An Uncaring State? The Overrepresentation of First Nations Children in the Canadian Child Welfare System

Aboriginal activists and agencies have repeatedly called for a paradigm shift from intervention to prevention; initiatives to accomplish this have produced mixed results. The Enhanced Prevention Focused Funding Approach replaced Directive 20-1; however, recent reviews of this model noted many of the same problems being replicated, particularly with respect to operational costs and the absence of measures to compare federal and provincial funding. Establishment of a national steering committee tasked with monitoring national trends for both Aboriginal and non-Aboriginal youth exposed to the child welfare system would allow researchers and policy-makers to more effectively identify areas where intervention is needed. Comprehensive and longitudinal research to identify the factors driving the high prevalence of neglect charges among Aboriginal families (e.g., programs targeting poverty, inadequate housing, substance misuse) is needed. Such research should be undertaken in collaboration with affected communities. Aboriginal researchers have called for service programming and delivery cultivated by Aboriginal people as key to successful programming. Physicians can do much to improve the lives of Aboriginal families and youth exposed to the child welfare system. This can include helping all Canadians, including policy-makers, better understand the legacy of colonization, as well as the health and social effects of intergenerational trauma. Physicians can also play an important role in advocating for system-level changes to better address the challenges faced by youth and families exposed to child welfare services, including advocating for equitable levels of government funding and service provision. Physician training opportunities within Aboriginal communities, collaborative work with community health representatives, and the development of cross-cultural communication skills among physicians are also needed. Multiple reports have identified the inadequate numbers of Aboriginal health care professionals. Accordingly, efforts are needed to strengthen the capacity of Aboriginal professional organizations (e.g., Indigenous Physicians Association of Canada) to provide mentorship and improve recruitment, training, and retention of Aboriginal health care providers.

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