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Toor JSK, Lavoie JG, Mudryj A. Inuit youth health and wellbeing programming in Canada. Int J Circumpolar Health 2024; 83:2376799. [PMID: 38988226 PMCID: PMC11351917 DOI: 10.1080/22423982.2024.2376799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/17/2024] [Accepted: 07/02/2024] [Indexed: 07/12/2024] Open
Abstract
Inuit youth face challenges in maintaining their wellbeing, stemming from continued impacts of colonisation. Recent work documented that urban centres, such as Winnipeg Canada, have large Inuit populations comprised of a high proportion of youth. However, youth lack culturally appropriate health and wellbeing services. This review aimed to scan peer-reviewed and grey literature on Inuit youth health and wellbeing programming in Canada. This review is to serve as an initial phase in the development of Inuit-centric youth programming for the Qanuinngitsiarutiksait program of research. Findings will support further work of this program of research, including the development of culturally congruent Inuit-youth centric programming in Winnipeg. We conducted an environmental scan and used an assessment criteria to assess the effectiveness of the identified programs. Results showed that identified programs had Inuit involvement in creation framing programming through Inuit knowledge and mostly informed by the culture as treatment approach. Evaluation of programs was diffcult to locate, and it was hard to discren between programming, pilots or explorative studies. Despite the growing urban population, more non-urban programming was found. Overall, research contributes to the development of effective strategies to enhance the health and wellbeing of Inuit youth living in Canada.
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Affiliation(s)
- Jeevan S K Toor
- Institute for Global Health, University College London, London, UK
| | - Josée G Lavoie
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Adriana Mudryj
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Moore H, Bablitz C, Santos Salas A, Morris H, Sinnarajah A, Watanabe SM. Describing the characteristics and symptom profile of a group of urban patients experiencing socioeconomic inequity and receiving palliative care: a descriptive exploratory analysis. Palliat Care Soc Pract 2024; 18:26323524241264880. [PMID: 39099621 PMCID: PMC11295232 DOI: 10.1177/26323524241264880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/11/2024] [Indexed: 08/06/2024] Open
Abstract
Background Individuals experiencing socioeconomic inequity have worse health outcomes and face barriers to palliative and end-of-life care. There is a need to develop palliative care programs tailored to this underserved population. Objectives To understand the characteristics and symptom profiles of a group of urban patients experiencing socioeconomic inequity and receiving palliative care. Design Descriptive exploratory analysis of a patient dataset. The patient dataset was generated through a pilot research study with patients experiencing socioeconomic inequity and life-limiting illness who received a community-based palliative care intervention. Methods The intervention took place over 1 year in the Palliative Care Outreach and Advocacy Team, a community-based urban palliative care clinic in Edmonton, Alberta, Canada, serving persons experiencing socioeconomic inequity. Participants had to be at least 18 years of age, be able to communicate in English, require palliative care for a life-limiting illness, and be able to consent to inclusion in the study. Results Twenty-five participants were enrolled. Participants predominantly identified as male and Indigenous, experienced poverty and housing instability, and had metastatic cancer. Our participants rated their pain, shortness of breath, and anxiety as more severe than the broader community-based palliative care population in the same city. Most patients died in inpatient hospices (73%). Conclusion Our analysis provides an in-depth picture of an understudied, underserved population requiring palliative care. Given the higher symptom severity experienced by participants, our analysis highlights the importance of person-centered palliative care. We suggest that socioeconomic inequity should be considered in patients with life-limiting illnesses. Further research is needed to explore palliative care delivery to those facing socioeconomic inequity.
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Affiliation(s)
- Harrison Moore
- Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, 8440 112 Street NW, Edmonton, AB T6G 2B7, Canada
| | - Cara Bablitz
- Department of Family Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta
- Family Medicine, Royal Alexandra Hospital, Edmonton, AB, Canada
| | - Anna Santos Salas
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Heather Morris
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Aynharan Sinnarajah
- Division of Palliative Medicine, Department of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Sharon M. Watanabe
- Department of Symptom Control and Palliative Care Cross Cancer Institute, Edmonton, AB, Canada
- Division of Palliative Care Medicine, Department of Oncology, Faculty of Medicine & Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
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Chan EC, Conlon K, Gagnon L. Risk factors and methods in suicides of elderly patients connected to mental health services from 1999-2024. Front Psychiatry 2024; 15:1425371. [PMID: 38952630 PMCID: PMC11215130 DOI: 10.3389/fpsyt.2024.1425371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
Introduction Suicide prevention is an important aspect of psychiatric care, with older men being a population identified at especially high suicide risk and a recent increase in suicides among older women. Methods Using data collected by the region's quality assurance team, we examined all suicide deaths occurring between March 1999 and February 2024 in patients aged 60 years or older who were connected to the region's Addiction and Mental Health Program at the time of death. Data were analyzed to describe which factors were most commonly identified in suicides in older adults receiving mental healthcare. We also compared male and female cases to determine whether certain factors were more commonly observed in one gender. Results We identified 48 cases of suicide occurring in patients aged 60 or over. 60% of suicides occurred in males. Overdose and hanging were the most common suicide methods used, and all suicides occurring on inpatient units occurred via hanging. Depression was the most common diagnosis, and was diagnosed more frequently in suicides of female older adults. A greater proportion of suicides in older women were associated with previous history of suicide attempts. Discussion Our findings support many current best practices for suicide prevention in psychiatric care, including minimizing ligatures and anchor points on inpatient settings, assessing for and limiting access to means in individuals at-risk, and assessing suicide risk in hospitalized patients prior to passes and discharge. Recognition and treatment of depression remain important aspects in the treatment of older adults to prevent suicide.
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Affiliation(s)
- Eric C. Chan
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
| | - Kim Conlon
- Alberta Health Services, Calgary, AB, Canada
| | - Lisa Gagnon
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
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Tse S, Chee K, Coleman TA, Coulombe S, Travers R. Exploring LGBT2Q+ Intracategorical Factors in Mental Health Service Utilization: Differences in Gender Modalities, Sexual Orientations, and Ethnoracial Groups in Canada. Community Ment Health J 2024:10.1007/s10597-024-01299-y. [PMID: 38850503 DOI: 10.1007/s10597-024-01299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/19/2024] [Indexed: 06/10/2024]
Abstract
LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples.
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Affiliation(s)
- Samson Tse
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada.
| | - Kenny Chee
- Faculty of Social Works, University of Toronto, Toronto, ON, Canada
| | - Todd A Coleman
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Simon Coulombe
- Department of Industrial Relations, Université Laval, Québec, QC, Canada
| | - Robb Travers
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
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La Parra-Casado D, San Sebastian M, Stoor JPA. Ethnic discrimination and mental health in the Sámi population in Sweden: The SámiHET study. Scand J Public Health 2024; 52:442-449. [PMID: 36883724 DOI: 10.1177/14034948231157571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
AIMS To assess the association between experiences of discrimination and mental health among the Sámi population in Sweden. METHODS Cross-sectional study among the self-identified Sámi population living in Sweden in 2021, registered in the electoral roll of the Sámi Parliament, the reindeer mark register and the 'Labour statistics based on administrative sources'. The analysis was based on a final sample of 3658 respondents aged between 18 and 84 years. Adjusted prevalence ratios aPRs for psychological distress (Kessler scale), self-reported anxiety and depression were estimated for four different forms of discrimination (direct experience of discrimination, offended because of ethnicity, historical trauma, and combined discrimination). RESULTS Higher aPRs of psychological distress, anxiety and depression were observed in women experiencing direct discrimination because of their ethnicity, having been offended because of their ethnicity, and those with a family history of discrimination. Among men, higher aPRs for psychological distress were observed in those experiencing the four different forms of discrimination, but not for anxiety. Depression was only detected in the case of having been offended. Adding experiences of discrimination was associated with a higher prevalence of negative outcomes for all the indicators in women and for psychological distress in men. CONCLUSIONS The observed association between experiences of discrimination and mental health problems would support a gender approach when considering ethnic discrimination in public health policies concerning the Sámi in Sweden.
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Affiliation(s)
| | - Miguel San Sebastian
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Sweden
| | - Jon Petter A Stoor
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Sweden
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Norway
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Basit T, Toombs M, Santomauro D, Whiteford H, Ferrari A. Correlates of mental disorder and harmful substance use in an indigenous Australian urban sample: an analysis of data from the Queensland Urban Indigenous Mental Health Survey. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02648-8. [PMID: 38506954 DOI: 10.1007/s00127-024-02648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/03/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Limited data exists on the relationship between sociodemographic and cultural variables and the prevalence of specific mental and substance use disorders (MSDs) among Indigenous Australians, using diagnostic prevalence data. This paper utilises data from the Queensland Urban Indigenous Mental Health Survey (QUIMHS), a population-level diagnostic mental health survey, to identify socioeconomic and cultural correlates of psychological distress and specific MSDs in an urban Indigenous Australian sample. METHODS Using a mixture of household sampling (door-knocking) and snowball sampling (promotion of the survey in the community), 406 participants aged 18 to 89 were recruited across key locations in Southeast Queensland. The study investigated various demographic, socioeconomic, and cultural factors as predictors of psychological distress (measured by the Kessler-5) and MSD diagnoses (utilising the Composite International Diagnostic Interview, CIDI 3.0) using a series of univariate logistic regressions. RESULTS Individuals in unstable housing (homeless, sleeping rough) and those reporting financial distress were more likely to experience an MSD in the past 12 months and throughout their lifetime. Individuals reporting lower levels of connection and belonging, limited participation in cultural events, and lower empowerment were more likely to have a lifetime mental disorder. CONCLUSION This data emphasises the importance of addressing systemic and social determinants of health when designing and delivering community mental health services and underscores the need for holistic approaches when working with Indigenous communities.
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Affiliation(s)
- Tabinda Basit
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Level 3 Dawson House, Wacol, QLD, 4076, Australia.
- School of Public Health, The University of Queensland, Herston, QLD, Australia.
| | - Maree Toombs
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Damian Santomauro
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Level 3 Dawson House, Wacol, QLD, 4076, Australia
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Harvey Whiteford
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Level 3 Dawson House, Wacol, QLD, 4076, Australia
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | - Alize Ferrari
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Level 3 Dawson House, Wacol, QLD, 4076, Australia
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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George MS, Ramu KA, Prasad R, Prashanth NS, Kenjoor S, Grant JB. "How can our children learn from us about our way of life or understand who they are?": Residential schools and their impact on the wellbeing of Indigenous youth in Attapadi, South India. Transcult Psychiatry 2024:13634615231213834. [PMID: 38404061 DOI: 10.1177/13634615231213834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Residential schools are commonly used in India to provide education for Indigenous youth, which requires young people to stay for long periods at distance from their families and communities. Internationally, there is clear evidence for the deleterious effects of residential schools on the mental health and social and community outcomes of Indigenous children, however little is known about the Indian Indigenous experience. This study examined the impact of residential schooling on Indigenous children's wellbeing and that of their communities, using data from an ethnographic research project in Attapadi, Kerala, including interviews, focus group discussions and participant observation with Indigenous communities. Key outcomes from residential schooling reported by the participants include the fear of losing Indigenous identity, shame of being Indigenous, change in the attitude of young people when they returned from schools, and feelings of confusion and stress that young Indigenous participants felt trying to fit into their communities on their return. Findings suggest that these Indigenous youth felt disconnected from several factors that are known to promote resilience for Indigenous communities including a strong cultural identity, connection to the land and ancestors, thereby making them more vulnerable to poor mental health and negative impacts on their overall wellbeing. Addressing these concerns requires a detailed understanding of the specific factors influencing outcomes for Indigenous youth within the Indian residential schooling system, and designing and implementing data-informed conceptual, structural and policy change including the provision of culturally safe mental health services.
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Affiliation(s)
| | - K A Ramu
- Karrara, Attapadi, Palakkad, Kerala, India
| | | | - N S Prashanth
- Institute of Public Health, Banashankari Stage II, Bengaluru, Karnataka, India
| | - Susheela Kenjoor
- Department of Social Work, Mysore University, Mysuru, Karnataka, India
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Ogden CL, Tutty LM. "Never Give Up. The Creator Has Good Things in Store for You": Risk Factors, Protective Factors, and Evidence of Resilience for Canadian Indigenous Women Abused by Intimate Partners. Violence Against Women 2024:10778012241233002. [PMID: 38374660 DOI: 10.1177/10778012241233002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Canadian Indigenous women often experience severe partner violence and child abuse, but few studies holistically examine risk and protective factors and evidence of resilience that affect their well-being. This mixed-methods secondary analysis explored the experiences of 40 Canadian Indigenous abused women. Risk factors included intimate partner violence (IPV), childhood abuse, poverty, colonization, and disability. Protective factors included formal and informal support, community support, spirituality, and childhood residence. Evidence of resilience is from interview quotes and none of the measures of depression, mental distress, and posttraumatic stress disorder was in the clinical range. Despite significant IPV and childhood abuse, the women's resilience is highlighted.
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Affiliation(s)
- Cindy L Ogden
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Leslie M Tutty
- Faculty of Social Work, University of Calgary, Calgary, Canada
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Nykiforuk CIJ, Thomson M, Curtin KD, Colman I, Wild TC, Hyshka E. Assessing support for mental health policies among policy influencers and the general public in Alberta and Manitoba, Canada. Int J Ment Health Syst 2024; 18:8. [PMID: 38360677 PMCID: PMC10868068 DOI: 10.1186/s13033-024-00624-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND There is a need to improve mental health policy in Canada to address the growing population burden of mental illness. Understanding support for policy options is critical for advocacy efforts to improve mental health policy. Our purpose was to describe support for population-level healthy public policies to improve mental health among policy influencers and the general public in Alberta and Manitoba; and, identify associations between levels of support and sociodemographic variables and relative to the Nuffield Bioethics Intervention Ladder framework. METHODS We used data from the 2019 Chronic Disease Prevention Survey, which recruited a representative sample of the general public in Alberta (n = 1792) and Manitoba (n = 1909) and policy influencers in each province (Alberta n = 291, Manitoba n = 129). Level of support was described for 16 policy options using a Likert-style scale for mental health policy options by province, sample type, and sociodemographic variables using ordinal regression modelling. Policy options were coded using the Nuffield Council on Bioethics Intervention Ladder to classify support for policy options by level of intrusiveness. RESULTS Policy options were categorized as 'Provide Information' and 'Enable Choice' according to the Nuffield Intervention Ladder. There was high support for all policy options, and few differences between samples or provinces. Strong support was more common among women and among those who were more politically left (versus center). Immigrants were more likely to strongly support most of the policies. Those who were politically right leaning (versus center) were less likely to support any of the mental health policies. Mental health status, education, and Indigenous identity were also associated with support for some policy options. CONCLUSIONS There is strong support for mental health policy in Western Canada. Results demonstrate a gap between support and implementation of mental health policy and provide evidence for advocates and policy makers looking to improve the policy landscape in Canada.
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Affiliation(s)
- Candace I J Nykiforuk
- School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Mathew Thomson
- Clinical Research Coordinator, Clinical Epidemiology Department, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Kimberley D Curtin
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, 8303-112 St NW - Room 7-80, Edmonton, AB, T6G 2T4, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Cr - Room 308C, Ottawa, ON, K1G 5Z3, Canada
| | - T Cameron Wild
- School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
| | - Elaine Hyshka
- Canada Research Chair in Health System Innovation, School of Public Health, University of Alberta, 3-300 ECHA, 11405-87 Ave, Edmonton, AB, T6G 1C9, Canada
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McKinley CE. "We have to … work for wholeness no matter what": Family and culture promoting wellness, resilience, and transcendence. Transcult Psychiatry 2024:13634615241227690. [PMID: 38327166 DOI: 10.1177/13634615241227690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Sociocultural, mental, behavioral, and physical factors are interrelated associates of chronic health conditions-such as diabetes, obesity, and cardiovascular disease-all of which are disproportionally high and drive much of the mortality and morbidity for Indigenous peoples. Indigenous worldviews conceptualize health holistically, with inseparability across social, spiritual, cultural, familial, mental, behavioral, physical, and social dimensions of wellness. Food, family, and culture are fundamental to Indigenous wellness. The purpose of this article is to use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) conceptualization of relational wellness to honor urban and rural U.S. Indigenous perspectives that highlight the intersections of family, culture, physical health, spiritual, and mental health to promote resilience and wellness. This research focused on interconnections between wellness, culture, health, and family. Thirty-one critical ethnographic interviews used a life-history approach with methodology following an Indigenous toolkit for ethical and culturally sensitive research strategies, such as building upon cultural strengths, engaging in long-term, relational commitments with communities, incorporating storytelling and oral history traditions, centering Indigenous methodologies and preferences, working with cultural insiders, and prioritizing the perspectives of Indigenous peoples. Emergent themes included: (a) roots of Indigenous wellness: cultural values promoting balance and connection; (b) practicing resilience: family transmission of health information; and (c) wholistic mental wellness and resilience, with the subtheme culture and wellness. Interventions can be developed in collaboration with tribes for optimum efficacy and cultural relevancy and can approach wellness holistically in culturally relevant ways that center foodways, culture, family, and spirituality.
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Muñoz AC, Rojano ÁEV, Caballero AR, Solé EP, Álvarez MG. Reprint of: Associations between mental health problems and Adverse Childhood Experiences ACEs in indigenous and non-indigenous Mexican adolescents. CHILD ABUSE & NEGLECT 2024; 148:106639. [PMID: 38242770 DOI: 10.1016/j.chiabu.2024.106639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have long-term consequences. The ACEs model has been extensively used in high-income countries. However, its effectiveness has yet to be demonstrated in low and middle-income countries and marginalized social groups. In indigenous populations, research has found inconsistent results in the prevalence and the relationship between ACEs and mental health outcomes. Therefore, the objectives of this study were 1) to determine the ACEs frequency among indigenous and non-indigenous Mexican adolescents; 2) to test the association between ACE scores and symptoms of Mental Health Problems (SMHP) in both groups; and 3) to review the ACEs model adequacy for the indigenous adolescents. PARTICIPANTS AND SETTINGS Data from an online survey in 20 of the 32 states of Mexico were analyzed. We selected an 87 adolescent sample from indigenous families and 174 non-indigenous matched for age, sex, and state of residence, with a mean age of 16 years; 60 % were women. METHODS ACE-IQ questionnaire and Youth Self Report instrument (eight SMHP) were used to collect data. ACEs' frequency was analyzed for each group, and Pearson correlations were used to identify the relationship between ACEs and SMHP. RESULTS There was no statistical significance between Indigenous and non-Indigenous adolescents in the ACEs report. ACE scores were associated with eight SMHP. Correlations between ACE score and SMHP were higher in non-indigenous adolescents. CONCLUSIONS ACEs were experienced similarly by both groups and were associated with mental health in all participants. Further research is needed to improve ACEs measurement in indigenous populations.
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Affiliation(s)
- Abigail Casas Muñoz
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Ángel Eduardo Velasco Rojano
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Aarón Rodríguez Caballero
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Eva Prado Solé
- Fondo de las Naciones Unidas para la Infancia, UNICEF, Mexico
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Dunn NS, McVittie J, Ansloos J, Obomsawin A, Azarshahi S. First Nations and Inuit mental health and the Non-Insured Health Benefits program: Urgent priorities for evaluation. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:143-147. [PMID: 38087185 PMCID: PMC10868570 DOI: 10.17269/s41997-023-00837-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 11/03/2023] [Indexed: 02/09/2024]
Abstract
The mental health needs and disparities facing First Nations and Inuit in Canada far exceed those of the general population and yet accessing culturally safe care remains a serious challenge. One means for accessing mental health care is through the Non-Insured Health Benefits (NIHB) mental health counselling program run by Indigenous Services Canada. However, evaluations of the efficacy of the NIHB's mental health counselling program remain entirely absent in the academic literature and this is startling given that this program receives significant federal funding to care for a population that experiences extreme marginalization. The following commentary will present three challenges observed with the present state of the program in the areas of service accessibility, the need for an Indigenous mental health workforce, and culturally safe care. For each challenge presented, we make recommendations on how to improve the program in its current state. The conclusion of this article advocates for a broader evaluation of the NIHB mental health counselling program from the perspective of its service users and its registered mental health professionals. This type of evaluation is commensurate with the Calls to Action outlined by the Truth and Reconciliation Commission of Canada.
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Poliakova N, Riva M, Fletcher C, Desrochers-Couture M, Courtemanche Y, Moisan C, Fraser S, Pépin C, Bélanger RE, Muckle G. Sociocultural factors in relation to mental health within the Inuit population of Nunavik. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:83-95. [PMID: 36344873 PMCID: PMC10830993 DOI: 10.17269/s41997-022-00705-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 08/17/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Built on the Inuit determinants approach of health, this study aimed to identify sociocultural factors associated with mental health among Inuit of Nunavik to guide programs and services. METHODS The data were collected through the Qanuilirpitaa? 2017, a survey characterized by the involvement of several Inuit representatives. Depressive symptoms (10-item Center for Epidemiologic Studies-Depression scale, CES-D), lifetime suicide ideation and attempts, and past-year ideation were self-reported mental health indicators. Sociocultural factors represented four thematic domains: social support, community activities, traditional practices, and cultural identity. Analyses tested whether the sociocultural factors were associated with indicators of mental health using weighted multivariate regressions. RESULTS Among the sociocultural factors considered, family cohesion and weekly hunting/fishing activities were associated with lower depression scores. Community cohesion and lower cultural identity (centrality scale) were associated with a lower likelihood of past-year and lifetime ideation while family cohesion was related to a lower likelihood of lifetime attempts. People with psychological distress (higher CES-D, suicidal ideation or attempts) were more likely to participate in healing and wellness activities. CONCLUSION Although limited by their cross-sectional character, these analyses, based on the community component of the Qanuilirpitaa?, suggest that strengthening of family and community cohesion, and support of regular hunting and fishing deserve further attention as potential cumulative preventive avenues for Inuit mental health.
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Affiliation(s)
- Natalia Poliakova
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Mylene Riva
- Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - Christopher Fletcher
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- Department of Social and Preventive Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Mireille Desrochers-Couture
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- School of Psychology, Université Laval, Quebec City, Quebec, Canada
| | - Yohann Courtemanche
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Caroline Moisan
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- School of Psychology, Université Laval, Quebec City, Quebec, Canada
| | - Sarah Fraser
- Faculty of Arts and Science, Université de Montréal, Montreal, Quebec, Canada
| | - Camille Pépin
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- School of Psychology, Université Laval, Quebec City, Quebec, Canada
| | - Richard E Bélanger
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada
- Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
| | - Gina Muckle
- Research Centre of CHU de Québec-Université Laval, Quebec City, Quebec, Canada.
- School of Psychology, Université Laval, Quebec City, Quebec, Canada.
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Muñoz AC, Rojano ÁEV, Caballero AR, Solé EP, Álvarez MG. Associations between mental health problems and Adverse Childhood Experiences ACEs in indigenous and non-indigenous Mexican adolescents. CHILD ABUSE & NEGLECT 2024; 147:106595. [PMID: 38061280 DOI: 10.1016/j.chiabu.2023.106595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Adverse Childhood Experiences (ACEs) have long-term consequences. The ACEs model has been extensively used in high-income countries. However, its effectiveness has yet to be demonstrated in low and middle-income countries and marginalized social groups. In indigenous populations, research has found inconsistent results in the prevalence and the relationship between ACEs and mental health outcomes. Therefore, the objectives of this study were 1) to determine the ACEs frequency among indigenous and non-indigenous Mexican adolescents; 2) to test the association between ACE scores and symptoms of Mental Health Problems (SMHP) in both groups; and 3) to review the ACEs model adequacy for the indigenous adolescents. PARTICIPANTS AND SETTINGS Data from an online survey in 20 of the 32 states of Mexico were analyzed. We selected an 87 adolescent sample from indigenous families and 174 non-indigenous matched for age, sex, and state of residence, with a mean age of 16 years; 60 % were women. METHODS ACE-IQ questionnaire and Youth Self Report instrument (eight SMHP) were used to collect data. ACEs' frequency was analyzed for each group, and Pearson correlations were used to identify the relationship between ACEs and SMHP. RESULTS There was no statistical significance between Indigenous and non-Indigenous adolescents in the ACEs report. ACE scores were associated with eight SMHP. Correlations between ACE score and SMHP were higher in non-indigenous adolescents. CONCLUSIONS ACEs were experienced similarly by both groups and were associated with mental health in all participants. Further research is needed to improve ACEs measurement in indigenous populations.
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Affiliation(s)
- Abigail Casas Muñoz
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico.
| | - Ángel Eduardo Velasco Rojano
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico.
| | - Aarón Rodríguez Caballero
- Centro de Estudios Avanzados sobre Violencia - Prevención (CEAVI-P), Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Eva Prado Solé
- Fondo de las Naciones Unidas para la Infancia, UNICEF, Mexico
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15
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Cheng C, Nadin S, Bohonis H, Katt M, Dewa CS. NorthBEAT: exploring the service needs of youth experiencing early psychosis in Northern Ontario. FRONTIERS IN HEALTH SERVICES 2023; 3:1163452. [PMID: 38028941 PMCID: PMC10646171 DOI: 10.3389/frhs.2023.1163452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023]
Abstract
Introduction Early Psychosis Intervention (EPI) is critical for best outcomes. Among 369 diseases, psychosis is among those causing the greatest disability. Evidence-based interventions for youth in early stages of psychosis (EPI programs) have prevented chronic disability. Yet, EPI is frequently inaccessible for youth living in rural communities. Moreover, Indigenous youth often face more precipitous situations given inadequate staffing, and culturally unsafe care. The NorthBEAT (Barriers to Early Assessment and Treatment) project sought to understand the service needs of youth with psychosis in Northern Ontario. The goals were: (1) to describe the mental health of a subset of adolescents receiving EPI care; (2) examine Indigenous youth as a significant and vulnerable population; (3) to understand the barriers and facilitators for Indigenous and non-Indigenous youth receiving EPI. Methods Mixed methods (structured and narrative interviews) included: psychometric scales interviews with youth, and narrative interviews with youth, their family, and service providers Data validation workshops were held with participants. Results Structured interviews with 26 youth (M = 17 years) found the participants functioning moderately well with duration of untreated psychosis ranging from 1 to 96 months (M = 26 months). No significant differences were found in functioning or duration of psychosis between Indigenous and non-Indigenous youth. Narrative interviews were conducted with 18 youth, 11 family members, and 14 service providers. Identified barriers were a lack of knowledge about psychosis among service providers, a disconnected system leading to delays in treatment, help not wanted by youth, expansive geographical context. Service needs were: finding the right point of access, support for families, pre-crisis intervention, reduced stigma for youth and their families, and an EPI approach to care. Discussion Rural and northern youth face similar barriers to accessing EPI as urban youth. However, northern youth face additional unique challenges due to expansive geographical context, limited resources and lack of knowledge about services.
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Affiliation(s)
- Chiachen Cheng
- Addictions and Mental Health, St. Joseph’s Care Group, Thunder Bay, ON, Canada
- Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Clinical Sciences Division, Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
| | - Shevaun Nadin
- Addictions and Mental Health, St. Joseph’s Care Group, Thunder Bay, ON, Canada
- Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
| | - Hafsa Bohonis
- Dr. Gilles Arcand Centre for Health Equity, Northern Ontario School of Medicine University, Thunder Bay, ON, Canada
| | - Mae Katt
- Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
| | - Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA, United States
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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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17
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Kshatriya M, Wang KW, Hildebrand J, Crawford R, Nadarajah A, Youssef M, Rivas A, Kaushal A, Banfield LE, Thabane L, Samaan MC. The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review. Adolesc Health Med Ther 2023; 14:175-193. [PMID: 37790916 PMCID: PMC10544169 DOI: 10.2147/ahmt.s405814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023] Open
Abstract
Background Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada. Methods Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence. Results Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs. Conclusion Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada. Systematic Review Registration PROSPERO CRD42017072781.
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Affiliation(s)
- Maya Kshatriya
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Julia Hildebrand
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Rebecca Crawford
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Michael Youssef
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ashleen Kaushal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Laura E Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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18
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Gmitroski KL, Hastings KG, Legault G, Barbic S. Métis health in Canada: a scoping review of Métis-specific health literature. CMAJ Open 2023; 11:E884-E893. [PMID: 37788865 PMCID: PMC10558240 DOI: 10.9778/cmajo.20230006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Métis are a culturally unique and distinct population, yet little research has evaluated their health separate from the broader Indigenous population. We sought to explore current literature regarding the health of Métis Peoples in Canada and identify potential trends and gaps. METHODS Using the Arksey-O'Malley, 5-stage, scoping review method, we searched PubMed, MEDLINE, iPortal Indigenous Articles Portal Research Tool and pertinent reference lists using the terms "Métis," "health" and "Canada." Two reviewers conducted the initial searches independently, including English articles from 2012 to 2022, and focused on only Métis populations' health within Canada. We described characteristics of the articles and themes for discussion. RESULTS Of the 572 articles we identified, we included a total of 28 articles in this scoping review, of which 16 were quantitative, 9 were qualitative and 3 used mixed methods. Thirteen articles used consultation with Métis communities as part of their methods, and 8 extracted data from national surveys. One article focused on children, while all other articles focused on adults. Nine articles used data from across Canada, 6 were based in Ontario, 5 in Alberta and 4 each in British Columbia and Manitoba. Themes included health, well-being and spirituality; mental health and substance use; health conditions and risk factors; access to adequate health resources; and experiences in health care. INTERPRETATION Métis-specific health research is lacking in Canada, with a gap in volume, subject matter and diversity in the demographics studied. This review illustrates the need for more research with strong community engagement to further explore Métis health and health service needs.
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Affiliation(s)
- Krysta-Leigh Gmitroski
- Faculty of Medicine (Gmitroski, Barbic), and School of Population and Public Health (Hastings), University of British Columbia; Foundry (Hastings, Barbic), Vancouver, BC; Department of Community, Culture, and Global Studies (Legault), University of British Columbia Okanagan, Kelowna, BC; Department of Occupational Science and Occupational Therapy (Barbic), University of British Columbia; Providence Research (Barbic); Centre for Health Evaluation & Outcome Sciences (Barbic), Vancouver, BC
| | - Katherine G Hastings
- Faculty of Medicine (Gmitroski, Barbic), and School of Population and Public Health (Hastings), University of British Columbia; Foundry (Hastings, Barbic), Vancouver, BC; Department of Community, Culture, and Global Studies (Legault), University of British Columbia Okanagan, Kelowna, BC; Department of Occupational Science and Occupational Therapy (Barbic), University of British Columbia; Providence Research (Barbic); Centre for Health Evaluation & Outcome Sciences (Barbic), Vancouver, BC
| | - Gabrielle Legault
- Faculty of Medicine (Gmitroski, Barbic), and School of Population and Public Health (Hastings), University of British Columbia; Foundry (Hastings, Barbic), Vancouver, BC; Department of Community, Culture, and Global Studies (Legault), University of British Columbia Okanagan, Kelowna, BC; Department of Occupational Science and Occupational Therapy (Barbic), University of British Columbia; Providence Research (Barbic); Centre for Health Evaluation & Outcome Sciences (Barbic), Vancouver, BC
| | - Skye Barbic
- Faculty of Medicine (Gmitroski, Barbic), and School of Population and Public Health (Hastings), University of British Columbia; Foundry (Hastings, Barbic), Vancouver, BC; Department of Community, Culture, and Global Studies (Legault), University of British Columbia Okanagan, Kelowna, BC; Department of Occupational Science and Occupational Therapy (Barbic), University of British Columbia; Providence Research (Barbic); Centre for Health Evaluation & Outcome Sciences (Barbic), Vancouver, BC
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Sapkota RP, Valli E, Wilhelms A, Adlam K, Bourgeault L, Heron V, Dickerson K, Nugent M, Hadjistavropoulos HD. Patient-Oriented Research to Improve Internet-Delivered Cognitive Behavioural Therapy for People of Diverse Ethnocultural Groups in Routine Practice. Healthcare (Basel) 2023; 11:2135. [PMID: 37570375 PMCID: PMC10418375 DOI: 10.3390/healthcare11152135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
There has been limited research on improving Internet-delivered Cognitive Behavioural Therapy (ICBT) in routine online therapy clinics that serve people from diverse ethnocultural groups (PDEGs). This article describes a patient-oriented adaptation approach used to address this gap in research. A working group consisting of people with lived experience, community representatives, ICBT clinicians, managers, and researchers was formed. The working group examined archival feedback on ICBT from past patients who self-identified as being from diverse ethnocultural backgrounds (N = 278) and the results of interviews with current patients (N = 16), community representatives (N = 6), and clinicians (N = 3). The archival data and interviews revealed the majority of the patients reported being satisfied with and benefitting from ICBT. Suggestions for improvement were not related to the cognitive-behavioural model and techniques, but rather to making treatment materials more inclusive. Consequently, the ICBT adaptation focused on adding content related to cultural influences on mental health, addressing stigma, diversifying case stories, examples, and imagery, adding audiovisual introductions, and replacing English idioms with more descriptive language. Moreover, further training was offered to clinicians, and efforts were made to improve community outreach. This study demonstrates a process for using patient-oriented research to improve ICBT within routine care serving patients of diverse backgrounds.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Heather D. Hadjistavropoulos
- Online Therapy Unit, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada; (R.P.S.); (E.V.); (A.W.); (K.A.); (L.B.); (V.H.); (K.D.); (M.N.)
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20
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Meldrum K, Andersson E, Webb T, Quigley R, Strivens E, Russell S. Screening depression and anxiety in Indigenous peoples: A global scoping review. Transcult Psychiatry 2023:13634615231187257. [PMID: 37490720 DOI: 10.1177/13634615231187257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Indigenous peoples' worldviews are intricately interconnected and interrelated with their communities and the environments in which they live. Their worldviews also manifest in a holistic view of health and well-being, which contrasts with those of the dominant western biomedical model. However, screening depression and/or anxiety in Indigenous peoples often occurs using standard western tools. Understandably, the cultural appropriateness of these tools has been questioned. The purpose of this scoping review was to map the literature that used any type of tool to screen depression or anxiety in Indigenous adults globally. A systematic scoping review method was used to search databases including, but not limited to, CINAHL, PubMed, Scopus and Google. Database-specific search terms associated with Indigenous peoples, depression and anxiety, and screening tools were used to identify literature. In addition, citation searches of related systematic reviews and relevant websites were conducted. The data set was limited to English language publications since database inception. Fifty-four publications met the review's inclusion criteria. Most studies were completed in community settings using standard western depression and anxiety screening tools. Thirty-three different tools were identified, with the Patient Health Questionnaire-9 being the most frequently used. The review's findings are concerning given repeated calls for culturally appropriate screening tools to be used with Indigenous peoples. Although there has been some work to cross-culturally adapt depression screening tools for specific Indigenous populations, clearly more clinicians and researchers need to be aware of, and use, culturally appropriate approaches to screening.
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Affiliation(s)
| | | | | | | | - Edward Strivens
- James Cook University
- Queensland Health, Cairns and Hinterland Hospital and Health Service
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21
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Carranza Esteban RF, Mamani-Benito O, Cjuno J, Tito-Betancur M, Lingán-Huamán SK, Arias-Chávez D. Translation and validation of the WHO-5 General well-being index into native language Quechua of the Peruvian South. Heliyon 2023; 9:e16843. [PMID: 37313139 PMCID: PMC10258449 DOI: 10.1016/j.heliyon.2023.e16843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
To translate and validate the WHO-5 General Well-being Index for the people of the Peruvian South, a cross-sectional instrumental study was carried out with the voluntary participation of 186 people of both sexes between the ages of 18 and 65 years (M = 29.67 years old; SD = 10.94) living in the south region of Peru. The validity evidence was assessed based on the content using Aiken's coefficient V according to the internal structure through a confirmatory factor analysis, and reliability was calculated through Cronbach's alpha coefficient. The expert judgment was favorable for all items (V > 0.70). The unidimensional structure of the scale was confirmed (χ2 = 10.86, df = 5, p = 0.05; RMR = 0.020; GFI = 0.980; CFI = 0.990; TLI = 0.980 y RMSEA = 0.080), and it presents a suitable reliability range (α = > 0.75). This shows that the WHO-5 General Well-being Index for the people of the Peruvian South is a valid and reliable scale.
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Affiliation(s)
- Renzo Felipe Carranza Esteban
- Grupo de Investigación Avances en Investigación Psicológica, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | | | - Julio Cjuno
- Universidad Privada Norbert Wiener, Lima, Peru
| | | | - Susana K. Lingán-Huamán
- Grupo de Investigación Avances en Investigación Psicológica, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima, Peru
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22
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Hicks LJ, Mushquash CJ, Toombs E. A national-level examination of First Nations peoples’ mental health data: Predicting mental well-being from social determinants of health using the 2017 Aboriginal Peoples Survey. Front Public Health 2023; 11:1073817. [PMID: 37064658 PMCID: PMC10102338 DOI: 10.3389/fpubh.2023.1073817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/07/2023] [Indexed: 04/03/2023] Open
Abstract
IntroductionA history of colonization and assimilation have resulted in social, economic, and political disparities for Indigenous people in Canada. Decades of discriminatory policies (e.g., the Indian Act, the Residential School System) have led to numerous health and mental health inequities, which have been intergenerationally maintained. Four main social determinants of health (i.e., income, education, employment, and housing) disproportionately influence the health of Indigenous peoples. These four social determinants have also been used within the Community Well-Being (CWB) index, which assesses the socio-economic wellbeing of a community. This study sought to extend previous research by assessing how specific indicators of CWB predict self-reported mental wellbeing within First Nations populations across Canada in a national dataset with more recent data.MethodsThis study utilized the 2017 Aboriginal Peoples Survey, which includes data on the social and economic conditions of First Nations people living off reserve aged 15 years and over.ResultsResults from a factorial ANOVA indicated that perceptions of income security, housing satisfaction, higher education, and employment are associated with increased self-reported mental health among First Nations individuals living off-reserve.DiscussionThese results support the idea that individual mental health interventions on their own are not enough; instead, broader social interventions aimed at addressing inequities in various social determinants of health (e.g., housing first initiatives) are needed to better support individual wellbeing.
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Affiliation(s)
- Lydia J. Hicks
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Sciences Center, Lakehead University, Thunder Bay, ON, Canada
- Thunder Bay Regional Health Research Institute, Lakehead University, Thunder Bay, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Thunder Bay, ON, Canada
- *Correspondence: Elaine Toombs,
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23
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Huggard L, Murphy R, O'Connor C, Nearchou F. The Social Determinants of Mental Illness: A Rapid Review of Systematic Reviews. Issues Ment Health Nurs 2023; 44:302-312. [PMID: 36972547 DOI: 10.1080/01612840.2023.2186124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Previous research agendas have prioritised the role of biological determinants in mental illness aetiology. This is of particular concern, as endorsing biological determinants has been shown to promote negative attitudes towards people with mental illness. The aim of this review was to provide an overview of high-quality evidence of the social determinants of mental illness. A rapid review of systematic reviews was conducted. Five databases were searched: Embase, Medline, Academic Search Complete, CINAHL Plus, and PsycINFO. Systematic reviews or meta-analyses that described any social determinant of mental illness, were published in peer-review journals in English, and focussed on human participants were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were applied for the selection procedure. Thirty-seven systematic reviews were deemed eligible for review and narrative synthesis. Determinants identified included conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, housing and living conditions, and demographic factors. We recommend that mental health nurses ensure adequate support be provided to those affected by the evidenced social determinants of mental illness.
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Josewski V, de Leeuw S, Greenwood M. Grounding Wellness: Coloniality, Placeism, Land, and a Critique of "Social" Determinants of Indigenous Mental Health in the Canadian Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4319. [PMID: 36901327 PMCID: PMC10002458 DOI: 10.3390/ijerph20054319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Authored by a small team of settler and Indigenous researchers, all of whom are deeply involved in scholarship and activism interrogating ongoing processes of coloniality in lands now known to many as Canada, this paper critically examines "social" and grounded determinants of Indigenous mental health and wellness. After placing ourselves on the grounds from which we write, we begin by providing an overview of the social determinants of health (SDOH), a conceptual framework with deep roots in colonial Canada. Though important in pushing against biomedical framings of Indigenous health and wellness, we argue that the SDOH framework nevertheless risks re-entrenching deeply colonial ways of thinking about and providing health services for Indigenous people: SDOH, we suggest, do not ultimately reckon with ecological, environmental, place-based, or geographic determinants of health in colonial states that continue to occupy stolen land. These theoretical interrogations of SDOH provide an entry point to, first, an overview of Indigenous ways of understanding mental wellness as tethered to ecology and physical geography, and second, a collection of narrative articulations from across British Columbia: these sets of knowledge offer clear and unequivocal evidence, in the form of Indigenous voices and perspectives, about the direct link between land, place, and mental wellness (or a lack thereof). We conclude with suggestions for future research, policy, and health practice actions that move beyond the current SDOH model of Indigenous health to account for and address the grounded, land-based, and ecologically self-determining nature of Indigenous mental health and wellness.
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Affiliation(s)
- Viviane Josewski
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Sarah de Leeuw
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | - Margo Greenwood
- School of Education, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
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Ansloos J, Cooper A. Is Suicide a Water Justice Issue? Investigating Long-Term Drinking Water Advisories and Suicide in First Nations in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4045. [PMID: 36901055 PMCID: PMC10002052 DOI: 10.3390/ijerph20054045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
First Nations experience disproportionate rates of suicide when compared to the general population. Various risk factors are identified to increase understanding of the prevalence of suicide among First Nations, but environmental dimensions of suicide are understudied. This study asks whether water insecurity, as reflected by long-term drinking water advisories (LT-DWA), has any bearing on the distribution of suicide in First Nations across Canada, and specifically in Ontario. To assess this, we established the proportion of First Nations with LT-DWAs in Canada and in Ontario that have had suicides occur between 2011 and 2016 through a review of media archives. This proportion was compared to census data on the proportion of First Nations with suicides in Canada and in Ontario between 2011 and 2016, and statistical significance of difference was determined through chi-square goodness of fit test. Overall, the findings were mixed. Nationally, there was no significantly difference of proportion of First Nations with LT-DWAs with combined (confirmed and probable) reported suicides occurring when compared to census proportions; however, at the provincial level, findings had significant differences. The authors conclude that water insecurity in First Nations, as indicated by the presence of a LT-DWA in First Nations across may be an important environmental dimension of suicide, contributing to enhanced risk for suicide in First Nations.
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Affiliation(s)
- Jeffrey Ansloos
- School of Cities and Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S 1V6, Canada
| | - Annelies Cooper
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S 1V6, Canada
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Shroff FMC. Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans. Front Glob Womens Health 2023; 4:1126934. [PMID: 36860346 PMCID: PMC9968936 DOI: 10.3389/fgwh.2023.1126934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023] Open
Abstract
COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.
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Affiliation(s)
- Farah Mahrukh Coomi Shroff
- Department of Family Practice and School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada,Maternal and Infant Health Canada, Vancouver, BC, Canada,Correspondence: Farah Mahrukh Coomi Shroff
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Smye V, Browne AJ, Josewski V, Keith B, Mussell W. Social Suffering: Indigenous Peoples' Experiences of Accessing Mental Health and Substance Use Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3288. [PMID: 36833982 PMCID: PMC9958899 DOI: 10.3390/ijerph20043288] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
In this paper, we present findings from a qualitative study that explored Indigenous people's experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples' lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples' lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized.
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Affiliation(s)
- Victoria Smye
- Arthur Labatt Family School of Nursing, Western University, 1151 Richmond Street, London, ON N6A 3K7, Canada
| | - Annette J. Browne
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Viviane Josewski
- School of Nursing, University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
| | | | - William Mussell
- Sal’i’shan Institute, 800 Wellington Ave, Chilliwack, BC V2P 6H7, Canada
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Bernett P, Spence S, Wilson C, Gurr E, Zentner D, Wendt DC. Canadian School Psychology and Indigenous Peoples: Opportunities and Recommendations. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2023. [DOI: 10.1177/08295735231151281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
School psychologists play important roles in working alongside Indigenous Peoples within Canada; however, a large gap exists between the discipline’s actions and the recommendations set forth by Indigenous Nations and governmental working groups. In this conceptual article, we seek to highlight the need for further Indigenous representation and engagement in the field of school psychology, as well as present key areas of relevance. We first briefly contextualize the relationship between Indigenous Peoples and school psychology, followed by the results of a brief survey concerning Indigenous representation and engagement across five school psychology doctoral programs in Canada. Next, we discuss nine key areas of consideration for school psychologists based on the Calls to Action of the Truth and Reconciliation Commission of Canada and the Calls for Justice of the National Inquiry into Missing and Murdered Indigenous Women and Girls. Each area of consideration provides school psychologists with a starting point for concrete actions when working with Indigenous students, families, and communities.
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Affiliation(s)
- Payton Bernett
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Sara Spence
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Candace Wilson
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Erin Gurr
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Daysi Zentner
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Dennis C. Wendt
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
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Nowrouzi-Kia B, Gohar B, Sithamparanathan G, Sun RY, Casole J. Workplace mental health characteristics of the Indigenous workforce in Canada: A descriptive study. Work 2023; 74:129-136. [PMID: 36214013 DOI: 10.3233/wor-210927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The Indigenous workforce in Canada is challenged by a history of Euro-Canadian colonialism that has presented deleterious health outcomes, including those in the workplace. OBJECTIVE The aim of this study was to describe the mental health of Indigenous workers in the workplace. METHODS We used the Canadian Community Health Survey (CCHS) between 2015 to 2016. Data were analyzed using the Public Use Microdata Files to profile the workplace mental health characteristics of First Nation Canadians (n = 6,297) and Canadians (n = 84,155). We utilized secondary data analysis design. The analyses included descriptive statistics (e.g., means and standard deviations) of self-reported mood disorders (depression, bipolar, mania, dysthymia), anxiety (phobia, OCD, panic) and occupational factors (e.g., demographic, days off work due to an acute mental health condition, job type, and job stress) in indigenous peoples living off-reserve and other Aboriginal settlements in the provinces. RESULTS We examined the indigenous cohort between the ages of 18-64 who were employed. The sample was 53.1% male, married (34.8%), and obtained a post-secondary diploma or university degree (57.9%). The study reported statistically significant gender and age differences across mood and anxiety disorders (p < 0.05), job stress (p < 0.05) and workload (p < 0.05). CONCLUSION To the best of our knowledge, this is the first study to describe the work profile of indigenous populations in Canada across various occupational mental health (e.g., mood disorders, anxiety) and demographic (e.g., age, education attainment) outcomes.
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Affiliation(s)
- Behdin Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Basem Gohar
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada.,Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Gobika Sithamparanathan
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ruo Yue Sun
- Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Casole
- Special Educational Department, Loretto College School, Toronto, Ontario, Canada
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Roberts C, Darroch F, Giles A, van Bruggen R. You’re carrying so many people’s stories: vicarious trauma among fly-in fly-out mental health service providers in Canada. Int J Qual Stud Health Well-being 2022; 17:2040089. [PMID: 35195506 PMCID: PMC8925925 DOI: 10.1080/17482631.2022.2040089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Candace Roberts
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Francine Darroch
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Audrey Giles
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
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Charise A, Pang C, Khalfan KA. What is Intergenerational Storytelling? Defining the Critical Issues for Aging Research in the Humanities. THE JOURNAL OF MEDICAL HUMANITIES 2022; 43:615-637. [PMID: 35462580 PMCID: PMC9759502 DOI: 10.1007/s10912-022-09735-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 06/14/2023]
Abstract
Intergenerational storytelling (IGS) has recently emerged as an arts- and humanities-focused approach to aging research. Despite growing appeal and applications, however, IGS methods, practices, and foundational concepts remain indistinct. In response to such heterogeneity, our objective was to comprehensively describe the state of IGS in aging research and assess the critical (e.g., conceptual, ethical, and social justice) issues raised by its current practice. Six databases (PsycINFO, MEDLINE, PubMed, Scopus, AgeLine, and Sociological Abstracts) were searched using search terms relating to age, intergenerational, story, and storytelling. Peer-reviewed, English-language studies conducted with participants residing in non-clinical settings were included. One thousand one hundred six (1106) studies were initially retrieved; 70 underwent full review, and 26 fulfilled all inclusion criteria. Most studies characterized IGS as a practice involving older adults (> 50 years old) and conventionally-aged postsecondary/college students (17-19 years old). Typical methodologies included oral and, in more recent literature, digital storytelling. Critical issues included inconsistently reported participant data, vast variations in study design and methods, undefined key concepts, including younger vs. older cohorts, generation, storytelling, and whether IGS comprised an intentional research method or a retrospective outcome. While IGS holds promise as an emerging field of arts- and humanities-based aging research, current limitations include a lack of shared data profiles and comparable study designs, limited cross-cultural representation, and insufficiently intersectional analysis of widespread IGS practices. To encourage more robust standards for future study design, data collection, and researcher reflexivity, we propose seven evidence-based recommendations for evolving IGS as a humanities-based approach to research in aging and intergenerational relations.
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Affiliation(s)
- Andrea Charise
- Department of Health & Society, University of Toronto Scarborough, 1265 Military Trail, c/o Highland Hall Rm. 220, Toronto, ON, M1C 1A4, Canada.
- Graduate Department of English, University of Toronto, Toronto, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada.
- The Health Humanities Learning Lab, University of Toronto, Toronto, Canada.
| | - Celeste Pang
- The Health Humanities Learning Lab, University of Toronto, Toronto, Canada
- Research Department, Egale Canada, Toronto, Canada
- Institute for Life Course and Aging, University of Toronto, Toronto, Canada
| | - Kaamil Ali Khalfan
- The Health Humanities Learning Lab, University of Toronto, Toronto, Canada
- Faculty of Law and Odette School of Business, University of Windsor, Windsor, Canada
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Reeson M, Polzin W, Pazderka H, Agyapong V, Greenshaw AJ, Hnatko G, Wei Y, Szymanski L, Silverstone PH. Child sexual abuse survivors: Differential complex multimodal treatment outcomes for pre-COVID and COVID era cohorts. CHILD ABUSE & NEGLECT 2022; 134:105926. [PMID: 36332320 PMCID: PMC9624116 DOI: 10.1016/j.chiabu.2022.105926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/28/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Child sexual abuse (CSA) is a form of early-life trauma that affects youth worldwide. In the midst of the current COVID-19 pandemic, it is imperative to investigate the potential impact of added stress on already vulnerable populations. OBJECTIVE The aim of this study was to evaluate the effectiveness of a multimodal treatment program on mental health outcomes for youth CSA survivors aged 8-17. Secondary to this, we explored the potential impact of the COVID-19 on treatment outcomes. PARTICIPANTS AND SETTING Participants of this study were children and youth aged 8-17 who were engaged in a complex multimodal treatment program specifically designed for youth CSA survivors. METHODS Participants were asked to complete self-report surveys at baseline and at the end of two subsequent treatment rounds. Surveys consisted of measures pertaining to: (1) PTSD, (2) depression, (3) anxiety, (4) quality of life, and (5) self-esteem. RESULTS Median scores improved for all groups at all timepoints for all five domains. For the pre-Covid participants, the largest improvements in the child program were reported in depression (36.6 %, p = 0.05); in the adolescent program anxiety showed the largest improvement (-35.7 %, p = 0.006). Improvements were generally maintained or increased at the end of round two. In almost every domain, the improvements of the pre-COVID group were greater than those of the COVID-I group. CONCLUSIONS A complex multimodal treatment program specifically designed for youth CSA survivors has the capacity to improve a number of relevant determinants of mental health and well-being. The COVID-19 pandemic may have retraumatized participants, resulting in treatment resistance.
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Affiliation(s)
- Matthew Reeson
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Wanda Polzin
- Little Warriors Be Brave Ranch, Edmonton, Alberta, Canada(1)
| | - Hannah Pazderka
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Vincent Agyapong
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | - Gary Hnatko
- CASA Child Treatment Center, 10645 63 Ave NW, Edmonton, Canada
| | - Yifeng Wei
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada
| | | | - Peter H Silverstone
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Center (WMC), 8440 112 St NW, Edmonton, Canada.
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Collaboration in Mental Healthcare for Indigenous Children and Youth: Using Actor-Network Analyses to Better Understand Dynamics, Strengths, and Ongoing Challenges in Collaboration. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00942-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Doery E, Satyen L, Paradies Y, Toumbourou JW. The Relationship Between Cultural Engagement and Psychological Well-being Among Indigenous Adolescents: A Systematic Review. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2022. [DOI: 10.1177/00220221221128215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The disproportionate burden of mental illness experienced by Indigenous adolescents is well established. Therefore, this review focused on how the well-being of Indigenous adolescents can be better promoted. The review identified studies that examined the relationship between cultural engagement and psychological well-being among Indigenous adolescents. To achieve this, a systematic search of published literature across seven online databases including Medline and EMBASE was conducted between October and November 2020. To meet the inclusion criteria, studies were required to include a sample of Indigenous adolescents and measure the relationship between psychological well-being and cultural engagement. Twenty-five studies met the inclusion criteria, yielding a total sample size of 19,231 participants. Eighteen studies (72%) reported a significant positive relationship between cultural engagement and psychological well-being, four studies (16%) reported a nonsignificant relationship, and three studies (12%) reported mixed findings. Despite measuring different domains of culture across the 25 studies, these findings demonstrate relatively strong evidence of a positive association between cultural engagement and psychological well-being. They highlight the importance of culture for young Indigenous Peoples in developing a positive well-being. In the future, researchers should focus on specifying how intervention factors contribute to cultural engagement effects and establish further contributors to well-being and positive development among Indigenous adolescents. The findings of this review advance our understanding of how Indigenous Peoples interpret culture and their engagement with this culture. This has implications for policy, programs, and interventions intended to enhance well-being outcomes for Indigenous communities.
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Affiliation(s)
| | - Lata Satyen
- Deakin University, Melbourne, Victoria, Australia
| | - Yin Paradies
- Deakin University, Melbourne, Victoria, Australia
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Muhajarine N, Adeyinka DA, Pisolkar V, Ahmed MS, Kallio N, Coomaran V, McIntosh T, Novik N, Jeffery B. Equity Analysis of Repeated Cross-Sectional Survey Data on Mental Health Outcomes in Saskatchewan, Canada during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192113808. [PMID: 36360688 PMCID: PMC9655244 DOI: 10.3390/ijerph192113808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/12/2022] [Accepted: 10/16/2022] [Indexed: 06/07/2023]
Abstract
This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.
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Affiliation(s)
- Nazeem Muhajarine
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Daniel A. Adeyinka
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Vaidehi Pisolkar
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Md Sabbir Ahmed
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Natalie Kallio
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Vithusha Coomaran
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Tom McIntosh
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Politics and International Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Nuelle Novik
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Faculty of Social Work, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Bonnie Jeffery
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Faculty of Social Work, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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Systematic Review and Meta-analysis: First Nations, Inuit, and Métis Youth Mental Health. J Am Acad Child Adolesc Psychiatry 2022; 61:1227-1250. [PMID: 35427729 DOI: 10.1016/j.jaac.2022.03.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 02/26/2022] [Accepted: 04/05/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The ongoing effects of colonialism disproportionately place Indigenous youth at risk for mental health challenges. This meta-analysis examined lifetime and past-year prevalence estimates of mental health challenges among First Nations, Inuit, and Métis youth in Canada. METHOD Five electronic databases were searched from their inceptions until June 17, 2021. Studies were included if they assessed mental health challenges among First Nations, Inuit, and/or Métis youth (≤18 years old). Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 28 articles were eligible. Sixteen studies contained data on First Nations, 2 on Inuit, one on Métis, and 10 aggregated Indigenous participants. Among First Nations participants, pooled prevalence estimates for past-year suicidality (8.9%), mood and/or anxiety (<2.9%), attention-deficit/hyperactivity (2.9%), oppositional defiant (8.8%), and conduct (12.8%) disorder diagnoses were identified. Limited studies containing Inuit, Métis, and aggregated Indigenous participants also found high levels of disruptive disorder symptoms. Data were very limited for lifetime prevalence estimates. Studies assessed to have a moderate or high methodological risk of bias (k = 19) or using measures that are not yet culturally validated (k = 25) may contribute to inaccuracies in prevalence estimates. CONCLUSION Existing data suggest that Indigenous youth have a low prevalence of mental health challenges, with the exception of disruptive behaviors. Future studies should use culturally validated tools and partner with Indigenous communities to ensure optimal identification of mental health challenges.
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Anishinabek sources of strength: Learning from First Nations people who have experienced mental health and substance use challenges. Soc Sci Med 2022; 309:115197. [DOI: 10.1016/j.socscimed.2022.115197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/09/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022]
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Meldrum K, Andersson E, Wallace V, Webb T, Quigley R, Strivens E, Russell S. Approaches to the development of new mental well-being screening tools for Indigenous peoples: a systematic mixed studies review protocol. BMJ Open 2022; 12:e063710. [PMID: 35973708 PMCID: PMC9386234 DOI: 10.1136/bmjopen-2022-063710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Indigenous peoples' world views are intricately interrelated and interconnected with those of their communities and the environments where they live. Consequently, Indigenous peoples have a holistic view of their health, which contrasts with the dominant Western biomedical paradigm. However, the mental well-being of Indigenous peoples is predominately screened using tools developed using the Western paradigm that may not be culturally appropriate. The objective of this systematic mixed studies review (SMSR) is to assess the extent of the literature related to approaches used to develop new tools to screen the mental well-being of Indigenous adults. METHODS AND ANALYSIS This SMSR will be conducted in accordance with the method proposed by Pluye et al. It will include studies that describe the development of any type of tool or approach to screen for mental well-being in Indigenous adults, globally. Searches will be limited to the English language and literature published since January 2000. Databases to be searched include: CINAHL, Medline, PsycINFO, PubMed and Scopus. Only published studies will be included in the SMSR. Data that answers the research questions will be extracted from the literature and recorded on the associated data charting form. A sequential synthesis method will be used to analyse data from qualitative, quantitative and mixed-method studies. Data will be presented graphically, diagrammatically or in tabular form depending on what approach best conveys its meaning. ETHICS AND DISSEMINATION The SMSR will describe the approach to developing new tools for screening the mental well-being of Indigenous peoples across the globe. It will support researchers, clinicians and practitioners to consider both their approach to new tool development or, if they are using a previously developed tool, how reliable and valid it is for the population that they intend to use it with. Peer-reviewed publications will be used to disseminate SMSR findings.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Ellaina Andersson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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Kaphle S, Hungerford C, Blanchard D, Doyle K, Ryan C, Cleary M. Cultural Safety or Cultural Competence: How Can We Address Inequities in Culturally Diverse Groups? Issues Ment Health Nurs 2022; 43:698-702. [PMID: 34807792 DOI: 10.1080/01612840.2021.1998849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sabitra Kaphle
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Denise Blanchard
- School of Nursing and Midwifery, University of Newcastle, Central Coast Clinical School, New South Wales, Australia
| | - Kerrie Doyle
- Indigenous Health, School of Medicine, Western Sydney University, Sydney, Australia
| | - Colleen Ryan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Brisbane, Queensland, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Sydney, New South Wales, Australia
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Sun X. The Practical Application of Oil Painting in the Treatment of Mental Illness. Occup Ther Int 2022; 2022:1727507. [PMID: 35821712 PMCID: PMC9232304 DOI: 10.1155/2022/1727507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
With the rapid development of economy, politics, science, and technology and the improvement of living material level, people pay more attention to personal physical and mental development. The incidence of mental illness is on the rise. Psychological education curriculum learning and psychological counselling are based on communication; there are still many limitations. The art media enables patients to reveal their subconscious and potential emotional needs, so that interveners have the opportunity to explore these issues and build a bridge of communication with patients. In this paper, oil painting therapy of nonverbal communication is proposed as a way of psychological therapy. The patients in the psychological department of a hospital are served by six stages of therapy, each stage of treatment has different arrangements, and continuous service and treatment are adopted. Based on the art analysis principle of oil painting creation, the therapeutic experience obtained from oil painting creation and the experience gained from oil painting were divided into groups to compare the therapeutic effect and explore the role of oil painting art therapy. The results showed that the scores of the treatment group were significantly lower than those of the control group at 4 weeks and 6 weeks after the art therapy of oil painting creation, showing a significant downward trend overall. Oil painting art therapy may alleviate anxiety, providing data support for the application of oil painting art therapy in patients with depressive episodes.
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Affiliation(s)
- Xiaoming Sun
- Shaanxi Normal University, Shaanxi 710062, China
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Symptoms of psychological distress reported by women from indigenous communities in South India: implications for methodology and future studies. Arch Womens Ment Health 2022; 25:667-670. [PMID: 35260932 DOI: 10.1007/s00737-022-01215-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/16/2022] [Indexed: 11/02/2022]
Abstract
'Indigenous peoples' across the globe suffer a disproportionate burden of mental illness. However, this burden is not fully explored in India despite having the second largest absolute concentration of indigenous peoples in the world. We did a secondary analysis of data from a cross-sectional survey in indigenous populations from the Nilgiri Biosphere Reserve in South India. Symptoms suggestive of psychological distress were reported by 39.9% participants. Being alone, tobacco use, hypertension, hypertension in family member, and violent conflict in household were independently associated with psychological distress. More epidemiological studies need to be conducted to map the burden and elaborate the relationships between mental health problems and socio-cultural factors in indigenous populations in India.
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Radford A, Toombs E, Zugic K, Boles K, Lund J, Mushquash CJ. Examining Adverse Childhood Experiences (ACEs) within Indigenous Populations: a Systematic Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:401-421. [PMID: 35600513 PMCID: PMC9120316 DOI: 10.1007/s40653-021-00393-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 06/03/2023]
Abstract
Health concerns in Indigenous people are often greater in comparison to those in non-Indigenous populations, including increased rates of chronic diseases and mental health concerns. Adverse childhood experiences (ACEs) may be an explanatory variable for such heightened rates of mental and physical health difficulties for Indigenous populations as these communities have experienced a lack of adequate health care due to remoteness, historical traumas, cultural insensitivity, racism, and perpetuating systemic discrimination. To date, relatively few studies have examined ACEs within an Indigenous population and their relevance to both physical and mental health outcomes. The present study explored existing ACE literature relevant to Indigenous populations and mental or physical health outcomes by retrieving and organizing available ACE literature. A systematic review was conducted using 14 electronic databases of peer-reviewed literature and 18 grey literature databases. Twenty-one publications investigating general health outcomes and prevalence of ACEs met eligibility criteria. ACEs were reported to be higher in Indigenous populations when compared to non-Indigenous population. Higher ACE scores for Indigenous participants were associated with increased rates of suicidality and psychological distress. Protective factors to reduce the impact of ACEs were cultural identity and connectedness, education, social support, and psychological resilience. Future research may further explore the relationship between ACE scores and protective factors, varying prevalence within specific sub-populations, and consistent reporting of outcomes across studies. Ongoing research has the potential to clarify existing dose-response relationships between early traumatic experiences and current health disparities experienced within some Indigenous communities.
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Affiliation(s)
- Abbey Radford
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Katie Zugic
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
| | - Kara Boles
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, ON Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON Canada
- Northern Ontario School of Medicine (NOSM), Lakehead University, Thunder Bay, ON Canada
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON Canada
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON Canada
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O’Keefe VM, Fish J, Maudrie TL, Hunter AM, Tai Rakena HG, Ullrich JS, Clifford C, Crawford A, Brockie T, Walls M, Haroz EE, Cwik M, Whitesell NR, Barlow A. Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6271. [PMID: 35627809 PMCID: PMC9140847 DOI: 10.3390/ijerph19106271] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/17/2022]
Abstract
Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include research, community-led programs, and national advocacy. Indigenous youth development and well-being occur through strengths-based relationships across interconnected environmental levels. This approach promotes Indigenous youth and communities considering complete ecologies of Indigenous youth to foster their whole health, including mental health. Future research and programming will benefit from understanding and identifying common, strengths-based solutions beyond narrow intervention targets. This approach not only promotes Indigenous youth health and mental health, but ripples out across the entire ecosystem to promote community well-being.
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Affiliation(s)
- Victoria M. O’Keefe
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Jillian Fish
- Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN 55417, USA;
| | - Tara L. Maudrie
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Amanda M. Hunter
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ 86011, USA;
| | - Hariata G. Tai Rakena
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | | | - Carrie Clifford
- Department of Psychology, University of Otago, Dunedin 9016, New Zealand;
| | - Allison Crawford
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 1X5, Canada;
| | - Teresa Brockie
- School of Nursing, Johns Hopkins University, Baltimore, MD 21231, USA;
| | - Melissa Walls
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Mary Cwik
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA;
| | - Allison Barlow
- Johns Hopkins Center for American Indian Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA; (T.L.M.); (H.G.T.R.); (M.W.); (E.E.H.); (M.C.); (A.B.)
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Ansloos JP, Wager AC, Dunn NS. Preventing Indigenous youth homelessness in Canada: A qualitative study on structural challenges and upstream prevention in education. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:1918-1934. [PMID: 34427328 DOI: 10.1002/jcop.22691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Abstract
Drawing on a partnership with a group of Indigenous youth experiencing homelessness in Vancouver, Canada, this study identifies four structural challenges that have impacted them and four actionable upstream strategies to further prevent youth housing precarity. As a secondary analysis of a community-engaged study with youth experiencing homelessness, we conducted a thematic analysis with qualitative data, which included qualitative interviews with five young people and researcher observations. The results reflect the racial, colonial, and economic concerns that impact Indigenous youth experiencing homelessness. The four actionable upstream solutions highlight human rights-based approaches to homelessness, ranging from advancing and strengthening public services, transitional justice processes, and cultural and socioeconomic safety. This study provides strategies to promote Indigenous youth wellbeing and decrease risk of housing precarity, while centering and drawing from youth knowledge production. Strengths and limitations of the study are also discussed.
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Affiliation(s)
- Jeffrey Paul Ansloos
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Claudia Wager
- Faculty of Education, Vancouver Island University, Nanaimo, British Columbia, Canada
| | - Nicole Santos Dunn
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
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Montesanti S, Fitzpatrick K, Fayant B, Pritchard C. Identifying priorities, directions and a vision for Indigenous mental health using a collaborative and consensus-based facilitation approach. BMC Health Serv Res 2022; 22:406. [PMID: 35346187 PMCID: PMC8958486 DOI: 10.1186/s12913-022-07682-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 02/24/2022] [Indexed: 12/19/2022] Open
Abstract
Background Mental health disparities between Indigenous and non-Indigenous people in Canada are related to underlying economic, social, and political inequities that are legacies of colonization and the oppression of Indigenous cultures. It also widely acknowledged that mental health services currently available may not be culturally appropriate in supporting the health needs of Indigenous Canadians. A two-day Indigenous mental health forum examined mental health needs and gaps among Indigenous communities across the Regional Municipality of Wood Buffalo (RMWB) on Treaty 8 territory, in northern Alberta, Canada. This paper outlines the insights generated by stakeholder engagement at the forum to identify and prioritize directions for Indigenous mental health and build a vision and strategy for improving mental health services and programs for the region’s diverse Indigenous population. Methods We applied a modified nominal group technique (NGT) consensus method embedded within Indigenous knowledge to determine key priorities and directions for Indigenous-focused mental health and synthesize information from discussions that occurred at the forum. Following the NGT, a participatory community visioning exercise was conducted with participants to develop a vision, guiding principles, and components of an action plan for an Indigenous mental health strategy for the RMWB. Results Four key themes for setting priorities and directions for Indigenous mental health emerged from roundtable group discussions: 1) understand the realities of mental health experiences for Indigenous peoples, 2) design a holistic and culturally rooted mental health system, 3) foster cross-sectoral engagement and collaboration on mental health service delivery, and 4) focus on children and youth. The community visioning exercise helped stakeholders to visualize a direction or path forward for addressing existing gaps in the mental health system and opportunities for strengthening Indigenous mental health in the region. Conclusions Forum participants described mental health and well-being around holistic concepts of social and emotional well-being. Addressing Indigenous mental health and wellness involves multi-sectoral action in various settings including community and school through programs, policies, and other interventions that promote mental health for all Indigenous peoples, as well as for those at greater risk such as children and youth. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07682-3.
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Richer A, Roddy AL. Opioid use in indigenous populations: indigenous perspectives and directions in culturally responsive care. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2022; 22:255-263. [PMID: 37292386 PMCID: PMC10249962 DOI: 10.1080/1533256x.2022.2049161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this work, we outline the necessary components for culturally responsive treatment to opioid use disorders in Indigenous communities. First, we examine the context of historical trauma faced by Indigenous groups in the U.S. and how this context may affect successful implementation of treatment. We then outline the strategies of Penobscot Nation and Little Earth in developing holistic treatment regimens for Indigenous peoples, and list policy interventions suited to improve outcomes for Indigenous groups related to opioid use disorders. We conclude with suggestions for future directions in anticolonial strategies for addressing opioid use in Indigenous communities. The combination of culturally responsive treatment, tribal sovereignty in the treatment of opioid use disorders, and effective resource allocation is necessary to affect positive change in Indigenous substance use trajectories.
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Affiliation(s)
- Ariel Richer
- Pre-Doctoral Fellow, School of Social Work, Columbia University, New York, New York, USA
| | - Ariel L. Roddy
- Doctoral Candidate, School of Criminal Justice, Michigan State University, East Lansing, Michigan, USA
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Abdel-Rahman O, North S. Socioeconomic disparities in the prevalence of comorbid chronic conditions among Canadian adults with cancer. Acta Oncol 2022; 61:294-301. [PMID: 34726566 DOI: 10.1080/0284186x.2021.1995892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the prevalence of comorbid chronic conditions among Canadian adults with cancer and the impact of socioeconomic background on the distribution of these conditions. METHODS Canadian Community Health Survey (CCHS) 2017-2018 dataset was accessed and individuals with complete information about cancer history were reviewed. The prevalence of the following 10 chronic conditions was reviewed: asthma, chronic obstructive pulmonary disease, arthritis, hypertension, hypercholesterolemia/hyperlipidemia, heart disease, stroke, diabetes, mood disorder, and anxiety disorder. Stratification of the prevalence was done according to age, sex, and racial subgroups. Multivariable logistic regression analysis was done to evaluate the association between sociodemographic characteristics and having multiple comorbid conditions. RESULTS A total of 104,362 participants were included in the current study (including 10,782 participants with a history of cancer; and 93,580 participants without a history of cancer). Among all age, sex, and race strata, participants with a history of cancer were more likely to have multiple chronic conditions (p < 0.05 for all comparisons). The most common three individual comorbid conditions among participants with cancer were arthritis (40.2%), hypertension (36.1%), and hypercholesterolemia (25.2%); while the most common cancer-comorbidity triad among participants with cancer was cancer/arthritis/hypertension (17.7%). In a multivariable logistic regression analysis among participants with cancer, the following sociodemographic factors were associated with having multiple comorbid conditions: older age (OR for age 80+ versus age 18-20 years: 8.32; 95% CI: 5.17-13.39), indigenous racial group (OR: 1.94; 95% CI: 1.43-2.63) and lower income (OR for income ≥80,000 Canadian dollars (CAD) versus income: ≤20,000 CAD: 0.29; 95% CI: 0.23-0.37). CONCLUSION History of cancer is associated with a higher probability of many comorbid conditions. This excess comorbidity burden seems to be unequally shouldered by individuals in the lower socioeconomic stratum as well as minority populations.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Scott North
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada
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Tanner B, Plain S, George T, George J, Mushquash CJ, Bernards S, Morton Ninomiya M, Wells S. Understanding Social Determinants of First Nations Health Using a Four-Domain Model of Health and Wellness Based on the Medicine Wheel: Findings from a Community Survey in One First Nation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2836. [PMID: 35270529 PMCID: PMC8910369 DOI: 10.3390/ijerph19052836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 02/01/2023]
Abstract
We examined the explanatory roles of social determinants of health (SDOH) for First Nations people using a four-domain model of health and wellness based on the Medicine Wheel (i.e., physical, mental, emotional, and spiritual health), including colonial-linked stressors (i.e., historical trauma, childhood adversities, racial discrimination) and cultural resilience factors (i.e., cultural strengths, traditional healing practices, social support). Data were collected in partnership with a First Nation in Ontario, Canada in 2013 through a community survey (n = 194). For each outcome (physical, mental, emotional, and spiritual health), a modified Poisson regression model estimated prevalence ratios for the SDOH, adjusting for age, sex, education, and marital status. Negative associations were found for historical trauma with physical, mental, emotional, and spiritual health; for childhood adversities with mental health; and for racial discrimination with physical, mental, and emotional health. Positive associations were found for cultural strengths with physical, mental, and emotional health and for social support with physical, mental, emotional, and spiritual health. We observed negative associations between use of traditional healing practices and mental and emotional health. Our findings suggest that these SDOH may play important roles in relation to wellness through associations with the domains of health modelled by the Medicine Wheel.
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Affiliation(s)
- Bryan Tanner
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
| | - Sara Plain
- E’Mino Bmaad-Zijig Health Centre, Aamjiwnaang First Nation, 1300 Tashmoo Ave, Sarnia, ON N7T 7H5, Canada; (S.P.); (T.G.)
| | - Tracey George
- E’Mino Bmaad-Zijig Health Centre, Aamjiwnaang First Nation, 1300 Tashmoo Ave, Sarnia, ON N7T 7H5, Canada; (S.P.); (T.G.)
| | - Julie George
- Mental Health, Addiction and Violence Support Program, Kettle & Stony Point Health Services, A-6275 Indian Lane, Kettle & Stony Point First Nation, Lambton Shores, ON N0N 1J1, Canada;
| | - Christopher J. Mushquash
- Department of Psychology, Lakehead University, 955 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada;
- Northern Ontario School of Medicine, Lakehead University, 955 Oliver Rd, Thunder Bay, ON P7B 5E1, Canada
- Dilico Anishinabek Family Care, 200 Anemki Pl, Fort William First Nation, ON P7J 1L6, Canada
- Centre for Rural and Northern Health Research, Thunder Bay, ON P7B 5E1, Canada
- Thunder Bay Regional Health Sciences Centre, 980 Oliver Rd, Thunder Bay, ON P7B 6V4, Canada
- Thunder Bay Regional Health Research Institute, 1040 Oliver Rd, Thunder Bay, ON P7B 7A5, Canada
| | - Sharon Bernards
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
| | - Melody Morton Ninomiya
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
- Health Sciences, Wilfrid Laurier University, 75 University Ave W, Waterloo, ON N2L 3C5, Canada
| | - Samantha Wells
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 100 Collip Circle, London, ON N6G 4X8, Canada; (S.B.); (M.M.N.); (S.W.)
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 33 Russel Street, Toronto, ON M5S 3M1, Canada
- Dalla Lana School of Public Health, University of Toronto, 150 College St, Toronto, ON M5T 3M7, Canada
- Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St., London, ON N6A 3K7, Canada
- Department of Psychiatry, University of Toronto, 27 King’s College Circle, Toronto, ON M5S 1A1, Canada
- School of Psychology, Deakin University, 664 Collins Street, Melbourne, VIC 3217, Australia
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Burnett C, Purkey E, Davison CM, Watson A, Kehoe J, Traviss S, Nolan D, Bayoumi I. Spirituality, Community Belonging, and Mental Health Outcomes of Indigenous Peoples during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042472. [PMID: 35206662 PMCID: PMC8872600 DOI: 10.3390/ijerph19042472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 12/03/2022]
Abstract
We aimed to assess the association between community belonging, spirituality, and mental health outcomes among Indigenous Peoples during the COVID-19 pandemic. This cross-sectional observational study used online survey distribution and targeted outreach to the local Indigenous community to collect a convenience sample between 23 April 2020 and 20 November 2020. The surveys included demographic information, self-reported symptoms of depression (PHQ-2) and anxiety (GAD-2), and measures of the sense of community belonging and the importance of spirituality. Multivariate logistic regression was used to model the association between the sense of community belonging and spirituality, and symptoms of anxiety and depression. Of the 263 self-identified Indigenous people who participated, 246 participants had complete outcome data, including 99 (40%) who reported symptoms of depression and 110 (45%) who reported symptoms of anxiety. Compared to Indigenous participants with a strong sense of community belonging, those with weak community belonging had 2.42 (95% CI: 1.12–5.24)-times greater odds of reporting symptoms of anxiety, and 4.40 (95% CI: 1.95–9.89)-times greater odds of reporting symptoms of depression. While spirituality was not associated with anxiety or depression in the adjusted models, 76% of Indigenous participants agreed that spirituality was important to them pre-pandemic, and 56% agreed that it had become more important since the pandemic began. Community belonging was associated with positive mental health outcomes. Indigenous-led cultural programs that foster community belonging may promote the mental health of Indigenous Peoples.
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Affiliation(s)
- Chantal Burnett
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (C.B.); (E.P.); (C.M.D.); (A.W.)
| | - Eva Purkey
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (C.B.); (E.P.); (C.M.D.); (A.W.)
| | - Colleen M. Davison
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (C.B.); (E.P.); (C.M.D.); (A.W.)
| | - Autumn Watson
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (C.B.); (E.P.); (C.M.D.); (A.W.)
- Indigenous Health Council, Kingston, ON K7K 2V4, Canada; (J.K.); (S.T.); (D.N.)
- Indigenous Diabetes Health Circle, Thorold, ON L2V 4Y6, Canada
| | - Jennifer Kehoe
- Indigenous Health Council, Kingston, ON K7K 2V4, Canada; (J.K.); (S.T.); (D.N.)
| | - Sheldon Traviss
- Indigenous Health Council, Kingston, ON K7K 2V4, Canada; (J.K.); (S.T.); (D.N.)
| | - Dionne Nolan
- Indigenous Health Council, Kingston, ON K7K 2V4, Canada; (J.K.); (S.T.); (D.N.)
| | - Imaan Bayoumi
- Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON K7L 3N6, Canada; (C.B.); (E.P.); (C.M.D.); (A.W.)
- Correspondence:
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50
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Pride T, Lam A, Swansburg J, Seno M, Lowe MB, Bomfim E, Toombs E, Marsan S, LoRusso J, Roy J, Gurr E, LaFontaine J, Paul J, Burack JA, Mushquash C, Stewart SH, Wendt DC. Trauma-informed Approaches to Substance Use Interventions with Indigenous Peoples: A Scoping Review. J Psychoactive Drugs 2021; 53:460-473. [PMID: 34895091 DOI: 10.1080/02791072.2021.1992047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Indigenous Peoples experience disproportionately higher rates of problematic substance use. These problems are situated in a context of individual and intergenerational trauma from colonization, residential schools, and racist and discriminatory practices, policies, and services. Therefore, substance use interventions need to adopt a trauma-informed approach. We aimed to synthesize and report the current literature exploring the intersection of trauma and substance use interventions for Indigenous Peoples. Fourteen databases were searched using keywords for Indigenous Peoples, trauma, and substance use. Of the 1373 sources identified, 117 met inclusion criteria. Literature on trauma and substance use with Indigenous Peoples has increased in the last 5 years (2012-2016, n = 29; 2017-2021, n = 48), with most literature coming from the United States and Canada and focusing on historical or intergenerational trauma. Few articles focused on intersectional identities such as 2SLGBTQIA+ (n = 4), and none focused on veterans. There were limited sources (n = 25) that reported specific interventions at the intersection of trauma and substance use. These sources advocate for multi-faceted, trauma-informed, and culturally safe interventions for use with Indigenous Peoples. This scoping review illuminates gaps in the literature and highlights a need for research reporting on trauma-informed interventions for substance use with Indigenous Peoples.
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Affiliation(s)
- T Pride
- Faculty of Health, Dalhousie University, Halifax, Canada
| | - A Lam
- Centre de Recherche du Chum, Université de Montréal, Montreal, Canada
| | - J Swansburg
- Centre de Recherche du Chum, Université de Montréal, Montreal, Canada.,Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - M Seno
- Centre de Recherche du Chum, Université de Montréal, Montreal, Canada.,Psychology and Neuroscience, Dalhousie University, Halifax, Canada.,Maastricht University, Psychology and Neuroscience, Maastricht, The Netherlands
| | - M B Lowe
- Health and Human Performance, Dalhousie University, Halifax, Canada
| | - E Bomfim
- Educational and Counselling Psychology, McGill University, Montreal, Canada.,Psychology, Concordia University, Montreal, Canada
| | - E Toombs
- Psychology, Lakehead University, Thunder Bay, Canada
| | - S Marsan
- Family and Emergency Medicine, Université de Montréal, Montreal, Canada
| | - J LoRusso
- Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - J Roy
- Social Work, McGill University, Montreal, Canada
| | - E Gurr
- Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - J LaFontaine
- Integrated Studies in Education, McGill University, Montreal, Canada
| | - J Paul
- Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - J A Burack
- Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - C Mushquash
- Psychology, Lakehead University, Thunder Bay, Canada
| | - S H Stewart
- Psychology and Neuroscience, Dalhousie University, Halifax, Canada.,Psychiatry, Dalhousie University, Halifax, Canada
| | - D C Wendt
- Educational and Counselling Psychology, McGill University, Montreal, Canada
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