Thoughts on Supporting Positive Mental Health for Indigenous Youth

In the wake of the suicide crisis in Attawapiskat this past week, I got a lot of questions from friends and colleagues about why this happens so often in Canada's First Nations. This week, I told everyone who asked to read editorials by Gabor Matte in the Globe and Joseph Boyden in MacLeans as they get right to the heart of the matter. The crises faced by Indigenous communities across Canada can be tied to one overarching cause -  the trauma of government-sponsored colonization and assimilation practices.

This blog is an attempt to use some science to support these claims. As I am about to join youth from across 4 communities in Manitoba to help a remote First Nation in crises, I will also provide some possible solutions. How can the trauma of colonization and residential school activities continue to impact the lives of Indigenous children in Canada today? A framework and rationale for health inequities among Indigenous people was outlined in a great review by Indigenous scholar Dr. Don Warne at North Dakota State University (great TedX Talk here).

For Western/settler people that have a hard time understanding this, perhaps this will convince you. Trauma, ( and the stress and anxiety that accompany it), imprint genes through "epigenetic" signatures that alter our genes. These imprints may limit a persons ability to response to stress or predispose individuals chronic diseases. The best and most extensive example of this was demonstrated in the ACEs (Adverse Childhood Experiences) study.  Children exposed to adversity early in life are more likely to adopt risky health behaviours, develop chronic diseases and die at a younger age. Indigenous children suffer from a number of these traumas, in addition to the trauma of poverty, food insecurity, living in overcrowded homes, and more intensely the lasting legacies their ancestors faced at the hands of racist government policies, that linger today within the Indian Act. The trauma Indigenous youth experience from generations of government-sponsored, racist assimilation (genocidal) policies cannot be solved through greater assimilation or moving to the big city. They need to be solves through respecting Indigenous people, their teachings and reconciliation.

Where do we start the healing process for youth facing so much trauma? Indigenous leaders across Canada often talk about the importance of land, culture and language. As a non-Indigenous person, this may be challenging to understand. I will admit that I had a very hard time appreciating this view, as I was trained in a western, reductionist approach to health and science. As non-Indigenous people are less in-tune with concepts of wholistic well being, connection with one another and connection to the land. We are also less able to see the larger social determinants that drive health inequities. Over the past 3 years, working closely with Indigenous youth and their community leaders, I have finally seen the light. We need to embrace these teachings if we want to stem the tide of inequities facing Indigenous people in Canada.

In the same way an unnatural change in the environment is killing polar bears in the far north, an unnatural social-political environment in Canada is killing Indigenous people across their own land. Trying to find the gene for diabetes, or the pill to prevent depression is meaningless if the social environment does not change is tantamount to genotyping bears to determine why they can't handle heat or creating novel cooling vests for them. More importantly, I believe that when we ignorethe wisdom of elders and stakeholders we are re-traumatizing and re-colonizing Indigenous communities. If you need "evidence" for their claim, here is the most important graph that every newspaper and columnist should reference when discussing suicide in Indigenous communities:

Rates of suicide are ~140 x lower in communities with extensive cultural continuity

Rates of suicide are ~140 x lower in communities with extensive cultural continuity

The study from BC published back in 1998 revealed that suicide rates were dramatically lower in communities that had greater control over services, land claims and cultural connection. For communities that were largely self-governed and connected to culture, suicide rates were LOWER than those in non-Indigenous communities. Importantly, these trends were observed independent of poverty and other social determinants of health. Experimental trials in Indigenous people at risk for type 2 diabetes reveal that culture and language-based programs are superior to traditional knowledge-based education about healthy living for improving risk. Promoting cultural activities, particularly if they are conducted in nature leads to better self esteem and enhances resilience among Indigenous youth in Canada. A large team if Indigenous elders, stakeholders and scientists are working with Western scientists to determine if culture is a treatment for addictions among Indigenous people. In light of this very compelling evidence, it pains me when white journalists and health care providers scoff at the notion that culture is a key solution for overcoming health disparities among Indigenous people.

What can we do? First, I would like to apologize to the youth, elders and community members of Indigenous Canada for the century of racist policies and government-sponsored assimilation practices my forefathers inflicted on your people. More of us need to apologize. Second, I suggest everyone turn off their biases and the noise in their heads to listen to the youth. Third, learn more about Indigenous culture, tradition and their history dealing with western cultures. In this way, we might respect the notion that land, culture, language and community connection are sources of healing. Fourth, make the government accountable to addressing disparities. Schools that support the growth of Indigenous youth receive ~50% less funding that schools that support white youth. This has to change. Our Minister of Indigenous and North Affairs is a white woman and follows a long-line of white men. This has to change. (How is that even possible in this day and age?) The Indian Act, a government sponsored cultural genocide that inspired apartheid in South Africa, is still in place today and wreaking havoc on Indigenous communities. This has to change. Finally, take time to read the Truth and Reconciliation Report and it's calls to action to understand what Indigenous leaders believe will begin to restore inequities and injustices in Canada.

This is the movement of our generation and until "White Canada" starts listening and responding to the Indigenous people, on who's land we live, work and play, these crises will continue into the next generation.