At least three psychologists working for Indigenous Services Canada haven’t been paid in months, and one no longer takes federal contracts following a change in government providers last July.
“It isn’t worth it anymore. I shouldn’t have to spend more time trying to get paid than I do working with a patient,” said one psychologist, who recently had to drop her only Indigenous client. “You file a claim with an authorization number, you’re told the number isn’t valid anymore. You refile, you get on the phone, you try again and nothing happens.”
Nakuset was taken from her sisters during the Sixties Scoop. She’s spent a lifetime dealing with the consequences of having her name, her language and her family stolen because of a racist federal policy.
Her therapist is an indispensable part of her life. Recently, she said the woman who has treated her for years told her she might not be able to keep her as a client.
“This is terrifying,” said Nakuset, executive director of the Native Women’s Shelter of Montreal. “You spend years building a relationship, a connection with someone to help you heal. And then one day it might all go away because of a glitch in some system.
A ‘chaotic’ transition
Members of First Nations who live with trauma are eligible for psychological support paid for by ISC. The government delivers these services through a contractor that pays psychologists, provided they register with it.
ISC sent memos to therapists across the country last spring, asking them to register with its new contractor, Express Scripts Canada. A company that specializes in providing coverage for non-insured health benefits like dental care, prescription drugs and psychotherapy.
Sources inside ISC say the transition has been chaotic and that psychologists across the country have flagged problems with Express Scripts’ billing system.
“Some providers may have experienced delays if they were not enrolled at the time of submitting their claims, or due to their claims not meeting the conditions necessary for immediate adjudication,” a spokesperson for ISC said in a statement sent to Ricochet.
“Express Scripts Canada continues to reach out to those providers who have not already re-enrolled in the NIHB [Non-Insured Health Benefits] Program as well as to providers whose claims have been rejected and require assistance with claims submission.”
Ricochet contacted 10 Quebec-based psychologists who work with ISC and three of them said they haven’t been paid since last summer. Eight of them said they experienced delays ranging from three weeks to several months before being compensated for their work. There are roughly 100 therapists who work with ISC in Quebec, according to a mailing list obtained by Ricochet.
“It wasn’t a well-oiled machine when it launched,” one therapist said. “I don’t think there was ill will on anyone’s part, I just think this was poorly executed. When I spoke to the people at Express Scripts, they were kind and patient.
“But it took time to solve the billing problems.”
Two of the psychologists said they experienced no delays at all. All 10 were registered with the new service provider when they forwarded their bills. Their names have been withheld for fear of harm to their careers.
Express Scripts Canada did not respond to messages seeking comment.
‘Four times more likely to suffer from severe trauma’
Indigenous people in Canada are about four times more likely to suffer from severe trauma than non-Indigenous Canadians, according to the Centre for Suicide Prevention. The causes are often traced back to being abused at residential school or being descended from someone who was sexually or physically assaulted while in state care.
There are those, like Nakuset, whose earliest memories are of being taken from the reserve and placed in foster care, or being adopted by a white family and given a non-Indigenous name and identity.
Four years ago, Nakuset and two of her sisters spoke for the first time in decades. They had been forcibly separated as children and it took them years to track each other down as adults. Sonya was living in Ontario, and Rose Mary had been sent overseas to Austria.
They planned an in-person reunion but Sonya took her life in 2018.
“I fell apart when that happened,” said Nakuset, who has spent her adult life helping other Indigenous women get back on their feet. “I try to be strong, to power through things, to fight, but that took a lot out of me.
“That’s why we need therapy. The trauma never stops. It lives inside you.”