Dismantling Dominant Discourse Surrounding Complex Death with Indigenous Youth Experience

Suicide is commonly described as an urgent health concern and tragedy afflicting Indigenous communities in Canada. This work aimed to develop more contextual understandings of complex death, specifically Indigenous youth deaths by suicide that considered social, economic, historical, ecological, and political factors. This work centered the voices of an often-overlooked demographic, urban-based Indigenous youth, and utilized qualitative methodology that included thematic analysis of archival interview data conducted with Indigenous youth wellness facilitators in British Columbia, Canada. Thematic analysis identified multiple socio-political, historical, and colonial factors that contribute to Indigenous youth challenges with suicidality, and mental health. Furthermore, Indigenous youth in the study conceptualized wellbeing in a manner that resisted psychocentrism and described creative, institutional, and structural interventions that are key to promoting a livable life. Critical implications of this work are discussed, particularly, regarding the roles of the psy-disciplines (psychology and psychiatry) in preventing Indigenous youth suicide in Canada.M.A

Identifying and understanding the health and social care needs of Indigenous older adults with multiple chronic conditions and their caregivers: a scoping review

Abstract Background Indigenous people continue to experience high rates of multiple chronic conditions (MCC) at younger ages than other populations, resulting in an increase in health and social care needs. Those who provide services designed to address MCC for Indigenous communities require synthesized information to develop interventions that meet the needs of their older adult population. This review seeks to answer the research question: What are the health and social care needs, priorities and preferences of Indigenous older adults (living outside of long-term care settings) with MCC and their caregivers? Methods A scoping review, guided by a refinement of the Arksey & O’Malley framework, was conducted. Articles were included if the authors reported on health and social care needs and priorities of older Indigenous adults. We also included articles that focused on Indigenous conceptions of wellness, resilience, well-being, and/or balance within the context of aging, and articles where authors drew from Indigenous specific worldviews, ways of knowing, cultural safety, cultural competence, cultural appropriateness, cultural relevance and community needs. Results This scoping review included 9 articles that were examined using an Indigenous determinants of health (IDH) theoretical framework to analyze the needs of older adults and CGs. Five areas of needs were identified: accessible health services; building community capacity; improved social support networks; preservation of cultural values in health care; and wellness-based approaches. Conclusion The review highlights key determinants of health that influenced older adults’ needs: education and literacy, ethnicity, and social support/network (proximal); health promotion and health care (intermediate); and a combination of historical and contemporary structures (distal). The findings highlight the importance of local Indigenous knowledge and perspectives to improve accessibility of culturally relevant health and social services

Community-Based screening and triage versus standard referral of Aboriginal children: A prospective cohort study protocol.

Health solutions for Aboriginal children should be guided by their community and grounded in evidence. This manuscript presents a prospective cohort study protocol, designed by a community-university collaborative research team. The study’s goal is to determine whether community-based screening and triage lead to earlier identification of children’s emotional health needs, and to improved emotional health 1 year later, compared to the standard referral process. We are recruiting a community-based sample and a clinical sample of children (ages 8 to 18 years) within one Canadian First Nation. All participants will complete the Aboriginal Children’s Health and Well-being Measure (ACHWM)© and a brief triage assessment with a local mental health worker. All participants will be followed for 1 year. Children with newly identified health concerns will be immediately connected to local services, generating a new opportunity to improve health. The development of the research design and its execution were impacted by several events (e.g., disparate worldviews, loss of access to schools). This manuscript describes lessons learned that are important to guide future community-based research with First Nations people. The optimal research design in an Aboriginal context is one that responds directly to local decision makers’ needs and respectfully integrates Aboriginal ways of knowing with Western scientific principles. Such an approach is critical because it will generate meaningful results that will be rapidly adopted, thus reducing the knowledge-to-action gap