Photo caption: Representatives from Dnaagdawenmag Binnoojiiyag and Mackenzie Health at the 2025 Ontario Health System Quality and Innovation Awards, where their collaborative partnership was recognized as one of the top three finalists for an Innovation Award.
By: Kathy Yang, Senior Communications Consultant, Mackenzie Health.
Relationships between families and care providers must begin with trust. For many Indigenous families, that trust has been difficult to build. Generations of systemic oppression that attempted to erase language, culture and identity have left deep and lasting impacts. Today, there is growing recognition across health care that better outcomes require more than services alone. They require care that is designed differently, in partnership with Indigenous communities.
Since 2023, the organizations have been offering a behavioural support program for Indigenous children and youth with complex behavioural needs, including developmental and neurodiverse diagnoses such as Autism Spectrum Disorder and Fetal Alcohol Spectrum Disorder.
In shaping the program, Elders shared that Indigenous communities do not use diagnostic labels. Instead, children who may receive diagnoses in western clinical settings are understood as Shiny Children, with the Gift of Thinking Differently. Guided by Elder John Rice’s teachings, and recognizing that diagnosis requirements often create barriers to accessing services, the program remains flexible in supporting children and families without formal diagnoses.
The program provides applied behaviour analysis (ABA)-informed services, an evidence-based approach that helps teach new skills, encourage positive behaviours and reduce behaviours that can interfere with daily life.
Its goal, however, is broader: to help families stay together, strengthen connections and support healing in ways that reflect Indigenous values and traditions.
“We knew from the beginning that this program had to look different,” says Mario Notarianni, Program Lead Consultant, Mackenzie Health. “We’re not coming in with a fixed plan. Partnership isn’t just part of the model — it is the model.”
The program was co-developed from the outset, with teams from both organizations working together alongside Elders and cultural advisors to reimagine service delivery. Dnaagdawenmag Binnoojiiyag also facilitated their five-day Indigenous Wholistic Practice training for Mackenzie Health staff, an experiential learning program co-developed with Chanie Wenjack School for Indigenous Studies that is focused on Indigenous culture, history and approaches to respectful care.
This collaborative and culturally sensitive approach extends to how care is delivered.
Rather than assessments or clinical checklists, service sessions often start with an opening Circle that brings together family members, Elders and clinicians to discuss goals, strengths and hopes.
“Families are the experts in their own lives,” says Stefanie Smith, Program Co-ordinator at Mackenzie Health. “Our role is to build on that knowledge, not override it.”
“Through my experience, one of the key components in the helping process is supporting parents,” adds Elder Hilton King, an Elder Knowledge Keeper with Dnaagdawenmag Binnoojiiyag. “By including parents and helping them understand that they are shareholders in their children’s care, it helps them begin to trust the system again and reduces reliance on it to “fix everything” — a dependency that stems from colonization.”
With both organizations working together, clinical strategies led by Mackenize Health are blended with Indigenous knowledge and wisdom led by Dnaagdawenmag Binnoojiiyag. Cultural practices and teachings, traditional medicines, drumming and song are incorporated into service delivery, depending on family preference. This reflects a “two-eyed seeing” approach, bridging Indigenous knowledge and western clinical practices.
The Medicine Wheel is also integrated into each child’s behaviour support plan to ensure care considers all parts of the child — emotional, social, physical and spiritual well-being.
“It’s about seeing the whole child, not just their behaviour,” Mario explains.
As part of this program, a Mobile Behaviour Treatment Team also travels to communities across Simcoe County, helping reduce barriers for families by meeting them where they are and providing care in familiar environments.
The impact is being felt at home where it matters most. Most children in the program show improvements in behaviour, while families report feeling more supported and less overwhelmed. Just as importantly, many children can remain at home, avoiding the disruption of separation from their families.
Behind those outcomes is something harder to measure but just as important: trust.
Partnerships like this show that meaningful change starts with listening and a willingness to do things differently. Grounded in guidance from Elder Knowledge Keepers, who highlighted the need for a different approach, this work reflects the Truth and Reconciliation Commission of Canada’s Calls to Action. Through relationship-building, shared decision-making and culturally grounded care, the partnership is moving beyond commitments to put these recommendations into practice.