Three Saskatchewan First Nations have declared a state of crisis and are calling for better health care in the face of numerous deaths leaders attribute to addiction, health and violence issues.

Chiefs of the Keeseekoose, Cote and Key First Nations sent an open letter Monday to several federal and provincial leaders, including Prime Minister Justin Trudeau and Saskatchewan Premier Brad Wall, declaring the crisis.

“We need help and we need it now,” Cote First Nation Chief Norman Whitehawk said in a media release. “Our communities are in constant state of grieving.”

The Cote First Nation saw four people die in one day last month, according to the media release.

The chiefs, alongside Federation of Saskatchewan Indian Nations Vice-Chief Kimberly Jonathan, want the three communities to receive better access to health care.

“First Nations face numerous barriers in accessing medical professionals — especially on-reserve,” Jonathan said. “The provincial health system must be equally accessible to all citizens of this province.”

An addictions treatment centre is set to open in the area soon, but leaders claim more is needed to combat the crisis.

The trio’s letter requested Trudeau and Wall, alongside the federal ministers of health and indigenous affairs, the provincial health minister and the chair of the Sunrise Health Region, meet with leaders in the communities to discuss the health issues.

Federal Health Minister Jane Philpott called the deaths tragic and said the Canadian government is willing to work with chiefs, as well as the province, to improve health conditions in the communities.

"My heart goes out to these communities as they deal with something that for most Canadians is unimaginable," Philpott said in a statement. "Our Government has made it very clear that it is taking a new approach to resolving these long standing problems and is committed to a renewed, nation-to-nation relationship based on recognition of rights, respect, co-operation, and partnership."

A spokesperson for the Saskatchewan government said Greg Ottenbreit, the province’s rural and remote health minister, met with leaders several weeks ago and would accept an invitation for further meetings.

The Sunrise Health Region region said officials frequently meet with the communities' chiefs. The region "welcomes the opportunity to continue our joint discussions," a statement read.