Infected Blanket Policies:: Joan Jack, B.Ed, LLB, #Ojibwaywarriormom

INFECTED BLANKET POLICIES:
BC NORTHERN HEALTH AUTHORITY & FIRST NATIONS HEALTH AUTHORITY MENTAL

HEALTH SERVICE PROVISION
Joan Jack, B.Ed, LLB, #ojibwaywarriormom
ABSTRACT
As First Nations, we are not islands unto ourselves and blanket mental health policies are, in my opinion,
clearly infected by individualistic thinking and financial considerations and are not based upon respect or
reconciliation with collective values or indigenous cultures.
INFECTED BLANKET POLICIES: BC NORTHERN HEALTH AUTHORITY & FIRST
NATION HEALTH AUTHORITY MENTAL HEALTH SERVICE PROVISION
I. INTRODUCTION
This paper has been drafted with the intention of making things better for everyone. While I know that
what I share will be upsetting to some or some may disagree with what I say, this paper is simply a
reflection of how things occurred for my family and me.
This is our story. Our story is not about being right. We share our story in order to be heard. We do not
need agreement.
While I may be stating the obvious to some, our story is also not up for debate and what you do with what
you read is your part. My email is in the footer and I welcome you to contact me and develop a
relationship.
Of critical importance to us is that the reader understands that the First Nation governments of BC
worked hard for many years to establish a First Nations Health Authority that is/was the first of its kind in
Canada [controlled by the First Nation Governments themselves].
The BC FNHA went “live” in 2013, some 6 years ago now, and
… works to reform the way health care is delivered to BC First Nations through direct
services and collaboration with provincial [and territorial] partners. … [by] establishing a
strong foundation that will allow us to innovate and redesign health services …” (emphasis
added)1
However, from what we share herein about what we experienced, you will hear that we did not
experience any innovative or redesigned mental health services. Things may have changed at the top, but
not at the bottom where it matters most to those the system is set up to serve, nothing has changed.
II. BACKGROUND
1. In order to advocate for our son, family and community, we have had to sacrifice our privacy.
Considering the stigma associated with mental health, we are deeply grateful to our son and very proud
of him for being willing to have his story, in general, told so that others may benefit. You are strong and
free son.
2. We also hereby express our genuine gratitude to those of you working behind the scenes, no
doubt with the best interests of our son, family and community in mind.
3. Atlin, BC is located a 2 hour drive away from Whitehorse, YT, which is our nearest hospital and
major centre.
4. Atlin is within the traditional territory of the Taku River Tlingit First Nation (TRTFN) and the town
is located at the end of the road, surrounded by mountains on three side, and situated on the side of Atlin
Lake, which is over 90 km long.
5. My husband is a member of the TRTFN Wolf Clan and I am Ojibway from the Berens River First
Nation in Manitoba, and on Dec. 12th we celebrated our 27th wedding anniversary.
1
www.fnha.ca
Page 2 of 17
Joan Jack, B.Ed, LLB
#ojibwaywarriormom
joanjack@hotmail.com
12.30.19
6. Tlingit land, our community, our family and each of our individual children, both birth and foster,
have been the focus of our marriage for these 27 years. We have three birth children and at least five
permanent foster children whom we consider our own; four daughters and four sons. And, there are
countless other children, Tlingit and Canadian, whom we love and love us as their Auntie and Uncle.
7. We have raised our children to “walk in both worlds” and they are all skilled in the ways of Tlingit
society and in the ways of Canadian society. We have raised our children to be strong, flexible and free
with the knowing that they are each responsible for their own lives.
8. While our children were young, we took them, and many other children, to our fish camp for the
entire summer where they were off the grid (nothing in their ears) for a minimum of six weeks. In 1999
and 2000, others joined us for periods of time, but our son, my husband and I lived on the Nakina River
for 5 months each year from the third week of April to the first week of October.
9. I shared that brief contextual history with you so that you would know where and how our son
was raised; and for the sake of brevity have not included his time with my Ojibway community and family
in Manitoba.
10. On Oct. 27, 2019, we called the RCMP in Atlin as our son appeared to have lost control of his
emotions. We were afraid for him and for ourselves. It took approximately 30 – 45 minutes for the RCMP
to reach our home after being called, so if he had wanted to cause us serious harm, he would’ve had
ample time. Furthermore, the moment we called the RCMP our son ceased his erratic behaviour and
went to his room to quietly wait for the RMCP. Ultimately, the RCMP “formed” our son as he was clearly
in need of mental health services and he was transported in the RCMP vehicle to the Whitehorse General
Hospital (WGH) and received by Dr.’s Elwell and Kuk and placed in the Secure Medical Unit (SMU).
11. Dr. Kuk, the psychiatrist, became his primary doctor and determined that it would be best if our
son was placed in a larger mental health facility with access to mental wellness services that do not exist
in the Yukon.
III. INFECTED BLANKET POLICIES

INFECTED BLANKET POLICY #1 – adult mental health patients being transferred to 24
hour care facilities do not require an escort.
12. Dr. Kuk agreed that, generally speaking, community and family play a key role in mental health
recovery, regardless of culture, and understood how important community and family are to indigenous
peoples due to her experience working in the north.
13. Based on her experience and understanding of working with indigenous peoples, Dr. Kuk
understood that it would be in our sons’ best interests that I accompany him as his escort as she
understood that culturally sensitive care meant he not be isolated from the community and family that
defined him.
14. From the outset, we explained to everyone that for those of us in the far and isolated part of
northern BC, the provision of culturally sensitive services; broadly defined as the ability of community and
family to support the patient, is best provided in the Lower Mainland simply due to cost access barriers.
Page 3 of 17
#ojibwaywarriormom
12.30.19
15. A plane ticket from Whitehorse to Vancouver on Air North can be as low as $400 return, making
it possible for our son to receive support from family and community from the far north.
16. If I had not been able to board the Medi-vac plane with our son in Whitehorse, Dr. Kuk’s order
that our son required an escort would have been ignored and I would have to travel via commercial flight
from Whitehorse to Vancouver and then back up to Terrace, weather permitting.
The decision to expend commercial travel funds, in our case, was within the purview of the BC First
Nations Health Authority (BCFNHA) “Exceptions Committee” 2 because traveling as our sons escort
because our situation was, atomically, an exception.
17. Aside from the costs of a mental health patient having an escort, which seems an absurd reason
to deny an escort as those in a mental health crisis need immediate and constant emotional support from
their family, this “infected” blanket policy is culturally inappropriate bordering on racist. I am prepared to
elaborate on this point if necessary, however, again, for the sake of brevity will not do so here.
18. As First Nations, we are not islands unto ourselves and blanket mental health policies are, in my
opinion, clearly infected by individualistic thinking and financial considerations and are not based upon
respect or reconciliation with collective values or indigenous cultures.
INFECTED BLANKET POLICY #2 – adult mental health patients in BC must receive

services at the psychiatric hospital nearest their home community.
19. We were advised that our son would likely be moved to Terrace, BC as that was the location of
the nearest psychiatric hospital, which is an 18 hour drive south from Atlin (one way) or approximately a
$1000 plane ticket (return) flying from Whitehorse to Vancouver and then back up to Terrace.
While in Terrace, we learned from our BCFNHA CEO (Community Engagement Officer) that the mental
health pathway was the only one that required patients from Whitehorse to go to Terrace (nearest
psychiatric hospital) and that all other urgent/acute health issues, such as heart or cancer, that could not
be dealt with in Whitehorse were supported through a pathway directly to St. Paul’s Hospital in
Vancouver.
When I shared this info with our TRTFN Clan Director Responsible for Health & Social, he was not aware
that this was the case – that our mental health patients were being forced into isolation from family and
community in order to receive mental health services.
20. We objected immediately to our son being placed in Terrace as that would isolate him 100%
from our family and community; which is the worst thing that can happen to a First Nation person as we
are identified by and with our land and community. Even those who are separated from their
families/communities, for whatever reasons, spend their lifetime trying to find their way home to their
people and land.
21. On Friday, Nov. 8th, Dr. Kuk advised us that she had spent 7 hours on the phone that day trying
to get a Dr (psychiatrist) from a Lower Mainland hospital to accept our son and that even Prince George
had refused him.
22. Dr. Kuk also advised that she was told that even if Terrace were acceptable to us, there was likely
an 8 to 10 week waiting period and that, even though she was not successful in finding a hospital in the
2
I will be commenting on the existence of the BCFNHA Exceptions Committee later.
Page 4 of 17
#ojibwaywarriormom
12.30.19
Lower Mainland to accept our son, the waiting period would likely be the same or longer in the Lower
Mainland.
23. Staying locked in a 4 bed unit, with 2 additional isolation rooms in a 50 foot locked hallway in
Whitehorse was just not acceptable mental health care for our son. So, Dr. Kuk advised that she had
escalated his case to the Chief of Medical Staff Dr. Rene Soucy and that he would be talking to other
Chiefs of Medical Staffs at other hospitals in the Lower Mainland.
24. I thanked her for her efforts and advised her that we too would be escalating our matter with our
Chiefs.
25. At that point, our son had a Substitute Decision Maker and I asked her to email Grand Chief (GC)
Doug Kelly, Sto:lo Nation, as I knew he had been the Chair of the BC First Nations Health Authority
(BCFNHA) and I had seen GC Kelly strongly and successfully advocate for our people on many occasions
over the last 20 years that I’d been involved in First Nations politics and law.
26. Within minutes, GC Kelly forwarded our email to persons he deemed appropriate within the
BCFNHA.
27. On Monday, Nov. 11th, our son asked to speak to me and I asked if we could take him out of the
SMU where he had been for two weeks. Dr. Kuk granted us a 2 hour visit outside the hospital and it went
well.
28. When we returned our son to the SMU that day around supper time, Dr. Kuk said that something
had happened “on your side” and Terrace was now suddenly able to receive our son on the next available
medi-vac flight and that she had received a promise that from Terrace he would be transferred to a
hospital in the Lower Mainland on a “Compassionate Basis”.
29. So, we agreed and Dr. Kuk made me our sons SDM.
30. I boarded the medi-vac plane with my son on Nov. 15 th, a couple of days later as delays were due
to weather and the plane being full with other higher priority medi-vac patients. Our son had been in the
tiny WGH Secure Medical Unit, formed, for 20 days at that point.
31. Within 24 hours of our arrival in Terrace, the psychiatrist, Dr. Mayone, assessed our son and
determined that he was no longer a danger to himself or others and said that if he chose to stay for
treatment, as was recommended, he could do so on a voluntary basis.
32. Our son immediately called me saying we could leave as was no longer an involuntary patient.
33. I requested that Dr. Mayone come in on his day off and speak with my son and I, which he
thankfully did, to explain how important it was that my son stay for treatment.
At this point, our son was not convinced he needed help and basically felt trapped and held against his
will. What convinced him to cooperate was two things – first, I supported the doctor saying that he
needed to be observed in an Acute Medical Facility for at least 30 days to make sure the medications
were not having any negative side effects.
And, secondly, I asked him “What would be happening right now if you were one of your cousins from
home?” His response was immediate, “They would be here all alone and wouldn’t know what was going
on.” So, to his credit, he agreed to stay.
Page 5 of 17
#ojibwaywarriormom
12.30.19
34. At this point, we were told by a psych nurse at the Terrace Hospital that, even if the promise to
move our son to Vancouver had been made, in five years she had been working there she had never seen
a patient transferred from Terrace to the Lower Mainland. And, to make matters more stressful and
confusing for us, no one in Terrace seemed to know anything about the promise made to Dr. Kuk that our
son “would be transferred to Vancouver as soon as possible on a compassionate basis”.
35. My response was that it has been my experience that everything happens for the first time -
once.
36. The Prince Rupert Aboriginal Community Services Society booked a hotel room for me in Terrace
as my sons’ escort until the 22nd and I was provided two cheques; each for $163.00 for my weekly meal
costs.3
37. On Friday, the Patient Travel Office Assistant called me and was kind enough to offer to drop off
the meal cheque for me in Terrace as she was going to “be in Terrace anyway”. When we did meet to
exchange the envelope, she said “they told me to tell you that we usually don’t provide an escort as your
son is an adult” and then added “we will go on a week by week basis”. More stress and anxiety.
From the outset, our TRTFN Community Health Representative (CHR) had explained to me that our case
(me being our son’s escort) was going before the BC FNHA Exceptions Committee.
INFECTED BLANKET POLICY #3 – At St. Paul’s Hospital mental health patients enter the
hospital through the PASU (Psychiatric Assessment and Stabilization Unit) and
presumably are all Formed.4
38. Then, suddenly, on November 23 rd, we were told that our son was being transferred to St. Paul’s
Hospital, but that the receiving psychiatrist 5 required that our son voluntarily agree to give up his rights
and be Formed for a minimum of 48 hours. In reading the print on the back of the BC “form”, it is clear
that once a person agrees or is formed, the psychiatrist can automatically extend the 48 hours to up to 30
days and, of course, the right of appeal exists, and we were made aware of the same.
39. For my part, I found this requirement too offensive as our son was clearly making progress and
was responding positively to the medication. My view was that we should just pack up and go home and
do our best with what little we have in Atlin.
Our son had been cooperating and improving for 28 days at this point and to be forced to “voluntarily
form himself” in order to get mental health services was in and of itself offensive and also a huge step
backwards.
40. So, I organized a FaceTime call with Dr. Mayone, the Head Psych Nurse, our son, myself and my
husband. It was my husband, in tears, who pleaded with our son saying “Son, if this is the only way we
3
NOTE: Not that I’m complaining or wanting any more meal money, but I never received further meal support or communications
in that regard and stayed with my son until he was discharged from hospital on Dec. 11, 2019
4
Again, I remind the reader that this document is not about “being right”; it is about how things occurred for us.
5
Later in our experience, there was some “confusion” explained to me as apparently the being formed was not a requirement of St.
Paul’s Hospital and yet that was the information, we had received at Mills Memorial Hospital in Terrace. “He said, she said”, which is
moot since my son, in fact, had to willingly give up his freedom and go back to square one in order to receive culturally sensitive
mental health services.
Page 6 of 17
#ojibwaywarriormom
12.30.19
can get you the help you need, please agree and go. I don’t want you to come back to Atlin and need help
again.”
41. To his credit, while our son was understandably angry about being forced to give up his basic
human rights to get help, he agreed to be formed again as we saw he had no other choice in order to get
culturally sensitive mental health services.
Our son agreed because we have raised him to respect his parents and earlier I he had recognized that we
had to remember that if this was happening to one of his cousins, they would be all alone – and that was
the most important reason for him to make the sacrifice. We are not heroes, we are indigenous peoples
and, as such, we are each and every one of us motivated in our core to serve our people.
INFECTED BLANKET POLICY #4 – adult mental health patients in BC being transported

by medi-vac must all be shackled hand and foot and, typically, escorts are not allowed
on the flight.
42. Needless to say, I was beside myself with emotional pain when I was told I couldn’t be on the
plane with our son. I felt beaten and broken. To make things worse, those helping me in the background
could not assure me that my hotel would be covered in Vancouver as it had to be approved by the FNHA
Exceptions Committee, and, going into a weekend, there was no one to help with medical travel anyways.
Ultimately, these were decisions within the purview of the FNHA Exceptions Committee, which did not
meet on weekends.
43. The cover photo is of our sons’ right arm shackled like a criminal – both arms and legs. Please
note when our son was transported from Whitehorse, YT to Terrace, BC via medi-vac flight, he was NOT
shackled and was only strapped onto the stretcher in the usual manner with seat belts.
III. OUR TIME AT ST. PAUL’S HOSPITAL

PASU (Psychiatric Assessment and Stabilization Unit)
44. The moment we arrived at St. Paul’s Hospital, the actions of the PASU psych nurses made it was
clear we were expected. In Terrace, we had been told by several psych nurses, Dr. Mayone and a
Northern Authority official, that our son would be in the PASU for 48 hours without visitors, without
smoke breaks, without his iPhone at all and without being able to leave the locked unit at all; all the
privileges he had earned after the first week in the Whitehorse General Hospital were taken away – so it
was Ground Zero again after 30 days of receiving “mental health care”.
45. What we experienced, however, was compassion from staff, I’m assuming because after seeing
us, the Air Ambulance Paramedic told me in Terrace that what was written in the paperwork was clearly
not what was occurring. I’m not sure at all what he meant because we don’t get to see what others write
about us and can only assume that things look worse in writing.
Charting, if I were in charge anywhere, would be something I would look at; particularly in light of the
systemic racism that exists in relation to indigenous peoples – just a thought.
46. I was also later told in passing that it was the St. Paul’s Hospital CEO that had made the decision
to accept our son as a patient, which I presume triggered the psychiatrist in the St. Paul’s PASU calling Dr.
Page 7 of 17
#ojibwaywarriormom
12.30.19
Mayone at the Psychiatric Acute Care Unit at Mills Memorial Hospital in Terrace, BC to initiate our son’s
transfer after we had been in Terrace for 10 days.
47. When we arrived at St. Paul’s PASU, I immediately and sadly expressed my concern that I
couldn’t see my son for 48 hours. In response, one nurse looking at me said, “You can come back
tomorrow at 3 pm to see your son and I will put it in the chart for the next shift that you are coming.”
Then another nurse said, “And, we will find the psychiatrist asap and make sure your son is seen and try
and have him out of here in 24 hours.” And, what touched me the most was the third nurse saying,
“Anyways, what he’s going through is because this has been happening to his people for generations.”
Her understanding and their compassionate response to our pain was the best we’d experienced from
psych nurses as a team.
48. Our son should have never been forced to “form” himself in order to get culturally sensitive
mental health services and the fear and trauma both he and I experienced knowing that our lives would
be controlled by such a massive hospital system was inexplicable and we were further traumatized.
I couldn’t stop crying for days and couldn’t sleep and neither could he.
MHTU (Mental Health Treatment Unit)
49. We were moved from the PASU to the MHTU within 24 hours, which was great.
50. The MHTU, however, is behind locked doors and patients voluntary or formed are not allowed to
leave the unit without permission as it is an Acute Care Unit 6. From what I could see, the unit in
underfunded and has simple group activities for patients involving art & crafts, cooking, walks outside, a
TV room, access to a phone, some desktop computers and a very pitiful Zen room, but it is still an acute
care unit.
I cannot overemphasize that both my son and I felt like we had gone backwards because the medications
were helping during the 30 days that we’d been trying to get to Vancouver.
Most upsetting to us was that patients at the MHTU have no private space to visit with family or friends,
except for the sad little Zen room.
Some days, psych nurses used their discretion and allowed us to use one of the three rooms available for
Doctors to meet with patients so that we could visit privately. Other days, the psych nurses were, in my
opinion, fear based and rule oriented and said we could sit in the kitchen, TV room or Zen room if we
wanted to visit privately. It was grim.
51. For at least the first 10 days of our stay at St. Paul’s, each night that I left my son he would say,
“You’re not going to leave me here mom, are you?” or he’d say in the morning “I couldn’t sleep. I kept
waking up thinking you were not coming back and that I felt like I was going to be stuck here forever.”
52. I advised Dr. Singh of the additional anxiety this entire experience had created for our son and I
and then created a diary system and would write in it each night what the plan was for tomorrow and told
him to read it if he felt anxious I wasn’t coming back. I also wrote him a letter of assurance as his mother
and the Serenity Prayer in the front and back covers of the diary.
6
I may not have the label of the unit right, but it seemed to me and I was told that the unit was not intended for long-term
psychiatric care.
Page 8 of 17
#ojibwaywarriormom
12.30.19
And for the first while, even with the passes, when I returned our son to the unit, he would call me about
9 pm to say good night and confirm that I would be coming in the morning.
It was heart breaking to suffer like this with him.

53. My son and I met with Dr. Singh every morning four days a week – together and then each
separately – in total for approximately a ½ hour to an hour each day.
54. After about a week, Dr. Singh began granting us “passes” for a few hours; something which Dr.
Kuk had done in Whitehorse after the two weeks that our son was locked in the SMU. The passes, by the
end of the first week became hourly and then by the second week we were granted overnight visits.
I advised the BC FNHA travel authority via a letter provided by Dr. Singh that our son may be in the St.
Paul’s Hospital as long as 30 days and she responded that the approval of my hotel would go before the
Exceptions Committee. My response was to be angry and I apologized for my rude response to her which
was something like “Ok, I’ll tell the psychiatrist she has until the 12 th to cure my son because I’m sick of
this (and I might have said bullshit).
At that point, I explained to Dr. Singh that the BC FNHA travel authority response to her letter was to say
that my hotel would need to go in front of the Exceptions Committee again. So, I engaged Dr. Singh in
talking about discharge planning because our son had clearly stabilized and was no longer in need of
acute care.
I shared with Dr. Singh that I thought we may as well go home now as nothing productive was coming of
this experience either and getting travel support was too stressful. Besides, our son had been monitored
on the medication for well over 30 days at that point and there did not appear to be adverse side effects,
so it was likely safe to go home to Atlin.
BIC (Brief Intervention Clinic)
55. On November 27th, I texted Mr. Blaine Bray7 saying that I, myself, needed some counselling and
he immediately made an appointment for me at the Brief Intervention Clinic. I also sent him a video
message, which I’m sure made my pain real for him.
56. I saw the psychiatrist there for about an hour, as that is the clinic intake process, then saw a
councillor there for 5/6 sessions to which clients are entitled as it is a “brief intervention” clinic.
57. As it turned out, receiving counselling at the Brief Intervention Clinic was key to my being able to
stay strong, focused and loving for our son and for my husband whom I phoned every night with updates
and for myself.
I am grateful because having this mental health support myself, I see in retrospect, was a critical piece of
ensuring the health of the family member who is in need of services. As far as I was aware, support for
mental health patient family members was not available in Whitehorse or Terrace.
58. If I were designing a culturally sensitive mental health process, I would for sure include support
for the patients’ family.
7
Blaine Bray, Director of Operations – Urban Health, Mental Health & Substance Abuse, St. Paul’s Hospital
Page 9 of 17
#ojibwaywarriormom
12.30.19
IV. DISCHARGE
59. We called the RCMP for help in Atlin, BC on Oct. 27 and our son was discharged from hospital 48
days later on December 11 th. If there were Acute Mental Health Programming in the Yukon, I’m sure this
whole process would have taken no more than 3 weeks or 21 days instead of the 48 days it did take for us
to receive help.
60. Because there is clearly, in my opinion, no Transboundary Agreement between the Yukon and BC
in relation to Acute Mental Health Care and in the Yukon there is only the WGH SMU that I’m assuming
exists for mental health stabilization, were forced to go through what we did in order to get the care we
needed for our son. I also realized that I was going to have to do the discharge social work myself.
61. I immediately drafted an email to the WGH Social Worker asking that she ask Dr. Kuk if she would
take our son on as an ongoing patient.
I contacted a Counsellor that has approval to provide services in both the Yukon and BC so that we could
arrange for both individual and family counselling in either Whitehorse or Atlin as needed.
I contacted our sons General Practitioner and advised her reception that she should let Dr. Madlung know
that we were being discharged and that medication was due on Dec. 20 th.
I connected Dr. Singh with Dr. Kuk and Dr. Singh advised that Dr. Kuk had agreed to take our son on as a
patient, and I also received an email from the WGH Social Worker saying the same.
INFECTED BLANKET POLICY #5 – BC mental health patients must

be seen by the psychiatrist in an out-patient clinic in the city
nearest their residence.
62. The very next day during our daily morning meeting Dr. Singh, she shared that Dr. Kuk apparently
could not see our son after all because he was not a resident of the Yukon and that he would have to go
and see a psychiatrist in Prince George every month.
63. If you’re still reading, you can imagine my reaction would be outrage, but I had reached a state of
determined resignation after seeing our son shackled and had created a belief that this was happening
“through us” and not “to us” so that he and I would stick it out and make a positive contribution leading
to change for others.
64. Dr. Singh expressed that she did not see why this was happening, so I explained some of the
“inter-territorial/provincial” blocks we had experienced along our journey and when I didn’t see
understanding in her eyes, I realized she didn’t know the geography in play.
So, I asked her for a blank piece of paper and drew a map of Alaska, the Yukon, BC and placed
Whitehorse, Atlin, Prince George and Vancouver on the map for her. I explained that Prince George was
at least 20 hour or two day drive one way from Atlin and that flying would require us to make the two
hour drive to Whitehorse and then fly to Vancouver and then fly back up to Prince George, weather
permitting of course.
Page 10 of 17
#ojibwaywarriormom
12.30.19
She responded with a shocked look and said, “Can I call Dr. Kuk again on your behalf?”
65. Dr. Singh made the call to Dr. Kuk and the next day told us that Dr. Kuk had agreed to take our
son on as her patient. I’m wondering how she’s going to get paid, but she’s on our Christmas List now and
at the time of this writing, we’ve already made one trip to meet with her and it went well.
INFECTED BLANKET POLICY #6 – PACIFIC BLUE CROSS

INSURANCE NOT EQUAL OR INTER-FACING SMOOTHLY FOR BC
BENEFICIARIES WHO MUST TRAVEL TO THE YUKON FOR
PHARMACY SERVICES
66. During our visit with Dr. Kuk, when she went to write the prescription for our sons’ medication,
she shared that she did not know the dosage as the records from St. Paul’s had not arrived.
67. Being indigenous is all about our relationships – period – and I said “I know what to do, I’ll text
Blaine” as he had given me his cell number when we arrived and said “I’m here to help you. Text me
anytime. I’ll help you in any way I can.”! So, I texted Blaine and I assume he texted Dr. Singh because we
had the dosage amount within minutes.
68. I dropped the prescription off at Shoppers Drug Mart in Whitehorse like I’ve done for 27 years
and came back hours later to discover that there was a problem with authorization of payment.
69. Through careful listening, I had learned that an “Exceptions Form” had to be signed by Dr. Kuk
and sent back to Pacific Blue Cross or FNHA, I’m not sure, before we could have the prescribed
medication.
70. I leave the drug store, start texting people. I head to our GP Dr. Madlung’s office where I had
been earlier because I know that if I leave Whitehorse without the medication, our son will need an
appointment in Whitehorse to have the medication administered whenever it was approved.
Our son preferred to have medications administered in Atlin by a nurse at the Atlin Medical Centre. But,
if we couldn’t take the medication home, then we needed to confirm the appointment that Dr. Madlung
had offered to “squeeze” into her packed schedule on December 17 th. We would have come back into
Whitehorse on the Thursday or our son would not receive his medication, which was due on December
20th.
71. Upon return to the pharmacy for the third time, I overheard the pharmacists discussing the
struggles with billing and our provider - BC Pacific Blue Cross.
I offered to pay, but the medication is extremely expensive, and one pharmacist says to the other
pharmacist in a nice voice, “Just give her the medication” and turns to me and says, “We’ll figure out the
billing.”.
I thanked him sincerely for exercising his discretion in the best interest of our son and family. I told him I
felt like the woman from the Ikea commercial, “Start the car son!” as I run out of the pharmacy!! We both
laughed, made eye contact and I felt “served”.
Page 11 of 17
#ojibwaywarriormom
12.30.19
72. One of the pharmacists also commented that the insurance coverage we received as registered
Indian residents from BC was far less than what was received by those in the Yukon and other parts of the
country where he had worked.
73. Incidentally, we are all being encouraged to set up an online profile with BC Pacific Blue Cross so
that we can pay for our medications and then get reimbursed when approval doesn’t happen smoothly.
I suppose that would work for the 10% or so of our people who are lucky enough to have jobs, especially
up north, but I’m not seeing this work at all for our people who are on Income Assistance which barely
provides enough money for food, never mind medication.
Again, this policy and process is, in my opinion, infected with middle class small “L” liberal thinking based
on the assumption that – we all have computers, internet access, computer skills and actually have
surplus funds to pay now and be reimbursed later.
As an aside, I drove my husband down to Vancouver from Atlin in early October to have a angiogram after
his stroke in September.
That was almost 2 ½ months ago and we are still waiting for the travel cheque from the BCFNHA – good
thing we had our own gas and food money because we did not want to fly. Oh, and by the way, the hotel
we were booked into in Prince George was a dump.
INFECTED BLANKET POLICY #7 – SOME MEDICATIONS MUST BE

APPROVED AS EXCEPTIONS
74. Why does any medication prescribed by a doctor then have to approved again by that same
doctor before it is processed for billing using the “Exceptions Form”?
I presume our insurance is infected by a blanket policy that says, “we can’t have doctors needlessly
spending too much money on medication for registered Indians”? Or, what?? “Hey Doctor. Are you sure
you knew what you were doing when you wrote that terribly expensive prescription? Could you just
confirm it is necessary to spend all this money by completing this “exceptions form”? Or, can you find
something cheaper for this registered Indian?”
This blanket policy is clearly infected by money and not health motives and if I was the prescribing Doctor
I would certainly tell someone I had better things to do than second guess myself.
V. IN GENERAL
75. Through this experience, our lives have been touched by so many that we know of and many we
don’t know. The purpose of this section of this paper is to highlight moments and people in our
experience.
ADVOCACY - On more than on occasion people told me they had never met such an efficient,
determined and effective advocate as me. I share this now as there is clearly a need for Mental Health
Patient Advocacy and especially for my/our people.
Page 12 of 17
#ojibwaywarriormom
12.30.19
I performed like I did because I am 59 and a lawyer 8 and have been a champion for my people and many
others for years. I brought my professional skills to the table.
Only one person said, “Oh this would be happening if you weren’t a lawyer.” I didn’t believe the person.
ATLIN HEALTH CENTRE (AHC) – Everyone at the AHC is pretty amazing! In particular, RN Delores
Gwerder has gone above and beyond befriending me and giving me her home phone number and email
welcoming me to reach out any time day or night thereby providing culturally sensitive health care – for
us – it’s all about relationship.
ATLIN RCMP – Again, everyone at the Atlin RCMP has treated us with respect and compassion and we
particularly thank Cst. MacDonald for deciding to “Form” our son because at that point we saw no other
solution to getting mental health help for him as there is no help in Atlin.
Turns out, there is no Acute Mental Health Program in Whitehorse either, but we knew we had to start
somewhere.
For those who do not live in the north, Cst. MacDonald had to drive the four hours to and from
Whitehorse and stay with our son until he was admitted, and this happened outside office hours.
AIR AMBULANCE PARAMEDICS – Yukon Air Ambulance Paramedics were friendly, respectful, smiling
and reassuring and did not shackle our son to the stretcher. The BC Air Ambulance Paramedics were
respectful and compassionate and apologized for having to shackle our son explaining that all mental
health patients in BC transported by air were shackled. 9
AMBULANCE PARAMEDICS – Like the Air Ambulance Paramedics, the Ambulance Paramedics both in
the Yukon and BC were friendly and respectful.
In Vancouver, when I asked, because our son had missed supper, they even stopped at a McDonalds on
the way so that I could run in and get him something to eat (hope we don’t get anyone in trouble as there
is probably a rule about not stopping)!
Our Atlin Ambulance Paramedic, who had nothing to do with our journey, except that he has developed a
relationship with us, knew we were gone and when he saw we were back came directly to our home and
visited us for two hours listening to me as I cried telling him what we had just been through – 100%
human being that guy and he is present in a relationship of service – therefore, no need to be culturally
sensitive!
FNHA – As someone who has spent her life working toward freedom for our people, I completely
understand why the First Nation governments (FNGs) in BC created the FNHA.
There were those within the FNHA, however, that responded as indigenous and there were those who
responded as employees. Some did not even respond.
In particular, based on the actual interactions I had with the FNHA staff, I 100% know that we would not
have ended up in St. Paul’s Hospital, where we should’ve been sent immediately, if it had not been for
former BCFNHA Chair and Grand Chief Kelly, Sto:lo Nation stepping up the moment we asked for his help.
Even with his help, it took 30 days to get to Vancouver.
8
I am a Member in Good Standing of the Manitoba Bar.
9
The reader should know that our son was sedated during both flights to the point where he fell asleep, hence no need to be
shackled.
Page 13 of 17
#ojibwaywarriormom
12.30.19
And all along the way, FNHA employees simply implemented the infected blanket policies.
I want to thank Nicole Cross, Regional Executive Director, FNHA North Region for being her Nisga’a self.
I also know that, once I engaged with our FNHA CEC, she worked hard to help us, and I believe we
strengthened our personal relationship.
Nonetheless, I still believe strongly that whenever possible, all positions within First Nation governments
and organizations must be filled by the members of the First Nation(s) served or filled by other indigenous
peoples.
Hiring non-indigenous people when we could have our own people to do the work is not good practice.
And, I do not see an “exception” for the BCFNHA.
Call me racist, but there is no point in doing all this work to create our own institutions and then not give
our own people priority and enhanced opportunity to work within our indigenous institutions. Even
writing this now give me tension in my stomach, but I must speak my truth.
GENERAL PRACTITIONERS – see comment on psychiatrists as medical doctors are treated the same.
In Whitehorse, Dr. Madlung popped in at the Whitehorse SMU to introduce herself to our son and say she
would be his GP when he returned.
In Terrace, I only met our son’s GP by “Godincidence” because I went to a clinic to see a doctor as I could
not sleep from stress and it turned out she was my sons GP.
At St. Paul’s Hospital, I never met the GP who I assume was assigned to care for my son.
PSYCHIATRISTS – Social workers, psych nurses and receptionists are the gate keepers for the
psychiatrists and it is made abundantly clear that psychiatrists are not accessible except in the prescribed
manner.
I am going to build a healing place where medicine people sit with psychiatrists who sit with elders who sit
with me, who sit with you, who sit with social workers, who sit with psych nurses – well, you get it and
that is my dream anyway.
PSYCH NURSES – are hit and miss. A few were amazing, while most were just doing a job.
In Whitehorse, a psych nurse told us to wait in the First Nations Office on the main floor and not come up
to buzz at the SMU where our son was being held.
In Terrace, the frontline psych nurses were friendly and relaxed and we felt calm and cared for by a team
whom I suspected had all been briefed about our situation, but didn’t vibe that against us.
At St. Paul’s PASU, where we were for only 24 hours, the psych nurses were amazing!
However, at St. Paul’s in the MHU, I got the feeling that I was more of an annoyance to most psych nurses
and reception and only felt supported by two of all the nurses we encountered. Most seemed focused on
the rules and it occurred for me to be a very fear-based environment.
Page 14 of 17
#ojibwaywarriormom
12.30.19
ST. PAULS HOSPITAL – Blaine Bray, Director of Operations – Urban Health, Mental Health & Substance
Abuse was especially helpful and without his direct involvement I’m sure our experience would have been
the same as it had been at the other hospitals – pretty poor or just ok.
The receptionist, psychiatrist and social worker who provided me counselling in the Brief Intervention
Clinic were all awesome! I felt especially welcomed/valued, not shamed, by the receptionist because
after my first visit they remembered my name! I was so shocked! How nice to be greeted with such
respect and dignity when in a crisis!
SOCIAL WORKERS10 – The Social Worker at the WGH knew the legislation and system well and was
accessible. She provided me her email and promptly returned communications, saying nice things about
my advocacy and love for our son.
I never met a Social Worker at Mills Memorial Hospital in Terrace.
The Social Worker at St. Paul’s Hospital would not provide me his email and I only met him after making at
least three requests to do so. We met for maybe 10 minutes and I made a judgement that he had no idea
about the north – maybe I was wrong – so I proceeded to email those who I thought needed to be
contacted; especially after Dr. Singh said she would be relying on that social worker to make connections
for us in our community.
TRTFN (Taku River Tlingit First Nation) – our CHR (Community Health Representative) did everything
he could for us within the parameters of what I call “infected blanket policies”. He was accessible and as
the journey continued, he provided us a number to contact him out of the office.
At this point, the TRTFN had no Health Director and I learned from a person at the FNHA that advocacy for
health services in “exceptional” situations like ours is typically handled by the Health Directors.
Once I contacted our TRTFN Clan Director Responsible for Health & Social, he made himself available at
any time and was ready to do whatever was needed to get us the help we needed.
Our TRTFN Spokesperson called me once and also responded via email once showing his support for our
efforts.
During our health journey, there was no TRTFN Health Director.
VI. FIRST NATION HEALTH PROGRAMS

76. The First Nation Health Programs at both the WGH and St. Paul’s Hospital are dismally
understaffed.
77. At WGH Ann Swan, who if an indigenous social worker, saw us when she could as she is clearly
overworked. And, several times, in response to our requests she said, “it’s out of my hands”. It seems
that Ann and others in the program would do more “if they could” or if they were empowered by the
system to do more.
10
This comment does not include social workers who are a part of the First Nation Health Program in Whitehorse.
Page 15 of 17
#ojibwaywarriormom
12.30.19
78. There was no First Nation Health Program that I experienced at Mills Memorial Hospital. The
FNHA CEC for our community referred me to a Northern Health Authority “aboriginal liaison” staff person
whom she described as very helpful (or something like that) and I called him.
He invited me to come to his office telling me where it was located within the hospital. I declined. My
expectation was that he should have come to us in “acute” care as we were the ones in crisis.
I had his email contact so copied him on our plea for culturally competent 11 services. He replied thanking
me for the information and that was the extent of our relationship.
79. At St. Paul’s our son was visited at least once and given a blade of sweetgrass and blanketed. I
also attended one Talking Circle and that same night our son was brought a meal of traditional food and
may have been brought another traditional meal as we were there two weeks. Someone may have
visited my son when I was not there, but I’m assuming this minimal engagement exists due to a lack of
funding.
80. It would have been so much nicer if someone would have come to us at both Mills Memorial and
St. Paul’s Hospital and identified themselves as an indigenous person who was there to help us while we
were in the hospital. Even if we didn’t see Ann much while we were in the WGH, we knew she was there
for us and knew who to call when we needed help; and, she was of great value to us, even if her hands
were tied.
81. The other reality not addressed in any of the hospitals is that many Indigenous peoples are
Christian. Now, I know this is a whole other can of worms, but my understanding of providing support in
most all contexts is to meet people where they are in their journey.
The question, in my opinion, needs to at least be posed by the Indigenous Programming – how can we
support you spiritually? Would you like to see an Elder? Do you smudge? Would you like to see
someone to pray with you? Maybe an Elder, minister or pastor or priest?
Personally, I am an “And”. I am a Pipe Carrier and a Christian.
VII. FLOODGATES ARGUMENT12 AND INFECTED BLANKET POLICIE

82. In law school, first year is common. Then in 2 nd and 3rd years, we get to select our own courses
and particular areas of the law have “recommended” courses of study. When I attended UBC Law School
from 1988 – 1991, aboriginal law was a new and emerging legal concept. Needless to say, there was no
“aboriginal law” stream that one could follow.
83. One of my areas of interest was Administrative Law as so much of our lives as registered Indians
is controlled by administrative law and policy with the two often being confused.
People within governments and institutions, Indigenous governments and institutions included, treat
policy as if it’s law. Leaders/management and employees enforce the law as bureaucrats as if they were
the police and patients or those served were criminals.
11
I overheard Blaine Bray say that he did not believe it was possible to achieve cultural competence in the context of the provision
of health services, but that the best we could do was achieve cultural sensitivity. I’m still thinking about his comment and am
thinking that in a large institution, he’s probably right. But, in smaller situations, we can and must do better.
12
https://en.wikipedia.org/wiki/Floodgates_principle
Page 16 of 17
#ojibwaywarriormom
12.30.19
Meanwhile, policy is intended to guide the decision making of leaders, managers and employees
responsible to those they serve.
Along our journey, there were a couple of people able to move beyond rule enforcement to a place of
compassion where discretion lives.
84. So, the floodgates argument underlies/infects the development of policy and is based on
individualistic thinking and values.
The floodgates argument, oversimplified, goes something like this –
OMG! We can’t do that for him/her or we’ll have to do that for everyone. We don’t
have the money to do that!!
Hence, giving/getting someone what they actually need must be justified as an “exception” – ta da! FNHA
Exception Committee – Pacific Blue Cross Exceptions Form – and so on!
And that is 100% anti-indigenous.
VIII CONCLUSION
85. Originally, I was going to make recommended changes and then I remembered I was working for
free!
86. Basically, I’ve supported our son through his mental health journey, which in and of itself was
traumatizing, while at the same time, I have worked for 50+ days as an Indigenous & Northern Systemic
Change Consultant for free in order to get the mental health services our son needed.
People kept calling me an amazing advocate and loving mother, or simply gave me annoyed vibes, but
what I’ve contributed is more than advocacy and motherly love.
I’ve donated my professional services and expertise in indigenous governance consultant every step along
the way and am now drafting this paper in the hope that it will do some good for others.
87. Instead of making recommendations, I am going to conclude by thanking all of you who helped
us or tried to help and apologize to those I’ve offended and invite any reader to contact me to “relate”.
88. I also do contract work. “Have pen, will travel” 
Page 17 of 17
#ojibwaywarriormom
12.30.19

Infected Blanket Policies:: Joan Jack, B.Ed, LLB, #Ojibwaywarriormom

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Infected Blanket Policies:: Joan Jack, B.Ed, LLB, #Ojibwaywarriormom

Uploaded by

Copyright:

Available Formats

INFECTED BLANKET POLICIES:

BC NORTHERN HEALTH AUTHORITY & FIRST NATIONS HEALTH AUTHORITY MENTAL

Joan Jack, B.Ed, LLB, #ojibwaywarriormom

III. INFECTED BLANKET POLICIES

INFECTED BLANKET POLICY #2 – adult mental health patients in BC must receive

INFECTED BLANKET POLICY #4 – adult mental health patients in BC being transported

III. OUR TIME AT ST. PAUL’S HOSPITAL

MHTU (Mental Health Treatment Unit)

It was heart breaking to suffer like this with him.

BIC (Brief Intervention Clinic)

INFECTED BLANKET POLICY #5 – BC mental health patients must

INFECTED BLANKET POLICY #6 – PACIFIC BLUE CROSS

INFECTED BLANKET POLICY #7 – SOME MEDICATIONS MUST BE

I never met a Social Worker at Mills Memorial Hospital in Terrace.

During our health journey, there was no TRTFN Health Director.

VI. FIRST NATION HEALTH PROGRAMS

Personally, I am an “And”. I am a Pipe Carrier and a Christian.

VII. FLOODGATES ARGUMENT12 AND INFECTED BLANKET POLICIE

The floodgates argument, oversimplified, goes something like this –

And that is 100% anti-indigenous.

88. I also do contract work. “Have pen, will travel” 

You might also like