Photo caption: Smudging Ceremony taking place at the CAMH Ceremony Grounds on the National Day for Truth and Reconciliation
By: Laura Stanley
At the Centre for Addiction and Mental Health (CAMH), First Nations, Inuit and Métis traditions, cultures, and values are being embedded in hospital policies and procedures to enable accessible, high quality, culturally safe care for Indigenous patients.
This work is being advanced by the Senior Health Policy Analyst within Shkaabe Makwa – the Centre for First Nations, Inuit and Métis wellness at CAMH. The Policy Analyst, a role designated for a First Nations, Inuit, or Métis person, works in close collaboration with staff from across the hospital including various hospital policy committees, and leads the review of CAMH’s internal policies by applying Indigenous cultural safety, anti-racism and anti-oppressive lenses.
In CAMH’s 2024-2030 strategic plan Connected CAMH, expanding culturally safe services for First Nations, Inuit and Métis patients and their families and deepening the organization’s commitment to Truth and Reconciliation are named as strategic goals. The Policy Analyst role is the strategic plan in action and reflects CAMH’s commitment to redressing the inequitable health outcomes of Indigenous peoples as a result of structural oppression and colonialism.
For example, in 2023, CAMH updated their Traditional Ceremonies for First Nations, Inuit and Métis Policy (first published in 2016) following a review by the Policy Analyst. This allowed for the inclusion of procedures related to CAMH patients and families engaging in Smudging – a ceremony practiced by some First Nations, Inuit, and Métis across Ontario which involves burning one or more sacred medicines (sage, cedar, sweetgrass, and/or sacred tobacco) - and using the Smudge (smoke) to ceremonially cleanse for prayer and remove negative feelings prior to individual or group prayers.
Taking it a step further, the Policy Analyst led the development of a Smudging Ceremony and Medicines Protocol, published in 2024, which detailed newly developed policies and procedures to serve the cultural and spiritual needs of Indigenous patients and support clinicians who are asked to respond to a request to Smudge from a patient, family member or community health provider at CAMH.
What followed was the introduction of Smudge Kits at CAMH, which allows Indigenous patients and families to engage in a Traditional Ceremony as part of their care plan. Between June 2024 – March 2025, 37 units across in-patient and out-patient settings received Smudge Kits while 60 hours of cultural clinical education on the importance of smudging was provided to CAMH clinicians.
Due in part to the Traditional Ceremonies for First Nations, Inuit and Métis Policy and a Smudging Ceremony and Medicines Protocol, the barriers to support culturally and spiritually appropriate patient care through the inclusion of Traditional Ceremonies in the hospital environment were reduced, allowing for impactful and culturally safe care for Indigenous patents.
As one First Nations patient noted, “I have been smudging and using medicines my entire life. To have resources here allow me to smudge and also share it with members [on the unit] ... I believe has made a huge impact physically and spiritually."
In order to engage in deeply meaningful work, people need spiritual, cultural, and psychological safety. At CAMH, we are striving to embed the perspectives and needs of Indigenous staff, patients, and families into hospital practices.
On June 11, 2024, CAMH hosted a panel on the place of the Smudging Ceremony in health care settings, and its therapeutic benefits for First Nations, Inuit and Métis patients. Moderate by Jeff D’Hondt (Manager, Shkaabe Makwa Clinical Services), the panelists included Kawennanoron Cindy White (Elder-In-Residence, Women’s College Hospital) and Leonard Benoit (Regional Indigenous Patient Navigator, Cancer Care Ontario). Click here to watch a recording of the panel.