After a spike in the number of deaths in the province's child care system last year, the concerning trend seems to continue in 2020, leading the Federation of Sovereign Indigenous Nations (FSIN) to call for immediate action.According to the Ministry of Social Services, a total of 25 Saskatchewan children or youth have died as of Aug. 31, 2020, with six of them in care of the Ministry of Social Services or a First Nations Child and Family Services (FNCFS) agency. The remaining 19 children or youth who died had families receiving services or they obtained services within the past 12 months."The numbers, of course, are heartbreaking," said David Pratt, second vice-chief for the Federation of Sovereign Indigenous Nation (FSIN)."The loss of any child is unacceptable. And I think that it just shows the amount of work that we have to do to reform the child welfare system and bring about those much-needed changes."The 25 deaths within the first eight months of 2020 are not far off the total 34 child deaths reported by the Saskatchewan Advocate for Children and Youth in their 2019 annual report. Last year's number had already been an increase in comparison to previous years.When a child who was in care or received services dies the ministry conducts "a thorough review to determine if the death or injury could have been prevented," said Joel Kilbride, an executive director with child and family programs, in a written statement.Majority are Indigenous childrenWhile information from the ministry was not available for one of the six children who died in care this year, the other five were all Indigenous and four were in care of the ministry. Of the 19 children in receipt of services or who got help within the previous 12 months only one was not Indigenous.This trend is not new. Canada-wide, about seven per cent of all children up to the age of 14 years are Indigenous, but they account for more than half of the kids in foster care in the same age group, according to 2016 census data.In her last annual report, the Saskatchewan Advocate for Children and Youth called it "unacceptable" and noted "that the number of Indigenous children and youth represented in the critical injury and death notifications received by our office continues to reflect their disproportionate representation within the child welfare and justice systems."Eighty-five per cent of the 34 recorded children and youth who died in 2019 were First Nations or Métis, according to the annual report of the Saskatchewan Advocate for Children and Youth.FSIN calls for actionAs a reaction to the current numbers, FSIN called on the federal and provincial government in a press release to cooperate with First Nations and "fully implement funding" for Bill C-92.Bill C-92, known officially as the Act Respecting First Nations, Inuit and Métis Children, Youth and Families, came into force on Jan. 1, 2020. Its goal is to decrease the number of Indigenous children in care and to allow communities create their own child and family services. In July, the the Assembly of First Nations and the government of Canada signed a protocol to set up "a new structure to support discussions on the implementation" of the bill, according to the government of Canada website. "We are working right now actively on implementing Bill C-92," said Pratt.The job of FSIN will be to ensure resources are adequate and available to each of the nations moving forward on implementing C-92, he said."We believe that it [statutory funding to implement that bill] will go a long way to addressing some of the current sobering statistics within the child welfare system."According to the FSIN vice-chief the federal government needs to provide proper resources to Indigenous child family service agencies."I hear the stories constantly of the lack of capacity and resources that's needed," said Pratt."Ultimately, we want to work on bringing those children safely home."According to the 2019-20 annual report, the Ministry of Social Services recorded a total revenue of $45.7 million with over $36 million coming from the federal government as transfer payments — from the Special Allowance for Children in Care and from Indigenous Services Canada.Cause of deathThe Ministry of Social Services was not able to provide full information on the causes of death of the children who died in 2020, but said records indicate suicide did not play a role. Fifteen of the 25 children who died were five years of age or younger."We work with very vulnerable children and youth, and this includes those who are medically fragile," said Kilbride in his statement."Any time a child experiences a critical injury, or passes away while in care or in receipt of services we work with other service providers involved with the child or youth ... to engage with the family."Internal reviews are then shared with the Advocate for Child and Youth and the Coroner's Service, according to Kilbride.In the last annual report, the Saskatchewan Children's Advocate pointed out the risk of suicide and self-harm. The advocate's office said 28 per cent of all critical injury and death notifications they received in 2019 were related to suicide, suicide attempts or self-harm. Pratt said he thinks suicide among Indigenous children and youth in the welfare system is directly connected to trauma."These young people have been taken away from their families, taken away from their culture, taken away from their communities," said Pratt."Of course that's going to create a sense of isolation on their part and the lack of identity and who they are. I think that if we can work on keeping those family and community connections with our young people that are within the system, it's going to go a long way."NumbersDeaths involving children with a legal status of 'in care'As of July 27, five children who were in the care of the ministry or a First Nations Child and Family Services Agency have died so far in 2020.Ministry/AgencyConstitutional StatusAge RangeGenderType of PlacementLocation of DeathMinistryIndigenous16-21MaleCBO Group HomeCommunity - urbanMinistryIndigenous11-15FemalePlace of Safety*Community - FNMinistryIndigenous16-21MalePlace of SafetyCommunity - urbanMinistryIndigenous0-5MaleFoster HomeFoster HomeAgencyIndigenous11-15FemaleHospitalHospital *Place of Safety – When a child is assessed to be in need of protection and their safety cannot be immediately ensured in the family home, an extended family member or other person who is willing and able to provide temporary and safe care may be approved as a Place of Safety for the child (Children's Services Manual 4.3.2) Deaths involving children in receipt of services or who were in receipt of services within the previous 12 monthsAs of August 21, 19 children whose families were in receipt of services or were in receipt of services within the previous 12 months by the Ministry or a First Nations Child and Family Services Agency have passed away in 2020. Thirteen of these children or youth passed away while in a hospital setting.Ministry/AgencyConstitutional StatusAge Range*GenderType of PlacementLocation of DeathMinistryIndigenous0-5yrsFParental HomeHospital MinistryIndigenous0-5yrsMParental HomeParental HomeMinistryIndigenous1 monthMParental HomeHospital MinistryIndigenous0-5yrsFParental HomeHospitalMinistryOther0-5yrsMParental HomeHospitalMinistryIndigenous0-5yrsMParental HomeHospitalMinistryIndigenous0-5yrsMhospitalHospital MinistryIndigenous16-21yrsMPSIHospital MinistryIndigenous16-21yrsFunknownHospital MinistryIndigenous0-5yrsMParental HomeHospitalMinistryIndigenous0-5yrsMunknownUnknown MinistryIndigenous0-5yrsFParental HomeHospitalMinistryIndigenous0-5yrsMunknownHospital AgencyIndigenous0-5yrsMParental HomeHospital AgencyIndigenous16-21yrsMParental HomeCommunity - FNAgencyIndigenous0-5yrsMParental HomeParental HomeAgencyIndigenous0-5yrsMParental HomeCommunity - FNAgencyIndigenous6-10yrsMParental HomeCommunity - FNAgencyIndigenous11-15yrsMParental HomeHospital Information in tables above provided by the Ministry of Social Services.If you're experiencing suicidal thoughts or having a mental health crisis, help is available.For an emergency or crisis situation, call 911.You can also contact the Saskatchewan suicide prevention line toll-free, 24/7 by calling 1-833-456-4566, texting 45645, or chatting online.You can contact the Regina mobile crisis services suicide line at 306-525-5333 or Saskatoon mobile crisis line at 306-933-6200.You can also text CONNECT to 686868 and get immediate support from a crisis responder through the Crisis Text Line, powered by Kids Help Phone.Kids Help Phone can also be reached at 1-800-668-6868, or you can access live chat counselling at www.kidshelpphone.ca.