Hailey: all right I hit the button now.

Interviewee: okay perfect!

Hailey: do you have any questions for me?

Interviewee: no no I'm just glad I can give you a little bit of insight into what I do here at First Nations Health Authority.

Hailey: yeah thank you so much for your coming to this interview and taking the time to do this.

Interviewee: you're welcome.

Hailey: it's short notice. yeah I really appreciate it. so I believe I sent you the questions but  I'll just be following those and then maybe asking some follow-ups if okay come up.

Interviewee: okay.

Hailey: the first question how do you integrate cultural practices and traditions into your healing approaches.

Interviewee: here at FNHA uh we're the first health authority in all of Canada to have our own health system  so I work in the public health response team and my team specifically is the mental health and wellness team and we have several people that deal with cultural practice and healing and  on our team we have a traditional wellness program a health emergency management program that deals with community crisis and individual and family crisis as well  we have a youth mental health worker that also works with youth and the many issues that face indigenous youth  we also just rolled out some funding to five regions for  healing centers or healing lodges to be built to deal with  having cultural approaches and healing opportunities for folks  as for me I'm the specialist in mental health and wellness and my my files are integrating health and cultural supports into communities and I basically have a team of about 100 people throughout BC that provide cultural support alongside the cultural supporters emotional support so  counselors and we also have supports for Indian day school survivors and the missing and murdered indigenous women and girls which also is inclusive of boys and men  and then the final couple things that we do is what we call an expanded trauma informed health support program and  the final thing is I don't know if you're aware of the Tekemoops announcement a few years ago where missing children were found in graves at the Tekemoops Indian residential school site so that work is happening all across Canada in BC there were 21 First Nation communities that had a residential school three of those were categorized as Indian hospitals and all of those are in the process of searching as well so in all of the work that we do here at FNHA we really work hard at mental health and wellness and providing first of all culturally safe approaches so that's a long-winded answer but we do a lot here at FNHA.

Hailey: I see okay  and so  as a follow-up how do you recognize  signs of trauma and clients or community members  how do you determine the best approach would be for the individual.

Interviewee:  so  we track quarterly which means every three months we track we  have the 10 organizations that I work with throughout BC  they basically send in their statistics and over time you can see whether the need is increasing or decreasing for all of the program areas that I talked about  so that  annually is rolled up which gives us a really good picture of what the needs are for communities and for individuals accessing the services we also track what we have in terms of crisis lines so we have three in BCs there's COUS it's KUUS we have one with South and Leland Healing Society and another one with the Indian Residential School Survivors Society so those three combined they're able to track the number of calls that come in and we're able to determine needs based on that and then I also do check-ins with all 10 organizations to see you know if there's any trends or anything popping up for example the people visit when the pope came to Canada really escalated the emotional needs of folks all across Canada so we were having to step up our work in community to support people that were being triggered by that trauma and that awakening of that historical memory so and then we also have a team that does research and also attracts socioeconomic factors so is there an increase in for example mental health and we track that through our counseling program we have a counseling program as well that's funded under my program the Indian Residential School program so there's just basically tracking of the socioeconomic needs of folks throughout BC First Nations of course so that's our our main target area so we do quite a lot of things to kind of keep our hands on the pulse I guess.

Hailey: So  do you  increase outreach or that's  dependent adjusting based on  the statistics?

Interviewee: Yes I think we have a very fluid workforce so they they work in offices throughout BC and within their region they're able to do outreach so say for instance in my community this week we had a loss of a young man who it may be you know opioid overdose or it may be homicide we don't know yet but there's a lot going on for the community around this so it's basically designated a crisis and we've been able to call folks in to debrief the first responders to work with the families to work with his friends and specific work with youth so that happens for every one of the two I think there's about 210 communities across BC so if something happens we're doing our best to provide a wraparound support that is trauma informed and culturally safe.

Hailey: And when you mention youth do you have any  specific initiatives for  intergenerational trauma maybe?

Interviewee: We just hired our our young youth what's his title did I say youth mental health program consultant so his name is <<>> and he's just in the process of pulling together a youth I guess a guiding team of sorts so a team of youth that are designated as leaders who will inform us the best approaches for working with youth so you know the work that I do is primarily targeted for older generation folks that have experienced either Indian day school or residential school or their direct descendants. <<>>'s work is working with a much younger generation so we do try to have a look at the life cycle in terms of how we determine our approaches.

Hailey: Okay moving on well I feel  this is  partly answered but  what strategies you use to address cultural safety and humility  within your organization?

Interviewee: Well that's a very broad scope in terms of First Nations Health Authority  I said we're the first organization that's a provincial body in all of Canada what we came out of the gates wanting and we're only I believe about 11 or 12 years old now as an organization is what's known as the Sannyas healing or Sannyas program it's a training program that basically it's an online training program where folks that work in health care no matter who you are I had to take it even have to do training on Indigenous cultural safety as part of their prerequisite for working with community and with First Nations individuals so within that they've created a standard they've created a committee they've advanced the training throughout all of BC and all health and all of health care they have a framework and an action plan so they do engage with cultural leadership and ensure that the work that they're doing really works at addressing power imbalance and it's creating a system of health care that's free of racism and discrimination that's the goal. And then how do you collaborate with other organizations or agencies to provide holistic care.

Hailey:  maybe do you maybe have contacts with  certain hospitals or  family doctors and  outreach them?

Interviewee: I think that off the top of my head I hadn't really thought that through but the way you just asked it creates a different answer for me so for instance for the physical aspect of health there's a very strong relationship with the ISPARC community and if you google ISPARC it's I-S-P-A-R-C I don't know exactly what it stands for but it's I think it's Indigenous Physical Sport Activity something they run programs all over BC and really deal with healthy eating nutrition exercise that sort of thing in terms of the spiritual our cultural support teams throughout BC the 100 folks I work with are very much involved with many programs and initiatives at FNHA in terms of the emotional every region has a mental health team that works with not only internal FNHA but with external regions for health care so there's a pretty strong collaboration to support the emotional needs of folks and then for mental we run Indigenous programs for students that are needing work experience coming out of post-secondary so we have an internship program there but also really wanting to be very involved with post-secondary colleges and universities to ensure that the colonial history is understood in the area of health care no matter what you know if you're going to be a nurse or a pharmacist or a mental health clinician I think it's important that everybody understand the history of Indigenous peoples.

Hailey: I feel  you did touch on the next question so I'll just skip that how do you involve  Indigenous elders for example or knowledge keepers and  you know stories from the past in your programs? How do we do that?

Interviewee: I've been collaborating a lot with my cultural support teams that I work with with <<>> who is my colleague so <<>>'s running a program to really help communities develop traditional wellness and traditional healing and land-based healing so we just for instance just completed about two weeks ago an Indigenous psychological first aid so the province has a program called psychological first aid but we really wanted to make it appropriate the experience of Indigenous people and reflect our culture and values and our ways of being in communities so the program was revamped and we provided it to about I think there was 16 participants on the land actually on our territory here in Wet'suwet'en territory at a land-based healing camp so when you're asking how we're wanting to really include knowledge keepers they really led the way in that in terms of that holistic education that they bring the knowledge that they bring around cultural practice and healing and ceremonies and you know creating medicine from the land all of those things were integrated into what we did so that's a little snapshot of something that might happen to answer your question.

Hailey: When you say  psychological first aid is it  a certification for  individuals  in the health care field or it can be basically what it's set up to do and is given not even health care workers but anybody in the community that's dealing with crisis?

Interviewee: basically gives them a toolkit of ways in which they can help and support an individual a family or community in crisis so for here in this community we were to have about 10 people trained the the ability to take care of people in that first round of the crisis where it's all fresh it's new everybody's you know falling apart and everyone's struggling as we bring in the resources there's that time frame where people can it's kind of  a band-aid putting a band-aid on temporarily until the experts show up so it's it's a similar idea so we're bringing in training so that people can have you know the bare minimum ability to help people stay grounded to feel supported to know that they're not alone and be reassured that help is on the way so that sort of thing so it's a really really cool program because it gave I took the training and I learned some things as well so I thought it was really interesting yeah I feel  more people should have access to that because yeah a lot of people don't know how to deal with  crisis situations yeah and a lot of crisis happens you know in terms of crisis I think that that that is among one of our top most I guess it's the file that keeps everybody the busiest so in BC we've had the pandemic so of course there was a lot of grief and loss as a result of the pandemic and and COVID and then during that time there was a really I think there was an incline in the use of substances and we're seeing now this opioid overdose situation happening it's still happening and it feels  it's escalating and then we had the third layer of trauma and crisis around environmental disasters so people you know whole communities burnt down or were partially burnt or you were evacuated and homeless so all those types of environmental disasters due to flooding and fires and so on created even more trauma and crisis with folks so it feels  in all those situations the amount of we call it cumulative grief increased so you know grief is loss of family loss of land loss of even homes so lots of lots of crisis happening I think in communities and we're seeing it by the escalating use of our need for counseling services for example so we've seen that times itself by 16 in one year so instead of costing one million it cost 16 million last year so the need is really you know it's really strong in terms of people looking for mental health counseling and mental health therapists and counselors so that was something that was quite drastic last year and we're still seeing that it's just as busy this year and I guess  it's going to become more relevant as  I don't  global warming accelerates and  more extreme  weather events probably will occur yes for sure for sure so you're in the right field if that's the way in the direction that you're going there's plenty of work you think maybe  also with  the increased  incidences of these events that  the stigma for seeking help might have  has there been an improvement in that  the stigma I'm sorry I couldn't hear that  of seeking help because  thinking therapy has been really stigmatized in the past are you seeing I feel  that's an area that we need to change our our  it's available the health is available but we're seeing for instance  with the opioid crisis we've noted that  I'm just giving an example we've noted that the majority of losses for a two-year period were men that were working and living alone that were passing away from the opioid crisis and so that told us you know that there was some potential for isolation there was some potential for especially with COVID everybody's on lockdown  the potential for them needing to reach out and not knowing who to reach out to and it's almost  a normal coping mechanism to go out and have a drink or you know get some weed or you know even turn to something stronger given the depth of despair they might be feeling so we were losing people that way so yeah that question makes sense so I was just trying to give an example as to how to answer it.

Hailey: okay and then if you're comfortable could you share an individual story of healing and resilience within your organizations.

Interviewee: I think there's a lot of success stories but I don't often get to hear them  what I was thinking I would do is  I was on a national committee  and the committee was first people's wellness circle and what they did was they interviewed cultural support workers and recipients of the programs that we run and basically wanted to get a snapshot of whether or not the program was working and in I think in that document and I think it's online what I'll do is I'll try to find the link and send it to you but if you read through that you can see  how much I think generally overall they were able to show the need for this kind of work to continue  we're unfortunately in the process of  trying to get the funding for this program every year rather than having it a core funded program so  we're having to and that's why the stats and all of the reporting and and the check-ins and you know that question you had earlier is so important is for the renewal of funding so  back to your question I can't think of anybody off and that I could speak directly to because I'm more of an administrative support in FNHA I'm not front line and I'm not interacting with clients so to speak so yeah okay if you do   get a hold of that document.

Hailey: I'd really appreciate it.

Interviewee: yeah I think it would be helpful because it really it highlights what's going on  what we did about it and then the interviewees the people that received the support and the help were able to give feedback on what that was  for them so yeah sure I could find it I'll do that right away after we're done this call.

Hailey: yeah  when I go to present to my school community  my findings I kind of wanted to make it  storytelling  through the art of about  the experiences I've learned about because I feel people learn more through  case studies and  kind of  hearing a narrative.  so I feel  that would be more  impactful  on  my school community because  most of us aren't  very educated on  other than how  we perceive health care  how do other people experience it and what struggles are they going through.

Interviewee: I'm going to refrain from going into too much detail, as these stories aren't mine to tell, but they're going on in our community. We’re grieving the loss, of uh, of two young people, whose lives were taken in tragic, preventable ways. The first loss was a young man who recently passed because of drug-related violence. This kind of goes to show why community support, a ‘strong circle,’ is so essential. When our people feel alone or unsupported, we all feel the impact. If we had stronger community support, maybe we could prevent these kinds of heartbreaks. The second loss, a young woman, she died from an overdose, alone in her home. Yeah, its been tough especially with the young people here since her life could’ve been saved if she wasn’t alone, if she had been in public maybe, or if we had better support you know. but if you want like more success stories so I really  yeah I'm also thinking on the on the website there may be stories but off the top of my head I can't think of where they would be I'm just gonna  First Nations Health Authority has a page and you can actually maybe even search there's a search tab right at the top right you might be able to search stories because there's a lot of YouTube videos and all kinds of interesting things so I would go to wellness and there's an area there called sharing our stories I'm gonna click on it while we're talking yeah so there's all kinds of snapshots here of things that have happened for folks I think that would be our best bet is to kind of cruise through here and see if something speaks to you in terms of what you'd like to talk about.

Hailey: okay. Thank you for sharing those stories, I'm sorry your community is going through that and it must be really tough, um, please don't feel pressured to tell me stories if you don't want but I appreciate you sharing those with me. Rest assured I'll censor them by the way. i, those are really moving. and yes please do send me that link to the FNHA tab.

Interviewee: thanks. no need to censor my name but that's very considerate thanks. yeah there seems to be quite a few stories yeah I think that's how I would approach it because then you've got a reliable source for saying this is where you got the story and here's the YouTube video or the information that you can reference.

Hailey: okay great  okay so move on to the next question then  how do you collect feedback from clients or community members about their experiences.

Interviewee: yeah I think the document I'll send you that's  basically a that is the feedback that people created in terms of that our researchers created in terms of the work that happens not only in BC but all across Canada the other thing we do is we request that at random our support workers whether they're dealing with any program area so emotional support cultural support mmiwg indian day school survivors or if they're supporting one of the 21 communities that are looking for missing children and unmarked graves when they're out in community we have this survey that they do call the client satisfaction sorry a client satisfaction survey so they do that and every now and then they'll send us    a brief overview of what the response was to the services provided  where we often do that the most is big events so  we just had for instance last  a couple months ago a national gathering for indian residential school survivors so people from all across Canada came I think there was about 400 and all residential school survivors that came to bc to Vancouver  I was responsible for setting up health and wellness rooms so we were basically bringing people in and providing cultural healing opportunities for them and we saw a lot of people and while they were doing that they were getting the survey filled out and at the end of the day it was  a 99 satisfaction rate with the work that you know they they had done so we know that we're on the right track in terms of providing the the cultural support people desired so when we do those things it really is helpful so that we know  I think one thing we've seen a real increase in especially after the pandemic which I find really interesting is people want hands-on healing so we started off by offering you know a few people to come in and do  chair massage because people hold all of the stress and the crisis and all of what they've been through over the especially the last few years in their bodies and they really appreciate you know learning to remove that stress from their body so that it doesn't you know escalate into a worse health care issue so that said that is our number one request now when we do any of these wellness events is to have hands-on healing so we have reiki practitioners and cultural energy healers and we provide masseuses that are registered to meet the need so we're seeing it become a more holistic cultural experience that people can opt for  they already get smudging they already get brushed down by cedar or by eagle feathers or other ways so yeah it's it's it's a growing area and that I think is something that's really interesting that's happened recently in the last I would say year and a half.

Hailey: that's interesting. when you talked about a physical manifestation of  I guess  an emotional tone yeah yeah well it just really speaks to the holistic need.

Interviewee: right  I know people that I'm one of them I've created a wellness plan that is holistic so I have a way of  you know if if I'm dealing with a health care issue which thankfully I'm not but I haven't passed I'll work with a dietitian for example to ensure that I'm eating well  I'll and I'll have a gym that I go to or I'll have a daily you know step count that I want to meet so I kind of take care of the physical that way  for emotional I have a mental health counselor therapist that I work with because I've also been impacted as an Indigenous woman so I I have somebody that I will see once every two weeks  and that's become necessary because this job is not easy and sometimes you hear things that are really hard to hear there's a lot of trauma going on a lot of crisis going on so I do that  my spiritual advisors are many but I have two that I go to that I just really appreciate them  taking the time to do ceremony with me that is cultural and that reflects who I am and then  what's the final area physical emotional spiritual mental oh we have opportunities to do to to learn so for example I did the psychological first aid training training but it was an Indigenous approach so you know for me I really appreciated that ability to learn as I move forward and I think that everybody needs those opportunities to provide themselves a wellness plan that keeps them grounded and healthy and well for sure.

Hailey: yeah  this question I didn't put it on the doc but  I kind of  just thought of it now   for with health care. what do you think  what are its shortcomings or  obstacles people face with it  is the first part and then  how do you think the system can kind of meet you  where you're at  what improvements could be made.

Interviewee: okay I think one improvement right off the bat is funding and resources so uh receiving adequate funding our funding comes from the federal government and it used to be that it was  expected because they had an obligation a legal obligation to support residential school survivors through the Indian Residential Settlement Agreement that time frame has passed and it's now become a policy driven support and we think it should be core funded we think it should be  any other health care funding coming our way  we know that the colonial impact and the trauma over the generations has not healed and in fact is actually really  accumulating so it's creating some really dire circumstances especially for our vulnerable population so  I think that they should just provide adequate funding and resources because it's hard to hold people in these jobs when we don't know if we're going to get money next year so then we we have a rotating workforce and therefore a human resource problem so that that's one thing I think that for sure we need to work on  can you ask your question again because there's something else I thought of?

Hailey: just  what are some obstacles people might face to healthcare.

Interviewee: yeah and I think the second is stigma mental health there's a real stigma around  needing to ask for help and we need to normalize the need for mental health support so that people treat it as if they maybe broke their arm or broke leg or need surgery for something it's  you know when that happens it's  nobody thinks twice about it but if you say you're going to you know see a counselor or find a therapist people just kind of go whoa and and it's it's almost not cool or you know and I think about that for the younger people so taking away the stigma of  understanding that there is a colonial history that impacts us still today and that we need to educate ourselves through you know post-secondary or workshops or online or whatever through our grandparents or our families about colonial history and its impacts or we find ways to learn about it in in a health care   related to post-secondary education and there again is another issue there I don't think is enough said in those institutions to really give  people a great  a good idea about what what's happening and what they'll face and why it's happening there's there's a reason and it's a very justifiable reason.

Hailey: so it's a very interesting topic yeah  I asked I have some friends who  are in  medical school for example and it's  barely touched on and I feel  it's an integral part of  if you're working in Canada you're working in  the greater Vancouver community  it's something that you should be prepared to  address.

Interviewee: they're not being prepared  I know when I was doing my master's coursework I was invited into a fourth-year social work program  course and it was labeled First Nations for you know fourth-year students I forget what the label was so this poor lady their their professor was trying to teach them everything they need to know before they went out to be social workers so when they go out to be social workers the highest number of  families that they will work with are it's close to 70 percent First Nations they had no understanding of Indigenous people by the time I reached them and they were graduating at the end of the term and I was just shocked  I really think that post-secondary institutes have an obligation to really teach our professionals the history of our our folks and you know I think I've shared with you a lot about what really goes on here at FNHA to support people in the trauma that they're dealing with  that goes across all all post-secondary you know training so social workers educators teachers  on and on it goes.

Hailey: yeah okay  the Zoom meeting has a time limit so okay and I have the free version so  it's gonna run out in in a minute and a half so I just wanted to thank you for  answering all my questions and giving such  thoughtful  and  detailed answers it was really informative.

Interviewee: yeah awesome and I will search for that document and send it your way I've got your email.

Hailey: yeah thank you so much nice to meet you.

Interviewee: Hailey yeah it was great meeting you. thank you. good luck with your future.

Hailey: yeah you too all.

Interviewee:  righty take care.

Hailey: have a great day all right