URBAN ABORIGINAL WOMEN AND MENTAL HEALTH potx

KISKÂYITAMAWIN MIYO-MAMITONECIKAN 1    URBAN ABORIGINAL WOMEN AND MENTAL HEALTH Roberta Stout June 2010 1. kiskâyitamawin miyo-mamitonecikan is a Plains Cree word which means “knowing mind fullness” Project #215 KISKÂYITAMAWIN MIYO-MAMITONECIKAN    URBAN ABORIGINAL WOMEN AND MENTAL HEALTH Roberta Stout June 2010 Prairie Women’s Health Centre of Excellence (PWHCE) is one of the Centres of Excellence for Women’s Health, funded by the Women’s Health Contribution Program of Health Canada. PWHCE supports new knowledge and research on women’s health issues; and provides policy advice, analysis and information to governments, health organizations and non-governmental organizations. The views expressed herein do not necessarily represent the official policy of the PWHCE or Health Canada. The Prairie Women’s Health Centre of Excellence 56 The Promenade Winnipeg, Manitoba R3B 3H9 Telephone (204) 982-6630 Fax (204) 982-6637 pwhce@uwinnipeg.ca This is project #215 of the Prairie Women’s Health Centre of Excellence. ISBN 978-1-897250-30-3 KISKÂYITAMAWIN MIYO-MAMITONECIKAN 1    URBAN ABORIGINAL WOMEN AND MENTAL HEALTH Roberta Stout June 2010 1. kiskâyitamawin miyo-mamitonecikan is a Plains Cree word which means “knowing mind fullness” K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH i Acknowledgments First and foremost, we wish to acknowledge all the Aboriginal women who came forward to share their personal stories and experiences with mental illness and mental health services in Winnipeg and Saskatoon. We are grateful for their courageous and powerful contributions to this project and for their collective visioning for better meeting the mental health needs of Aboriginal women. Prairie Women’s Health Centre of Excellence would like to thank our esteemed Elders for providing their cultural understandings on mental health and well-being. We also extend our appreciation to the front-line workers, Dr. Caroline Tait, PhD and Madeleine Dion Stout, for providing invaluable on-the-ground perspectives on mental health issues faced by Aboriginal women along with research, service delivery and policy recommendations. We also acknowledge the Native Women’s Transition Centre, the Central Urban Métis Federation Inc., White Buffalo Youth Lodge, Partners for Careers at the Murdo Scribe Centre, and the University of Winnipeg for providing spaces for holding our interviews and focus groups. Finally, PWHCE wishes to thank the tireless researchers who collaborated on this project: Marlene Larocque, Julia Peristerakis and Ann Kielo, and Rick Harp and Sheryl Peters for their editing assistance. K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH ii I’m going to get help. I am determined. ‘Cause if I don’t get help, I’m worried that I’m going to lose everything I have. And I just don’t think that anybody understands that. — Interviewee K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH iii TABLE OF CONTENTS ACKNOWLEDGEMENTS i TABLE OF CONTENTS iii ACRONYMS v EXECUTIVE SUMMARY vii RÉSUMÉ xiii SECTION 1: INTRODUCTION AND BACKGROUND TO THE PROJECT 1 Introduction 1 Background 1 Methodology and procedures 3 Limitations 4 Participant demographics 4 Lifelong experiences 6 SECTION 2: LOOKING BACK OVER A LIFETIME: FRAMING ABORIGINAL WOMEN’S EXPERIENCES 9 Women’s reflections and narratives on childhood, teen and adulthood experiences 10 Framing childhood/teen experiences 11 Child sexual abuse 11 Child protection services 13 Racism/discrimination and identity 17 Residential schools 20 SECTION 3: ABORIGINAL WOMEN’S PERSPECTIVES ON MENTAL HEALTH 23 Defining mental health 23 Self-assessed mental health 25 Coping with their mental health 28 SECTION 4: BARRIERS TO “KNOWING MIND FULLNESS” 35 Anonymity 36 Confidentiality and trust 36 Inter-personal relationships 37 Fear of losing children 40 Lack of childcare within mental health programming 41 Cookie cutter approaches 41 Lack of cultural awareness and training of mental care workers 42 Fear of institutionalized care settings 43 Misdirected focus of mental health programs 45 K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH iv Process: waiting lists, diagnosis and referrals 45 Lack of validation 47 Distribution, usability and access to mental health information racism 49 Physical disabilities 50 Side-effects of medication, over-medication and the wrong medication 50 Stigma 52 SECTION 5: ABORIGINAL WOMEN’S MENTAL HEALTH NEEDS: THROUGH THEIR OWN EYES, IN THEIR OWN WORDS 57 The need to be heard and receive answers 57 The need to talk to someone 58 The need for care, support and acceptance 61 SECTION 6: CONCLUSION ABORIGINAL WOMEN ENVISAGE “KNOWING MIND FULLNESS” 69 Policy implications 75 REFERENCES 79 ADDITIONAL READINGS 82 APPENDIX 1: One-to-one interview guide 85 APPENDIX 2: Focus group guide 87 APPENDIX 3: Interview guide with elders 89 APPENDIX 4: Interview guide with front-line workers 91 APPENDIX 5: Interview guide with researcher 93 APPENDIX 6: PWHCE project team member observations on researching mental health services and programs in Winnipeg 95 K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH v A CRONYMS AHF Aboriginal Healing Foundation AFN Assembly of First Nations CWHN Canadian Women’s Health Network CCPA Canadian Centre for Policy Alternatives FNIHB First Nations and Inuit Health Branch INAC Indian and Northern Affairs Canada IPHRC Indigenous Peoples’ Health Research Centre ITK Inuit Tapiriit Kanatami MWAC Mental Wellness Advisory Committee NAHO National Aboriginal Health Organization NCCAH National Collaborating Centre for Aboriginal Health NWAC Native Women’s Association of Canada PWHCE Prairie Women’s Health Centre of Excellence RHS First Nations Regional Longitudinal Health Survey K ISKÂYITAMAWIN M IYO -M AMITONECIKAN : U RBAN A BORIGINAL W OMEN AND M ENTAL H EALTH vi [...]... Emphasize mental health promotion and mental illness prevention along with diagnosis and treatment by providing mental health KISKÂYITAMAWIN MIYO-MAMITONECIKAN: URBAN ABORIGINAL WOMEN AND MENTAL HEALTH xi literacy training for health and social services professionals and mental health first-aid training to family and friends iv Advocate person-centered care for Aboriginal women with lived mental health. .. incorporate oral traditions and examples of mental health and well-being) iv Utilize a gender balanced framework in further research on Aboriginal women s mental health 3 Reframe mental health services and supports so they mirror Aboriginal women s realities, living conditions and aspirations for hope and recovery i Improve Aboriginal women s access to mental health services and supports and enhance their attachment... Aboriginal women More specifically the research sought to answer the following five questions: 1 What are the key factors influencing Aboriginal women s mental health? 2 What does mental health mean to Aboriginal women? 3 Are Aboriginal women aware of and/ or using available mental health resources? 4 What are Aboriginal women s mental health needs? 5 What would Aboriginal women suggest for future policy and. .. research on the meaning and application of an Aboriginal lens when addressing the mental health and well-being of Aboriginal women i x Deepen the public understanding of the worldviews of Aboriginal women emphasizing the wholeness of the mind, body and spirit but also by examining the women s views of the world which they KISKÂYITAMAWIN MIYO-MAMITONECIKAN: URBAN ABORIGINAL WOMEN AND MENTAL HEALTH generally... MIYO-MAMITONECIKAN: URBAN ABORIGINAL WOMEN AND MENTAL HEALTH ix POLICY IMPLICATIONS 1 Examine how cultural (relationships) and structural (policy) level changes can be made to serve and support the mental health and wellbeing of Aboriginal women in the changing policy climate Cultural changes i Catalyze conversations on everyday forms of mental health and wellbeing to determine what is working for Aboriginal women. .. in the area of mental health? Background As part of a response to emerging regional and national health priorities PWHCE proposed an interprovincial (Saskatchewan and Manitoba) exploratory project focusing on the issue of Aboriginal women s mental health As Aboriginal women s health generally - and their mental health specifically - remain largely unexplored compared with other women s health research... Aboriginal women s concepts of mental health and well-being, key factors impacting the mental health of Aboriginal women, experiences with the mental health services and programs and what would lead to better outcomes for their mental well-being Community organizations, service providers and educational institutes, who are known to have high traffic of Aboriginal community women, students and professionals,... 46 Aboriginal women from Winnipeg and Saskatoon to talk about their mental health concerns, needs and coping strategies, and particularly to gather their suggestions on how to better improve the mental health services and programs This report seeks to fill a gap in the current knowledge on understanding mental health through the unique and diverse community-based perspectives and narratives of Aboriginal. .. of mental health, it was also becoming a topic on the national agenda for Aboriginal and non -Aboriginal organizations alike Aboriginal organizations, such as the National Aboriginal Health Organization (NAHO) recognized mental health and mental wellness as emerging fields and called for a greater understanding of these areas specific to Aboriginal peoples (Kinnon, 2002) In a chapter related to mental. .. stories, experiences, knowledge and wisdom of Aboriginal women who live with mental health problems and illnesses iii Bring into sharper relief the optimism, pragmatism, resilience and human agency of Aboriginal women living with mental health illnesses iv Understand the impacts of residential schools, foster care and the biomedical model of health care lived by Aboriginal women by taking a critical look . research on Aboriginal women s mental health. 3. Reframe mental health services and supports so they mirror Aboriginal women s realities, living conditions and aspirations for hope and recovery the mental health needs of Aboriginal women. Prairie Women s Health Centre of Excellence would like to thank our esteemed Elders for providing their cultural understandings on mental health and. lived mental health experiences in order to better define, identify and remedy their health disparities and inequities. ii. Provide mental health services and supports to Aboriginal women close