Mental Health Among the Indigenous Peoples of Canada: A Post-Colonial Approach

Mental Health Among the Indigenous Peoples of Canada: A Post-Colonial Approach

It is becoming increasingly prevalent that the Indigenous population has experienced colonialism in Canada for years. Colonialism exists from standardized policies that work in maintaining government structure, to individualized effects that lead to poor health and unemployment (Nelson & Wilson, 2017). These exploitations have caused a disproportionate suffering on the mental and physical health of the Indigenous populations in Canada (Nelson & Wilson, 2017). This paper will define “Indigenous peoples” as those who are connected to Aboriginal ancestral land and those who identify as First Nations, Métis, or Inuit (Nelson & Wilson, 2017). The purpose of this paper is to address the mental health of indigenous peoples and how Canada’s healthcare system lacks in treating these individuals.

Mental Health in the Indigenous Population

According to Cianconi and colleagues (2019), mental health can be a relevant marker to the adjustment of historical and lifetime hardships and contributes to the outcome of liberalization. The indigenous population has faced a great deal of cultural sufferings, leading to intergenerational trauma and has caused a high prevalence of substance abuse, suicide, and PTSD (Cianconi et al., 2019). It is important to mention however, that many other types of mental illnesses effect indigenous peoples but there is a gap in research as only these disorders are primarily discussed (Cianconi et al., 2019). The colonialism that contributed to this mental health burden began in 1876 when the Canadian Government implemented the “Indian Act” in hopes to eliminate the indigenous culture (Nelson & Wilson, 2017). This marked the beginning of a cultural crisis where the indigenous peoples faced dispossession of their land, residential schools, and the “sixties scoop”, in attempt to weaken their societal and cultural norms (Nelson & Wilson, 2017). Recently, initiatives have been created to help this population reclaim their culture, however there is still a cultural disparity seen within the healthcare system today (Browne et al., 2016).

The Canadian healthcare system is primarily led by Western medicine which encompasses the use of doctors, nurses, surgeries, drugs, and evidenced-based practice (Cianconi et al., 2019). This view of medicine does not align with the healing techniques of the indigenous peoples and the healthcare system fails to incorporate their holistic outlook in treatment (Cianconi et al., 2019). The use of Western medicine in hospitals and healthcare settings could also cause indigenous communities to feel unsafe as these government services still fail to consider their culture (Cianconi et al., 2019). Though, some research has suggested that traditional indigenous medicines cannot treat mental illnesses alone, incorporating these practices within the recovery of mental illness can contribute to culturally safe care (Browne et al., 2016).

Understanding Indigenous Mental Health Through a Post-Colonial Lens

A post-colonial lens allows nurses to be aware of the assumptions made regarding culture and race and the health inequalities that arise from these issues (Beavis et al., 2015). When discussing issues related to indigenous populations and mental health, the poststructural and critical-feminist lens have an important role, however, a post-colonial lens seems most appropriate (Horrill et al., 2018). In regards to the indigenous population, nurses should understand how to identify their clients based on their proper titles, such as elders or chiefs, should be aware of what groups, tribes, and nations these individuals belong to, and also refrain from any unacceptable terms and stereotypes such as “Indian” or “drunks” (Horrill et al., 2018). Though the indigenous community is already at a disadvantage in the healthcare system, a critical feminist lens, promotes the equality of indigenous women, older aboriginals, and those of a lower socioeconomic status (Horrill et al., 2018)

Practicing safe and competent nursing through a post-colonial lens requires self-reflection on one’s own cultural and how it is reflected in their care (Beavis et al., 2015). This lens also highlights any knowledge gaps a nurse may have around race and culture and what underlying stereotypes they may be caught up in (Beavis et al., 2015). When caring for indigenous patients, it is important to consider their historical experiences, and how this affects their social, mental, and emotional well-being (Beavis et al., 2015). It is also important to gain an understanding of what mental health means to the individual as it may deviate from the Western medicine definition (Beavis et al., 2015). Being aware of their healing practices, languages, and beliefs will reduce any power dynamics and assist in providing a positive experiencing for these individuals, therefore creating better access (Beavis et al., 2015).

The Impact of Mental Health on Indigenous Families and How it is Understood

The historical trauma experienced by the indigenous population has created a great burden on their mental health (Nelson & Wilson, 2017). These events have not only affected the survivors of this cultural hate, but it has caused high rates of depressive symptoms, suicidal ideations, and childhood abuse among adults who had a parent or grandparent a part of the residential schools (Nelson & Wilson, 2017). Boksa and colleagues (2015) found a negative relationship between the amount of pride indigenous peoples feel in identifying with their culture and illicit drug use. By reducing racism and promoting acceptance of the indigenous culture, Canadians can have a large impact of the mental health of these individuals (Boksa et al., 2015). The lack of understanding regarding the indigenous views and mental health also make it difficult for this population to receive adequate treatment, leaving indigenous families struggling to feel understood (Browne et al., 2016).

Failing to Incorporate Indigenous Healing in Western Medicine

Mental health is a definition based on biomedical practices and holds a different meaning to the indigenous community (Horrill et al., 2018). These definitions differ as the indigenous peoples hold a holistic view regarding mental wellness as it is seen as being in balance with family, community, and the larger environment (Horrill et al., 2018). These differences impact the effectiveness of treatment and the Western medicine model tends to have less success with this group (Horrill et al., 2018). For years, suicide and self-inflicted injuries have been the leading cause of death among the indigenous youth as there is discordance with what suicide means in Indigenous culture and how it is treated (Barker et al., 2017). Though Canada is striving to draw attention a promote the wellbeing of this culture, they fail to incorporate indigenous beliefs when treating these individuals (Browne et al., 2016).

Social Determinants of Mental Health

Many research papers have understood the social determinants of mental health amongst the indigenous community to be attributed to colonialism, with residential schools being the most significant (Nelson, 2015). The “sixties scoop” should also be mentioned when discussing this topic as this created further colonization and homelessness of aboriginal children (Nelson, 2015). This homelessness did not just include the absence of a home, but it also removed family, land, culture, water, and identities from these individuals (Nelson, 2015). Though the indigenous population has shown great resilience to the hardships they have faced, these crises have caused long-term effects on the mental health of these individuals and their relatives (Greenwood & de Leeuw, 2012). Today, the indigenous population experiences greater rates of poverty than non-indigenous Canadians and this a huge negative impact on the mental health of these individuals as it deprives them of food, water, shelter, education, sanitation and social exclusion (Greenwood & de Leeuw, 2012).

Considering Indigenous Mental Health Through Curiosity and Compassion

Curiosity plays an important role when considering the mental health of the indigenous peoples as they may have a very different view on how to treat their illness and what their desired outcomes are (Beavis et al., 2015). Though we have been taught the basic information regarding mental illnesses as imposed by colonialism, we must remain curious and enact on systemic growth to expand on our personal ways of knowing and incorporate indigenous ways of knowing (Beavis et al., 2015). To implement curiosity into our own nursing practices, one must practice active listening, maintain an open mind, and acknowledge the story behind their views (Beavis et al., 2015). Curiosity, especially in a mental health, can help a nurse better understand what well-being, productivity, and balance means from an indigenous viewpoint (Beavis et al., 2015).

When caring for indigenous peoples and their mental health, nurses must show compassion to themselves and these individuals (Prince, 2015). Understanding a culture that is different from our own can be quite challenging (Prince, 2015). It is essential however, to demonstrate compassion towards the indigenous population as they have experienced historical trauma most people will never fully understand (Prince, 2015). By keeping up to date with past and present history and acknowledging the hardships rather than running from them, indigenous peoples will feel supported and will be willing to engage in healing techniques to help end their suffering (Prince, 2015).

Conclusion

Mental health is an important aspect to an individuals well-being. As nurses, we can strengthen the mental well-being of the indigenous peoples by recognizing their cultural beliefs and reflect on how their values define health. There is great optimism that this country will continue to correct their wrongdoings, however, much work needs to be done regarding the healthcare system in integrating the indigenous ways of healing.