Saman Khan

Reprinted from "Aboriginal People" issue of Visions Journal, 2008, 5 (1), pp. 6-7

It’s well known that the Aboriginal people of Canada face a unique set of mental health challenges.2 But what may not be so well known is that, in a 2002/03 survey, about 70% of First Nations adults living on reserves felt in balance physically, emotionally, mentally and spiritually. And, among Aboriginal people living both on and off reserve, those who did experience a mental health problem were much more likely than the rest of Canadians to seek professional help—a positive step towards healing. In some groups, the number of Aboriginal people seeking help was as high as 17%—compared to the Canadian average of 8%. These numbers would probably have been even higher if more mental health professionals were available in isolated areas.



In spite of this, there are serious concerns about mental illness and social ills such as substance abuse, addiction, suicide and violence among Aboriginal people and communities. The imposition of European culture and the loss of indigenous culture, lifestyle and self-determination is seen as a major cause of health and social problems in the population.

Mental health challenges

Suicide

The loss of human life through suicide is a tragic reality in First Nations and Inuit communities. These two communities experience a much higher suicide rate than the Canadian population as a whole.

Suicide rates among Inuit are shockingly high at six to 11 times the Canadian average. In Nunavut in particular, 27% of all deaths since 1999 have been suicides. This is one of the highest suicide rates in the world, and it continues to rise, especially among youth.



For the First Nations population, suicide rates are twice the national average and show no signs of decreasing. However, these rates differ from community to community. Some communities have had “epidemics” of suicide, while others have had few or no suicides for several years.

In both Aboriginal groups, females attempt suicide more often than males. This trend is also seen in the general Canadian population, but the difference in rates is alarming. While the Canadian average is around 4% of females and 2% of males reporting they’ve attempted suicide, in the Aboriginal survey, it was 19% of females and 13% of males.



Rates of completed suicides, however, are higher among males. And young adults ages 15 to 24 represent the age group with the highest rate of suicides. Completed suicides among First Nation young adults is five to seven times the Canadian average for the same age group.

Youth with a close family member who had committed suicide in the past 12 months, or who had a parent who attended a residential school, were more likely to have experienced suicidal thoughts.

Depression

Depression is a common and life-changing mental illness in the Canadian population. This is especially true for First Nations people, who experience major depression at twice the national average. A 1997 survey found that 16% of First Nation adults living on reserve experienced major depression, compared to 8% of the general Canadian population. Of the First Nations people in the study who experienced depression, 26% said that depression interfered with their lives, compared to 16% of the overall Canadian population.



Depression rates among the Inuit, however, are far below the Canadian average. In a Statistics Canada survey, only 3% of Inuit had suffered a major depressive episode. Only 6% were at high risk of depression. These findings don’t make much sense when we consider the extremely high suicide rate among this group. One possible explanation is that the scales used to measure depression accurately for the rest of the Canadian population, are not as accurate for the Inuit. Another explanation is that depression among men is not easily identified, as it often shows itself as alcohol or drug problems, violence or conflict with the law.

Alcohol and Drug Use

Alcohol use is of great concern to people in First Nations and Inuit communities. Surveys show that:

Around 75% of all residents feel alcohol use is a problem in their community

33% indicate that it’s a problem in their own family or household

25% say that they have a personal problem with alcohol

This is interesting in light of the fact that lower than average numbers of First Nations and Inuit people drink alcohol. Only 66% of First Nations adults living on reserve consumed alcohol compared to 76% of the general population. This suggests that those who do drink, drink heavily, consuming five or more drinks on one occasion on a weekly basis.



Figures drawn from hospital records in BC and Alberta show that First Nations people, especially men, are admitted to hospital for problem substance use more often than other residents of these provinces. Cannabis use is also common among First Nations adults (27%) and youth (32%).

The good news is that about one-third of survey respondents reported that there was progress in reducing the amount of alcohol and drug use in their communities.

Treatment

Aboriginal people have a holistic view of mental wellness. Wellness means being in a state of balance with family, community and the larger environment. Because of this, European models of treatment that remove the person from their surroundings tend not to work for this group.

Culture and spirituality are the frameworks of treatment developed by first Nations and Inuit communities. Family and community have a key role in helping individuals regain their sense of balance. Effective treatment involves identifying the strengths of families and communities and developing programs that build on these strengths.



“You can’t do it for us, you can only do it with us.”3 Aboriginal communities are motivated to take local control of health services and to come up with their own solutions for health challenges. This can create a sense of collective pride, which is positive step towards boosting Aboriginal mental health.