Health committee  Thank you so much for the question. I think the Australian example is a good one to look to. There are similarities in terms of geographic distribution of the population, as well as the unique needs of the indigenous aboriginal populations in Australia. I think they are a really good example to learn from.

Health committee  It's politically charged, but a universal basic income and having more financial stability would speak to food security and a lot of those basics that have that foundational wellness and can then enable additional insights. Another thing is education. I think a lot of these things can be implemented now in terms of how you take care of yourself and how you promote your own mental health.

Health committee  Agreed. I have worked to create some curricula for genetic counselling programs on perinatal mental health and mental health generally, but it's still something that is a very small number of hours.

Health committee  I don't know if there's any time for me to add a little bit. Even before we have the biomarkers or anything like that in a blood test, even right now, as a genetic counsellor, I take family histories. You can tell a lot about risk based on what's happened in somebody's family.

Health committee  Yes.

Health committee  What a dream. Just on a very small scale, it would be great to have universal standardized screening recommended. What I mean by that is to have a clear message sent to all primary care providers that this is important and that there's nuance in how you do it. If you use the gold standard globally—that's called the Edinburgh postnatal depression scale—you can use it, but you can make it part of a conversation.

Health committee  I think that would be great, yes. It would be fantastic. I'd also love to see a role for psychiatric genetic counsellors to support that.

Health committee  Sure. Are you talking about the task force recommendation that came out in 2022?

Health committee  That's okay. When that was released, it was actually consistent with the previous task force recommendation, which was focused more generally on depression in women or in adults, and it was still recommending against tool-based screening—so, using a questionnaire, basically, and suggesting that a conversation with your doctor would be better.

Health committee  I'm sorry. It was a little quiet there with the translation. Your question was about how mental health conditions can impact parents when they desire to get pregnant and then as they're parenting. I have one story that comes to my mind. I worked as a psychiatric genetic counsellor for a while.

Health committee  One thing, off the top of my mind, is the histories of intergenerational and personal trauma. Pregnancy is a time when trauma can really come to the surface in ways that people don't expect. You grapple with identity shifts and it connects to your ancestors and generations going forward.

Health committee  It's such an important issue to think about. There's a history of removing children from indigenous families, which is just so tragic. That has been seen as part of the perinatal health care system as well and has manifested in a practice known as birth alerts for indigenous women.

Health committee  All right. Well, it can be very difficult. I don't know the exact rates of depression, but they're high. Infertility can be incredibly stressful and can lead to anxiety and depression. In loss, it can be difficult to tease apart postpartum grief reaction versus postpartum depression, but it's important not to dismiss postpartum depression, assume that it is grief and not have good support for people in that context too.

Health committee  I feel like we need to continue to expand our attention in that area. I do see that there is more research happening and more attention being paid to support mental health for the indigenous community, but it's still early days. There's such a problem with the lack of trust, as has been mentioned and as I'm sure you're all aware, in terms of someone actually being able to feel comfortable self-identifying as indigenous.

Health committee  In British Columbia, for example, there's the Pacific Post Partum Support Society, which provides support by phone or by text message. A person who is experiencing postpartum depression can connect with a peer who is on the other end of the line. The hours are not 24-7, but it's very accessible.