Versus Cultural Competence: A Critical Distinction Journal of Health Care for the Poor and Underserved).

Connecting to Care - SHR System level: Culturally responsive programming (cultural advisor) Service provider level: Cultural humility (meeting the client where they are at literally!) http://saskatoon.ctvnews.ca/video?clipid=796664&binid=1.1165954&playlistpagenum=1 #_gus&_gucid=&_gup=facebook&_gsc=iunsrwc

2:45 3:00 Health Break http://www.addictionresearchch air.ca/creatingknowledge/provincial/sharingthe-role-of-aboriginaltraditional-culture-in-healingfrom-addictions/what-is-beingshared/view/

3:00 4:00 THEME: Knowledge Dissemination AIM: Learn about an innovative approach and promising practice the Connecting with Culture: Growing Your Wellness client activity guide and facilitator manual. Mary Deleary from the Thunderbird Partnership Foundation will be presenting.

4:00 5:00 THEME: Knowledge Mobilization AIM: Examine through a creative group activity personal priorities for enhanced care delivery in mental health and addictions by increasing our cultural responsiveness in the province.

Take opportunities to talk with people of Aboriginal origin to learn about their diverse perspectives on these issues. Read and become informed on the history of Canada s Aboriginal peoples to better understand the current context. Bear witness to the facts of history and acknowledge that effects are still deeply felt today by all.

Become culturally competent, with an understanding of historical legacy and current challenges that impact mental health in some Aboriginal communities. The Indigenous Physicians Association of Canada and the Royal College of Physicians and Surgeons of Canada have prepared basic training materials in cultural safety. Remember there is not a single pan-aboriginal identity. Learn about the issues but be open to becoming acquainted with the large diversity of Aboriginal communities and with individuals with their own personal stories. Provide mental health services in culturally responsive ways and working respectfully within Aboriginal frameworks of mental wellness. Given the history of trauma and high level of adversity experienced by some First Nations people, a trauma-informed approach to mental health care, based on compassion, placing priority on a trauma survivor s safety, choice, and control is recommended by the 2015 First Nations Mental Wellness Continuum Framework. Yet caution must also be taken in perpetuating cultural stereotypes. Engage in respectful collaborations with traditional healers and knowledge holders.

Acknowledge that local indigenous knowledge must guide the development of relevant mental health programs. There is much that Western mental health professionals can learn from some of the innovative, comprehensive and humanistic approaches to mental wellness and mental health care delivery that have been developed in some Aboriginal communities. As a practicing psychiatrist, consider serving Aboriginal communities to address lack of services and long wait lists, preferably within the community itself. For early-career psychiatrists interested in social justice and cultural diversity, this may be a rewarding opportunity. (Note: DSM-5 contains a semi-structured interview, the Cultural Formulation Interview, which is a 16-item questionnaire designed to tap into cultural topics for clinicians to consider in patient assessment, diagnosis and treatment) Support Aboriginal mental wellness workers in navigating and collaborating with mental health services. Encourage and actively support the training of young Aboriginal health professionals. Support and lobby for cooperation among federal, provincial and territorial governments to provide sustainable, dedicated funding for clinical mental health services in Aboriginal communities.

Ribbons of Reconciliation TRC: http://www.trc.ca/websites/reconciliation/index.php?p=332 & http://www.trc.ca/websites/reconciliation/index.php?p=335 Clinical Pathways Video: https://youtu.be/2hev9td89cw

Ribbons of Reconciliation How can you (re)imagine your role in offering culturally responsive programming?

Keep in Touch Sharon.Clarke@saskatoonhe althregion.ca Colleen.Dell@usask.ca Mdeleary@thunderbirdpf.org Barbara.Fornssler@usask.ca Fern.stockdalewinder@saska toonhealthregion.ca Please fill out the evaluation you will receive through email?