Intergenerational residential school attendance and increased substance use among First Nation adults living off-reserve: An analysis of the aboriginal peoples survey 2017

IntroductionThe Truth and Reconciliation Commission of Canada (TRCC) published 94 Calls to Action in 2015 to address long-term, intergenerational effects of the residential school system, highlighting the pervasive impact of colonialism on the wellbeing of Indigenous peoples in Canada. Indeed, research with Indigenous populations in Canada has captured that prior experiences of residential schools contributes to the intergenerational transmission of mental and physical health disparities. Despite these studies, further research is needed that contextualizes the influence of residential schools within broader frameworks that consider Indigenous social determinants of health in Canada. As such, the purpose of the present study was to examine patterns of substance use and mental and physical health among individuals with a history of residential school attendance (RSA) and individuals reporting parent or two-generation (parent and grandparent) RSA.MethodData from the Aboriginal Peoples Survey (2017), involving 10,030 First Nations individuals living off reserve, were analyzed.ResultsSelf-reported mental and physical health scores were significantly lower among those had attended residential schools, whose parents attended residential schools, and whose grandparents attended residential schools, when compared to those who did not. Further, family RSA was associated with increased substance use among participants, though the findings were variable based on sex and specific substance analyzed. Meanwhile, individual and family RSA was not associated with increased likelihood of a mental health diagnosis.DiscussionThese findings provide additional support for how both parental and two-generation family histories of RSA are associated with individual physical and mental health outcomes. Further, these findings articulate the need for the TRCC's Calls to Action to be actually implemented, including community-based approaches that harness the strength of Indigenous people and communities who aim to close the gap in these health disparities for their children and families

A national-level examination of First Nations peoples’ mental health data: Predicting mental well-being from social determinants of health using the 2017 Aboriginal Peoples Survey

IntroductionA history of colonization and assimilation have resulted in social, economic, and political disparities for Indigenous people in Canada. Decades of discriminatory policies (e.g., the Indian Act, the Residential School System) have led to numerous health and mental health inequities, which have been intergenerationally maintained. Four main social determinants of health (i.e., income, education, employment, and housing) disproportionately influence the health of Indigenous peoples. These four social determinants have also been used within the Community Well-Being (CWB) index, which assesses the socio-economic wellbeing of a community. This study sought to extend previous research by assessing how specific indicators of CWB predict self-reported mental wellbeing within First Nations populations across Canada in a national dataset with more recent data.MethodsThis study utilized the 2017 Aboriginal Peoples Survey, which includes data on the social and economic conditions of First Nations people living off reserve aged 15 years and over.ResultsResults from a factorial ANOVA indicated that perceptions of income security, housing satisfaction, higher education, and employment are associated with increased self-reported mental health among First Nations individuals living off-reserve.DiscussionThese results support the idea that individual mental health interventions on their own are not enough; instead, broader social interventions aimed at addressing inequities in various social determinants of health (e.g., housing first initiatives) are needed to better support individual wellbeing

Examination of the cue-reactivity of reports of gambling wins

The present study explored the cue-reactivity associated with reports of gambling wins. A 61-item questionnaire administered via the Internet collected information on gambling behaviours, effects of reports of large gambling wins, and thoughts that might underlie either the activation or the inhibition of gambling behaviour in response to these reports. The sample consisted of 46 females and 135 males (one individual not indicating gender) for a total of 182 respondents, with mean age of 32.3 years. Reports of wins from friends or relatives and those that were read, elicited significantly stronger urges to gamble than stories of wins on television. Gamblers were most likely to act on urges to gamble because of emotional reasons such as, “I just feel the urge to gamble” and “I really want to win a similar amount”. Finally, individuals who exhibit pathological gambling behaviours were more susceptible to feeling urges after hearing about the reports of other people’s wins and were more likely to report acting on these urges

Hopelessness and Excessive Drinking among Aboriginal Adolescents: The Mediating Roles of Depressive Symptoms and Drinking to Cope

Canadian Aboriginal youth show high rates of excessive drinking, hopelessness, and depressive symptoms. We propose that Aboriginal adolescents with higher levels of hopelessness are more susceptible to depressive symptoms, which in turn predispose them to drinking to cope—which ultimately puts them at risk for excessive drinking. Adolescent drinkers (n = 551; 52% boys; mean age = 15.9 years) from 10 Canadian schools completed a survey consisting of the substance use risk profile scale (hopelessness), the brief symptom inventory (depressive symptoms), the drinking motives questionnaire—revised (drinking to cope), and quantity, frequency, and binge measures of excessive drinking. Structural equation modeling demonstrated the excellent fit of a model linking hopelessness to excessive drinking indirectly via depressive symptoms and drinking to cope. Bootstrapping indicated that this indirect effect was significant. Both depressive symptoms and drinking to cope should be intervention targets to prevent/decrease excessive drinking among Aboriginal youth high in hopelessness

Community-based screening and triage connecting First Nations children and youth to local supports: a cross-sectional study

BACKGROUND: First Nations children in Canada experience health inequities. We aimed to determine whether a self-report health app identified children's needs for support earlier in their illness than would typically occur. METHODS: Children (aged 8 to 18 yr) were recruited from a rural First Nation community. Children completed the Aaniish Naa Gegii: the Children's Health and Well-being Measure (ACHWM) and then met with a local mental health worker who determined their risk status. ACHWM Emotional Quadrant Scores (EQS) were compared between 3 groups of children: healthy peers (HP) who were not at risk, those with newly identified needs (NIN) who were at risk and not previously identified, and a typical treatment (TT) group who were at risk and already receiving support. RESULTS: We included 227 children (57.1% girls), and the mean age was 12.9 (standard deviation [SD] 2.9) years. The 134 children in the HP group had a mean EQS of 80.1 (SD 11.25), the 35 children in the NIN group had a mean EQS of 67.2 (SD 13.27) and the 58 children in the TT group had a mean EQS of 66.2 (SD 16.30). The HP group had significantly better EQS than the NIN and TT groups (p < 0.001). The EQS did not differ between the NIN and TT groups (p = 0.8). INTERPRETATION: The ACHWM screening process identified needs for support among 35 children, and the associated triage process connected them to local services; the similarity of EQS in the NIN and TT groups highlights the value of community screening to optimize access to services. Future research will examine the impact of this process over the subsequent year in these groups

Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study

Abstract Background Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.http://deepblue.lib.umich.edu/bitstream/2027.42/109517/1/13011_2014_Article_307.pd

PERSONALITY AND MOTIVES FOR ALCOHOL USE IN ABORIGINAL ADOLESCENTS: A CULTURALLY RELEVANT APPROACH TO ALCOHOL ABUSE EARLY INTERVENTION

There are high levels of alcohol abuse and associated problems among Aboriginal youth in Canada. In order to understand high-risk adolescents’ relationships with alcohol, four inter-related questions were explored: 1) How do youth at particular risk of alcohol abuse, understand their reasons for alcohol use?; 2) How does personality relate to reasons for drinking for First Nations adolescents?; 3) Can established alcohol abuse brief early interventions be effectively tailored to meet the needs of high personality risk First Nations adolescents?, and 4) Do interventions developed specifically for First Nations youth with varying personality risk characteristics and maladaptive motives for alcohol use effectively reduce drinking behaviour and problems associated with alcohol use? The factor-structure of Cooper’s (1994) motivational model of adolescent alcohol use was examined among a group of Mi’kmaq adolescents. Rather than the hypothesized four-factor model, a three-factor model better explained these data, where Enhancement and Social motives combined into a single motive reflective of positive reinforcement. A qualitative follow-up study showed that these youth had a tendency toward drinking for Enhancement motives rather than for Social affiliation. Next, a quantitative examination of the relationships between personality factors and motives for alcohol use in First Nations adolescents showed consistency with majority culture findings; Impulsivity and Sensation Seeking was associated with Enhancement motives for alcohol use; Anxiety Sensitivity was associated with Conformity motives; and Hopelessness was associated with Coping motives. Finally, an alcohol early intervention, which combined promising Western scientific approaches with traditional knowledge, was delivered to at-risk First Nations youth. Compared to eligible students who did not participate in the intervention program, intervention completers drank less frequently, engaged in less heavy episodic drinking, had lower levels of alcohol-related problems, were more likely to abstain from alcohol use, and reduced their marijuana use at four months following the interventions relative to their levels at pre-treatment baseline. First Nations youth can be empowered through pride in their heritage and ways of life, to find balance within themselves through learning healthy coping skills to deal with their own unique predispositions to heavy drinking and alcohol-related problems