Skip to main content
Top
Published in: International Journal of Mental Health Systems 1/2009

Open Access 01-12-2009 | Research

Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada

Authors: Marion A Maar, Barbara Erskine, Lorrilee McGregor, Tricia L Larose, Mariette E Sutherland, Douglas Graham, Marjory Shawande, Tammy Gordon

Published in: International Journal of Mental Health Systems | Issue 1/2009

Login to get access

Abstract

Background

Collaborative, culturally safe services that integrate clinical approaches with traditional Aboriginal healing have been hailed as promising approaches to ameliorate the high rates of mental health problems in Aboriginal communities in Canada. Overcoming significant financial and human resources barriers, a mental health team in northern Ontario is beginning to realize this ideal. We studied the strategies, strengths and challenges related to collaborative Aboriginal mental health care.

Methods

A participatory action research approach was employed to evaluate the Knaw Chi Ge Win services and their place in the broader mental health system. Qualitative methods were used as the primary source of data collection and included document review, ethnographic interviews with 15 providers and 23 clients; and 3 focus groups with community workers and managers.

Results

The Knaw Chi Ge Win model is an innovative, community-based Aboriginal mental health care model that has led to various improvements in care in a challenging rural, high needs environment. Formal opportunities to share information, shared protocols and ongoing education support this model of collaborative care. Positive outcomes associated with this model include improved quality of care, cultural safety, and integration of traditional Aboriginal healing with clinical approaches. Ongoing challenges include chronic lack of resources, health information and the still cursory understanding of Aboriginal healing and outcomes.

Conclusions

This model can serve to inform collaborative care in other rural and Indigenous mental health systems. Further research into traditional Aboriginal approaches to mental health is needed to continue advances in collaborative practice in a clinical setting.
Appendix
Available only for authorised users
Literature
1.
go back to reference Health Canada: The Human Face of Mental Health and Mental Illness in Canada. 2006, 164-176. Health Canada: The Human Face of Mental Health and Mental Illness in Canada. 2006, 164-176.
2.
go back to reference Hawkins EH, Cummins LH, Marlatt GA: Preventing Substance Abuse in American Indian and Alaska Native Youth: Promising Strategies for Healthier Communities. Psychological bulletin. 2004, 130 (2): 304-323. 10.1037/0033-2909.130.2.304.CrossRefPubMed Hawkins EH, Cummins LH, Marlatt GA: Preventing Substance Abuse in American Indian and Alaska Native Youth: Promising Strategies for Healthier Communities. Psychological bulletin. 2004, 130 (2): 304-323. 10.1037/0033-2909.130.2.304.CrossRefPubMed
3.
go back to reference Dion-Stout M, Kipling G: Aboriginal People, Resilience and the Residental School Legacy. 2003, Ottawa: Aboriginal Healing Foundation Research Series Dion-Stout M, Kipling G: Aboriginal People, Resilience and the Residental School Legacy. 2003, Ottawa: Aboriginal Healing Foundation Research Series
4.
go back to reference Waldram JB, Herring DA, Young TK: Aboriginal health in Canada: Historical, cultural and epidemiological perspectives. 2006, Toronto: University of Toronto Press, 2 Waldram JB, Herring DA, Young TK: Aboriginal health in Canada: Historical, cultural and epidemiological perspectives. 2006, Toronto: University of Toronto Press, 2
5.
go back to reference Brave Heart MY, De Bruyn LM: The American Indian Holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research. 1998, 8 (2): 56-78.PubMed Brave Heart MY, De Bruyn LM: The American Indian Holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research. 1998, 8 (2): 56-78.PubMed
6.
go back to reference Kirmayer LJ, Brass GM, Tait CL: The mental health of Aboriginal peoples: transformations of identity and community. Can J Psychiatry. 2000, 45 (7): 607-616.PubMed Kirmayer LJ, Brass GM, Tait CL: The mental health of Aboriginal peoples: transformations of identity and community. Can J Psychiatry. 2000, 45 (7): 607-616.PubMed
7.
go back to reference Wesley-Esquimaux CC, Smolewski : Historic trauma and aboriginal healing. 2004, Ottawa, ON: Aboriginal Healing Foundation Wesley-Esquimaux CC, Smolewski : Historic trauma and aboriginal healing. 2004, Ottawa, ON: Aboriginal Healing Foundation
8.
go back to reference Mitchell TL, Maracle DT: Healing the Generations: Post-Traumatic Stress and the Health Status of Aboriginal Populations in Canada. Journal of Aboriginal Health. 2005, 2: 14-14. Mitchell TL, Maracle DT: Healing the Generations: Post-Traumatic Stress and the Health Status of Aboriginal Populations in Canada. Journal of Aboriginal Health. 2005, 2: 14-14.
9.
go back to reference Canadian Psychiatry Aujourd'hui: Fast Facts on the mental health of Aboriginal peoples. Canadian Psychiatry Aujourd'hui. 2007, 3: Canadian Psychiatry Aujourd'hui: Fast Facts on the mental health of Aboriginal peoples. Canadian Psychiatry Aujourd'hui. 2007, 3:
10.
go back to reference Kirmayer LJ, Guthrie Valaskakis G, (Eds.): Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. 2009, Vancouver: UBC Press Kirmayer LJ, Guthrie Valaskakis G, (Eds.): Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. 2009, Vancouver: UBC Press
11.
go back to reference Capp K, Deane FP, Lambert G: Suicide prevention in Aboriginal communities: application of community gatekeeper training. Aust N Z J Public Health. 2001, 25 (4): 315-321. 10.1111/j.1467-842X.2001.tb00586.x.CrossRefPubMed Capp K, Deane FP, Lambert G: Suicide prevention in Aboriginal communities: application of community gatekeeper training. Aust N Z J Public Health. 2001, 25 (4): 315-321. 10.1111/j.1467-842X.2001.tb00586.x.CrossRefPubMed
12.
go back to reference Strickland CJ, Walsh E, Cooper M: Healing fractured families: parents' and elders' perspectives on the impact of colonization and youth suicide prevention in a pacific northwest American Indian tribe. J Transcult Nurs. 2006, 17 (1): 5-12. 10.1177/1043659605281982.CrossRefPubMed Strickland CJ, Walsh E, Cooper M: Healing fractured families: parents' and elders' perspectives on the impact of colonization and youth suicide prevention in a pacific northwest American Indian tribe. J Transcult Nurs. 2006, 17 (1): 5-12. 10.1177/1043659605281982.CrossRefPubMed
13.
go back to reference Gone JP: "We never was happy living like a Whiteman": mental health disparities and the postcolonial predicament in American Indian communities. Am J Community Psychol. 2007, 40 (3-4): 290-300. 10.1007/s10464-007-9136-x.CrossRefPubMed Gone JP: "We never was happy living like a Whiteman": mental health disparities and the postcolonial predicament in American Indian communities. Am J Community Psychol. 2007, 40 (3-4): 290-300. 10.1007/s10464-007-9136-x.CrossRefPubMed
16.
go back to reference Niezen R: Revival of aboriginal culture and practices key to suicide intervention programs. Canadian Psychiatry Aujourd'hui. 2007, 3 (1): 11-19. Niezen R: Revival of aboriginal culture and practices key to suicide intervention programs. Canadian Psychiatry Aujourd'hui. 2007, 3 (1): 11-19.
17.
go back to reference Wieman C: Six Nations Mental Health Services: A Model of Care for Aboriginal Communities. Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. Edited by: Kirmayer LJ, Guthrie Valaskakis G. 2009, Vancouver: UBC Press Wieman C: Six Nations Mental Health Services: A Model of Care for Aboriginal Communities. Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. Edited by: Kirmayer LJ, Guthrie Valaskakis G. 2009, Vancouver: UBC Press
18.
go back to reference Royal Commission on Aboriginal Peoples: People to people, nation to nation: Highlights of the Royal Commission on Aboriginal Peoples. 1996, Ottawa: Canada Communication Group Royal Commission on Aboriginal Peoples: People to people, nation to nation: Highlights of the Royal Commission on Aboriginal Peoples. 1996, Ottawa: Canada Communication Group
19.
go back to reference Reason P, Bradbury H: Introduction: Inquiry and Participation in search of a World Worthy of Human Aspiration. Participative Inquiry and Practice: Handbook of Action Research. Edited by: Reason P, Bradbury H. 2001, Thousand Oaks: Sage, 1-14. Reason P, Bradbury H: Introduction: Inquiry and Participation in search of a World Worthy of Human Aspiration. Participative Inquiry and Practice: Handbook of Action Research. Edited by: Reason P, Bradbury H. 2001, Thousand Oaks: Sage, 1-14.
20.
21.
go back to reference Aronson J: A pragmatic view of thematic analysis. The Qualitative Report. 1994, 2 (1): Aronson J: A pragmatic view of thematic analysis. The Qualitative Report. 1994, 2 (1):
22.
go back to reference Creswell JW: Qualitative Inquiry and Research Design. 1998, Thousand Oaks: Sage Creswell JW: Qualitative Inquiry and Research Design. 1998, Thousand Oaks: Sage
23.
go back to reference Maar M, Shawande M: Traditional Anishinabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care. Journal Of Aboriginal Health. Maar M, Shawande M: Traditional Anishinabe Healing in a Clinical Setting: The Development of an Aboriginal Interdisciplinary Approach to Community-based Aboriginal Mental Health Care. Journal Of Aboriginal Health.
24.
go back to reference Maar M, Sutherland M, McGregor L: A Regional Model for Ethical Engagement: The First Nations Research Ethics Committee on Manitoulin Island. Aboriginal Policy Research Moving Forward, Making a Difference. Edited by: White JP, Wingert SDB, Maxim P. 2007, Toronto: Thompson Education Publishing, IV: Maar M, Sutherland M, McGregor L: A Regional Model for Ethical Engagement: The First Nations Research Ethics Committee on Manitoulin Island. Aboriginal Policy Research Moving Forward, Making a Difference. Edited by: White JP, Wingert SDB, Maxim P. 2007, Toronto: Thompson Education Publishing, IV:
29.
go back to reference Priest HM, Roberts P, Dent H, Blincoe C, Lawton D, Armstrong C: Interprofessional education and working in mental health: in search of the evidence base. J Nurs Manag. 2008, 16 (4): 474-485. 10.1111/j.1365-2834.2008.00867.x.CrossRefPubMed Priest HM, Roberts P, Dent H, Blincoe C, Lawton D, Armstrong C: Interprofessional education and working in mental health: in search of the evidence base. J Nurs Manag. 2008, 16 (4): 474-485. 10.1111/j.1365-2834.2008.00867.x.CrossRefPubMed
30.
go back to reference Mullarkey K, Keeley P, Playle JF: Multiprofessional clinical supervision: challenges for mental health nurses. J Psychiatr Ment Health Nurs. 2001, 8 (3): 205-211. 10.1046/j.1365-2850.2001.00376.x.CrossRefPubMed Mullarkey K, Keeley P, Playle JF: Multiprofessional clinical supervision: challenges for mental health nurses. J Psychiatr Ment Health Nurs. 2001, 8 (3): 205-211. 10.1046/j.1365-2850.2001.00376.x.CrossRefPubMed
31.
go back to reference Davidson M, Smith RA, Dodd KJ, Smith JS, O'Loughlan MJ: Interprofessional pre-qualification clinical education: a systematic review. Aust Health Rev. 2008, 32 (1): 111-120. 10.1071/AH080111.CrossRefPubMed Davidson M, Smith RA, Dodd KJ, Smith JS, O'Loughlan MJ: Interprofessional pre-qualification clinical education: a systematic review. Aust Health Rev. 2008, 32 (1): 111-120. 10.1071/AH080111.CrossRefPubMed
32.
go back to reference Mullarkey K, Keeley P, Playle J: Multiprofessional clinical supervision: challenges for mental health nurses. Journal of Psychiatric and Mental Health Nursing. 2001, 8: 205-211. 10.1046/j.1365-2850.2001.00376.x.CrossRefPubMed Mullarkey K, Keeley P, Playle J: Multiprofessional clinical supervision: challenges for mental health nurses. Journal of Psychiatric and Mental Health Nursing. 2001, 8: 205-211. 10.1046/j.1365-2850.2001.00376.x.CrossRefPubMed
34.
go back to reference Regulated Health Professions Act, Statutes of Ontario. 1991 Regulated Health Professions Act, Statutes of Ontario. 1991
35.
go back to reference Cook SJ: Use of traditional Mi'kmaq medicine among patients at a First Nations community health centre. Canadian Journal of Rural Medicine. 2005, 10 (2): 95-99.PubMed Cook SJ: Use of traditional Mi'kmaq medicine among patients at a First Nations community health centre. Canadian Journal of Rural Medicine. 2005, 10 (2): 95-99.PubMed
36.
go back to reference Smye V, Browne AJ: 'Cultural safety' and the analysis of health policy affecting aboriginal people. Nurse Res. 2002, 9 (3): 42-56.CrossRefPubMed Smye V, Browne AJ: 'Cultural safety' and the analysis of health policy affecting aboriginal people. Nurse Res. 2002, 9 (3): 42-56.CrossRefPubMed
37.
38.
go back to reference Varcoe C, McCormick J: Racing around the classroom margins: Race, racism and teaching nursing. Teaching nursing: Developing a student-centred learning environment. Edited by: Young L, Paterson B. 2006, Philadelphia: Lippincott, Williams & Williams, 437-466. Varcoe C, McCormick J: Racing around the classroom margins: Race, racism and teaching nursing. Teaching nursing: Developing a student-centred learning environment. Edited by: Young L, Paterson B. 2006, Philadelphia: Lippincott, Williams & Williams, 437-466.
39.
go back to reference Gone JP, Alca'ntara C: Identifying Effective Mental Health Interventions for American Indians and Alaska Natives: A Review of the Literature. Cultural Diversity and Ethnic Minority Psychology. 2007, 13 (4): 356-363. 10.1037/1099-9809.13.4.356.CrossRefPubMed Gone JP, Alca'ntara C: Identifying Effective Mental Health Interventions for American Indians and Alaska Natives: A Review of the Literature. Cultural Diversity and Ethnic Minority Psychology. 2007, 13 (4): 356-363. 10.1037/1099-9809.13.4.356.CrossRefPubMed
Metadata
Title
Innovations on a shoestring: a study of a collaborative community-based Aboriginal mental health service model in rural Canada
Authors
Marion A Maar
Barbara Erskine
Lorrilee McGregor
Tricia L Larose
Mariette E Sutherland
Douglas Graham
Marjory Shawande
Tammy Gordon
Publication date
01-12-2009
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2009
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/1752-4458-3-27

Other articles of this Issue 1/2009

International Journal of Mental Health Systems 1/2009 Go to the issue