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CAMH Stories Centre for Addiction
and Mental Health

ECHO addresses integrated physical, mental and spiritual health for Indigenous communities

By Michael McKinnon


A CA​MH collaboration is combining technology with traditional Indigenous healing and knowledge to improve wholistic care for First Nations, Inuit and Métis people across Ontario.

ECHO Ontario First Nations, Inuit and Métis Wellness
is one of six new ECHOs to be funded by the Ministry of Health and Long-Term Care. CAMH is helping lead this expansion of the broader ECHO Ontario Mental Health at CAMH and U of T program to also include community-based addictions (working with St. Michael’s Hospital); gender identity; obsessive compulsive disorder (working with Sunnybrook); structured psychotherapies; and advanced practice mental health.

  IMG_4177_600.jpgThrough weekly teleconferencing, ECHO Ontario First Nations, Inuit and Métis Wellness connects experts at the Toronto hub with primary care providers at Ontario remote and rural communities to share knowledge and discuss complex cases.​

ECHOs follow a collaborative model, connecting health care providers in Toronto with primary care and mental health care providers working with remote and rural communities to share knowledge and improve care. Through weekly teleconferencing, ECHO teams  including psychiatrists, physicians and social workers  discusses complex cases and makes recommendations for specific populations. ECHO Ontario First Nations, Inuit and Métis Wellness has been further customized to include First Nations social workers and traditional healers, and Elders.


“In remote and rural communities, primary care providers and front line mental health and addictions providers really have to do it all, and so this kind of telemental health support is key to establishing a learning community and supporting one another,” says CAMH Elder Kahontakwas Diane Longboat, ECHO’s traditional healer.


Through community engagement, the team has ensured traditional Indigenous approaches and knowledge are an integral part of wellness at the ECHO table. The Elder opens and closes each session with a prayer while an Indigenous host guides discussions; the team plans to welcome Elders from ECHO’s partner sites to share in these roles, as well, recognizing that Indigenous knowledge and traditions differ from community to community. All participants contribute equally to case discussions and recommendations from the elder to psychiatrists and physicians to the primary care providers and service providers in the remote and rural settings.


“All of us view each other as equal team members; that’s an important dynamic that needs to be highlighted. Everything threaded through the ECHO is a balanced response from the traditional healer, the psychiatrists and physicians present, and the partner sites,” says Longboat.

 DSC_0025_460.jpgElder Kahontakwas Diane Longboat, ECHO’s traditional healer, right, listens to Dr. Renee Linklater, Director of Aboriginal Engagement and Outreach in the Provincial System Support Program, speak at the opening of the CAMH’s Ceremony Grounds in June 2016. Both play an important role in ECHO Ontario First Nations, Inuit and Métis Wellness.​

ECHO Ontario First Nations, Inuit and Métis Wellness aims to address complete wellness – physical and spiritual, as well as mental. With Longboat and other Indigenous staff addressing the spiritual side, Dr. Lisa Richardson, General Internal Medicine at UHN, provides expertise in physical health.


“We chose the word wellness rather than health because we want to signal the broad perspective that we’re taking – integrating both physical and mental health wellness, but also integrating spiritual wellbeing, family, community, and Indigenous knowledge,” explains Dr. Allison Crawford, a CAMH psychiatrist who co-leads the ECHO with Dr. Renee Linklater, Director of Aboriginal Engagement and Outreach in the Provincial System Support Program. “This ECHO is really enhancing best practices for people with complex mental and physical health challenges, and it’s also deepening the connection and relationship between best practices, traditional healing practices and Indigenous knowledge.”


ECHO is aligned with the Medical Psychiatry Alliance, a unique health care partnership aimed at integrating health care services for those living with mental illness. 

Published on January 30, 2018

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