Abstract
BackgroundCollaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care.MethodsA participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers.ResultsThe Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes.ConclusionsThis model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.
Highlights
Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada
We focused on three research questions: How is collaborative mental health care provided in this northern Aboriginal context? What strategies support interdisciplinary collaboration and service integration? And, what are the strengths and challenges related to this model?
Overview of the Service Model The Knaw Chi Ge Win service system we studied is located on Manitoulin Island in Northern Ontario
Summary
Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Multi-generational marginalization, power disparities and governmental assimilation practices and in particular the residential school systems subjected generations of Aboriginal people in Canada to physical, mental, spiritual and sexual abuse and eroded family relationships; loss of language, land, culture and traditional economies have had devastating impacts on the social determinants of health [2,3,4] This connection between colonial forces and mental illness and addictions is supported by an increasing body of literature [3,510]. A few fragmented national services do exist, accessible only to a relatively small proportion of Aboriginal people, dependant on their legal status and place of residence These services include community-based paraprofessional addictions services, regional treatment centres and short term clinical treatment for crisis intervention consisting of coverage for up to 10 treatment sessions [14,15]. A community-driven approach is essential to achieve community acceptance and to organize the scarce resources in a way that supports the development of local systems of care[17]
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