Lack of mental health services for Indigenous communities

Hello everyone, I finally posted a piece that is close to my heart. I am incredibly passionate about Indigenous health, and I cried reading some of the research papers. I want to thank Dr. Jessica Vorstermans, my professor at the health department of York University, for being kind enough to read my article and provide feedback. I hope you enjoy reading this piece.

Traumatic events can impact mental health for years. Globally, the adverse effects of historical and ongoing colonialism on Indigenous communities' physical and mental well-being are tremendous. Indigenous communities experience discrimination in their every-day lives. Racial discrimination is further magnified in the context of mental health issues and poverty. Colonization has had a direct effect on Indigenous communities for generations. The historical and ongoing colonial activities have strived to separate Indigenous people from their culture and traditions, leading to mass trauma, lower life expectancy, and mental health challenges (Lavallee & Poole, 2009). Mental health is composed of our social, emotional, and psychological well-being. Mental health affects our thoughts, feelings, and actions. From childhood to adulthood, mental health is an important aspect of every life stage. Our overall health consists of mental and physical health, and both are equally valuable. According to CDC, mental illnesses such as depression can increase the risk of many physical health problems (Learn about mental health, 2018). This issue becomes more visible when we look at the Indigenous communities. Various documents in Canada showcase mental health disparities between Indigenous and non-Indigenous communities. These disparities have been strongly associated with the intergenerational effects of residential schools, removal of children from the Indigenous communities, and gaps in mental health services (King, Smith, & Gracey, 2009). Several studies indicate mental health issues amongst Indigenous communities have resulted from a troubled childhood, trauma, and social discrimination (Boksa, Joober, & Kirmayer, 2015). Additionally, the data suggests social determinants of health such as unemployment and lack of job security, living in poverty, lack of food security, and inadequate housing have a significant impact on mental health challenges faced by Indigenous communities (Matheson et al., 2019). The inequity problem in Canada is the lack of mental health services for Indigenous communities or, in other words, there is a gap in mental health resources for Indigenous people. The research suggests when we talk about the prevalence of mental illness, we should take colonialism and its adverse intergenerational effects into account. Historically researching the mental health of Indigenous communities in Canada has been dominated by settlers utilizing colonial and non-Indigenous methods. To this day, disregard for Indigenous viewpoints perseveres in current mental health research in Canada (Waldram, 2004). In the ensuing paragraphs, the lack of mental health services and resources for Indigenous communities and the absence of Indigenous perspectives in mental health services and research will be explored through an intersectionality lens.

Addressing mental health through an intersectionality lens means that factors such as poverty, socioeconomical status, access to education, trauma, marginalization, and food insecurity should be considered. Intersectionality gives us the tools to go past the single factor explanations and allows us to deeply analyze one's mental health challenges based on one's social location. For the mental health, healing, and recovery of Indigenous people, we need to consider their identity, history, culture, and language (Lavallee & Poole, 2009). Research suggests many health issues, such as high rates of chronic pain and infant mortality amongst Indigenous communities, are strongly linked to social determinants of health. To elaborate, poverty, inadequate housing, lack of food security, and racism are determinants of health that have arisen from colonialism. Data implies that the high suicide rate and other mental health issues amongst Indigenous communities may be a consequence of mass trauma that stemmed from colonization. Furthermore, in Canada, evidence infers that the residential schools' system has resulted in severe trauma. Survivors further confirmed being abused in residential schools and consequent mental health problems. Moreover," It has been further postulated that the effects of trauma can also be passed inter-generationally" (Elias et al., 2012, p 1). From the 1890s effective until 1996, children were removed from their families and communities and sent to residential schools administered by the catholic church. Many children in residential schools underwent loss of language, culture, family bonding, community bonding, self-respect, and traditional values. The loss of bonding with families and the language intruded the passage of Indigenous culture to the subsequent generations and caused major traumas for Indigenous communities (Morrissette, 1994). Often when it comes to healing and recovering from mental health issues, the identity, history, culture, intergenerational effects of mass trauma, and people's social locations are not considered. Food insecurity, poverty, and housing should also be considered when it comes to mental health recovery. Food insecurity refers to a situation where the members of a household can not afford meals or skip meals due to the lack of money. Data suggests when individuals do not have food security, poor mental health arises (Raphael, 2016). “In 2012, one in five (20%) First Nations people aged 15 and older living off-reserve experienced household food insecurity.” (Government of Canada, 2016). Low income and poverty are also highly associated with poor mental health. According to the 2011 NHS, the household income of non-Indigenous people is higher than the first nations. Therefore, Indigenous people are experiencing a unique mental health burden; hence they require healing and recovery methods specialized for them.

A blended approach should be used to address this health inequity issue. Targeted universalism considers that universalism may still cause a health gap that is not accepted. This approach is used because it recognizes the barriers faced by a particular group of people. Since mental health is a part of overall health, all mental health resources and services should be free of charge and funded by the federal government. The human right approach suggests health is a human right, and no part of it should be dependent on how much money individuals make, which is known to intersect with race, class, gender, and identity. Furthermore, Indigenous communities should receive specialized mental health resources and services that align with their unique history and identity. For instance, land-based healing is a traditionally and culturally appropriate approach for helping Indigenous people who are dealing with mental health problems recover. Land-based healing is a practice or service that occurs in a nature-based location on a spiritually honored land (Redvers, 2020). Other aspects of the blended targeted universal approach include hiring more Indigenous practitioners who can help the Indigenous communities facing mental health challenges with cultural, spiritual, and traditional methods. Indigenous communities in Canada have culturally specific practices and programs that target mental health challenges. They have various workshops that focus on healing mental health issues using spiritual and cultural practices with special traditional ceremonies (Lavallee & Poole, 2009). It is essential to use Indigenous practitioners to tailor the mental health services and programs for Indigenous communities because real healing for Indigenous communities should work around the Indigenous culture and identity. Indigenous people's identity should be considered because one of the primary aspects that colonization has attacked and is still attacking is the cultural integrity of Indigenous people (Lavallee & Poole, 2009). Additionally, using the western-modernized approaches for Indigenous communities' mental health is a band-aid solution rather than a solution that treats the root of the problems, which is colonization and cultural identity disruption (Lavallee & Poole, 2009). If the cultural loss and impacts of colonization on Indigenous mental health are considered, the healing plans must focus on rebuilding the identity of Indigenous people. Therefore, using Indigenous practitioners and identity-based methods are essential. The blended approach was used to address this issue because being able to afford mental health services is a right for all; therefore, it should be free of cost. Special groups with unique needs require specialized treatments and services since, after all, one shoe can't fit all, and intersectionality should be considered when it comes to mental health.

In conclusion, when it comes to Indigenous people, their history, intergenerational traumas, traditions, language, culture, and identity should not be left behind or forgotten. The mental health services should be focused on Indigenous healing methods rooted in their rich cultural identity. Furthermore, the system can benefit from Indigenous practitioners since the real healing for Indigenous communities should happen through their culture and identity. The historical and ongoing colonialism have had major negative impacts on the mental health of Indigenous people, and the intergenerational effects of trauma should not be neglected. After all, going back in time to rewrite the history of colonialism and residential schools is not possible; however, setting an example for subsequent generations by doing it right in contemporary times is plausible. As George Orwell once said: “The most effective way to destroy people is to deny and obliterate their own understanding of their history.”

References

Arriagada, P., Hahmann, T., & O’Donnell, V. (2020, June 23). Indigenous people and mental health during the COVID-19 pandemic. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00035-eng.htm.

Boksa, P., Joober, R., & Kirmayer, L. J. (2015). Mental wellness In Canada’s Aboriginal communities: Striving Toward reconciliation. Journal of Psychiatry & Neuroscience, 40(6), 363–365. https://doi.org/10.1503/jpn.150309

Elias, B., Mignone, J., Hall, M., Hong, S. P., Hart, L., & Sareen, J. (2012). Trauma and Suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada's residential school system. Social Science & Medicine, 74(10), 1560–1569. https://doi.org/10.1016/j.socscimed.2012.01.026

Government of Canada, S. C. (2016, August 12). Social determinants of health for the off-reserve First Nations population, 15 years of age and older. https://www150.statcan.gc.ca/n1/pub/89-653-x/89-653-x2016010-eng.htm.

King, M., Smith, A., & Gracey, M. (2009). Indigenous health Part 2: The underlying causes of the health gap. The Lancet, 374(9683), 76–85. https://doi.org/10.1016/s0140-6736(09)60827-8

Lavallee, L. F., & Poole, J. M. (2009). Beyond recovery: COLONIZATION, health and healing for indigenous people in Canada. International Journal of Mental Health and Addiction, 8(2), 271–281. https://doi.org/10.1007/s11469-009-9239-8

Learn about mental health . (2018, January 26). https://www.cdc.gov/mentalhealth/learn/index.htm#:~:text=Why%20is%20mental%20health%20important,2%20diabetes%2C%20and%20heart%20disease.

Matheson, K., Bombay, A., Dixon, K., & Anisman, H. (2019). Intergenerational communication regarding Indian Residential Schools: Implications for cultural Identity, Perceived discrimination, and depressive symptoms. Transcultural Psychiatry, 57(2), 304–320. https://doi.org/10.1177/1363461519832240

Morrissette, P. J. (1994). The Holocaust of first NATION people: Residual effects on parenting and Treatment implications. Contemporary Family Therapy, 16(5), 381–392. https://doi.org/10.1007/bf02197900

Raphael, D. (2016). Social determinants of health: Canadian perspectives. Canadian Scholars' Press Inc.

Redvers, J. (2020). “The land is A healer”: Perspectives on LAND-BASED healing from indigenous practitioners in northern Canada. International Journal of Indigenous Health, 15(1), 90–107. https://doi.org/10.32799/ijih.v15i1.34046

Waldram, J. B. (2004). Revenge of the windigo the construction of the mind and mental health of North American Aboriginal peoples. University of Toronto Press.