Mental Health Interventions for First Nations, Inuit, and Métis Peoples in Canada: A Systematic Review

Authors

  • Simon Graham Office of the Chief Medical Officer, First Nations Health Authority, Canada, and Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Australia
  • Krista Stelkia Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
  • Cornelia Wieman Office of the Chief Medical Officer, First Nations Health Authority, West Vancouver, British Columbia, Canada
  • Evan Adams Chief Medical Officer First Nations Health Authority, West Vancouver, British Columbia, Canada

DOI:

https://doi.org/10.18584/iipj.2021.12.2.10820

Keywords:

Indigenous, Aboriginal, Anxiety, Depression, Suicide, Elders, Culture as treatment, First Nations, Métis, Inuit

Abstract

Higher rates of anxiety, depression, and attempted suicide are reported among First Nations, Inuit, and Métis people compared with non-Indigenous people in Canada. This systematic review summarises the key components of mental health interventions among Indigenous Peoples in Canada. We searched MEDLINE, PubMed, PsycINFO, and Web of Science between January 1,1970, and August 30, 2019. Studies needed to be an intervention addressing suicide, depression, or anxiety. There were 14 studies: 8 quantitative, 2 qualitative, and 4 mixed methods. By geographical location, 5 were urban, 5 non-urban, and 4 included multiple areas. Beneficial interventions included ceremony, being on the land, engaging in traditional food gathering, culturally grounded indoor and outdoor activities, and the sharing of Indigenous knowledge by Elders.

Author Biographies

Simon Graham , Office of the Chief Medical Officer, First Nations Health Authority, Canada, and Department of Infectious Diseases, Melbourne Medical School, University of Melbourne, Australia

Simon is a Narrunga man from South Australia. He is an Endeavour Research Leadership Fellow at the First Nations Health Authority in Vancouver and a National Health and Medical Research fellow at the Doherty Institute, University of Melbourne. He has led a community-based trial that successfully increased sexually transmitted infection (STI) and viral hepatitis testing and improved managed of these infections among young Aboriginal people in small regional towns in New South Wales. Simon spent two years at the London School of Hygiene and Tropical Medicine and he has been a Fulbright fellow based at the PRIDE Health Research Consortium in New York City. He is a graduate of the Master of Applied Epidemiology, a field epidemiology degree where he evaluated Australia’s National perinatal surveillance system and investigated an outbreak in Western Sydney. Simon previously worked in international developed based in Bangkok and Hanoi. He has an interest in field epidemiology that has clear community benefits.

Krista Stelkia , Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada

Krista Stelkia, Syilx/Tlingit from Osoyoos Indian Band, is a University Research Associate in the Faculty of Health Sciences at Simon Fraser University (SFU). Krista completed her Bachelor of Arts (First Class Honours) and Master of Arts in Criminology at SFU. Her doctoral research, funded by a Canadian Institutes of Health Research (CIHR) Doctoral Research Award, examines the complex and intersecting ways in which structural racism can influence chronic disease and comorbidity among First Nations in Canada. Krista brings over 12 years of professional experience working with First Nations communities and organizations, most recently in the Office of the Chief Medical Officer at the First Nations Health Authority.

Cornelia Wieman, Office of the Chief Medical Officer, First Nations Health Authority, West Vancouver, British Columbia, Canada

Nel is Canada’s first female Indigenous psychiatrist (Anishnawbe – Little Grand Rapids First Nation, Manitoba). In January 2018, Nel joined the First Nations Health Authority in BC as a Senior Medical Officer, Mental Health & Wellness, in the FNHA’s Office of the Chief Medical Officer. From 2013-2018, she was a staff psychiatrist at the Centre for Addictions and Mental Health (CAMH) in Toronto, in CAMH’s Aboriginal Services Unit, Tele-psychiatry Service (Northern Psychiatric Outreach Program), Crisis Clinic and General Assessment Clinic. Since 2016, Nel has also served as the Faculty Advisor to the Indigenous Students’ Health Sciences Office at McMaster University. Prior to this, Nel was a member of the Clinical Support Team at YWCA Toronto’s Elm Centre providing psychiatric services to over 100 women living with serious mental illness and addictions, and was a special consultant to the Chief Public Health Officer of the Public Health Agency of Canada. From 2004-2011, she was the Co-Director of the Indigenous Health Research Development Program and an Assistant Professor in the Dalla Lana School of Public Health, Faculty of Medicine at the University of Toronto. Nel began her career by providing psychiatric services at the community mental health clinic on Six Nations of the Grand River Territory (1997-2005) after completing her medical degree (1993) and while completing her psychiatry specialty training (1998) at McMaster University in Hamilton, Ontario. In February 2013, Nel was awarded the Queen Elizabeth II Diamond Jubilee Medal.

Evan Adams, Chief Medical Officer First Nations Health Authority, West Vancouver, British Columbia, Canada

Dr. Evan Adams is of Sliammon First Nation ancestry. He is the Deputy Chief Medical Officer of Public Health, Director General’s Office of Population and Public Health, First Nation and Inuit Health Branch, Indigenous Services Canada, Government of Canada. Previously he was the Chief Medical Officer (CMO) for the First Nations Health Authority. In his role as CMO, Dr. Adams provides invaluable leadership representing the FNHA. He works closely with government partners on population and public health matters that affect First Nations and all British Columbians.
Prior to working with the FNHA, Dr. Adams was appointed as Deputy Provincial Health Officer and worked alongside Provincial Health Officer (PHO) Dr. Perry Kendall and Deputy PHO Dr. Eric Young. In this role, he provided independent direction on First Nations and Aboriginal health issues to the Ministry of Health. He also reported to citizens on health issues affecting the general population and set out a path for the improvement of First Nations and Aboriginal health and wellness.
Dr. Adams leads a team of FNHA physicians—health and wellness partners to BC First Nations—who focus on First Nations health and wellness with the aim of creating a unique health care model that will be the first of its kind in Canada. He contributes to the continued transformation of health care and responds to the wellness directives provided by First Nations communities.
Dr. Adams completed his Doctor of Medicine (MD) at the University of Calgary, his Aboriginal Family Practice residency at St Paul’s Hospital/UBC (as Chief Resident), a Masters of Public Health from Johns Hopkins University, and served as the Director of UBC’s Division of Aboriginal Peoples Health.
Dr. Adams likes to keep his family close, including his five sons and step-daughter, and honours his family. He is a marathon runner and is beginning to add swimming to his wellness plans. Dr. Adams is notable for his acting role in the movie “Smoke Signals”; he truly enjoys the arts.

References

Aguiar, W., & Halseth, R. (2015). Aboriginal Peoples and historical trauma: The processes of intergenerational transmission. National Collaborating Centre for Aboriginal Health. http://www.nccah-ccnsa.ca/Publications/Lists/Publications/Attachments/142/2015-04-28-AguiarHalseth-RPT-IntergenTraumaHistory-EN-Web.pdf

Alianait Inuit-Specific Mental Wellness Task Group. (2007). Alianait Inuit Mental Wellness Action Plan. https://www.itk.ca/wp-content/uploads/2009/12/Alianait-Inuit-Mental-Wellness-Action-Plan-2009.pdf

Allan, B., & Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous Peoples in Canada. https://www.wellesleyinstitute.com/wp-content/uploads/2015/02/Summary-First-Peoples-Second-Class-Treatment-Final.pdf

Anderson, T. (2015). The social determinants of higher mental distress among Inuit. https://assembly.nu.ca/library/Edocs/2015/001921-e.pdf

Ansloos, J., Stewart, S., Fellner, K., Goodwill, A., Graham, H., McCormick, R., Harder, H., & Jeffrey, M. (2019). Indigenous Peoples and professional training in psychology in Canada. Graduate Education, Research, and Professional Training in Psychology, 60(4), 265-280. https://doi.org/10.1037/cap0000189

Assembly of First Nations. (2020). Assembly of First Nations. https://www.afn.ca/Home/

Bartram, M., & Chodos, H. (2013). Changing directions, changing lives: The mental health strategy for Canada. Canadian Journal of Community Mental Health, 32(4). https://doi.org/10.7870/cjcmh-2013-001

Baxter, J., Kingi, T. K., Tapsell, R., Durie, M., & McGee, M. A. (2006). Prevalence of mental disorders among Māori in Te Rau Hinengaro: The New Zealand Mental Health Survey. Australian and New Zealand Journal of Psychiatry, 40(10), 914-923. https://doi.org/10.1080/j.1440-1614.2006.01911.x

Bombay, A., Matheson, K., & Anisman, H. (2011). The impact of stressors on second generation Indian residential school Survivors. Transcultural Psychiatry, 48(4), 367-391. https://doi.org/10.1177/1363461511410240

Cooper, E., & Driedger, S. M. (2019). ‘If you fall down, you get back up’: Creating a space for testimony and witnessing by urban Indigenous women and girls. The International Indigenous Policy Journal, 10(1), 1-22. https://doi.org/10.18584/iipj.2019.10.1.1

Corrado, R. R., & Cohen, I. M. (2003). Mental health profiles for a sample of British Columbia’s Aboriginal Survivors of the Canadian residential school system. http://www.ahf.ca/downloads/mental-health.pdf

Crooks, C. V, Exner-Cortens, D., Burm, S., Lapointe, A., & Chiodo, D. (2017). Two years of relationship-focused mentoring for First Nations, Métis, and Inuit adolescents: Promoting positive mental health. The Journal of Primary Prevention, 38(1-2), 87-104. https://doi.org/10.1007/s10935-016-0457-0

DeWit, D. J., Wells, S., Elton-Marshall, T., & George, J. (2017). Mentoring relationships and the mental health of Aboriginal youth in Canada. The Journal of Primary Prevention, 38(1-2), 49-66. https://doi.org/10.1007/s10935-016-0441-8

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 and Medicine, 74(10), 1560-1569. https://doi.org/10.1016/j.socscimed.2012.01.026

First Nations Health Authority. (2019). Mental health and substance use. https://www.healthlinkbc.ca/mental-health-substance-use/resources/fnha-mhsu

First Nations Information Governance Centre. (2018). National report of the First Nations Regional Health Survey Phase 3: Volume one. https://fnigc.ca/sites/default/files/docs/fnigc_rhs_phase_3_national_report_vol_1_en_final_web.pdf

First Nations Information Governance Centre. (2018). National report of the First Nations Regional Health Survey Phase 3: Volume two. https://fnigc.ca/wp-content/uploads/2020/09/713c8fd606a8eeb021debc927332938d_FNIGC-RHS-Phase-III-Report1-FINAL-VERSION-Dec.2018.pdf

Fox, J., Manitowabi, D., & Ward, J. A. (1984). An Indian community with a high suicide rate—5 years after. Canadian Journal of Psychiatry, 29(5), 425-427. https://doi.org/10.1177/070674378402900512

Gionet, L., & Roshanafshar, S. (2016). Select health indicators of First Nations people living off reserve, Métis and Inuit (Catalogue no. 82-624-X). Statistics Canada. https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/11763-eng.htm

Gone, J. P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for Indigenous culture as mental health treatment. Transcultural Psychiatry, 50(5). https://doi.org/10.1177/1363461513487669

Government of Canada. (1982). Constitution Act, Section 35. Indigenous Peoples of Canada. https://indigenousfoundations.arts.ubc.ca/constitution_act_1982_section_35/#:~:text=Section%2035%20of%20the%20Constitution%20Act%20states%3A,and%20M%C3%A9tis%20peoples%20of%20Canada

Government of Canada. (2011). Aboriginal demographics from the 2011 National Household Survey. http://publications.gc.ca/collections/collection_2013/aadnc-aandc/R5-16-2013-eng.pdf

Government of Canada. (2020). What is Indian Status? https://www.sac-isc.gc.ca/Eng/1100100032463/1572459644986

Gracey, M., & King, M. (2009). Indigenous health Part 1: Determinants and disease patterns. The Lancet, 374(9683), 65-75. https://doi.org/10.1016/S0140-6736(09)60914-4

Gross, P. A., Efimoff, I., Patrick, L., Josewski, V., Hau, K., Lambert, S., & Smye, V. (2016). The DUDES Club: A brotherhood for men’s health. Canadian Family Physician, 62(6), E311-E318.

Hackett, C., Feeny, D., & Tompa, E. (2016). Canada’s residential school system: Measuring the intergenerational impact of familial attendance on health and mental health outcomes. Journal of Epidemiology and Community Health, 70(11), 1096–1105. https://doi.org/10.1136/jech-2016-207380

Hadjipavlou, G., Varcoe, C., Tu, D., Dehoney, J., Price, R., & Browne, A. J. (2018). ‘All my relations’: Experiences and perceptions of Indigenous patients connecting with Indigenous Elders in an inner city primary care partnership for mental health and well-being. Canadian Medical Association Journal, 190(20), E608–E615. https://doi.org/10.1503/cmaj.171390

Harder, H. G., Holyk, T., Russell, V. L., & Klassen-Ross, T. (2015). Nges Siy (I love you): A community-based youth suicide intervention in Northern British Columbia. International Journal of Indigenous Health, 10(2), 21-32. https://doi.org/10.18357/ijih.102201514309

Hardt, J. V. (2012). Alpha brain-wave neurofeedback training reduces psychopathology in a cohort of male and female Canadian Aboriginals. Advances in Mind-Body Medicine, 26(2), 8-12.

Indigenous Services Canada. (2019). Youth empowerment and healing and wellness investment for First Nations communities. https://www.newswire.ca/news-releases/youth-empowerment-and-healing-and-wellness-investment-for-first-nations-communities-843055793.html

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

Kumar, M. B., & Tjepkema, M. (2019). Suicide among First Nations people, Métis and Inuit (2011-2016): Findings from the 2011 Canadian Census Health and Environment Cohort (CanCHEC). Statistics Canada. https://www150.statcan.gc.ca/n1/pub/99-011-x/99-011-x2019001-eng.htm

Leske, S., Harris, M. G., Charlson, F. J., Ferrari, A. J., Baxter, A. J., Logan, J. M., Toombs, M., & Whiteford, H. (2016). Systematic review of interventions for Indigenous adults with mental and substance use disorders in Australia, Canada, New Zealand and the United States. The Australian and New Zealand Journal of Psychiatry, 50(11), 1040–1054. https://doi.org/10.1177/0004867416662150

McKenzie, K., Tuck, A., & Ekanayake, S. (2014). Suicide in diverse populations: Implications for Canada’s suicide strategies. In Routledge International Handbook of Clinical Suicide Research (pp. 103-113). https://www.routledgehandbooks.com/doi/10.4324/9780203795583.ch9

Mental Health Commission of Canada. (2016). Advancing the mental health strategy for Canada: A framework for action (2017-2022). https://www.mentalhealthcommission.ca/sites/default/files/2016-08/advancing_the_mental_health_strategy_for_canada_a_framework_for_action.pdf

Métis Nation. (2018, September 6). Métis Nation presses health and wellness, family and child care priorities at policy sessions in Ottawa. https://nationtalk.ca/story/metis-nation-presses-health-and-wellness-family-and-child-care-priorities-at-policy-sessions-in-ottawa

Métis Nation. (2020). Métis Nation. https://www2.metisnation.ca/

Miller, L. D., Laye-Gindhu, A., Bennett, J. L., Liu, Y., Gold, S., March, J. S., Olson, B. F., & Waechtler, V. E. (2011). An effectiveness study of a culturally enriched school-based CBT anxiety prevention program. Journal of Clinical Child and Adolescent Psychology, 40(4), 618-629. https://doi.org/10.1080/15374416.2011.581619

Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., & the PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med, 6(7). https://doi.org/doi: 10.1371/journal.pmed.1000097

Nasir, B. F., Toombs, M. R., Kondalsamy-Chennakesavan, S., Kisely, S., Gill, N. S., Black, E., Hayman, N., Ranmuthugala, G., Beccaria, G., Ostini, R., & Nicholson, G. C. (2018). Common mental disorders among Indigenous people living in regional, remote and metropolitan Australia: A cross-sectional study. BMJ Open, 8(6). https://doi.org/10.1136/bmjopen-2017-020196

National Inquiry into Missing and Murdered Indigenous Women and Girls. (2019). Reclaiming power and place: The final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls. https://www.mmiwg-ffada.ca/final-report/

Nelson, S. E., & Wilson, K. (2017). The mental health of Indigenous Peoples in Canada: A critical review of research. Social Science and Medicine, 176, 93-112. https://doi.org/10.1016/j.socscimed.2017.01.021

Public Health Agency Canada. (2018). Key health inequalities in Canada: A national portrait. Government of Canada. https://www.canada.ca/en/public-health/services/publications/science-research-data/key-health-inequalities-canada-national-portrait-executive-summary.html

Ring, I., & Brown, N. (2003). The health status of Indigenous Peoples and others: The gap is narrowing in the United States, Canada, and New Zealand, but a lot more is needed. BMJ, 327(7412), 404-405. https://doi.org/10.1136/bmj.327.7412.404

Ritchie, S. D., Wabano, M.-J., Russell, K., Enosse, L., & Young, N. L. (2014). Promoting resilience and wellbeing through an outdoor intervention designed for Aboriginal adolescents. Rural and Remote Health, 14, 2523.

Smylie, J. (2009). The health of Aboriginal Peoples. In D. Raphael (Ed.), Social determinants of health: Canadian perspectives (2nd ed., pp. 280-304). Canadian Scholars’ Press Inc.

Statistics Canada. (2011). National Household Survey: Aboriginal demographics, educational attainment and labour market outcomes. https://www.sac-isc.gc.ca/eng/1376329205785/1604610645621

Statistics Canada. (2017). Aboriginal Peoples in Canada: Key results from the 2016 Census. https://www150.statcan.gc.ca/n1/daily-quotidien/171025/dq171025a-eng.pdf

Statistics Canada. (2020). Health indicators, by Aboriginal identity, age-standardized rates, four-year period estimates. https://doi.org/10.25318/1310045801-eng

Thomas, G., Lucas, P., Capler, N. R., Tupper, K. W., & Martin, G. (2013). Ayahuasca-assisted therapy for addiction: Results from a preliminary observational study in Canada. Current Drug Abuse Reviews, 6(1), 30-42. https://doi.org/10.2174/15733998113099990003

Thunderbird Partnership Foundation. (2011). Honouring our strengths: Growth and evolution to new horizons. https://thunderbirdpf.org/honouring-our-strengths-full-version-2/

Toombs, M., Nasir, B., Kisely, S., Kondalsamy-Chennakesavan, S., Hides, L., Gill, N., Beccaria, G., Brennan-Olsen, S., Butten, K., & Nicholson, G. (2020). Australian Indigenous model of mental healthcare based on transdiagnostic cognitive–behavioural therapy co-designed with the Indigenous community: Protocol for a randomised controlled trial. BJPsych Open, 6(3), e33. https://doi.org/10.1192/bjo.2020.16

Truth and Reconciliation Commission of Canada. (2015a). Canada’s residential schools: The history, Part I origins to 1939 (Vol. 1). Government of Canada. http://www.trc.ca/assets/pdf/Volume_1_History_Part_1_English_Web.pdf

Truth and Reconciliation Commission of Canada. (2015b). Honouring the truth, reconciling for the future: Summary of the final report of the Truth and Reconciliation Commission of Canada. http://publications.gc.ca/collections/collection_2015/trc/IR4-7-2015-eng.pdf

Truth and Reconciliation Commission of Canada. (2015c). Truth and Reconciliation Commission of Canada: Calls to Action. http://www.trc.ca/assets/pdf/Calls_to_Action_English2.pdf

Tu, D., Hadjipavlou, G., Dehoney, J., Price, E. R., Dusdal, C., Browne, A. J., & Varcoe, C. (2019). Partnering with Indigenous Elders in primary care improves mental health outcomes of inner-city Indigenous patients: Prospective cohort study. Canadian Family Physician, 65(4), 274-281.

Tungasuvvingat Inuit. (2020). Tungasuvvingat Inuit. https://tiontario.ca/

United Nations. (2007). United Nations Declaration on the Rights of Indigenous Peoples. https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2018/11/UNDRIP_E_web.pdf

Varcoe, C., Browne, A. J., Ford-Gilboe, M., Dion Stout, M., McKenzie, H., Price, R., Bungay, V., Smye, V., Inyallie, J., Day, L., Khan, K., Heino, A., & Merritt-Gray, M. (2017). Reclaiming our spirits: Development and pilot testing of a health promotion intervention for Indigenous women who have experienced intimate partner violence. Research in Nursing & Health, 40(3), 237-254. https://doi.org/10.1002/nur.21795

Varcoe, C., Ford-Gilboe, M., Browne, A. J., Perrin, N., Bungay, V., McKenzie, H., Smye, V., Price Elder, R., Inyallie, J., Khan, K., & Dion Stout, M. (2019). The efficacy of a health promotion intervention for Indigenous women: Reclaiming our spirits. Journal of Interpersonal Violence. https://doi.org//10.1177/0886260518820818

Wieman, C. (2006). Improving the mental health status of Canada’s Aboriginal youth. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 15(4), 157-158.

Wilk, P., Maltby, A., & Cooke, M. (2017). Residential schools and the effects on Indigenous health and well-being in Canada—A scoping review. Public Health Reviews, 38(1). https://doi.org/10.1186/s40985-017-0055-6

Williams, A. D., Clark, T. C., & Lewycka, S. (2018). The associations between cultural identity and mental health outcomes for Indigenous Māori youth in New Zealand. Frontiers in Public Health, 6(319). https://doi.org/10.3389/fpubh.2018.00319

International Indigenous Policy Journal April 2021 Volume 12 Issue 2; Nicholas Spence, Editor-in-Chief; Susan Wingert, Managing Editor

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2021-05-20

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Vol. 12 No. 2 (2021)

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Copyright (c) 2021 Simon Graham , Krista Stelkia , Cornelia Wieman, Evan Adams

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