1. What constitutes culturally safe practice and what are the conditions in which such practice could take root/thrive/be supported?
2. Do cultural and social institutions need to be restored or reformed in any way in order to accommodate cultural safety? If so, what changes need to be made and what is the best way to approach this?

Phil: In my experience, cultural safety or a safe place is one in which the atmosphere is created where you can be yourself at any given time. I recognized this when I was in the psychiatric hospital where the nurses were wonderful. As soon as the nurses tried to persuade me to become a better person for the sake of my first wife with whom my marriage was on the rocks, I shut down. It took me a while and a change of nurses before that unsafe place became a safe place for me. The culture, my sense of it, was a relationship of not accepting who I was, as a male. Culture can be provided in many ways. That experience still rattles me when I think about it because I felt I was being taken advantage of. I needed to find out who I was as a person. My culture was male and they invalidated me. In terms of healing, you have to be secure.

Lorna: Safe places are those in which you are not threatened, but accepted and loved for whom you are, and others not making assumptions as to what your maleness is.

Phil: Exactly. I grew up with assumptions about who I was and what I should become. I didn’t know who I was and it would have been good to have the guidance much earlier in my life about who I was. I got nothing from the church in which I grew up, in terms of spirituality.

Vicki: It is practice that at some level disrupts. At the level of policy, there is disruption that occurs. Culturally safe practice would disrupt the status quo; there would be a broader effect, some actionability. One thing that is different about it is that is it meant to disrupt the system. People feel uncomfortable for some time at the personal level. Cultural safety means we don’t always feel good from a cultural perspective.

Tina: I feel safe in the MDS of Manitoba. Our Executive Director “cleans up behind us”. She asked me to take a look at cognitive behaviour and I re-wrote it myself. She has empowered each of us to do our best. Everyone is accepted where I work. It is okay if we are having a bad time, no one questions it. One time, I forgot to do a presentation, and my Executive Director said, “I hate when that happens.” I come from a background of real estate where that would get you fired. I had myself packing my bags, but her attitude was let’s get on with it. I have the opportunity to go at my own pace. Her biggest job is getting the self-help workers to have a normal life, keeping them engaged with their 20 hours a week. We are all allowed to have hopes and dreams. That is something we forget when we have an illness. The doctors at the Selkirk Mental Institution had a token consumer and were talking about what they could do for consumers. The consumer said he wanted housing in the best part of town. The Doctor gave him back the ability to have a dream, and began to help him take the steps to achieve that.

Ed: Cultural safety is a word that is now capturing different pieces, creating language for me. Often we try to summarize bigger ideas with one word, in a labeling process. I guess we try to do that to capture many concepts succinctly. Cultural safety summarizes many concepts I have been learning in my healing journey; trust, respect, equal, non-power relationships. I have been learning that through my own healing process with elders, the teaching process I have been through. This story is a core example of what it is that we are seeking, what we can call cultural safety, relational healing.

Years ago, when I was learning in North West Ontario with Alex Steed, one of my elders, we were waiting at a youth gathering for the youth to arrive. He was teaching me some things and all of a sudden, his gaze went to the floor. I followed his eyes and saw this little ant walking into the circle. Alex says, “See that ant?” I said “yeah”. He said “He is my brother. He is no better than I, and I am no better than him. When we as humans can think that way, we will have the peace we seek.” That has transformed my relationship with all people and all of creation. How do we bridge the gaps, those artificial barriers between us? I don’t believe we can help people on their journeys of healing if we are one up and they are one down. When people refer to me as a Doctor, I often do a teaching like this, especially with young people. I like that they respect the education I achieved but I don’t want that to be a barrier to the kind of relationship we want.

“Patient” automatically creates that relationship. I am not even comfortable with the word “client”. “People” is what I come down to. We are all humans, and I am no greater than you nor you, me.

Brenda: As a grad student going to Queens, a fairly white University, I was one of two visible minorities in my grad class. I asked how things would apply to Northern Ontario for FN communities, and they would say “I don’t know”. I found that difficult and challenging. Luckily, I met Ed and Dr. Clare Brandt who showed me there were different ways. I worked in a federal prison and realized it was only by the grace of G-d that I walked out the door every night rather than back into the prison. We had much the same experiences. In reflecting back, we can sympathize, empathize, see ourselves in others. The women didn’t see me as top down. They taught me more than I taught them. I didn’t know much of my culture and tradition and invited them to teach me. They showed me I did know lots about my culture, for example, about respect to our elders, the importance of family. I may not have known a lot about the ceremony, but I did know lots about our culture. We would be deep in conversation and this woman 20 years older than me, said she could have changed my diaper when I was a kid, and we laughed. They reminded me I was just the same as them. Just because I am a Doctor doesn’t mean I know it all and would refer them to others who knew more than me. You are there more as a guide. Being humble, not acting as an expert is part of cultural safety.

Last year, I was commissioned to write about mental health and illness. I consulted with elders who told me that in traditional times, people with mental illness would be seen as people with gifts, in our communities as teachers, to remind us of something about ourselves. We are all human beings, whether we are prisoners or not. During the riots, some of the women had been strip searched, and were told they had to have an internal exam before getting their clothes back. I was asked to go in and interview one woman. She was shackled, naked on a bare floor. I felt that as so wrong. As a human being, how would we treat each other?

Eric: So far we have heard vantages distinctly different from mine; front-line, researchers. I worked in an institution that ultimately represents the holder of power, rightly or wrongly, for centuries. What is interesting is how do we create an interest within the walls of that powerful institution to create balance, not make assumptions about others? That represents an enormous shift for a huge institution with a long history.

Trust and respect are fairly constant expectations. Patricia yesterday offered the notion that there needs to be respect between the holder of power and those historically who have been without power. The holder of power could feel guilty, and the person without power could feel angry. Achieving that at a systemic level is bigger, not altogether different. The challenge is to create conditions to help people understand. It feels like this massive locomotive plowing through the world for the past 4 or 5 hundred years may slowly be losing its momentum. There are those of us on the train trying to find the levers to convince the conductor to slow it down. I don’t know what the strategy is to do that. Being invited into the circle and being able to hear may be in and of itself the most effective one. When Bill said this morning, government people don’t speak from the heart, I bristled. The challenge is how do you reach people that are part of that institution?

Rose Sones: I apologize for being late. Yesterday, I was doing competency training for government. Sometimes I feel a lone voice. This is a values based discussion. There is no time line. The more I work with government, the more I realize this does take a long time. We should not be surprised that people who have had no opportunity to ask the questions are not on board. How do we build the intentional space in which people are safe to ask the questions? It is very rare to have those safe places to ask those questions in confidence. This is process, a learning opportunity, to build cultural competence that is a two way street. The people who hold onto the information are the FN, Inuit and Métis, and we have to be prepared to share. The opposite is also true; the level of secrecy in government prohibits sharing.

We have a lifetime of practice; it is not an open end state. Learning about FHIM may be a little different than learning about immigrants. That self-awareness of your immediate response to individuals is what we have to have. It is that intentional space. There are those willing to take the risk to be vulnerable. You need gate openers in government who are willing to have that conversation.

Patricia: We have been starting to explore how FNIHB could strive more to cultural safety. So, I have had the opportunity for a lot of discussions, including at the NMHA meeting in September, 2009. A phrase shared at that meeting by Sylvia McAdam was that our people would call this “walking together”. It is the closest, simplest way to approach talking about cultural safety. What are the barriers to doing this? They have a lot to do with power, and being self-reflective about power relationships. In my case, I am a white psychiatrist, working with the Feds, and I need to be self-reflective about that.

I see it operating on many levels, personal, individual, and organizational. From the ant story comes humility. A progress and flow comes from walking together, not a linear walk, but a striving. How do we get there, support cultural safety? The answers there are very complicated. Ideally, there should be supports in place. It goes beyond the individual and the roles people are expected to play. The problem, what drives it, is accountability and how that is perceived. If someone walks out of your office and commits suicide, you are accountable. I want to move beyond the push back, and develop some solutions. Walking together is how I understand cultural safety.

Rob: All of us have culture. Some have many within our beings. I think about the cultures I have worked within, for example, the culture of professionals, corrections, boundaries in all these areas in your life. It is about power and control. That affects us more than anything.

Culture is a dynamic thing. I have a lot of respect for aboriginal cultures from what I have learned. As a child, the Pentecostal Church system terrorized me with their speaking in tongues. Two neighbour boys were Catholic and told me I was going to hell and they weren’t.

Institutional powers and their cultures make you pay a price for going against their cultures. If you go against the dominant culture, you will pay a price for it. People inherently understand what culture is. There is a growing understanding of respect and what it means. Respect to me is when someone has been heard and also understood.

I have sat in many circles with many different purposes, healing, prayer, sweat lodges. You realize that everyone is your teacher and come to respect some people as elders. It is a lie long learning process to me about respect and cultural safety.

In Saskatchewan, we are talking about patient centered care. In the research I have done, it boils down to cultural safety. It is more than that. We can’t teach our care providers without making sure there is competence in the system. If the system doesn’t change, it won’t be safe for the care providers. Someone has to step in front of the train sometimes. The dominant system has exercised power and control to keep the status quo.

Diane: Thanks to Lorna, who I recognize as my elder, for facilitating the circle. How do we go about changing things? We are currently involved in a project that involves FNIHB, Addictions and Mental Health, community members, our Director of Health, about 10 people in all. Our Director of Health is competent, a Mik’Maw. We didn’t get a shift in our colleagues until Claudia spoke about being able to go anywhere in this country, but when she leaves her community she doesn’t quite fit. The people realized there is more to it; there is this outside part. What you are trying to do is connect with someone in a real way. We have been trying to get our professional people in a room so they will shift a little bit more.

My frustration is that it always comes from the people who are vulnerable. They have to do all the relationship building re: trust. When will our mainstream partners imitate them? They are willing to come into the circle, but when will this shift happen? To me, that is the biggest barrier, that it is always the most vulnerable reaching out.

I want to define cultural safety in a different way. A lady that has every label calls our office; no one wants to take her calls. One day, I picked up her call. She was angry because she could not see her psychiatrist. After my conversation with her, she was calmed, just happy that someone listened to her and didn’t hang up. People should be respected for being living human beings. Another example is an alleged sex offender who wants to do the sex inventory. We take 3 hours to get through a quarter of the test. He came back 5 times in one day. Eventually, he said, I don’t want to do this anymore and I want my file destroyed. So, I shredded his file. He asked me, “Do you feel safe with me?” I said I did. We have ugly jobs to do but we can do them in a culturally safe way.

Jennifer: Listening, I realize that what happens in a culturally safe place is that you are open to new ways of thinking. With each person, I am making new meaning. Myself, I feel cultural safety when I am being treated with dignity, and I know its absence, when I am being treated as an object.

It is easy for me to understand cultural safety in a therapeutic perspective. Cultural safety seems so benign. The concept may not capture what is required at a policy level where there must be disruption. There is a politicized aspect to cultural safety in New Zealand, a socially transformative agenda. I wonder, can cultural safety hold all these ideas? But maybe that openness is what is required. By standardizing it and saying what the competencies are might do injustice to the concept and the spirit of this. This notion of identity and categorizing ourselves, they are such “thin” descriptions of ourselves. I am attracted to “thickened” narratives that invite us to see the cultural restraints we are all up against. The possibility of collaboration presents itself.

Terry: Picking up on what Jennifer said when you enter a circle and it is safe, it permits whatever in you that is related to what others are saying to surface, and new understandings to emerge. Safe circles are where we continue our journey of learning. Thinking about Diane’s comment that it is often the most vulnerable who have to initiate relationships and educate, I wonder whether they are in fact the strongest. Their circumstances may make them vulnerable, but if they have chosen to enter those circumstances with a purpose connected to the Creator, perhaps in providing leadership in cultural safety and social justice, they are fulfilling their purpose. Sometimes we spend a lifetime figuring out what our purpose is.

I have a need to understand institutional power relationships and how to unsettle them, dislodge and change them without pushing them to become more entrenched. I felt like an “adolescent” when I went on a diatribe about pharmaceutical companies and the biomedical model. Mentors, elders in the group brought me back to “adulthood” and the recognition that we must deal with these tensions in ways that bring groups into alignment, not opposition with one another.

I think hope exists in the way we are engaging with each other here. This we can duplicate in whatever spheres of influence we are part of. This has to be a collective process; the challenge is to get ego concerns, our individualism, out of the way to develop alliances with others. I still need to learn not to be conflictual with those with whom I do not agree; but instead to invite them into a dialogue. They are not the “enemy”. We are all in this together. Some may be responsive to hearing my point of view, and be able to shift their own, just as I will in hearing theirs. The only reliable way of inviting cultural safety is through relationships. This means learning through encounters that provide an experiential, direct understanding of relational practice and cultural safety. A recent example is President Obama’s reaching out across Party divisions to engage Republicans and Democrats in the health care discussion. Even though there was considerable resistance, having the gathering was a good example of “walking the talk”, demonstrating what collaboration means, and his belief in the possibility of achieving it.

A final thought I have is my concern that these terms, “cultural safety and relational practice” may be co-opted so institutions can appear to be politically correct. Using the words and putting them into practice are two different things; only in relationships do people learn and experience these concepts. That is why what we are doing here is so important.

Lorna: One thing I have been hearing in my work with people who ware working in spheres where there have been inequalities of some kind, what comes up is shame; all different kinds of shame that people feel. It is from people who hold the power and wield the power they hold, people who have been acting a role they do not feel aligned with. Because we live and work in such hierarchical structures, though we might have power, there is always someone who has power over us. From the shame comes the anger, and often we don’t get the opportunity to recognize it, sublimate it, so we push it back.

The other is that when people can be generous and appreciative in spirit with one another; I have been working with groups who have been newly in partnerships with one another. It was a challenge for me to learn what worked. I learned from the old people I spent some time with how generous each was to everyone. It was generosity of the whole spirit; how carefully they observed and were watchful of everyone in the community to be sure that everyone was in a state of wellbeing, and if they weren’t they didn’t make a big deal of it but helped them return to a better state. We haven’t learned in our world how to be caring for the communities we are part of.

Phil: The experts to me are the patients and consumers in the system and experts should not be brought in to say what person centered care should be—let the people inform the services.

3. What do all of us know that would contribute to advancing excellence in relational practice?
4. Do we envision a relationship between social exclusion, peer support and relational practice?
5. Who do we need to target? What do we need to convince them of?

Lorna: This morning many things came up that contribute to this next set of questions. If each of could speak to these reflecting on what we heard this morning. These questions almost point to us coming up with a criterion base for defining cultural safety and relational practice, so be aware of that as we speak to these. What advances or contributes to relational practice?

Ed: I, too, have the fear that we are getting into defining, coming up with criteria, creating training. I think the point of this is to create the dialogue, the common language that can create the dialogue. It is people that tell the system how to change, not visa versa. I have many ideas to explore that are stimulated by this conversation. I am listening to what is going on and thinking what for me is cultural safety. I think of my relationships and I realize another part is speaking from the heart. The spiritual, the intuitive part is such an important part of us. Spirit is important in the healing journey. We talk about human relationships that are culturally safe, trusting, equal, respectful; all possible when we engage with each other on all those levels of heart, mind, spirit, physical. In my exchanges with people, I can identify moments of change for me as well as them because I am engaged on all those levels because we have had that full engagement. Often I will share my stories when the person triggers that for me, regardless of so called professional boundaries. We need to start with our own sphere of influence. It is a mindfulness of your personal beliefs and systems, and yours of mine, because we are all part of the same human family. We need to start with young people. Art Soloman said, “Your beliefs do not negate or change my beliefs and visa versa” and when we have that relationship we have cultural safety.

Phil: For myself, having been an observer for a long time, I think it has to start with ourselves, modeling the behaviours. Our elected and non-elected governments have allocated to themselves huge amounts of power. You can see it the way corporations conduct themselves. They used to give back to the community. I think we have to look to ourselves and our own conduct. Cultural safety is a daily practice. Relationships are things we build every day and don’t come easily, and we have to work at it. We have to look at how we abuse the little bits of power we do have. Returning to some of the earlier teachings all of us have, developing a sense of respect for other people. Like Rob, I grew up with Pentecostalism. I now have a safe space for myself that I have carved out.

Rob: social and cultural institutions need to be reformed. When I saw what happened at the University of Ottawa when Ann Coulter spoke there and wasn’t allowed to speak because of safety concerns, I was happy about that, but questioned myself. When you are or not allowed to speak is a big issue in cultural safety. It starts with the individual and goes out from there. There is a need for change in terms of what our government organizations are prepared to accept as acceptable. I don’t have any answers as to how that change needs to happen.

Patricia: I agree that change needs to start with each of us, but what needs to happen at an institutional level that can support these individual attempts? In our own organization there are some emerging examples of how governance has been changed in terms of who is invited to the table, looking at what is in the parameters of what we can do together. Having AFN at the table has helped us move the process forward. Cultural safety is really exciting and perhaps one aspect of that is to lift up examples of what is working well in terms of working together—you sense movement. When we are striving for cultural safety, we sense movement. By lifting up examples, you have some role modeling. People can see both parties in the relationship benefitting.

Even in the short term, I can see an evolution that is happening in terms of how we are looking at partnership instead of consultations, a shift and movement in that, yet a long way from achieving anything that is truly culturally safe, giving voice to those who haven’t had much voice.

In a lot of discussions, the medical model is seen as being fixed and top down, patients not being heard. I sense a transformation coming in the medical model through inter professional teams. I see the emergence of that. I see a budging happening within the medical model, a movement towards teamwork. In Health Canada we are looking at what that would mean in aboriginal communities. The recovery model having peers and consumers survivors at the table is informing the work of the MHCC. There is a democratization going on that is inclusive.

Diane: I would like to fin excellence in relational practice. At the systemic level, we could check the medical model from the medicine wheel. If we require our systems structures to ask those same questions, are the physical, mental, emotional, environmental, spiritual components culturally safe? Are we allowed to be essentially who we are in our system? We need to check our systems. How do we get the work done? When do we collaborate? Work in our office, the one on one, doesn’t happen. I am for it 100%, but not sure how we do it in a way that balances it with one on one time. We are an outcome oriented group; it is all about stats at the end of the day. Relational practice is about process, not about stats. What if the person doesn’t change, but the journey was worth the time? How do we evaluate that? We need to be able to find a way to balance our process with the systems expectations for certain outcomes. Where is the middle?

Jennifer: What counts, what is measurable, may obscure what is meaningful. So much at Universities is predicated on developing specialized knowledge and people can go away feeling they have specialized knowledge that is authorized against other kinds of knowledge. How do we honor the knowledge people gain but maintain openness to other knowledge? Outcome measurements authorize a single form of knowledge that is scientific knowledge, not specific to the medical model but to others as well, How as educators can we use a space for people to be reflective in what they know and do? Do we have to convince somebody? Isn’t it about creating experiences like this to live it, to be transformed and open? It is not that any idea can be held without comment or being remarked on, but not convincing people that this is the way to go, rather setting up collaborative opportunities and engaging them in these.

Ed: Looking at the world, we can say there is a paradigm shift in the world. Can we institutionalize that paradigm shift and if we can what is the impact of that?

Rose: My background is psychology. Some of the weakness in the humanistic approach, just providing a space in which people can share, is not enough. There is racism so deep (for example, in Churches), there are remnants and structures in society that are against having that discussion. There are people that have to stand up and say there are things that are not right, not moral.

I want to make a pitch for criteria. I sat on the committee writing cultural competency curriculum for Doctors. That is a starting point. You have to set the bar. There is a total risk that people will stay with the check box approach to cultural safety. The New Zealand government was proud of their approach and put out a post card explaining how you introduce an elder that is a check box approach, not the relational. But that is a place to start.

Vicki: Your earlier point was about values. I believe that when we are targeting we are always targeting ourselves first. In different interactions, you are confronted with something different about yourself. I am involved in a nursing circle of mainly women. One woman in the group says she starts every day asking “what is the highest good I can do today?” The target is there. My students also teach me every day. One of the questions that regularly come up is where is cultural safety in terms of the providers when racial stereotypes are present? Sometimes, patients will say, “I don’t want that nurse”. That may be unsettling. How do we address those things? It has to be said, “That is not okay”. Cultural safety is taking a stance. It is about health equity. Let’s make it so we have health equity in this country. I struggle with how to do that so it is culturally safe for all. The kind of discussions we have in the classroom mean that in my evaluation I have a backlash for those desires. I have to keep the outcome in mind, which is health equity and wellbeing for everyone. Much of it is achieved by how we interact, but there are other things we are attuned to.

Terry: There is something I have been wondering for a while, and that is, how do we get our “best practices” supported so they are sustainable over time? It seems that so many of what we consider to be culturally safe programs are the result of the coming together of like minded people who manage to acquire funding and support for periods of time, then fade away because of contextual factors. Good examples of such programs are many of those funded by the Aboriginal Healing Foundation, Browndale, and some of the ones Bill briefly described earlier. I am sure many of us have experience with such programs, and lots of evidence as to why they were such good models of relational, culturally safe practice. How do we ensure they persist over time? It isn’t enough for us to have good conversations about what constitutes culturally safe practice; we need long range support for that embedded in systems, and a commitment by government through their funding mechanisms to these values and practices.

Eric: Thinking about that point and Lorna’s, it is an existential question. Is government meant to be a reflection of the values and perspectives of people it serves or does it influence the values and perspectives of people it serves? In some instances, government has to be visionary. In FNIHB some people have been leading this effort. Our Deputy Minister is the first who has ever been to communities, spending time with the Chief, being on the land. He has become a quiet champion for all these things. When we were talking to him about the need for a greater sense of cultural safety within the government, even with this personal experience, he said he has visiting a cutting edge program in Winnipeg that demonstrated cultural safety, so it isn’t new. What I wished I had said is that excellence has existed in corners despite the system, but the system has to evolve to support the excellence. Inviting people into the circle, physically and metaphorically is an essential element.

Rose: ITK does this, takes people from the government and sets them down at the kitchen tables, into the communities. It is simple.

Rob: Your comments yesterday regarding the fear of people who are threatened by cultural safety, the fear those providers have to deal with because of the shift to person centered care; cultural safety might need to find ways to eliminate that fear or lower that fear.

Brenda: I was thinking as I was listening and thought of a few things, how the elders connect with people and their ability to be present in what the person is saying, and to be a “safe haven”. How do we do that for others? I was struck by what Eric and Vicki shared about disrupting the status quo. Our elders do that with us sometimes about where we are going. The feather teaching is that the feather is the length of the distance from the mind to the heart. On the systemic as well as the personal level, that might be one way to look for cultural safety.

Ed: Cultural safety is a piece of a paradigm shift. It may be really simple. I had an experience with Frank McNaulty running a suicide prevention program on an Island, having the elders teaching the youth. We had the funder join in for a day. There was a thunderstorm and afterwards we had to get the elders back from the Island in the dark with the rain coming down. That was relational and it tied him and I together ever since. A while ago I was having some difficulty with FNIHB and Frank took the time out of his day to listen to me about the concerns and told me from the FNIHB perspective why some of those concerns were there. That is relational, based on people connecting and knowing those connections are there on so many levels. Having him explain in person was more effective than anything I could have written.

Lorna: I want to say how much I appreciate that story. This gathering is called BB2. There are lots of things that happen within our institutions and organizations that are long held habits of the way we treat each other and those who have been marginalized and excluded like those with mental health and addictions challenges; habits we developed in the way we “othered” them and excluded them. In Prince George at the gathering, people were telling stories about how people were treated up there by people of the medical profession. The first assumption when they come for care is that they are drunk.

When I was working with a group responsible for the treaty process, one person asked when are those people going to stop being victims, get back their history? They must feel safe to say that. How do people get to feel culturally safe enough to stand up to those statements? Especially in a country where we have perfected our ability to deny that racism, othering, exclusion, exist, and we are so quick to say “we are nice, we are not like that”.

That is what these questions are asking. How do we create strength in people to stand up and say that is unacceptable in all our work places? What got us into this place as intelligent, caring human beings? What keeps us here, upholding these practices and inhumane, exclusionary institutions? It has to be worked at, at many different levels, personal and institutional. The leadership is extremely important as models to others. What do we do to affect the leadership? We have to be included in these dialogues on mental health fully and take leadership roles.

I think of an evaluation I did in BC in which leadership between the indigenous and the western group had to sort things out, sit down and be open to each other. They hired two people, one that had understanding of the indigenous ways of being, and the other who acted for the company. They were trying to forge a working partnership to achieve something.

Each person had to make a statement about how this partnership would benefit the indigenous group and how it would benefit the company. It wasn’t just the benefit to the indigenous group who are usually seen as lesser than. The two people, whenever there were points of tension, would get together and hash it out, then go back to talk to their own side. Each of them had to see the tensions from the other side. That was the key to the amazing outcomes that occurred.

The sense of “we are in this together”, there is something each of us is contributing to the collective work we are doing. It is gaining knowledge, getting to a deeper understanding of each other’s cultural ways and values, and knowing when you can change those in order to work together.

Jennifer: My concern is that cultural safety not become formulaic, but rather a teaching relationship, teaching about how to think and how to relate, to prepare people to challenges, raise the issues in the workplace. People come in wanting the answers, wanting you to be the authority figure, and you have to challenge, de-construct that.

Terry: The challenge is not only in preparing students in this way, but in changing systems to support their ability to relate in this way.

Tina: From a business environment, people will only make change if they are convinced they will save money by focusing on mental wellness. The greater world is focused on business and making money.

Jennifer: Educating people one at a time is again individualistic, and we are looking for how to support this collectively. I heard this a.m. the need for solidarity, the need for social action, sharing a common vision that can stand up in solidarity against oppression in all its forms. There are people across all sectors who can share this vision.

Diane: Being part of this circle now ties me to you and to your ancestors.

Ed: All of this is processes for building critical mass, where all this becomes obvious.

Patricia: The challenge is to move it beyond individuals. FNIHB is looking to create a tool.