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The Mental Health of Indigenous Peoples

Samantha Karp

Authors

Authors

Laurence J. Kirkmayer

Laurence J. Kirkmayer

Works at McGill University in Montreal

World leading expert in cultural psychology

Caroline L. Tait

Caroline L. Tait

Received her MA from Berkeley

PhD from the department of Anthropology and Social Studies of Medicine at McGill University

Professor at the University of Saskatchewan

Cori Simpson

Also Co Authored a few books and papers in the field of indigenous studies

Cori Simpson

Overview

Identifying key concepts and issues in order to guide culturally appropriate mental health treatments and strategies for aboriginal peoples in Canada

Methods

Authors review recent literature looking at the links between colonialism/government interventions and the mental health of aboriginal peoples in Canada

Aboriginal Peoples in Canada

In 2006, 1.17 million individuals self-identified as Aboriginal in Canada (3.8% of total population)

Geographic Distribution

Life expectancy

Life Expectancy

According to Health Canada, in 2001 the average life expectancy for First Nations men was 70.4 compared to 77.1 years for the general population and for First Nations women it was 75.5 versus 82.2 years

Overview

Statistics

Aboriginal peoples suffer from a wide range of health problems at much higher rates than other Canadians.

Statistics

Aboriginal peoples are:

- 6 to 7 times more likely to develop tuberculosis

- 4 to 5 times more likely to develop diabetes

- 3 times more likely to have heart disease and hypertension

- Injuries and poisonings main cause of potential years lost

- 1.5x national death rate

- 6.5x the national rate of death by injuries or poisoning

Why??

Why do we see these health differences between Aboriginals and Non-Aboriginals?

Social Origins of Distress

Aboriginal people of Canada have faced cultural oppression and social marginalization through the action of European colonizers and their institutions since the earliest periods of time

Colonization

Edmonton - Grandin LRT station (2021)

Economic, political, and religious institutions of the European settlers all contributed to the displacement and oppression of indigenous peoples

Colonization

Disease

Prior to the arrival of Europeans, estimates of the indigenous population of North America ranges upward from about 7 million - close to 90% of these people died as a result of direct and indirect effects of culture contact

Canadian Policies

Canadian Policies

Canadian policies have continued the process of destruction of indigenous cultures.

These policies caused: the creation of reserves, relocation to remote regions, residential schools, chronic underfunding and poor resourcing of essential services such as health care and education, and bureaucratic control.

Residential Schools in Canada

www.CBC.ca

Photo of children at the St. Albert Youville Residential School. (Photo via the National Centre for Truth and Reconciliation.)

Making a bad situation worse

Making a bad situation worse

Aboriginal housing was often poor quality and crowded which increased the risk of disease transmission (such as TB), which leads to:

- prolonged visits to hospitals

- further subversion of aboriginal communities

A family in the First Nations community of Pikangikum in northwestern Ontario (2011)

www.CBC.ca

In the best interest of the government

In the best interest of the government

Iqaluit reserve (2020) www.CBC.ca

Aboriginal people did not choose any of the aboriginal settlements

They were moved to undesirable plots of land

Governmental Control

Governmental Control

Went beyond reservations and residential schools

Provinces were put in charge for the welfare of aboriginal peoples

60s Scoop

Mental Health Consequences

Mental Health Consequences

What are the consequences of being assimilated and having your identity being stripped from you?

We will look at epidemiological studies and ethnographic studies to answer this

Mental illness is a prominent concern for indigenous communities

Research

Research

Epidemiological

Identifies the magnitude and distribution of mental health and social problems of Aboriginal peoples in Canada

Epidemiological

Methods

Instead of using questionnaires, researchers instead utilized structured interviews.

Clinic- and service-utilization services

Results

High variation is found for results for prevalence rates

Some studies suggest there is less mental illness

Some studies suggest there is more than twice the rate of mental illness

Why??

Why are we seeing so much variation in our results?

Why??

More Surveys...

More Surveys

Flower of Two Soils Re-Interview Study

- Found that 43% of respondents received at least one diagnosis for a DSM-III-R disorder

- Two thirds of respondents reported experiencing a traumatic event

Suicide in Indigenous Communities

Suicide Rates

- Dramatic indicator of distress

- Suicide rates are variable

- Variations between communities have much to teach us about the community-level factors that affect suicide rate

Ethnographic Studies

Ethnographic

- Qualitative

- Looking at narrative and life histories

- Looking at structural effects of disrupting families and communities

- Looking at the transmission of explicit models and ideologies of parenting based on experiences in punitive institutional settings

Cultural Continuity Research

Cultural Continuity

Research

Research looking at seven factors: Self government, involvemnet in land claims, band control of education, health services, cultural facilities, police services, and fire services

- Correlation between suicide and factors of cultural continuity

Why is this significant?

Why is this significant?

Provides evidence for the impact that community-level factors can have on an individual

Provides basis for future studies that are looking to investigate mental health - we need to be looking at history, structure, and dynamics of communities

Transformations of Identity and Community

Transformations of Identity and Community

Cultural and ethnic identity must be understood as a construction of contemporary people responding to their current situation - cultures are in a constant flux

View of "the person"

View of the person

Egotistic vs Ecotistic

Ecotistic view of the person emphasizes not only community relationships but also nature

Re-Articulating Tradition

Recent efforts for reversing the cultural marginalization

1993 RCMP investigation of residential schools (1890-1984)

- "Breaking the silence"

Canada responded with: Canada's Aboriginal Action Plan

Residential School Settlement Agreement

Residential School Settlement Agreement

1.9 billion dollar agreement

- Common experience payment

Complete solution?

Is this a complete solution?

www.CBC.ca (2015)

Complete solution?

- Throwing money at the problem

- Must address environmental aspects of the problem

Conclusion

Conclusion

The social origins of mental health problems in Aboriginal communities demand political and social attention/action

Further research into the variations in the prevalence of health disorders across communities may provide vital information about community level variables

Questions or comments?

Questions or comments

Other areas of possible focus for future research regarding mental health of indigenous peoples?

Factors we are not considering?

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