Mental Health Strengths and Needs Among Aboriginal Peoples in Ontario- Foundations & Context

Tuesday, February 16th, 2016 11:00 a.m. – 12:30 p.m. (EST)

Part One of a Two Part Series:

Mental Health Strengths and Needs among Aboriginal Peoples in Ontario- Foundations & Context

Holly Smith, OT Bill Hill, RPN, BSW, MSW, RSW, B.Ed

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Webinar Objectives

• Discuss the historical context and how this impacts mental health and well-being amongst First Nations, Inuit, and Métis (FNIM) populations • Discuss potential risk/protective factors for mental illness and addiction among FNIM populations • Discuss the prevalence and systemic issues regarding mental illness and addiction concerns for FNIM

populations • Discuss best practice interventions approaches that can be used to support FNIM populations • Demonstrate how culturally-relevant practices can be incorporated into prevention/treatment

Coming up…

Holly Smith, OT Bill Hill, RPN, BSW, MSW, RSW, B.Ed

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5 Mental Health Strengths and Needs among Aboriginal Peoples in Ontario

Click to edit Master title style

HollyClick toSmith, edit MasterOT Reg. subtitle (Ont.) style Provincial System Support Program Aboriginal Engagement and Outreach Agenda

. Clarifying language

. Historical context

. Current context

. Research gaps

. Strengths and resiliency Clarifying Language

. Indian • A person who is registered as an Indian under the Indian Act (1985) . Aboriginal • Government imposed term in Canadian Constitution Act 1982 • Collectively refers to First Nations, Inuit, and Métis . Indigenous • People who consider themselves related to or who have historical continuity with “First Peoples” • Pre-colonial societies; consider themselves distinct from other sectors of the society now prevailing on those territories Allan & Smylie, 2015; Smylie (2014)

Clarifying Language

. First Nations • Canadian government classifies First Nations according to whether they are registered under the federal Indian Act

– Status Indians are registered under the Indian Act

– Non-status Indians are not registered under the Indian Act • 617 First Nations communities across Canada • 50 distinct First Nations in Canada • 134 First Nations communities in Ontario

– Algonquin, Anishinabek, Cree, Delaware, Haudenosaunee (Iroquois), Odawa, Potawatomi

INAC (2015a)

First Nations Communities in Ontario

K-net (2014)

Clarifying Language

. Inuit • Traditional territories in Arctic regions of Canada • Culture and language is vastly distinct from First Nations, and Métis • Inuktitut language is first language for many Inuit • Despite modern influences, the Inuit have retained their language, core knowledge, and beliefs • Remote, isolated communities in the far north • Distinct experiences of historical trauma and oppression

Inuit Tapiriit Kanatami

Inuit Nunangat – “the place where Inuit live”

Clarifying Language

. Métis • Métis people emerged out of relationships between Indian women and European men working with fur trade • Decedents of those early ancestors of mixed heritage and who identified with Métis culture • Recognized as a distinct Aboriginal group under the Constitution Act in 1982 • “Métis means a person who self-identifies as Métis, is of historic Métis Nation Ancestry, is distinct from other Aboriginal people and is accepted by the Métis Nation”

Métis National Council (2011)

Métis Land Connections

https://www.mheducation.ca/web_resources/sch/ShapingcanadaCH3.pdf

Historical Context Impacts of Colonization

• Disease and illness • Loss of traditional lands • Relocated and resettled • Outlawing of traditional practices and languages • Overhunting and overfishing

Assimilation Strategies

• Residential Schools • Child welfare policies • Outlawing traditional practices • Coercion and deception • Disenfranchisement • Loss of identity

Historical Documents

1763 - Royal Proclamation • British Crown recognizes Aboriginal title • Only the Crown could acquire lands from First Nations and only through treaty 1867 - British North America Act • First Nations and their land became the responsibility of federal government 1876 - Indian Act • Extinguished any remaining self government • First Nations became wards of the state Historical timelines

1870 First residential schools

1870 – 1885 Red River and Northwest Rebellion

1950 – 1970 Inuit sled dog slaughter

1960 – ??? Sixties Scoop

1985 Indian Act revised

1990 Oka Crisis

1995 Ipperwash Crisis

2006 Grand River land dispute Historical timelines

2008 Residential School apology

2012 Idle No More

2013 Attention to water and housing crises

Murdered and Missing Indigenous Women (MMIW)

2015 Supreme Court Chief Beverly McLachlin “cultural genocide”

2015 Truth and Reconciliation Commission

2016 Inquiry into MMIW? Loss of Traditional Lands

http://www.sixnations.ca/LandsResources/LCMap.pdf Historical Trauma

. Trauma which is cumulative across generations . Massive traumatic group experiences . Unresolved grief . Impacts of genocide of a people . Current psychosocial conditions and historical legacy continues the cycle of intergenerational trauma . Post traumatic stress disorder (PTSD) fails to inadequately address historical trauma

Brave Heart (2003); Marsh, Coholic, Cote-Meek, & Najavits (2015)

Current Context Aboriginal Populations in Canada

2011 Census . 1.4 million self reported Aboriginal identity . 4.3% of Canadian population . 850,000 identified as First Nations . 450,00 identified as Métis . 60,000 identified as Inuit

Turner (2013) 2011 Census Data

Turner (2013) Aboriginal Populations in Ontario

Aboriginal Group Population

First Nations 201,100

Métis 86,015

Inuit 705 in Ottawa region Current Context

. Complex social issues • Poverty • Inadequate housing • Lack of access to drinking water • Incompletion of education • Lack of employment and economic opportunities • High prevalence of chronic and communicable disease • Over representation in child welfare • Mental health and substance use

Mental Health Commission of Canada, 2012 Rates of poverty

. 40% of Indigenous children live in poverty (171,000) • 50% Status First Nations children (120,000) • 27% Métis, Inuit, non-status (51,000)

Macdonald & Wilson (2013)

Inadequate Housing

. 85,000 housing units are required across Canada for First Nations people . Of available housing: • 44% need major repairs compared to 7% non-Aboriginal • 15% need replacement

Patterson & Dyck (2015), AFN (2011)

Lack of safe drinking water

. 46 FN communities with boil water advisories in Ontario . 73% of FN water systems at medium-high risk of contamination

Health Canada (2015), Council of Canadians (2015) Education

. High school diploma (age 20-24) off reserve: • 70% First Nations students • 80% Métis students • 90% non-Aboriginal students . High school diploma (age 20-24) on reserve: • 42% of First Nations students . Students on reserve funded $3000-$7000 less

Richards (2014); AFN (2011)

Lack of employment and economic opportunities

. 72% participation in the workforce . Employment rate • 63% Aboriginal working age population • 76% non-Aboriginal . Unemployment rates • 22% on reserve • 9% Métis • 20% for Inuit

INAC (2011) Chronic and communicable disease

. Tuberculosis 30 times the national average • 26.6 per 100,000 . Diabetes • 17.2% First Nations on reserve • 10.3% off reserve • 7.3% Métis • 5% non- Aboriginal

INAC (2015b) Child Welfare System

. Aboriginal children disproportionately represented in the child welfare system • 5% of population; 50% of children under government care • Government spends 22% less per child living on reserve • 3 times as many children under government care today than at height of residential school era . Canadian Human Rights Tribunal - 2016 • Federal Government discriminates against First Nations children on reserves

Barker, Alfred, Kerr (2014)

Mental health

. Suicide as a leading cause of death • First Nations males 126 per 100,000 vs. 24 per 100,000 • First Nations females 35 per 100,000 vs 5 per 100,00 • 11 times higher among Inuit • Suicide rates unknown for Métis people . Suicidal ideation • 24% Aboriginal women off reserve vs. 14% non-Aboriginal • 22% FN and Inuit men vs 11% non-Aboriginal

Aboriginal Peoples Survey (2012)

Research gaps

. Variations of prevalence rates between different communities . Deficit based rather than strength based . Lack of knowledge around rates of serious mental illness • Bipolar, schizophrenia, mood and anxiety . More evidence required for culturally relevant treatment interventions . Measuring and evaluating outcomes Resiliency and Protective Factors

. Language . Land . Gifts . Culture . Humor . Spirituality . Self determination . Reconnection

References

Aboriginal Peoples Survey. (2012). Lifetime suicidal thoughts among First Nations living off reserve, Métis and Inuit aged 26 to 59: Prevalence and associated characteristics.

Allan, B. & Smylie, J. (2015). First Peoples, second class treatment: The role of racism in the health and well-being of Indigenous peoples in Canada. Toronto, ON: the Wellesley Institute.

Assembly of First Nations (2011). Quality of life of First Nations. Retrieved from http://www.afn.ca/uploads/files/factsheets/quality_of_life_final_fe.pdf

Barker, B., Alfred, G.T., & Kerr, T. (2014). An uncaring state? The overrepresentation of First Nations children in the Canadian child welfare system. CMAJ, 186, E533-5.

Brave Heart, M.Y. (2003). The historical trauma response among natives and its relationship with substance abuse: A Lakota illustration. Journal of Psychoactive Drugs, 35, 7-13.

Health Canada (2015). Drinking water advisories in First Nations communities. Retrieved from http://www.hc-sc.gc.ca/fniah-spnia/promotion/public-publique/water-dwa-eau-aqep-eng.php#a3

INAC (2015a) First Nations. Retrieved from http://www.aadnc- aandc.gc.ca/eng/1100100013791/1100100013795

INAC (2015b). Tuberculosis. Retrieved from http://www.hc-sc.gc.ca/fniah-spnia/diseases- maladies/tuberculos/index-eng.php

References

INAC (2011). Fact sheet: 2011 National household survey Aboriginal demographics, educational attainment and labour market outcomes. Retrieved from https://www.aadnc- aandc.gc.ca/eng/1376329205785/1376329233875

Inuit Tapiriit Kanatami.(n.d). Inuit Tapiriit Kanatami. Retrieved from https://www.itk.ca

Kuhkenah Network (K-Net) (2014). First Nations communities in Ontario. Retrieved from http://communities.knet.ca

Macdonald, D., & Wilson, D. (2013). Poverty or prosperity: Indigenous children in Canada. Retrieved from https://www.policyalternatives.ca/sites/default/files/uploads/publications/National%20Office/2013/ 06/Poverty_or_Prosperity_Indigenous_Children.pdf

Marsh, T.N., Coholic, D., Cote-Meek, S., & Najavits, L.M. (2015). Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in Northeastern Ontario, Canada. Harm Reduction Journal, 12.

Mental Health Commission of Canada. (2012). Changing directions, changing lives: Mental health strategy for Canada. Retrieved from http://www.mentalhealthcommission.ca/English/system/files/private/MHStrategy_Strategy_ENG_ 0.pdf

References

Métis National Council (2011). The Métis. Retrieved from http://www.metisnation.ca/wp- content/uploads/2011/02/The-MEtis-publication.pdf

Patterson, D. & Dyck, L. (2015). Housing on First Nation reserves: Challenges and successes. Retrieved from http://www.parl.gc.ca/Content/SEN/Committee/412/appa/rep/rep08feb15b-e.pdf

Richards, J. (2014). Are we making progress? New evidence on Aboriginal education outcomes in provincial and reserve schools. Retrieved from https://www.cdhowe.org/sites/default/files/attachments/research_papers/mixed/Commentary_4 08.pdf

Smylie, J. (2014). Indigenous Child Health in Canada, In A.C. Michalos (Ed.) Encyclopedia of Quality of Life and Well-being Research. Dordrecht, Netherlands: Springer

Turner, A. (2013). A brief portrait of Aboriginal people in Canada. Retreieved from http://www12.statcan.gc.ca/nhs-enm/video/video-abor-eng.cfm

The Council of Canadians. (2015). Safe water for First Nations. Retrieved from http://canadians.org/fn- water

Culturally relevant treatment validating aboriginal healing methods through implementation

Bill Hill Parkwood Institute Mental Health London ACT 2 [email protected] The importance of identity in mental health treatment The importance of identity in mental health treatment The importance of identity in mental health treatment The importance of identity in mental health treatment The importance of identity in mental health treatment The importance of identity in mental health treatment Psychosocial Rehabilitation and Recovery Oriented Practice

What the PSR literature tells us about Recovery and Cultural Competence vs. what we are doing, doesn’t reflect the best practice Focus 1

Why Health Promotion, prevention and/or treatment efforts need to be culturally relevant and tailored to FNIM populations With respect to providing Recovery Oriented services - Why Are First Nations People Different Than Other Minorities in Canada?

• Regardless of which country a person arrives from, they come with 4 sacred gifts “INTACT” that Canada promises to protect: • Culture • Language • Identity • Faith Which ONE of These four Gifts could you remove from your daily lives that would NOT affect your mental health? Culture, Language, Identity, Faith

References

Elijah, B. (2016). Oneida Traditional Healer: Oral Interview and Quote

Chandler, M. J., & Lalonde, C. E. (2004). Transferring Whose Knowledge? Exchanging Whose Best Practices?: On Knowing About Indigenous Knowledge and Aboriginal Suicide. In J. White, P. Maxim, and D. Beavon (Eds.) Aboriginal Policy Research: Setting the agenda for change, Vol. 2. Thompson: Toronto ON.

Marion A. Marr, M. S. (n.d.). Traditional Anishinabe Healing in a Clinical Setting. Journal de la santé autochthones, janvier 2010 .

PSR CANADA, Partners in Recovery. (2013). Competencies of Practice for Recovery Orientated Psychosocial Rehabilitation Practitioners .

Weaver, H. (2001). Indigenous Identity: What is IT and Who Really Has it? The American Indian Quarterly, 25 (2), 240-255 .

Young Kim., P. L. (1998). "I Can Walk Both Ways" Identity Integration of American Indians. Human Communication Research, 25 (2), 252-274. Questions and Answers

Questions?

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Evaluation Link

https://myrnao.ca/evaluationfebruary16