George Hadjipavlou1, Colleen Varcoe2, David Tu2, Jennifer Dehoney2, Roberta Price2, Annette J Browne2. 1. Department of Psychiatry ( Hadjipavlou), School of Nursing (Varcoe, Browne, Price), Department of Family Practice (Tu), University of British Columbia, Vancouver, BC; Member of the Missanabie Cree First Nation (Dehoney), Missanabie, Ont.; Member of the Snuneymuxw, Nanaimo, BC and Cowichan First Nations (Price), Duncan, BC hadj@mail.ubc.ca. 2. Department of Psychiatry ( Hadjipavlou), School of Nursing (Varcoe, Browne, Price), Department of Family Practice (Tu), University of British Columbia, Vancouver, BC; Member of the Missanabie Cree First Nation (Dehoney), Missanabie, Ont.; Member of the Snuneymuxw, Nanaimo, BC and Cowichan First Nations (Price), Duncan, BC.
Abstract
BACKGROUND: Mental health services in urban settings generally have not been adapted to serve the needs of Indigenous patients. We explored how patients' encounters with Indigenous Elders affected their overall mental health and well-being to identify therapeutic mechanisms underlying improvement. METHODS: We conducted qualitative interviews of participants enrolled in a 6-month prospective mixed-methods evaluation of a program for mental health and well-being that featured the inclusion of Elders in the direct care of Indigenous patients in an inner city primary care clinic. Individual semistructured interviews were conducted to explore patients' experiences and perceptions of their participation in the Elders program. RESULTS: We included 37 participants from at least 20 different First Nations. All but 1 participant described substantial benefits from their encounters with Elders, and none reported being negatively affected. Five overarching themes were identified: experiencing healing after prolonged periods of seeking and desperation; strengthening cultural identity and belonging; developing trust and opening up; coping with losses; and engaging in ceremony and spiritual dimensions of care as a resource for hope. INTERPRETATION: Our evaluation illustrates that the Elders program was perceived by participants to have a broad range of positive impacts on their care and well-being. Although this study was based on experiences at a single urban clinic, these findings support the Truth and Reconciliation Commission of Canada's calls to action regarding the inclusion of Elders as a strategy to improve care of Indigenous patients in Canadian health care systems.
BACKGROUND: Mental health services in urban settings generally have not been adapted to serve the needs of Indigenous patients. We explored how patients' encounters with Indigenous Elders affected their overall mental health and well-being to identify therapeutic mechanisms underlying improvement. METHODS: We conducted qualitative interviews of participants enrolled in a 6-month prospective mixed-methods evaluation of a program for mental health and well-being that featured the inclusion of Elders in the direct care of Indigenous patients in an inner city primary care clinic. Individual semistructured interviews were conducted to explore patients' experiences and perceptions of their participation in the Elders program. RESULTS: We included 37 participants from at least 20 different First Nations. All but 1 participant described substantial benefits from their encounters with Elders, and none reported being negatively affected. Five overarching themes were identified: experiencing healing after prolonged periods of seeking and desperation; strengthening cultural identity and belonging; developing trust and opening up; coping with losses; and engaging in ceremony and spiritual dimensions of care as a resource for hope. INTERPRETATION: Our evaluation illustrates that the Elders program was perceived by participants to have a broad range of positive impacts on their care and well-being. Although this study was based on experiences at a single urban clinic, these findings support the Truth and Reconciliation Commission of Canada's calls to action regarding the inclusion of Elders as a strategy to improve care of Indigenous patients in Canadian health care systems.
Authors: Colleen Varcoe; Annette J Browne; Marilyn Ford-Gilboe; Madeleine Dion Stout; Holly McKenzie; Roberta Price; Victoria Bungay; Victoria Smye; Jane Inyallie; Linda Day; Koushambhi Khan; Angela Heino; Marilyn Merritt-Gray Journal: Res Nurs Health Date: 2017-04-21 Impact factor: 2.228
Authors: Marie-Eve Poitras; Vanessa T Vaillancourt; Amanda Canapé; Amélie Boudreault; Kate Bacon; Sharon Hatcher Journal: Fam Med Community Health Date: 2022-05
Authors: Chantal Viscogliosi; Hugo Asselin; Lise Trottier; Monia D'Amours; Mélanie Levasseur Journal: BMC Public Health Date: 2022-03-16 Impact factor: 3.295