Manitoba's child and youth advocate says reducing the risk of suicide and homicide among Indigenous boys needs to be part of reconciliation.

Ainsley Krone makes the call in a review of the deaths of 45 boys who died by suicide or homicide between 2009 and 2018 -- more than 80 per cent of them First Nations or Metis.

The review found most of the boys experienced neglect, violence in the home and parental substance use -- but poverty, racial discrimination in school and involvement with the justice system played a role in some cases.

Krone made four new recommendations, including development of culturally safe interventions for parents with substance use disorders and culturally appropriate school initiatives tailored to Indigenous boys.

The report also highlights a previous recommendation from 2018 urging the government to respond to a lack of effective treatment services for youth with substance use problems.

A statement from Manitoba Mental Health, Wellness and Recovery said the province is reviewing the report and consulting with Manitobans, including participation and feedback from the advocate’s office, to develop a five-year action plan.

“We continue evaluating and implementing cost effective, safe, evidence-based harm reduction and addictions treatment programs and service,” said the statement from the provincial department.