Whitehorse - February 27.  This was the first of three meetings planned in each of the three territories.  We met in a sunny community room on the second floor of the local bakery/vegetarian restaurant, with a good mix of service providers, people with lived experience of mental health issues, a mother/son duo, government officials, NGOs, and First Nations Health and Social Directors from communities across the Yukon.  Many of the issues that were brought forward reflected a unique northern perspective. 

With regard to recovery, there was a real diversity of views.  Some called for more of an upstream focus, others called for more focus on meeting the urgent and complex needs that are so pervasive in some communities.  Much as we heard in St. John’s, there was a real concern about invoking the HOPE of recovery – does it raise false hopes when there are such barriers to access to services  (poverty, shortages of services in remote communities, and lack of supportive friends/families/communities)?  I found this interesting, as these are not the usual concerns about false hope, which centre more on concern that it raises false hope to say that recovery is possible for people with serious mental illness. 

Another theme that emerged related to alternative approaches to healing and recovery – could the framework do more to advocate for greater recognition and support of alternative approaches?

The discussion around the promotion and prevention goal echoed the discussion of the recovery goal.   While some felt that this goal needed to be strengthened (can we do better than “action is taken?  How about strong leadership?), others felt that goal 5 should come before this, that our real priority should be access to services.

An interesting idea emerged on cultural safety – given concerns about slotting people in to cultural stereotypes, would it be better to focus on safety in the face of unequal power relationships?  Is it hard to really talk about something that goes beyond cultural sensitivity and competence, that still uses the word “culture?”   How is cultural safety really different than cultural sensitivity?  There was strong support for the inclusion of support for translation services, and a suggestion to acknowledge literacy as well. 

With regard to family, there was a very balanced and respectful discussion that on the one hand supported the call for greater recognition of  and increased support for families, and on the other hand, raised concern that the goal as currently formulated seems to gloss over the fact that not all families are supportive or interested in being supportive.  Consent and confidentiality issues were flagged, particularly  given the northern and remote nature of their communities.   And the importance of being able to choose  who we consider to be our families was also raised.  Questions included:

·         Can the goal be re-balanced to put more emphasis on personal choice, while still honouring the contribution of family and their need for increased support?  

·         One participant memorably likened the onset of mental illness to “being run over by a truck.”  Can we strengthen the discussion of prevention, to make clearer that sometimes it is very hard if not impossible to prevent mental illness? 

·         Where is the discussion on legal issues such as community treatment orders? 

·         Has adopting a comprehensive framework led the commission to dilute the clarity on the needs of family caregivers that Out of the Shadows had? 

Another issue that we haven’t heard before – what can be done to address the differences in legal and policy frameworks between territorial and provincial services when people are sent south, to improve integration of services across jurisdictions? 

The discussion of the access and integration goal kept coming back to the primacy of addressing inequities, of looking at access issues through the lens of major socio-economic disparities.   Other issues with a northern flavour included continuity of care with services in Alberta, and the need for choice of services in order to address concerns about  confidentiality in small communities. 

A striking point was made regarding the research goal, that it isn’t just about translating knowledge into practice, but also about translating knowledge into POLICY.

With regard to stigma, there was some questioning of the term “illness,” is it stigmatizing?  Would it be better to reframe the goal more positively, as in “everyone is accepted” ?

With regard to the social movement, similar concerns were raised as in other sessions regarding support for consumer organizations and how the movement will be managed.  There was also a passionate call for this to focus on adequate funding of services and supports for people with urgent needs.