The Chiefs of Ontario is looking for individuals, youth and Elders/First Nation Knowledge Keepers that have knowledge and experience in First Nation health research, research practices, community-based research, experience with the Regional Health Survey (RHS), reviewing and writing research projects, knowledge of First Nation research ethics to sit on the First Nation Data Governance Committee.

The following “Terms of Reference”, sets out the mandate, purpose, roles, and membership of the First Nation Data Governance Committee.

Supported by the Ontario government’s commitment to improving Ontario First Nations relations and health outcomes for First Nations people living on reserve, a meeting was held on November 24, 2010, between the Chair of Ontario Chiefs Committee on Health (OCCOH) on behalf of the Chiefs of Ontario (COO), Deputy Ministers (DMs) of the Ontario Ministry of Health and Long-Term Care (MOHLTC), Ministry of Aboriginal Affairs (MAA), and Cabinet Office, Intergovernmental Affairs. The purpose of this meeting was to discuss opportunities to continue and strengthen government-to-government relations and to address First Nations health challenges; the parties agreed to focus on achieving progress on mutually identified priority areas (diabetes prevention and management, mental health and addictions, public health, and data collection/analysis).

It was further agreed that the Federal government be engaged as an active participant given its historical and continuing role with First Nations. Health Canada, representing the Federal government is committed to participate in a trilateral process with Ontario First Nations and the provincial government to improve health outcomes for First Nations, in a manner that is guided by the honour of the Crown.

These discussions have lead to the establishment of a Trilateral First Nations Health Senior Officials Committee (TFNHSOC) to work collaboratively in identifying and implementing practical measures on specific priority areas. COO maintains that: “First Nations have a right to the enjoyment of the highest attainable standard of health (physical, mental, spiritual, emotional and environmental) through their Inherent Rights including Treaty Rights” and aspires to the development and implementation of an Ontario-First Nations Health Accord. Notwithstanding this aspiration, the parties agree to continue and strengthen existing government-to-government relationships regarding First Nations health in Ontario. The parties (Ontario, Canada, and COO) agree to work collaboratively in identifying and implementing practical measures in specific areas over the short term to begin to address the health program and service gaps that exist while exploring ways to continue and strengthen the government-to-government relationship over time.

The parties agree that the TFNHSOC will develop approaches to protect and promote the health of First Nations people by:

• undertaking targeted activities in the priority areas of mental health and addictions with a focus on prescription drug abuse; public health; diabetes prevention and management; and data collection and analysis;
• collaboratively identifying health service gaps for First Nations people living on-reserve in relation to identified priority areas;
• advancing the availability and effectiveness of services for and within First Nations communities in Ontario;
• improving the integration and coordination of federally and provincially funded health services for First Nations communities in Ontario which focus on improving health outcomes;
• providing practical recommendations on how to improve collaboration on federally and provincially funded health services in the identified priority areas for First Nations communities in Ontario ; and
• exploring ways to continue and strengthen the government-to-government relationship between First Nations, Ontario and Canada.
• attempt to address the unique geographical and socio-economic concerns of many First Nations communities in Ontario

Access to Mental Health and Addiction (MHA) services have been identified as a priority within First Nations communities. Consequently, there is a need for a focused report assessing MHA service use and system performance. A request was submitted to ICES by the Chiefs of Ontario to replicate an Ontario Mental Health Scorecard1 using First Nations identifiers across the lifespan. The Indian Register (IR) has been linked with ICES health administrative data and is used to identify First Nations people in Ontario with a history of MHA-related service use and outcomes. ICES received approval from the Chiefs of Ontario to use the IR for this project on March 12, 2018. It examines rates of mental health service use and median length of hospital stay for First Nations people, compared to non- First Nations people and to Ontario overall. This is the first project to assess MHA-related performance indicators and factors relating to those indicators among the First Nations population in Ontario.

• Download the Mental Health and Addictions System Performance in Ontario First Nations (2009 2019) – Interim Report 

Ontario, deaths due to opioid-related poisoning have increased substantially during the COVID-19 pandemic2-3; however, little is known about the impacts of the pandemic on rates of opioid-related poisoning among First Nations people specifically. This information is needed to ensure Ontario’s public health response is informed by the needs of First Nations communities and to provide communities with First Nations-specific data to inform their local responses.

The Chiefs of Ontario (COO; PI Bernadette deGonzague) and Ontario Drug Policy Research Network (ODPRN; PI Tara Gomes) have been collaborating on research led by a Steering Committee of First Nations representatives and community members to better understand trends in opioid use and opioid-related poisoning among First Nations people in Ontario. A companion report, ‘Opioid use, related harms, and access to treatment among First Nations in Ontario, 2013-2019’, examines trends in opioid prescribing and opioid-related poisoning among First Nations and non-First Nations people in the province4. This accompanying report provides recent information on the impact of COVID-19 on trends in opioid-related poisonings. Specifically, we describe the impact of COVID-19 on hospital visits and deaths due to opioid-related poisoning among First Nations and non-First Nations people in Ontario, Canada.

• Download the First Nations COVID Opioid-Related Poisoning Report
• Download the First Nations COVID Opioid-Related Poisoning Infographic

Opioid-related harms are a leading public health issue in Canada.3 While the opioid crisis impacts communities across the country, research suggests that First Nations communities are at a higher risk of experiencing opioid-related morbidity and mortality due to the intergenerational impacts of colonialism and residential schools, the historical erosion of First Nations culture, and the ongoing barriers to accessing health care services.4,5 However, there is little published research examining prescription opioid use, access to treatment, and opioid-related harms among First Nations people at a provincial or national level. As a result, First Nations communities and policymakers in Ontario have not had access to the data needed to generate evidence-based and culturally informed responses to the opioid crisis.

Over the past several years, the Chiefs of Ontario (COO) and the Ontario Drug Policy Research Network (ODPRN) have been collaborating to study opioid prescribing and opioid-related harms among First Nations people in Ontario. In 2013, the Chiefs in Assembly passed a Prescription Opioid Surveillance Resolution 13/10 which mandated COO to begin this work and saw the establishment of the Opioid Surveillance Steering Committee, guided by an Elder and comprised of First Nations representatives from the Political Territorial Organizations, Independent First Nations, Six Nations of the Grand River, and the Ontario First Nations Young Peoples’ Council. This Steering Committee continues to guide the research questions, approaches, and interpretations of the data, ensuring that the research meets the needs of the community and is culturally relevant. The timeline below outlines our progress, beginning in 2013 and continuing into the future.

• Download the First Nations Opioid Use Harms and Treatment Report
• Download the First Nations Opioid Use Harms and Treatment Infographic

The First Nations Mental Wellness Continuum Framework (FNMWC), launched on January 28 2015, is comprehensive of mental wellness services across a continuum and outlines opportunities to build on community strengths and control of resources in order to strengthen existing mental wellness programming for First Nation communities. The establishment of the FNMWC Implementation Team (IT) has been a key component to implementation of the framework from a social determinant of health approach. The team which is co-chaired by FNIHB, the AFN and an Indigenous mental health leader, is comprised of First Nation regional representatives and Indigenous organizations with a focus on mental health and addictions, alongside other key federal departments. The team supports the ongoing implementation of the framework, and ensures transition in the system to support the provision of culturally-based, culturally-relevant and effective mental wellness services to First Nations in the coming years.

• Indigenous Wellness Framework
• History and Process
• Framework Presentation Thunderbird FNMHA
• FNMWC Presentation_Thunderbird PF_October 2015
• FNMWC Implementation Overview January 2016
• First Nations Mental Wellness Continuum Summary Report_Final_EN
• First Nations Mental Wellness Continuum Framework_Final_EN
• Brief Guide for Using the FNMWC Model_April 15
• 2013 07 20 Draft MW Continuum Ontario Region Report
• 20-05-2016 First Nations Mental Wellness Continuum
• 02 – FNMWC – Defining Concepts

• 20-18 Prescription Opioid Surveillance
• Opioid Use Among First Nations in Ontario 2017-10-05
• Res 13-10 Prescription Opioid Surveillance