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Ontario Health Minister Eric Hoskins is announcing funding for 20 full-time mental health workers for Pikangikum First Nation

John Woods/the canadian press

Ontario will dispatch up to 20 additional mental-health workers to a remote First Nations community where at least four youths took their own lives this month as government and Indigenous leaders meet Monday to discuss a health-care overhaul on Northern Ontario reserves.

Ontario Health Minister Eric Hoskins said on Sunday the provincial government is allocating $1.6-million to send more counsellors to Pikangikum, a fly-in community of about 2,800 close to the Manitoba border. Nearly 400 people there are seeking counselling amidst a suicide epidemic whose victims include two 12-year-olds who killed themselves on the Canada Day long weekend.

"There's no doubt in my mind," Dr. Hoskins said, "that it's a community in crisis."

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Read more: Ontario First Nation 'in shock' after two more young people take their own lives

The tragedies in Pikangikum are part of the worst year in recent memory for suicides in the Nishnawbe Aski Nation (NAN), a territory of about 45,000 people spread over 49 communities in Ontario's vast hinterland. At least 24 people in NAN territory have taken their own lives so far this year, the most since 2006.

Eight were between the ages of 10 and 14, the most NAN has recorded in that age bracket since it began tracking self-inflicted deaths in 1986, according to a NAN spokesperson who added that, even among the youngest victims, hanging is the most common method of suicide.

The suicide crisis will loom large when Dr. Hoskins, federal Health Minister Jane Philpott and NAN Grand Chief Alvin Fiddler meet in Ottawa Monday to formally sign off on a "Charter of relationship principles," that is intended to lead to a transformation of the health-care system in NAN territory.

Grand Chief Fiddler said the charter is meant to address not just the suicide epidemic, but the problems that underpin it: Poverty, dilapidated housing, unsafe drinking water.

He also spoke of a health-care system that he said is too tightly controlled by federal bureaucrats far removed from life on isolated reserves."All of us have agreed there has to be a total transformation of how health care is delivered in the NAN territory," Mr. Fiddler said. "The charter of principles outlines how this will happen."

The charter of principles has been in the works since Grand Chief Fiddler and the Sioux Lookout Area Chiefs committee on health declared a public-health emergency in February, 2016, a move they hoped would force the federal government to provide clean drinking water and respond to a 2015 federal auditor-general's report that highlighted shocking shortcomings at the nursing stations on reserves in northern Ontario and Manitoba.

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In separate interviews with The Globe and Mail on Sunday, Dr. Philpott and Dr. Hoskins mentioned British Columbia's experience of devolving front-line control of health to First Nations as a good example that could one day be followed in NAN territory, although both said that decision ultimately rests with the territory's people and leaders. In 2013, Health Canada's First Nations and Inuit Health Branch (Pacific Region) handed all of its responsibilities over to a new province-wide First Nations Health Authority, the first of its kind in the country.

Dr. Philpott said the current system in Northern Ontario doesn't "necessarily recognize the desire that First Nations have to control health systems and be able to be in a position of setting their own priorities and making their own decisions. [The B.C. model] has been a successful model in Canada and there's a real desire in Ontario to work toward a similar type of structure." She said she was open to considering the B.C. model in other places, not just NAN territory.

Dr. Hoskins said that, along with the $1.6-million for more counsellors in Pikangikum, his government will set up a new Indigenous youth and community wellness secretariat that is intended to act as a one-stop shop for First Nations communities seeking a quick response to their calls for help. Right now, there are between six and eight mental-health workers in Pikangikum, Dr. Hoskins said. The new full-time counsellors are "going to be there as long as needed," he added.

Dr. Hoskins was moved by a 75-minute conference call last Monday with Mr. Fiddler and front-line workers in Pikangikum that came after a heartbreaking weekend in which two girls in their mid-teens died by suicide, including the older sister of a 12-year-old girl who took her life earlier in the month.

Asked why the extra help was not sent after the two suicides on the Canada Day weekend, Dr. Hoskins said some additional counsellors had already been dispatched, including a few relocated from Fort Frances, about 350 kilometres west of Thunder Bay.

"Things are being done," he said. "Part of it is, it's difficult to know when it's enough or when it's effective."

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