Placemat - Phase One Evaluation of the Mental Wellness Program
PDF Version (253 Kb, 6 pages)Findings and Recommendations
Overview: Through the MWP, FNIHB provides funding and support for mental wellness programs and services for primarily First Nations and Inuit, and delivered predominantly on-reserve, and in Inuit Nunangat. To respond to an identified need for a more holistic approach to mental wellness and to align with priorities articulated in key partner frameworks, the 2020 Mental Wellness Alignment brought changes to the MWP.
Scope: The evaluation covered the 2015-16 to 2020-21 period and included relevance, effectiveness, and efficiency, with a special focus on cross-cutting themes.
Program Resources: Funding for the MWP increased during the evaluation period from an approximate annual allocation of $236M in 2015-2016 to $481M in 2021-22).
Governance: the advisory group included AFN, ITK, Thunderbird Partnership Foundation, First Peoples Wellness Circle and ISC Evaluation and Program officials.
Key Findings – Relevance:
- There is a great need for funding and support through the MWP to address the ongoing and intergenerational impacts of colonization and systemic racism and to support healing and well-being across the lifespan.
- Funding through the MWP is mostly relevant to the priorities of First Nations and Inuit because of its flexibility and recent funding enhancements in key areas. However, some considerations related to funding stipulations (e.g., capital spending) and need for services for priority populations were noted.
Key Findings – Effectiveness:
- Service access and uptake has grown. Regionally, First Nations and Inuit-led programs are showcasing promising approaches that are grounded in culture, strengths-based, trauma-informed, and responsive to priorities.
- Findings from governance-level partners suggest that there were persistent challenges in access to medical detox services, case management and service transition, and access to treatment services and community-based substance use supports.
- Partnerships are important for supporting the MWP to respond to priorities and for advancing a coordinated system of care. Yet, a lack of provincial partnership and investment is an enduring challenge that has impeded progress and led to duplication.
Key Findings – Design, Delivery & Efficiency:
- The MWP undertook efforts to enhance flexibility and reduce funding siloes through the introduction of the Mental Wellness Alignment. Preliminarily, the Alignment supported more flexibility across funding streams, though building awareness of its intent and purpose should continue.
- Regional First Nations and Inuit regional respondents generally perceived FNIHB-MWP staff as supportive and flexible. Some opportunities to improve were identified (i.e., internal management, communication, and engagement).
- There was strong agreement that available financial resources within the MWP do not meet the demands for services, which greatly affect the ability of Inuit and First Nations to meet needs, develop stable operations, and retain a healthy workforce.
- Efforts by the MWP to reduce siloes and support efficiency were observed through the transfer of FNIHB to ISC. The opportunities introduced through an integrated department could be further maximized.
Key Findings – Performance Measurement:
- Demonstrating performance within the program is challenged by reporting processes (i.e., streamlined reporting), available indicators and outcomes, and short timeframes of investments. Performance measurement approaches could be improved by applying First Nations and Inuit concepts of wellness and supporting capacity to collect meaningful data to inform planning on the basis of these concepts.
Findings (Thematic Areas) and Recommendations
Key Findings – Thematic Areas
Children and Youth: Both Inuit and First Nations representatives described youth-based mental wellness programming and services as an area requiring increased attention within the MWP and across the department.
Climate Change: Climate change is disrupting important and distinct pathways for good health and well-being among First Nations and Inuit (e.g. access to traditional activities, emergency events) in complex ways that will further challenge the MWP operating environment and increase need.
Service Transfer: The MWP has taken steps to support self-determination and advance Indigenous control over services; notwithstanding the wide diversity of contexts, some overall barriers and opportunities were identified (i.e., funding, intra-governmental alignment, restoring capacity, partnership building).
The COVID-19 Pandemic: The COVID-19 pandemic simultaneously created increased need for, and challenges, to deliver the MWP; but new and flexible resources and innovative practices helped mitigate the impact and provided lessons learned for the future.
Recommendations
Recommendation 1 - Indigenous partner-led Phase Two Study: ISC should support an Indigenous-led second phase of study that focuses on First Nations and Inuit community voices that were not captured within Phase One.
Recommendation 2 - Collaboration: ISC should review and identify measures to advance a) intra-departmental; and b) regional collaboration to better address the complex and multi-faceted challenges present within mental wellness (e.g., the social determinants of health, Health Emergency Management planning, children and youth).
Recommendation 3 - Funding: ISC should develop options for overcoming the program delivery challenges created by restrictions on capital spending and revisit and update as required the program's funding approaches, including with respect to the need for sufficient ongoing funding with appropriate escalators, and the appropriate distribution of available funds.
Recommendation 4 - Workforce development: ISC should work collaboratively with First Nations and Inuit partners to explore opportunities/mechanisms that could further support workforce development and support an updated assessment of the impacts of competitive wages on workforce development and retention.
Recommendation 5 - Performance measurement: ISC should work collaboratively with partners to identify opportunities to align performance measurement activities with community perspectives on wellness, ensure alignment between the logic model and program indictors, and continue to fund partner-led assessments to gather meaningful data (e.g., on important topics, issues, and population-specific considerations within the MWP).
Management Response and Action Plan
Recommendation 1: Indigenous partner-led Phase Two Study: ISC should support an Indigenous-led second phase of study that focuses on First Nations and Inuit community voices that were not captured within Phase One.
ACTION: 1.1. Indigenous Services Canada will support an Indigenous-led second phase of study by providing funding for Indigenous-led and community-focused evaluations of treatment centres, mental wellness teams, and opioid agonist treatment wraparound services. (March 31, 2026, to be confirmed with the partners undertaking the work)
Recommendation 2: Collaboration: ISC should review and identify measures to advance a) intra-departmental; and b) regional collaboration to better address the complex and multi-faceted challenges present within mental wellness (e.g., the social determinants of health, Health Emergency Management planning, children and youth).
ACTION:
Indigenous Services Canada will continue to collaborate with regions and sectors to address mental wellness needs in the context of the social determinants of health and other interrelated factors.
2.1 (a): Establish tracking system for Statements of Local Emergency, facilitating equal access to information, and improving opportunities for collaboration between the mental wellness program and other programs/ sectors which support emergency response (Completed, 2021).
2.2 (b): Host National Summits on Indigenous Mental Wellness (Completed, 2024).
2.3 (b): Support ongoing regional collaboration and knowledge sharing with mental wellness leads from each FNIHB region, including sharing updates from regional partnership tables. Monthly virtual meetings, annual bilateral meetings, and an annual in-person meeting. (ongoing)
Recommendation 3: Funding: ISC should develop options for overcoming the program delivery challenges created by restrictions on capital spending and revisit and update as required the program's funding approaches, including with respect to the need for sufficient ongoing funding with appropriate escalators, and the appropriate distribution of available funds.
ACTION:
Indigenous Services Canada will update and refine the funding formulas used to allocate mental wellness resources on an ongoing basis, based on the most relevant and recent data, and will fund knowledge development to inform costing and funding allocations for the mental wellness program.
3.1: Update population-based regional funding allocations with the latest available population data. (Completed, 2024)
3.2: Work with Health Facilities and Infrastructure to map out infrastructure needs and identify options to support community capital needs related to mental wellness. (March 31, 2026)
3.3: Commission a report(s) to assess the funding required to continue to deliver existing mental wellness services and/or to expand or improve mental wellness services with considerations including such issues as capital and infrastructure needs, escalators, distribution of funds, and competitive wages. (March 31, 2026)
Recommendation 4: Workforce development: ISC should work collaboratively with First Nations and Inuit partners to explore opportunities/mechanisms that could further support workforce development and support an updated assessment of the impacts of competitive wages on workforce development and retention.
ACTION:
Indigenous Services Canada will continue to work with key Indigenous partners to support community-based workforce development, including through providing funding to Indigenous organizations to develop initiatives to support, enhance, and develop the community-based workforce.
4.1: Provide funding for national Indigenous organizations (e.g. Inuit Tapiriit Kanatami, National Centre for Truth and Reconciliation) and Indigenous subject matter experts (e.g. 2 Spirits in Motion, We Matter) to develop resources and training materials for the community-based mental wellness workforce (Completed, 2024)
4.2: Provide funding for the development of the First Peoples Wellness Circle's Formative Analysis for the IRS Resolution Health Support Program, which includes recommendations around training needs and networking opportunities for the trauma-specialized workforce. (Completed, 2024)
4.3: Support the First Peoples Wellness Circle and Thunderbird Partnership Foundation to develop a workforce wellness strategy (Completed, 2024)
4.4: Provide funding to support the Thunderbird Partnership Foundation and First Peoples Wellness Circle to explore the development of a national mental wellness workforce association that could consider various priority issues including how to continue to assess the impacts of competitive wages on workforce development and retention. (March 31, 2026)
Recommendation 5: Performance measurement: ISC should work collaboratively with partners to identify opportunities to align performance measurement activities with community perspectives on wellness, ensure alignment between the logic model and program indictors, and continue to fund partner-led assessments to gather meaningful data (e.g., on important topics, issues, and population-specific considerations within the MWP).
ACTION:
Indigenous Services Canada will continue to work collaboratively with Indigenous partners to develop culturally appropriate and relevant approaches to performance measurement, supporting and leveraging the work of Indigenous partners, and implementing the Mental Wellness Program Results Framework.
5.1: The Mental Wellness Program will provide funding to Indigenous organizations to build capacity and/or implement culturally appropriate and relevant approaches to performance measurement and/or evaluation. (March 31, 2025)
5.2: The Mental Wellness Program will provide a Program Results Framework to the Treasury Board Secretariat, outlining the Mental Wellness Program's proposed approach to performance measurement, key considerations involved in this work, and the preliminary structure of the Results Framework. (Winter/Spring 2024/2025)
5.3: The Mental Wellness Program will implement the Program Results Framework, including the logic model and corresponding performance indicators considerations, developed under the four key themes of Availability, Accessibility, Quality, and Effectiveness. (March 31, 2026)