Perhaps no group has suffered more from stereotyping, and been as chronically misunderstood, as First Nations people. Mentioning addiction and mental illness within the indigenous communities conjures images of homelessness, rampant intoxication, and individuals who are fully responsible for those challenges.
Mental health and substance abuse are serious issues faced by most indigenous communities. While the same can be said for any community, there are aspects of aboriginal culture that make managing these issues uniquely challenging for aboriginals.
The struggle to hold onto their traditions in the face of the imposition of western thinking has contributed significantly to the health and social problems experienced by indigenous peoples.
Mental Health Challenges
Suicide is at a crisis level worldwide, and the number of deaths annually continues to climb. This, tragically, is even truer for the indigenous population.
Statistics Canada reports that suicides rates among the First Nations population are twice the national average. Suicide is more prevalent among males, and it is highest among aboriginal youth aged 15-24. That is five to seven times the Canadian average for the same group.
Mental health conditions, particularly depression, are very common globally. Again, indigenous people experience these at a higher rate than the general population. They are twice as likely to experience major depression, or other mental illnesses.
In aboriginal communities, wellness is about balance and harmony, and being connected to family. The focus is on strengths rather than weaknesses. This is in contrast with North American approaches, and this makes it more difficult to access treatment.
Years of victimization through colonization, residential schools, child welfare programs and intergenerational trauma, have led to challenges with mental health, higher rates of suicide and substance abuse.
Substance Use Disorder
Drug and alcohol addiction among the indigenous communities is a cause for great concern. Research findings indicate that 75% of aboriginals feel that substance use is present in their community, 33% see it is an issue in their own family or household, and 25% report a personal problem with substance abuse.
In Alberta and British Columbia, hospital records show that First Nations people, particularly men, are admitted for problems with addiction more frequently than other residents in those provinces. Approximately 27% of aboriginal adults, and 32% of youth, use cannabis.
Substance abuse increases the likelihood of developing an addiction. The earlier this use begins, the greater the risk. It also has a significant impact on physical and cognitive development, and eventually causes issues at school, and, later, with obtaining and maintaining employment.
Issues with violence, even among family members, is another challenge faced by indigenous communities, and this is directly related to substance use problems.
Suicide, substance use disorder, and mental illness are all closely interconnected, and each condition exacerbates the other. They must be treated together, with an integrated approach.
Treatment for Indigenous Peoples
The health care system has evolved in its understanding of the needs of indigenous communities. As with any group, medical services and prevention programs are crucial in treating mental health conditions and substance abuse. Prompted by research projects that have revealed gaps and changes needed in treatment for aboriginals, the Federal government has been working with First Nations organizations to address disparities in mental health care.
Residential school survivors and their family members receive community based mental health care services and substance abuse programs provided by Health Canada. The First Nations Inuit and Mental Wellness Advisory Committee was formed, and has been working collaboratively with elders to develop strategies to address mental illness and addiction.
Healing of aboriginal peoples follows a holistic approach, and involves interconnectedness between family, community, spirituality and nature. This may include traditional teaching, spiritual practices like ceremonial prayers and songs, sacred remedies such as tobacco, sweet grass or sage, healing circles, sweat lodges, and interactions with elders or other medicine people.
The Aboriginal Child and Family Services agencies are located in both rural and urban communities, on and off-reserve. They provide a wide variety of mental health programs, particularly for children and youth.
Also offering health and social support services to Inuit and First Nations communities, Aboriginal Health Access Centres (AHAC) are another resource. These are found throughout Ontario, in cities and rural areas, both on the reserve and off. Services include mental health counselling, addiction programs, traditional healing, and cultural activities.
Indigenous Friendship Centres are found across Ontario. They provide a combination of health and social supports. These include the Children’s Mental Health Project for First Nations children and youth aged 7-15. Another service, the Children Who Witness violence, for children 7-14, works to address the traumatic stress associated with events experienced by many indigenous families.
The Métis Nation of Ontario provides mental health care services including assessment, intake, early intervention, referrals, and aftercare support, using a combination of traditional and contemporary approaches. A variety of programs that honour the needs of indigenous women and children are available through the Ontario Native Women’s Association.
Mental health services can be accessed at mainstream centres, clinics, agencies, and hospitals for anyone suffering from mental illness or substance use disorder. A health care provider, an expert in addiction, works with the person who is struggling, and his or her family members, to develop an individualized treatment plan.
Honouring a Promise
The Truth and Reconciliation Commission of Canada was originally formed in 2008 as a result of the Indian Residential Schools Settlement Agreement (IRSSA). The largest settlement in Canadian history, it was intended to compensate for the impact of residential schools on the survivors and their families, as well as to begin to address the inequities and injustice faced by indigenous people.
With the hope of creating a more just and equitable future, it is critical for health care services to continue to honour traditional treatment interventions. Family, community, and spirituality are all key components of indigenous well-being, along with a sense of control over their own health.
Indigenous People and Substance Abuse World Health Organization (WHO), Copyright 2019
Mental Health Addictions and Indigenous Health Report Prepared for Health Canada, Date Modified: May 17, 2019
Indigenous and Non-Indigenous People Experiencing Homelessness and Mental Illness in Two Canadian Cities Brittany Bingham, et al., US National Library of Medicine, April 8, 2019
Truth and Reconciliation Commission of Canada Government of Canada: Indigenous Relations and Northern Affairs Date modified: February 19, 2019
Mental Wellness in Canada’s Aboriginal Communities: Striving Toward Reconciliation Patricia Boksa, et al., Journal of Psychiatry and Neuroscience, November 2018
Mental Health and Suicide in Indigenous Communities Ryan Sioux, et al., National Institutes of Health, November 2017