Changing the Face of Boys and Men’s Mental Health in First Nations Communities

By Dr. Julie George, a member of Kettle & Stony Point First Nation (KSPFN), Project Scientist in CAMH’s Social and Epidemiological Research Department and the Mental Health, Addiction and Violence Support Program Manager at the Health Services Department in her home community.

As a member of Kettle & Stony Point First Nation and as a service provider, I am witness to the mental health challenges that boys and men face.

As a researcher, I am also part of an innovative new project to address these challenges, a project that is part of a paradigm shift in Aboriginal research and program development. This new approach directly involves Aboriginal people in defining problems, conducting research, and facilitating solutions.

Photovoice offers potential to explore life experiences adequately and appropriately, engage participants in critical reflection, and advocate for community-level change. Its ability to effectively balance power and create a sense of ownership may be one reason for its success: participants determine what they are photographing and the meanings of their images. As photos are then collaboratively interpreted, it also increases dialogue on these issues, with the goal of positively influencing program and policy development.

Working with a multi-disciplinary team of First Nations men, health researchers, clinicians and local advocates, we are examining the root causes of mental health problems and the role of protective and resilience factors in supporting well-being through difficult life experiences.

Our own community has long recognized that First Nations men are impacted by a myriad of problems, such as substance use and abuse. These struggles are built on a foundation of loss, unresolved grief, and trauma. In addition, many are impacted by unequal social and economic opportunity, and early and numerous contacts with the criminal justice system. Many also grapple with issues of masculine identity; not only what it means to be a man, but what it means to be a First Nations man in a contemporary context. The combined weight of these issues substantially increases the risk of ill-health. It has set the stage for a mental health crisis in countless First Nations – a problem that is exacerbated by high rates of unmet service needs.

Our goal is for Acting Locally to Address a National Problem to provide a best-practice framework for engaging boys and men. Our team is developing a comprehensive, well-integrated and culturally-appropriate program of prevention, with early intervention, including community/cultural support and treatment services. Through this project, First Nations men will have control and ownership over objectives, methods, analysis and the sharing of information. The approach supports and recognizes the community as its own best resource, by using the knowledge and experiences of community members to develop services and supports that best meet their needs.

I believe the new research paradigm underlying this project is what sets it apart from past research. Respect of history and culture is an important part of this new approach. It is key to building and sustaining partnerships, facilitating locally-relevant outcomes, and encouraging multiple sites of knowledge transfer.

This project also incorporates a strong evidence base. It builds on two research projects: Researching Health in Ontario Communities (RHOC) and Five Views on a Journey. Through in-depth interviews with people who sought help for mental health, substance use/addiction or violence problems, we are learning that mental health problems in First Nations men are overwhelmingly trauma-related. In addition, First Nations men go untreated for their mental health-related issues. These and other findings from the RHOC and Five Views projects, funded through the Canadian Institutes of Health Research, are being used to provide the initial knowledge-base for mental health programming in the community.

For example, based on findings from this research, KSPFN Health Services now provides a counseling program to support boys and men who have experienced trauma. In addition, several new programs are being offered to all men in the community, including a Fitness for Recovery Program, Art Drop-In, and Stages of Change Pre-Contemplation Group.

The RHOC project also included a survey in Kettle & Stony Point, whose results suggest that men’s mental health must be considered within the context of losses, trauma, racism and concerns about stigma. For instance, most men reported identifying with feelings of loss, such as loss of culture, land or through early death. Nearly seven in 10 reported loss of language, and nearly three in 10 reported physical abuse. Most also reported feeling treated unfairly in society.

Acting Locally to Address a National Problem offers a new model of preventing and addressing First Nations boys’ and men’s mental health has the potential to be applied nationally. It uses a holistic approach at the individual, family, and community level that addresses the underlying history and context for our people’s well-being.

The health of Aboriginal communities must be supported by improving the functioning of men in community and family life. I believe that this program is a first important step toward achieving this goal.