Eskasoni crisis model could work in other places

The suicide crisis in the First Nations community of Attawapiskat is bringing up difficult memories and fresh frustrations for the Cape Breton First Nations community of Eskasoni.  

Eskasoni faced its own suicide crisis in 2009 and the community's director of health, Sharon Paul-Rudderham, said she's seeing a similar pattern emerge in Attawapiskat. 

"Everyone wants to respond when you're in crisis. Governments want to see action when there's a crisis, so you see on the news now that they're parachuting in all kinds of people to provide the support and counselling to community members," said Paul-Rudderham.

"But unfortunately, yes ok, that might help in the short term but that's not going to help in the long term."

New model

"We need community resources at the community level that are culturally appropriate and the government is not funding those programs or services within our community."

She said after the crisis in Eskasoni, the community came up with a mental health services model that she thinks could work for other First Nations communities across the country. 

• Hear details of Eskasoni's response here

One of the first things Eskasoni did, according to the director of mental health services, Daphne Hutt-MacLeod, was to identify a problem with the way they were being funded.

"It is siloed money, so the money comes down for a particular program," she explained. "By the time it gets down to the community level, the amount is very small.

"That siloed system was creating gaps in our community-based system. Those gaps were translating into grave sites and were being filled by the bodies of young people who were falling through the system." 

Hutt-MacLeod said they decided to amalgamate the funding and all the services under one umbrella to help fund new services such as a crisis line and a youth mental health team.   

They also developed what she calls a "fishing net" model of delivering mental health services. 

Out in the community

"Our mental health workers are out providing sports, recreation, cultural and traditional activities," she said. "So they're out in the community doing non-traditional clinical mental health services, so that people in the community see them and interact with them freely."

"We try to reduce the stigma associated with being involved with a mental health person. The net is our workers, when people need our help, they scoop them up and bring them into the office and have them referred, with their permission." 

Hutt-MacLeod says the approach also works as a preventive model.

"If somebody is in good mental health, we want to keep them that way, so we put on programs and activities to keep people in good mental health," she said.

Sharon Paul-Rudderham said they can see evidence that the approach and services like the crisis line are working.  

"We can see it in the lives of the community. We haven't had any suicides since we began the crisis line and since we began to change the way that we're providing services." 

Funding woes

She worries now, though, that the crisis line is in trouble. 

"As our crisis went away from the news headlines, the funding source dried up, so we are in jeopardy everyday of losing our crisis line," she said.

She says for now, chief and council are providing financial support, but the funding model has to change or there will be more communities in crisis. 

"That's what's going to happen on the other First Nations communities unless there are real changes in the way that government looks at the way they fund mental health service."

The province responds

Nova Scotia Department of Health spokesman Tony Kiritsis sent the following email response to query from CBC for a comment:

"Ensuring all Nova Scotians have access to mental health services is an issue government takes seriously. We know that the federal government has signaled their interest in making more investments into First Nations' health services, including mental health services.

They have identified this as an area of priority and we look forward to opportunities to work with our federal partners to address barriers to accessing health services.

All Nova Scotians have access to mental health services, including the 24/7 provincial mental health crisis line. We would encourage any Nova Scotian who needs help, to access this and other services across the province.

We will continue to address barriers to accessing health services by continuing to work closely with our First Nations' communities and the federal government."