In Kettle & Stony Point First Nation, the impacts of a research project to support Indigenous men’s health are clearly visible: an outdoor sacred healing space, comprised of a sweat lodge, a tipi and a food and medicine garden, with tobacco, sage and sweetgrass.
The men participating in the research envisioned and helped bring this healing space to fruition. Just as tangibly, they are enhancing mental health and addiction services in the southern Ontario First Nation.
“I describe it as a community-based, participatory action research project, and I mean this literally,” says Dr. Julie George, referring to both the involvement of participants and using research to improve care. Dr. George is a member of Kettle & Stony Point First Nation and Scientist in CAMH’s Institute for Mental Health Policy Research. She is also the Mental Health, Addiction and Violence Support Program Manager at the Health Services Department in her community.
“I strongly believe that we have something special here in terms of helping men deal with addiction and mental health problems,” says Dr. George. “This could be a model for care in other Indigenous communities.”
Funded by Movember Canada, the ongoing, three-year project came out of an earlier CAMH study in eight communities across Ontario, including Aamjiwnaang First Nation and Kettle & Stony Point.
Based on the initial study’s results, Dr. George and an advisory committee – including health services providers, members of Chief and Council and community members from Kettle & Stony Point – agreed that men’s needs were not being met. “What I heard from the advisory committee was the importance of having an impact,” says Dr. George. “Research should always result in an action to do, especially in First Nations communities, given the history of colonialism and intergenerational trauma. This amounts to better research and better outcomes for the communities.”
The research team decided upon two novel approaches: participatory action research (PAR), and a qualitative method used for PAR – Photovoice – which involved men taking photographs of places and things in their community, describing each photograph’s significance in terms of impact on their physical, mental, emotional and spiritual health, then discussing the images as a group. Fifteen men participated in the Photovoice component of the project, together taking in excess of 1,000 photographs over the course of one-and-a-half years. “This was the impetus for men to identify how being a First Nations man and living in a First Nations community had influenced their health and what their needs were, says Dr. George. (See examples of the men’s Photovoice storytelling.)
A theme that emerged among the men was spirit-centredness – what Spirit is; having a good connection to Spirit, the Creator and the natural world; finding a balance of physical health, mental health, emotional health and spiritual health; and developing connections with family and community.
“Out of the Photovoice project, men are deciding for themselves how they want to approach developing the program of mental health and addiction services in our community,” says Dr. George. “We’re developing and implementing programs with the men – they are involved at every stage.” For example, addiction treatment services have expanded to offer a continuum of care incorporating the Stages of Change model, from reducing substance use to sober living, based on a client’s readiness to change.
Mental health and addiction services have also shifted from mainly clinical approaches to include cultural activities centred on a connection to the Spirit, leading to the development and implementation of the sweat lodge, tipi and garden, which together are used for both ceremonial purposes and as an educational area for the community. Other new developments are a men’s wellness and youth social drum circle and a traditional dance program. The men will come together to hold solstice celebrations in the fall, and will hold the first naming ceremony this winter.
“A whole lot has been incorporated into the program as a direct result of the men using Photovoice to contemplate questions around ‘why I’m here in this situation’ and ‘what I can do to get better’,” says Dr. George.