Indigenous communities and CAMH researchers are collaborating on a growing number of research projects to identify effective ways – both existing and new – to promote mental wellness among Indigenous peoples. Read our project snapshots.
“During our previous project, the men didn’t want to talk so much about problems or what they had experienced in the past, but about learning what helped them heal or overcome terrible experiences, such as having hope, supporting your family or being connected to nature,” says Dr. Julie George, who led the men’s project. Dr. George is a Scientist in CAMH’s Institute for Mental Health Policy Research and the Mental Health, Addiction and Violence Support Program Manager in Kettle & Stony Point’s Health Services Department.
“We have to think about strengths, rather than looking through a deficits lens,” says Dr. Samantha Wells, Senior Scientist in CAMH’s Institute for Mental Health Policy Research. “This project will look at a wide range of measures of strength and resilience – such as strength in family, in community, in culture – and how they buffer the impact of stress and trauma in relation to mental health and substance use outcomes.”
Women and men in the two First Nations communities will convey what strength and resilience mean to them using Photovoice. First applied on the men’s project, Photovoice involves people taking photos, describing their significance, and then discussing as a group.
“Taking photos and applying narrative is a wonderful way of giving people a voice, and it breaks down communication barriers, drawing people into conversations,” says Dr. Wells. “The participant is active in the research process.”
Drawing on insights from the earlier community-based studies and this study’s findings, the collaborators will develop recommendations for strengths-based services.
Dr. Wells, Dr. George and Dr. Christopher Mushquash, a member of Pays Plat First Nation and a Canada Research Chair in Indigenous Mental Health and Addiction at Lakehead University in Thunder Bay, are leading the research. Dr. Mushquash is also a Clinical Psychologist at Dilico Anishinabek Family Care in northern Ontario.
The need to develop a new assessment tool came from Indigenous leaders and service providers through a dialogue CAMH hosted in 2013, which explored the use of screening, assessment and outcome-based tools with First Nations, Inuit and Métis peoples, says Dr. Renee Linklater, a member of Rainy River First Nations and Director of Aboriginal Engagement and Outreach. “There is a lack of both culturally appropriate and trauma-informed substance use and addiction treatment tools for Indigenous peoples.”
More than 200 individuals, including Indigenous leaders and staff members from service providers across Ontario worked together to create the tool. “People were incredibly engaged and committed to bringing forward the knowledge and expertise that exists within Indigenous communities,” says Dr. Linklater. The project was supported by the Ontario Drug Treatment Funding Program.
The new assessment tool for First Nations, Inuit and Métis will gather essential information to identify the appropriate healing pathway, and compile addiction referral information. The tool will also collect important systems-level data that will inform health-care services planning province-wide, says Dr. Linklater.
Both Indigenous and mainstream service providers will be invited to pilot and test the tool, and the study will evaluate its effectiveness. The team is seeking funding for this phase of the project.
“There’s a need to expand our understanding of evaluation from an Indigenous context,” says Dr. Linklater. “For example, there may be a difference in outcome indicators that we need to be mindful of.
“We also need to present our work in a way that is not only respectful, but purposeful, to ensure that Indigenous communities benefit,” she says.
In other initiatives, ECHO Ontario First Nations, Inuit and Métis Wellness, a collaboration between CAMH and the University of Toronto, is a televideo-based mentoring program to increase capacity to address the health-care needs of Indigenous patients and communities. CAMH's Clinical Outreach and Aboriginal Engagement and Outreach teams are partnering to provide clinical expertise and to evaluate the program, through Co-Leads Dr. Allison Crawford, Dr. Renee Linklater and Eva Serhal of CAMH and Dr. Lisa Richardson of the University of Toronto.
Wellness in Remote Northern Reaches
New collaborations are bringing together CAMH researchers and Indigenous communities in northern Newfoundland and Labrador and Ontario.
One project involves two Innu communities in Labrador: Sheshatshiu and Natuashish, home to about 1,300 and 950 people, respectively. Supported by the Canadian Institutes of Health Research (CIHR), the project aims to better understand how an Innu-led initiative, called the Outpost Program, influences wellness among the Innu people.
Through the Outpost Program, community members go out “to the country,” live off the land, stay in tents, hunt and fish, and live the traditional way of the Innu people. The program is viewed as an important healing approach.
In another project, Sandy Lake First Nation in Ontario reached out to collaborate with CAMH researchers to improve wellness in the remote fly-in community, located about 600 km northwest of Thunder Bay.