Ottawa to stop approving travel for Indigenous mental health program

The federal government says a key mental health program will no longer cover travel for counsellors to visit residents in isolated communities – or vice versa.

Earlier this week, Indigenous Services Canada (ISC) said funding delays were to blame for disruption to a counselling program on which some northerners rely.

The program is called the Indian Residential Schools Resolution Health Support Program. According to ISC, it is part of a broader package of supports named the Trauma-Informed Health and Cultural Support Program.

Survivors of residential schools and their families can use the program to access mental health counselling. In recent weeks, some said their counselling had stopped because the federal government had placed the program on hold.

In its initial statement to reporters, ISC said the program would continue, gave little detail about the funding delays, and made no mention of any changes to the supports northerners can receive.

But an email sent to mental health workers on Friday by ISC’s director general for the North, Heather MacPhail, makes clear that the delays have lasted for months and caused significant disruption, while a major change has been introduced with immediate effect.

$630 million announced in March to extend a suite of mental health supports didn’t actually arrive until the end of June, MacPhail wrote, saying this had caused “disruption in the department’s ability to pay invoices in a timely fashion.”

Multiple mental health workers contacted Cabin Radio over the past week to assert that despite ISC’s Monday insistence it was now “approving invoices within service standards,” they had not been paid for months and had been told expenses related to new clients would not be reimbursed.

Two people said they were continuing to see clients but considered themselves “volunteers” as they felt unable to turn people away who had recently started counselling but whose costs were now not covered by ISC.

In her Friday email, MacPhail said ISC recognized “the challenge that this presented for providers of important mental health services” but insisted invoices are now being processed and payments sent.

No more travel

While mental health workers who received the email interpreted it to mean they can resume accepting clients under the program and invoicing accordingly, the email outlined a major change in how the program is actually delivered.

“Going forward, in Nunavut and the Northwest Territories, approvals will be for virtual services only, as there is no funding to support client or service provider travel,” MacPhail wrote.

Two mental health workers said this amounted to confirmation of a large shift. They described routinely travelling to isolated communities to deliver counselling under the program, or clients travelling to larger centres for in-person help.

“Almost all NWT communities had at least one service provider who would go into communities every 4-8 weeks to provide counselling. This is no longer the case,” one mental health worker wrote, requesting anonymity to freely discuss their work.

They said the change had already taken effect in recent months, meaning that while clients in Yellowknife could still meet with a counsellor in person, others in smaller communities are now restricted to video or phone sessions only.

“Many clients live in overcrowded households and cannot access a private, safe space for virtual counselling,” the mental health worker wrote, and they might struggle to access reliable internet or have enough cell phone minutes.

Sessions by phone make it harder for mental health workers to assess someone’s emotional state, the mental health worker added, while some approaches that can help people are less effective by phone or video.

“Many treatment plans for clients who are in the middle of processing their trauma will need to be revamped, and the processing of trauma will likely have to be abandoned as a treatment goal for many clients due to the lack of safety and effectiveness of virtual counselling,” the mental health worker wrote.

Shift behind the scenes

In her email, MacPhail said some of the disruption comes from behind-the-scenes changes to the way funding works.

Previously, funding came from a mix of the Trauma-Informed Health and Cultural Support Program and the separate Non-Insured Health Benefits program, which is already heavily criticized in the NWT as it does not fully cover costs that the territorial government says the federal government should bear.

NIHB is now considered the primary funder for this kind of mental health counselling program, but NIHB “has not enrolled mental health service providers” in the North – in part because the Trauma-Informed Health and Cultural Support Program was previously handling that, MacPhail wrote. That seems to have contributed to the breakdown of the system that paid mental health workers.

“We heard from many of you regarding the challenges and impacts this may have caused,” MacPhail wrote, adding that “planning is under way now for service provision in Nunavut and Northwest Territories beginning in April 2027 to avoid any service disruption.”

This is not the first time Indigenous Services Canada has made nationwide changes that had the effect of reducing service in the North.

Massive changes to the Jordan’s Principle program, which removed tens of millions of dollars in education funding from NWT schools, led multiple officials to question whether ISC had realized the territory has barely any reserves. (Jordan’s Principle funding for education remains accessible to schools on reserves, but the NWT has only one school on a reserve and almost 50 that aren’t. Of those, the vast majority have student populations that are almost entirely Indigenous.)

For the Northwest Territories, another new system to fund this form of counselling is now likely for 2027 onward.

“We will ensure to provide you with adequate time and information regarding any upcoming changes,” MacPhail told mental health workers.