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Research has shown a higher prevalence of mental illness, including depression, addiction and suicidal behavior in some First Nations, Inuit, and Métis communities, relative to the general Canadian population. Interventions and resources are often allocated to Indigenous communities in times of crisis, but these have often had limited success due to the lack of cultural competence, limited understanding of the local context, and failure to address the wholistic mental health care needs of the community. Often approaches to wellness focus on medical ways of knowing to the exclusion of Indigenous knowledge, values and practices for wellness. Another limitation is the tendency to focus on ‘disorder’ with adequate attention to strength and resilience.
Support for primary care providers to address mental health and addiction needs in a culturally-relevant way, within community care settings, has been identified as a promising approach for the delivery of mental health services in First Nations, Inuit, and Métis communities. Support must be collaborative, community driven, and incorporate both cultural approaches to wellness and best practice mental health care to create community partnership and provide culturally competent care to patients.
Last year the Centre for Addiction and Mental Health (CAMH) partnered with the University of Toronto to develop Project ECHO (Extension of Clinical Health Outcomes) Ontario Mental Health at CAMH and the University of Toronto (ECHO Ontario Mental Health). After a successful pilot cycle, ECHO Ontario Mental Health is launching a new project to address mental wellness from the perspective of wholism and support primary and community care providers in First Nations, Inuit, and Métis communities: ECHO Ontario First Nations, Inuit, and Métis Wellness (ECHO ON FNIM Wellness). This project is fully funded and does not require any payment from primary care provider sites or participants.
ECHO is a ‘Hub' and ‘Spoke' model of knowledge dissemination and capacity building, which aims to exchange knowledge between academic health science centers and the frontline of community care. It relies on the flow of knowledge in multiple directions: from specialists to community care providers; between community care providers; and from community care providers to specialists. This model is appropriate for both physicians and allied healthcare providers, and has been successfully replicated throughout the US, and globally.
This project is fully funded and does not require any payment from primary care provider sites.