First Nations Perspective on Health and Wellness and Recovery Capital

Dr. Cornelia Wieman

Day: September 6th 11:00am Studio 411


Health studies involving First Nations (FN) peoples demonstrate a significant impact of substance use disorders. The FN Regional Health Surveys (RHS) in 2002-03 and 2008-10 showed higher rates of abstinence from alcohol amongst FN adults compared to the general Canadian population but also higher rates of binge drinking and heavy drinking. FN are disproportionally impacted by the opioid crisis in BC. FN comprise 3.4% of the provincial population and yet FN people are overrepresented among overdose events (14%) and deaths (10%).

FN are 5X more likely to experience an overdose event and 3X more likely to die of an overdose. Opioid use disorders and adverse events impact FN men (52%) and women (48%) equally, a pattern that diverges from the general BC population. These findings demonstrate the need to develop more effective, culturally safe and innovative substance use treatments and wellness programming for FN.

The construct of “recovery capital” and its’ four components is consistent with the FN Perspective on Health and Wellness and there may be value in exploring similar themes between the two, for the benefit of both populations. The FN perspective on health and wellness begins with the understanding that at the time of contact, FN peoples enjoyed good overall health. Our vision of health and wellness comes from our ancestors and is relational. Colonization interrupted this worldview. Our perspective on wellness acknowledges all four aspects of self (physical, emotional, mental, spiritual), is related to values and recognizes spheres of influence such as home, family, community, land and social determinants of health.

Given the extent, impact and urgency of substance use disorders in FN, developing, delivering and evaluating substance abuse, recovery and wellness programming and services will help to achieve the FNHA vision of healthy, self-determining and vibrant BC First Nations children, families and communities.

Learning Objectives:

1. by the end of this presentation, conference attendees will be more familiar with First Nations Health Authority, its’ mental health and wellness programming and services (including treatment of substance use disorders – eg. alcohol use disorder, opioid use disorder), including innovative programming for substance use disorders such as land-based programs.
2. by the end of this presentation, conference attendees will have a greater understanding of BC First Nations Perspective on Health and Wellness and how this perspective aligns with the components of recovery capital: social capital, physical capital, human capital and cultural capital
3. by the end of this presentation, conference attendees will have a greater understanding of how historical and contemporary traumas impact upon BC First Nations substance use disorders and treatment options, particularly regarding the notion of cultural capital and social connection as part of the recovery (short-term and long-term) process.


1. First Nations Health Authority, BC Ministry of Health and Health Canada (2013) A Path Forward: BC First Nations and Aboriginal Peoples Mental Wellness and Substance Use – 10 Year Plan. A Provincial Approach to Facilitate Regional and Local Planning and Action.
2. First Nations Information Governance Centre (FNIGC) (2012) First Nations Regional Health Survey (RHS) 2008/10. Ottawa: FNIGC.
3. BC Ministry of Health (2017) BC’s Mental Health and Substance Use Strategy 2017-2020. Province of BC.


Dr. Shannon McDonald (Métis/Anishinaabe) completed her MD in 1998 followed with post-graduate medical training in Community Medicine and Psychiatry. She has had broad experience at multiple levels of health care service delivery and health administration in challenging environments. She has worked for over 20 years in the area of First Nations and Indigenous Health, as a manager in the federal and provincial government contexts and for 5 years as the Executive Director of Aboriginal Health at the BC Ministry of Health. She joined the First Nations Health Authority (FNHA) in September 2015 as the Senior Medical Officer for Vancouver Island, and is currently serving as the Acting Chief Medical Officer for FNHA.

Dr. Cornelia (Nel) Wieman (Little Grand Rapids FN, Anishnawbe) is Canada’s first female Indigenous psychiatrist. Following her psychiatry training (1998), she worked at a community-based mental health clinic on the Six Nations of the Grand River Territory. She was an Assistant Professor in the Faculty of Medicine and Dalla Lana School of Public Health (2005-2011) where her primary research focus was First Nations youth suicide. She worked in urgent care psychiatry during 5 years at the Centre for Addictions and Mental Health. Most recently, she joined First Nations Health Authority as a Senior Medical Officer – Mental Health and Wellness in the Office of the Chief Medical Officer. She is currently serving a 3-year term as the President of the Indigenous Physicians Association of Canada. Sarah Lalonde, MBA is a member of Saulteau First Nations (Cree). She currently works in the Office of the Chief Medical Officer as a Manager, Population Health and Wellness at the First Nations Health Authority.

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September 6th and 7th, 2018

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