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Owais S, Savoy CD, Hill T, Lai J, Burack JA, Van Lieshout RJ. Mental Health Challenges Among First Nations Adolescents Living Off-Reserve in Ontario, Canada. Child Psychiatry Hum Dev 2023; 54:1242-1249. [PMID: 35201524 DOI: 10.1007/s10578-022-01333-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/03/2022]
Abstract
Limited data exist on the mental health challenges facing First Nations adolescents and the factors that modify these difficulties. The current study compared levels of common mental health challenges among 112 off-reserve First Nations and 3334 non-First Nations adolescents (12-17 years old) and examined the impact of maternal psychological distress on these mental health challenges. First Nations adolescents self-reported higher symptoms of conduct, oppositional-defiant, attention-deficit hyperactivity, major depressive, social phobia, generalized anxiety, and separation anxiety disorders and all associations remained statistically significant after adjusting for covariates. Moderation analyses found that increasing levels of maternal distress were associated more strongly with symptoms of oppositional defiant, attention-deficit hyperactivity, major depressive, and generalized anxiety disorders in First Nations adolescents. Future work aimed at improving the mental health of First Nations youth that focus on supporting these adolescents, and their mothers in particular, could result in substantial benefits.
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Affiliation(s)
- Sawayra Owais
- MD/PhD Program, McMaster University, Hamilton, L8N 3Z5, Canada.
| | - Calan D Savoy
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8N 3Z5, Canada
| | - Troy Hill
- Department of Education, Brock University, Hamilton, ON, L8K 1V7, Canada
| | - Jessica Lai
- Department of Education & Counselling Psychology, McGill University, Montreal, QC, H3A 2T5, Canada
| | - Jacob A Burack
- Department of Education & Counselling Psychology, McGill University, Montreal, QC, H3A 2T5, Canada
| | - Ryan J Van Lieshout
- MD/PhD Program, McMaster University, Hamilton, L8N 3Z5, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, L8N 3Z5, Canada
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Wennberg E, Lasry A, Windle SB, Filion KB, Thombs BD, Gore G, Fischer B, Eisenberg MJ. Non-medical cannabis use among Indigenous Canadians: A systematic review of prevalence and associated factors. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 90:103081. [PMID: 33360735 DOI: 10.1016/j.drugpo.2020.103081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/02/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Indigenous Canadians may be at an increased risk of non-medical cannabis use. The aim of this review was to synthesize the prevalence of non-medical cannabis use and its associated factors among Indigenous Canadians. METHODS We systematically searched MEDLINE, EMBASE, Web of Science, and Scopus from inception to January 29th, 2020 for publications reporting the prevalence of non-medical cannabis use among Indigenous Canadians. We included studies published in English after January 1st, 2000. Included publications were hand-searched for potentially relevant peer-reviewed and gray literature publications. Results were synthesized descriptively. RESULTS We identified 16 peer-reviewed and 7 gray literature publications which met our inclusion criteria. All data were collected prior to cannabis legalization in Canada (October 17th, 2018). The most recent estimates of prevalence of use in the past year were 27% among on-reserve First Nations adults, 50% among off-reserve First Nations adults, and 60% among Nunavik Inuit. In youth, they were 45% among all Indigenous youth grades 9-12, 27% among on-reserve First Nations youth aged 12-17, and 69% in Nunavik Inuit aged 16-22. Direct comparisons indicated a 1.2-15 times higher prevalence of use in Indigenous compared to non-Indigenous youth. Factors associated with cannabis use in adults included younger age and male sex. In youth, factors included older age, poorer mental and physical health, and a poorer relationship with school. CONCLUSION Results suggest that Indigenous Canadians are at a higher risk for non-medical cannabis use than the general Canadian population. Further research is warranted to inform the development of targeted interventions.
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Affiliation(s)
- Erica Wennberg
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada
| | - Ariane Lasry
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada; Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sarah B Windle
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada
| | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada; Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Brett D Thombs
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada; Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Departments of Psychiatry, Psychology, and Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Genevieve Gore
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, QC, Canada
| | - Benedikt Fischer
- Schools of Population Health and Pharmacy, University of Auckland, Auckland, New Zealand; Centre for Applied Research in Mental Health & Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
| | - Mark J Eisenberg
- Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital/McGill University, Montreal, QC, Canada; Departments of Medicine and Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Division of Cardiology, Jewish General Hospital/McGill University, Montreal, QC, Canada.
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Heath LM, Torrie J, Gill KJ. Mental Health in the Cree Peoples of Northern Quebec: Relationships Among Trauma, Familial Psychological Distress, and Mood or Anxiety Disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:180-189. [PMID: 29929388 PMCID: PMC6405817 DOI: 10.1177/0706743718784938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examined the physical and mental health of Cree adults, as well as the personal, clinical, and environmental factors associated with the presence of lifetime anxiety and mood disorders. METHODS Mental health was assessed using the computerised version of the Diagnostic Interview Schedule (CDIS-IV), and standardised instruments were used to assess physical health, addiction severity, and psychological distress in 506 randomly selected participants from 4 Northern Cree communities in Quebec. RESULTS Overall, 46.1% of participants reported chronic medical problems, 42.1% were current smokers and 34.5% met the DSM-IV criteria for an anxiety or mood disorder. Individuals with an anxiety or mood disorder were younger, predominantly female, and with higher educational levels, and a large proportion (47.7%) met the lifetime criteria for substance dependence. Hierarchical regression determined that anxiety or mood disorders were associated with serious problems getting along with parents, a history of physical and sexual abuse, and a lifetime diagnosis of substance dependence. Overall, 29.7% of Cree adults reported sexual abuse, 47.1% physical abuse, and 52.9% emotional abuse. CONCLUSIONS This study highlights the high rates of physical and mental health problems in Cree communities and the association among parental history of psychological problems, history of abuse, and psychological distress. Participants expressed a desire for additional medical and psychological treatments to address the patterns of abuse, trauma, and mental disorders that are burdening the Cree communities in Northern Quebec.
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Affiliation(s)
- Laura M Heath
- 1 Department of Psychiatry, McGill University, Montreal, Quebec
| | - Jill Torrie
- 2 Public Health Department, Cree Board of Health and Social Services of James Bay, Mistissini, Quebec
| | - Kathryn J Gill
- 1 Department of Psychiatry, McGill University, Montreal, Quebec.,3 Addictions Unit, McGill University Health Centre, Montreal, Quebec
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Harriss LR, Kyle M, Connolly K, Murgha E, Bulmer M, Miller D, Munn P, Neal P, Pearson K, Walsh M, Campbell S, Berger M, McDermott R, McDonald M. Screening for depression in young Indigenous people: building on a unique community initiative. Aust J Prim Health 2018; 24:PY18006. [PMID: 30089528 DOI: 10.1071/py18006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 05/20/2018] [Indexed: 02/28/2024]
Abstract
Gurriny Yealamucka Health Service Aboriginal Corporation (GYHSAC) is an Indigenous community-controlled health organisation providing comprehensive primary care to the people of Yarrabah in far north Queensland, Australia. GYHSAC conducts an annual Young Person's Health Check (YPC) for people aged 15-25 years based on the Medical Benefits Schedule Item 715. However, the YPC is constantly evolving to meet the needs of the community, and in 2016, in response to concerns about psychological risk among Indigenous youth, GYHSAC teamed up with James Cook University to trial an adapted PHQ-9 depression screening tool (aPHQ-9) as part of the YPC. This study describes the 2016 YPC event, reports the prevalence of depressive symptoms, examines local issues related to the use of the screening tool and proposes recommendations for future health screening. Experienced health professionals conducted the aPHQ-9 assessment in a private area of the clinic. One-in-five young people were found to have moderate-severe symptoms or self-harm ideation in the previous 2 weeks; they were referred to the mental health service. The aPHQ-9 screening process was found to be straightforward and well accepted by staff and youth. Importantly, it provided valuable 'space' to facilitate communication on sensitive issues and was a conduit for speedy referral and follow up by trained staff. Based on our experience, we recommend dedicated depression screening in future routine community health checks for young people and adults.
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Young C, Hanson C, Craig JC, Clapham K, Williamson A. Psychosocial factors associated with the mental health of indigenous children living in high income countries: a systematic review. Int J Equity Health 2017; 16:153. [PMID: 28830449 PMCID: PMC5568067 DOI: 10.1186/s12939-017-0652-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/15/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. METHODS A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. RESULTS Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. CONCLUSIONS Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Camilla Hanson
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Jonathan C. Craig
- Sydney School of Public Health, The University of Sydney, Edward Ford Building (A27), Fisher Road, Camperdown, NSW 2006 Australia
- Centre for Kidney Research, Westmead Institute for Medical Research, 179 Hawkesbury Rd, Westmead, NSW 2145 Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, Innovation Campus, University of Wollongong, Building 234 (iC Enterprise 1), Wollongong, NSW 2522 Australia
| | - Anna Williamson
- The Sax Institute, Level 13, Building 10, 235 Jones Street, Ultimo, NSW 2007 Australia
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Nelson SE, Wilson K. The mental health of Indigenous peoples in Canada: A critical review of research. Soc Sci Med 2017; 176:93-112. [PMID: 28135694 DOI: 10.1016/j.socscimed.2017.01.021] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/06/2016] [Accepted: 01/16/2017] [Indexed: 01/18/2023]
Abstract
Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world.
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Affiliation(s)
- Sarah E Nelson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Kathi Wilson
- University of Toronto Mississauga, Department of Geography, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
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Kisely S, Alichniewicz KK, Black EB, Siskind D, Spurling G, Toombs M. The prevalence of depression and anxiety disorders in indigenous people of the Americas: A systematic review and meta-analysis. J Psychiatr Res 2017; 84:137-152. [PMID: 27741502 DOI: 10.1016/j.jpsychires.2016.09.032] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 09/30/2016] [Accepted: 09/30/2016] [Indexed: 01/11/2023]
Abstract
Indigenous populations are considered at higher risk of psychiatric disorder but many studies do not include direct comparisons with similar non-Indigenous controls. We undertook a meta-analysis of studies that compared the prevalence of depression and anxiety disorders in Indigenous populations in the Americas with those of non-Indigenous groups with similar socio-demographic features (Registration number: CRD42015025854). A systematic search of PubMed, Medline, PsycInfo, PsycArticles, ScienceDirect, EMBASE, and article bibliographies was performed. We included comparisons of lifetime rates and prevalence of up to 12 months. We found 19 studies (n = 250, 959) from Latin America, Canada and the US. There were no differences between Indigenous and similar non-Indigenous groups in the 12-month prevalence of depressive, generalised anxiety and panic disorders. However, Indigenous people were at greater risk of PTSD. For lifetime prevalence, rates of generalised anxiety, panic and all the depressive disorders were significantly lower in Indigenous participants, whilst PTSD (on adjusted analyses) and social phobia were significantly higher. Results were similar for sub-analyses of Latin America, Canada and the US, and sensitivity analyses by study quality or setting (e.g. health, community etc.). Risk factors for psychiatric illness may therefore be a complex interaction of biological, educational, economic and socio-cultural factors that may vary between disorders. Accordingly, interventions should reflect that the association between disadvantage and psychiatric illness is rarely due to one factor. However, it is also possible that assessment tools don't accurately measure psychiatric symptoms in Indigenous populations and that further cross-cultural validation of diagnostic instruments may be needed too.
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Affiliation(s)
- Steve Kisely
- Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Canada; School of Medicine, The University of Queensland, Australia.
| | | | - Emma B Black
- Rural Clinical School, School of Medicine, The University of Queensland, Australia
| | - Dan Siskind
- School of Medicine, The University of Queensland and Metro South Addiction and Mental Health Service, Australia
| | - Geoffrey Spurling
- School of Medicine, The University of Queensland and Inala Indigenous Health Service, Australia
| | - Maree Toombs
- Rural Clinical School, School of Medicine, The University of Queensland, Australia
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Cushon J, Waldner C, Scott C, Neudorf C. Planning Adolescent Mental Health Promotion Programming in Saskatoon. THE JOURNAL OF SCHOOL HEALTH 2016; 86:578-584. [PMID: 27374347 DOI: 10.1111/josh.12410] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/29/2015] [Accepted: 01/09/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND We assessed associations between key demographic risk factors and the outcome of depressed mood in Saskatoon, Saskatchewan, to inform the planning and implementation of mental health promotion programming in schools. METHODS In the 2008/2009 school year, 3958 students from grades 5 through 8 from 76 elementary schools completed questions regarding depressed mood on the Student Health Survey administered by the Saskatoon Health Region. The demographic risk factors for depressed mood considered in this study included age, sex, cultural status, and neighborhood income, as well as the role of school and age cohorts or grades within schools. RESULTS We found Aboriginal students were significantly more likely to report moderate/severe depressed mood than other students. We also found older female adolescents were significantly more likely to report moderate/severe depressed mood. Neighborhood income explained the largest proportion (40%) of depressed mood differences between schools. CONCLUSIONS These results can inform the planning and implementation of mental health promotion programming by the health sector in Saskatoon's elementary schools, including an appropriate balance between targeted and population-based interventions that address both the distal and proximal determinants of depressed mood in adolescents.
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Affiliation(s)
- Jennifer Cushon
- Population and Public Health, Saskatoon Health Region, Royal University Hospital, Box 67, Saskatoon, Canada S7N 0W8.
| | - Cheryl Waldner
- School of Public Health and Western College of Veterinary Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, Canada S7N 2Z4.
| | - Christina Scott
- Public Health Observatory, Saskatoon Health Region, #101-310 Idylwyld Drive North, Saskatoon, Canada S7L 0Z2.
| | - Cordell Neudorf
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.
- Saskatoon Health Region, #101-310 Idylwyld Drive North, Saskatoon, Canada S7L 0Z2.
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The Protective Role of Optimism and Self-esteem on Depressive Symptom Pathways Among Canadian Aboriginal Youth. J Youth Adolesc 2013; 44:142-54. [DOI: 10.1007/s10964-013-0016-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 09/02/2013] [Indexed: 10/26/2022]
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Kaspar V. Mental health of Aboriginal children and adolescents in violent school environments: Protective mediators of violence and psychological/nervous disorders. Soc Sci Med 2013; 81:70-8. [DOI: 10.1016/j.socscimed.2012.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 08/23/2012] [Accepted: 12/11/2012] [Indexed: 11/26/2022]
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