Advertisement

Canadian Journal of Public Health

, Volume 106, Issue 6, pp e375–e381 | Cite as

Mental health and substance use in an urban First Nations population in Hamilton, Ontario

  • Michelle FirestoneEmail author
  • Janet Smylie
  • Sylvia Maracle
  • Constance McKnight
  • Michael Spiller
  • Patricia O’Campo
Quantitative Research
  • 1 Downloads

Abstract

OBJECTIVES: Mental health and substance use have been identified as health priorities currently facing Indigenous peoples in Canada; however, accessible and culturally relevant population health data for this group are almost non-existent. The aim of the Our Health Counts study was to generate First Nations adult population health data in partnership with the De dwa da dehs ney>s Aboriginal Health Access Centre in Hamilton, Ontario.

METHODS: Analysis involved data gathered through respondent-driven sampling. Prevalence estimates and 95% confidence intervals were generated for diagnosis and treatment of a psychological disorder or mental illness, depression, anxiety, post-traumatic stress disorder (PTSD) and suicide, alcohol and substance use, and access to emotional support.

RESULTS: Of the 554 First Nations adults who participated in the Our Health Counts study in Hamilton, 42% had been told by a health care worker that they had a psychological and/or mental health disorder. High rates of depression (39%) and PTSD (34%), as well as suicide ideation (41%) and attempts (51%) were reported. Half of the sample reported marijuana use in the previous 12 months, and 19% reported the use of cocaine and opiates.

CONCLUSION: First Nations adults living in Hamilton experience a disproportionate burden of mental health and addictions. By working in partnership with urban Aboriginal organizations, it is possible to produce policy- and service-relevant data and address the current deficiency in appropriate mental health and substance use services for urban Aboriginal people.

Key Words

Canada urban Aboriginal health First Nations community-based research respondent driven sampling mental health substance use 

Mots Clés

Canada santé autochtone en milieu urbain Premières Nations recherche communautaire échantillonnage en fonction des répondants santé mentale consommation de substances 

Résumé

Objectifs: La santé mentale et la consommation de substances sont considérées comme deux enjeux prioritaires pour la santé des peuples autochtones au Canada à l’heure actuelle; cependant, les données de santé des populations accessibles et culturellement appropriées sur ce groupe sont presque inexistantes. L’objet de l’étude Our Health Counts était de produire des données de santé des populations sur les adultes des Premières Nations, en partenariat avec le Centre autochtone d’accès aux soins de santé De dwa da dehs ney>s de Hamilton (Ontario).

Méthode: Nous avons analysé des données recueillies par échantillonnage en fonction des répondants. Des estimations de prévalence et des intervalles de confiance de 95 % ont été générés pour le diagnostic et le traitement d’un trouble psychologique ou d’une maladie mentale, la dépression, l’anxiété, l’état de stress post-traumatique (ESPT), le suicide, la consommation d’alcool et de substances et l’accès au soutien affectif.

Résultats: Des 554 adultes des Premières Nations ayant participé à l’étude Our Health Counts à Hamilton, 42 % avaient été informés par un travailleur de la santé qu’ils avaient un trouble psychologique et/ou de santé mentale. Des taux élevés de dépression (39 %) et d’ESPT (34 %), ainsi que d’idéation suicidaire (41 %) et de tentatives de suicide (51 %) ont été déclarés. La moitié de l’échantillon a dit avoir consommé de la marijuana au cours des 12 mois antérieurs, et 19 % ont dit avoir consommé de la cocaïne et des opiacés.

Conclusion: Les adultes des Premières Nations vivant à Hamilton portent un fardeau disproportionné de troubles mentaux et de toxicomanie. En travaillant en partenariat avec des organismes autochtones en milieu urbain, il est possible de produire des données utiles pour les politiques et les services et de répondre au manque actuel de services en santé mentale et en toxicomanie pour les Autochtones en milieu urbain.

References

  1. 1.
    Loppie Reading C, Wien F. Health Inequalities and Social Determinants of Aboriginal Peoples’ Health. National Collaborating Centre for Aboriginal Health, Prince George, BC, 2009.Google Scholar
  2. 2.
    National Collaborating Centre for Aboriginal Health (NCCAH). An Overview of Aboriginal Health in Canada. Prince George, BC: Author, 2013.Google Scholar
  3. 3.
    Health Canada. A Statistical Profile on the Health of First Nations in Canada. Ottawa, ON: Author, 2002.Google Scholar
  4. 4.
    Indian and Northern Affairs Canada. Report of the Royal Commission on Aboriginal Peoples (RCAP). Ottawa: Author, 1996.Google Scholar
  5. 5.
    Statistics Canada. Aboriginal Peoples in Canada in 2006: Inuit, Métis and First Nations, 2006 Census. Ottawa: Ministry of Industry, 2008.Google Scholar
  6. 6.
    Garner R, Carrière G, Sanmartin C, Longitudinal Health and Administrative Data Research Team. The Health of First Nations Living Off -Reserve, Inuit, and Métis Adults in Canada: The Impact of Socio-economic Status on Inequalities in Health. Ottawa: Statistics Canada, Health Analysis Division, 2010._Report No: 82-622-X.Google Scholar
  7. 7.
    Kirmayer LJ, Brass GM, Tait CL. The mental health of aboriginal peoples: Transformations of identity and community. Can J Psychiatry 2000;45:607–16. PMID: 11056823.CrossRefGoogle Scholar
  8. 8.
    Smylie J, Anderson I, Ratima M, Crengle S, Anderson M. Who is measuring and why? Indigenous health performance measurement systems in Canada, Australia, and New Zealand. Lancet 2006;367:2029–31. doi: 10.1016/S0140-6736(06)68893-4.CrossRefGoogle Scholar
  9. 9.
    Kirmayer LJ, Tait CL, Simpson C. The mental health of aboriginal peoples in Canada: Transformations of identity and community. In: Kirmayer LJ, Valaskakis G (Eds.), Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. Vancouver, BC: UBC Press, 2009, 3–35.Google Scholar
  10. 10.
    Dumont J. First Nations Regional Longitudinal Health Survey (RHS): Cultural Framework. Ottawa: The First Nations Information Governance Centre, 2005.Google Scholar
  11. 11.
    Assembly of First Nations. First Nations Regional Longitudinal Health Survey (RHS) 2002/03: Results for Adult, Youth and Children Living in First Nations Communities. Ottawa, ON, 2007.Google Scholar
  12. 12.
    Tjepkema M. The Health of the Off-reserve Aboriginal Population. Supplement to Health Reports, vol. 13. Statistics Canada, 2002.Google Scholar
  13. 13.
    Statistics Canada. Canadian Community Health Survey. Ottawa: Author, 2007.Google Scholar
  14. 14.
    Chandler MJ, Lalonde C. Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcult Psychiatry 1998;35(2):191–219. doi: 10.1177/136346159803500202.CrossRefGoogle Scholar
  15. 15.
    Chandler MJ, Lalonde C. Cultural continuity as a moderator of suicide risk among Canada’s First Nations. In: Kirmayer LJ, Valaskakis G (Eds.), Healing Traditions: The Mental Health of Aboriginal Peoples in Canada. Vancouver: UBC Press, 2009, 221–48.Google Scholar
  16. 16.
    Aboriginal Healing Foundation. Suicide Among Aboriginal People in Canada. Ottawa: Author, 2007.Google Scholar
  17. 17.
    Health Canada. Unintentional and Intentional Injury Profile for Aboriginal People in Canada 1990-1999. Ottawa: Minister of Public Works and Government Services Canada, 2001.Google Scholar
  18. 18.
    Fraser Health Authority. Fraser Region Aboriginal Youth Suicide Prevention Collaborative: Suicide Prevention, Intervention and Postvention Initiative, 2010.Google Scholar
  19. 19.
    Estey MA, Smylie J, Macaulay AC. Aboriginal Knowledge Translation: Understanding and Respecting the Distinct Needs of Aboriginal Communities in Research. Ottawa: Canadian Institutes of Health Research, 2009.Google Scholar
  20. 20.
    Vukic A, Rudderham S, Misener-Martin R. A community partnership to explore gaps in mental health services in First Nations communities in Nova Scotia. Can J Public Health 2009;100(6):432–35. PMID: 20209736.PubMedGoogle Scholar
  21. 21.
    Smye V, Mussell B. Aboriginal Mental Health: What Works Best. Vancouver: Mental Health Evaluation and Community Consultation Unit, UBC, 2001.Google Scholar
  22. 22.
    Abdul-Quader A, Heckathorn D, Sabin K, Saidel T. Implementation and analysis of respondent driven sampling: Lessons from the field. J Urban Health 2006;83(1):1–5. doi: 10.1007/s11524-006-9108-8.CrossRefGoogle Scholar
  23. 23.
    Heckathorn D. Respondent-driven sampling II: Deriving valid population estimates from chain referral samples of hidden populations. Soc Probl 2002;49(1):11–34. doi: 10.1525/sp.2002.49.1.11.CrossRefGoogle Scholar
  24. 24.
    Heckathorn D, Seeman S, Broadhead R, Hugues J. Extensions of respondent driven sampling: A new approach to the study of injection drug users aged 18–25. AIDS Behav 2002;6(1):55–67. doi: 10.1023/A:1014528612685.CrossRefGoogle Scholar
  25. 25.
    Canadian Institutes of Health Research. CIHR Guidelines for Health Research Involving Aboriginal People. Ottawa: Author, 2007.Google Scholar
  26. 26.
    Ball J, Janyst P. Enacting research ethics partnerships with Indigenous communities and Canada: “Do it in a good way”. J EmpirRes Hum Res Ethics 2008;3(2):33–51. PMID: 19385744. doi: 10.1525/jer.2008.3.2.33.CrossRefGoogle Scholar
  27. 27.
    First Nations Centre. First Nations Conceptual Frameworks and Applied Models on Ethics, Privacy, and Consent in Health Research and Information. Ottawa: National Aboriginal Health Organization, 2006.Google Scholar
  28. 28.
    Ontario Federation of Indian Friendship Centres. USAI Utility Self-Voicing Access Inter-relationality Reserach Framework, Toronto, ON, 2012.Google Scholar
  29. 29.
    Smylie J, Firestone M, Cochran L, Prince C, Maracle S, Morley M, et al. Our Health Counts - Urban Aboriginal Health Database Research Project: Community Report, Toronto, ON, 2011.Google Scholar
  30. 30.
    Firestone M, Smylie J, Maracle S, Spiller M, De dwa da dehs ney>s Aboriginal Health Access Centre, O’Campo P. Unmasking health determinants and health outcomes for urban First Nations using respondent driven sampling. BMJ Open 2014;4:e004978. doi: 10.1136/bmjopen-2014-004978.CrossRefGoogle Scholar
  31. 31.
    Statistics Canada. Hamilton, Ontario (Code3525005) (table). 2006 Community Profiles. 2006 Census. Ottawa: Author, 2007. Report No.: Catalogue no. 92-591-XWE.Google Scholar
  32. 32.
    Salganik MJ. Variance estimation, design effects, and sample size calculations for respondent-driven sampling. J Urban Health 2006;83(6 Suppl)):98–112. PMID: 16937083.CrossRefGoogle Scholar
  33. 33.
    Firestone M, Smylie J, Maracle S, Siedule C, O’Campo P. Concept mapping: Application of a community-based methodology in three urban Aboriginal populations. Am Indian Cult Res J 2014;38(4):85–104. doi: 10.17953/aicr.38.4.571154up25876h72.CrossRefGoogle Scholar
  34. 34.
    IBM® SPSS® Data Collection Author [computer program]. Version 6.0.1. Chicago, IL: SPSS Inc., 2000.Google Scholar
  35. 35.
    Kessler RC, Andrew G, Colpe LJ, Hiripi E, Mroczek DK, Normand SL, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959–76. PMID: 12214795.CrossRefGoogle Scholar
  36. 36.
    Andrews G, Slade T. Interpreting scores on the Kessler Psychological Distress Scale. Aust N Z J Public Health 2001;25(6):494–97. PMID: 11824981.CrossRefGoogle Scholar
  37. 37.
    Slade T, Grove R, Burgess P. Kessler Psychological Distress Scale: Normative data from the 2007 Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2011;45(4):308–16. PMID: 21332432. doi: 10.3109/00048674.2010.543653.CrossRefGoogle Scholar
  38. 38.
    Mitchell C, Beals J. The utility of the Kessler Screening Scale for Psychological Distress (K6) in two American Indian communities. Psychol Assess 2011; 23(3):752–61. PMID: 21534694. doi: 10.1037/a0023288.CrossRefGoogle Scholar
  39. 39.
    Prins A, Ouimette P, Kimerling R, Camerond RP, Hugelshofer DS, Shaw-Hegwer J. The primary care PTSD screen (PC-PTSD): Development and operating characteristics. Prim Care Psychiatry 2003;9(1):9–14. doi: 10.1185/135525703125002360.CrossRefGoogle Scholar
  40. 40.
    Statistics Canada. Aboriginal Peoples Survey 2006: Adults, Children and Youth. Ottawa: Author, 2006.Google Scholar
  41. 41.
    The First Nations Information Governance Centre. First Nations Regional Health Survey (RHS) Phase 2 (2008/10) National Report on theAdult, Youth and Children Living in First Nations Communities. Ottawa: Author, 2012.Google Scholar
  42. 42.
    Respondent-Driven Sampling Analysis Tool (RDSAT) Version 7.1 [computer program]. Ithaca, NY: Cornell University, 2007.Google Scholar
  43. 43.
    Wejnert C. An empirical test of respondent-driven sampling: Point estimates, variance, degree measures, and out-of-equilibrium data. Soc Methodol 2009; 39(1):73–116. doi: 10.1111/j.1467-9531.2009.01216.x.CrossRefGoogle Scholar
  44. 44.
    Anderson M, Smylie J. Performance measurement systems in Canada: How well do they perform in First Nations, Inuit and Métis contexts? Pimatisiwin 2009;7(1):99–115. PMID: 23450984.PubMedPubMedCentralGoogle Scholar
  45. 45.
    Smylie J, Anderson M. Understanding the health of Indigenous peoples in Canada: Key methodologic and conceptual challenges. Can Med Assoc J 2006;175(6):602–5. doi: 10.1503/cmaj.060940.CrossRefGoogle Scholar
  46. 46.
    Stolk Y, Kaplan I, Szwarc J. Clinical use of the Kessler Psychological Distress Scales with culturally diverse groups. Int J Methods in Psychiatric Res 2014;23(2):161–83. PMID: 24733815. doi: 10.1002/mpr.1426.CrossRefGoogle Scholar
  47. 47.
    Cunningham J, Paradies Y. Sociodemographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18–64 years: Analysis of national survey data. BMC Public Health 2012;12(95):1–15. PMID: 22296820. doi: 10.1186/1471-2458-12-95.Google Scholar
  48. 48.
    Environics Institute. Urban Aboriginal Peoples Study Main Report. Toronto: Author, 2010.Google Scholar
  49. 49.
    The First Nations Information Governance Centre. First Nations Regional Health Survey (RHS) Phase 2 (2008/10) National Report on the Adult, Youth and Children Living in First Nations Communities. Ottawa: Author, 2012.Google Scholar
  50. 50.
    Battiste M. Introduction: Unfolding the lessons of colonization. In: Battiste M (Ed.), Reclaiming Indigenous Voice and Vision. Vancouver: UBC Press, 2000, xvi–xxx.Google Scholar
  51. 51.
    Waldram JB, Herring AD, Young TK. Aboriginal Health in Canada: Historical, Cultural and Epidemiological Perspectives. Toronto: University of Toronto Press, 2009.Google Scholar
  52. 52.
    Bombay A, Matheson K, Anisman H. Intergenerational trauma: Convergence of multiple processes among First Nations peoples in Canada. J Aborig Health 2009;5(3):6–47.Google Scholar
  53. 53.
    Van Ameringen M, Mancini C, Patterson B, Boyle MH. Post-traumatic stress disorder in Canada. CNS Neurosci Ther 2008;14(3):171–81. PMID: 18801110. doi: 10.1111/j.1755-5949.2008.00049.x.CrossRefGoogle Scholar
  54. 54.
    Menzies P. Intergenerational trauma from a mental health perspective. Native Soc Work J 2010;7:63–85.Google Scholar
  55. 55.
    Corrado RR, Cohen IM. Mental Health Profiles for a Sample of British Columbia’s Survivors of the Canadian Residential School System. Ottawa: Aboriginal Health Foundation, 2003.Google Scholar
  56. 56.
    Ontario Federation of Indian Friendship Centres (OFIFC), Ontario Métis Aboriginal Association, Ontario Native Women’s Association (ONWA). Urban Aboriginal Task Force Final Report. Toronto, ON, 2007.Google Scholar
  57. 57.
    Anishnawbe Health Toronto. About Anishnawbe Health Toronto. 2010. Available at: http://www.aht.ca/about (Accessed June 8, 2014).Google Scholar
  58. 58.
    Zahradnik M, Stewart SH, O’Connor RM, Stevens D, Ungar M, Wekerle C. Resilience moderates the relationship between exposure to violence and posttraumatic reexperiencing in mi’kmaq youth. Int J Ment Health Addict 2010;8(2):408–20. doi: 10.1007/s11469-009-9228-y.CrossRefGoogle Scholar
  59. 59.
    White RG, Lansky A, Goel S, Wilson D, Hladik W Hakim A, et al. Respondent driven sampling - where we are and where should we be going? Sex Transm Dis 2012;88(6):397–99. doi: 10.1136/sextrans-2012-050703.CrossRefGoogle Scholar
  60. 60.
    Gile KJ, Handcock MS. Respondent-driven sampling: An assessment of current methodology. Soc Methodol 2010;40(1):285–327. doi: 10.1111/j.1467-9531.2010.01223.x.CrossRefGoogle Scholar
  61. 61.
    Wejnert C, Pham H, Krishna N, Le B, DiNenno E. Estimating design effect and calculating sample size for respondent-driven sampling studies of injection drug users in the United States. AIDS Behav 2012;16(4):797–806. PMID: 22350828. doi: 10.1007/s10461-012-0147-8.CrossRefGoogle Scholar
  62. 62.
    City of Hamilton. Hamilton Homelessness Partnering Strategy Priority Development (2012-2014). Hamilton, ON, 2011.Google Scholar

Copyright information

© The Canadian Public Health Association 2015

Authors and Affiliations

  • Michelle Firestone
    • 1
    Email author
  • Janet Smylie
    • 1
    • 2
  • Sylvia Maracle
    • 3
  • Constance McKnight
    • 4
  • Michael Spiller
    • 4
    • 5
  • Patricia O’Campo
    • 6
  1. 1.Well Living House Action Research Centre for Indigenous Infant Child and Family Health and Wellbeing, Centre for Research on Inner City HealthKeenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s HospitalTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Ontario Federation of Indigenous Friendship Centres (OFIFC)TorontoCanada
  4. 4.De dwa da dehs ney>s Aboriginal Health Access CentreHamiltonCanada
  5. 5.Department of SociologyCornell UniversityIthacaUSA
  6. 6.Centre for Research on Inner City HealthKeenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s HospitalTorontoCanada

Personalised recommendations