First Nations family says culturally sensitive mental health care difficult to find

Alycia Two Bears has spent a lot of time in the Alberta Children’s Hospital emergency room seeking emergency mental health care for her children.

His first visit was almost ten years ago, with his now 16-year-old daughter.

“Our introduction with the mental health system actually involved taking my oldest child to the children’s hospital in their mental health unit for particularly violent behavior,” she said.

WATCH | Alycia Two Bears explains how mental health supports can be better for Indigenous children, in the video at the top of this story

We got involved a lot in community counseling and then it passed to my fourth child, who is now 10 years old, also including hospital stays on the mental health unit and more. “

As a First Nations family, it has been particularly difficult to access the care she and her children need, says Two Bears.

“I had to talk to doctors about what intergenerational trauma means and how it impacts our family,” said the mother, who is a member of the Mistawasis Nêhiyawak First Nation in Saskatchewan but now resides in Calgary.

“I don’t think I should be doing this in times of distress and crisis – having to sit down and put on my teacher’s hat to educate.”

In a written statement, Alberta Health Services (AHS) said it understands the province’s Indigenous population has specific needs and has dedicated Indigenous staff available across the province.

“AHS takes into consideration culturally appropriate health services for First Nations, Métis and Inuit people across the province,” he said.

“All AHS employees are expected to complete Aboriginal Awareness training to increase their awareness of the unique health care needs of Aboriginal people in Alberta. “

When Two Bears accessed the emergency room at Alberta Children’s Hospital for one of her children, the mother of five says she has never had or received culturally appropriate care.

“In most mental health services you don’t have someone who necessarily always has that lens of trauma-informed, who knows the ceremony, who knows the tradition, and who also knows that they are complex and different.” , she said.

“Were [a] Nêhiyawak family, so we don’t need Niitsitapi values ​​or necessarily a knowledge keeper, because they are not all the same. Finding someone who is a licensed psychologist, who understands the complex history we have with Canada, is difficult. “

Natalie St-Denis is Assistant Professor and Director of the Indigenous Social Work Circle at the University of Calgary.

She says all mental health professionals who work with Indigenous youth and families need to understand the effects of the complex and cumulative trauma they experience.

“I am always surprised at the number of people, even professionals, whether they are social workers, psychologists, nurses or doctors, who still do not know or still do not understand the impact of these challenges that many members of our community have lived it throughout their lives, ”she said.

Looking at the sensitivity and skill formation of the province, St-Denis, who has mixed ancestry with Mi’kmaq and Acadian heritage, was disappointed.

AHS says the training is one-time, for a total of four hours.

“What do you learn in four hours about another culture? About history ? I wouldn’t say much, ”she said.

St-Denis says improving care for Indigenous people in health service settings is something that has been called for by the Truth and Reconciliation Commission of Canada.

“He clearly identifies very specific steps for health care centers and education that he should include in the work we do on reserves and not only on reserves but also in urban settings,” he said. she declared.

Two Bears says she and each of her five children must have had access to mental health services at some point.

“Whether it’s directly for them for personal care, but also realizing that we are an entire family unit that is all affected by mental health,” she said.

Two Bears says her family also faces the same challenges as any other family seeking mental health care for their children, which means lots of waiting lists and short-term programs.

“As a mother, it’s frustrating. You hope you’re going to get some help, then you realize it’s only going to last six months, and your family dynamic is still going on, and then the issues are always there, they always show up, “she said.

“Then you have to get back in the queue to potentially get up to six months of waiting list to get the same help you asked for a year ago.”

But she believes if there had been more culturally appropriate care for Indigenous youth and families in Alberta, it would have improved her family’s mental health journey.

“In the system, your parenting is criticized, why you are there is criticized, and while they are absolutely there to help all of your family dynamics, it can seem like a very lonely process as a single parent,” he said. she declared.

“If I had had an elder or someone to be present with me I think it would have reduced a lot of anxiety or the perception of ‘this is a fight I have to do on my own. “”

St-Denis said the reality is that many indigenous people will not seek help in hospitals because they fear their children will be apprehended.

“Even a mother who welcomes her youth, she may be like, ‘Oh, well, she will blame me and therefore she will apprehend my child.’ So there are all these barriers and fears in place, because of the way the systems interact with members of our community, ”she said.

AHS says it is working to improve access to culturally safe health care for Indigenous patients and their families.

He indicates that there are already a few programs, including Indigenous mental health programs that help families navigate services for their Indigenous children within AHS and the community and Honor the Life program.

“[It] addresses risk and protective factors and builds community capacity to support Aboriginal youth resilience and suicide prevention through holistic community wellness programs, ”said AHS.

St-Denis says it’s important to understand that not all Indigenous youth will be ready to connect with someone like an Elder or Indigenous Liaison.

“But having these people there is really important,” she said.

Ultimately, it’s about creating a safe space for Indigenous youth and families, she said.

“If there was a purification room that the young people can go to, if it’s something they practice,” she said. “Corn [also] to have someone who understands it, maybe a knowledge keeper or an indigenous liaison within the hospital system or even the elders. “

Two Bears says that although his family was not culturally sensitive through AHS, they have recently had some success with a national program, Non-Insured Health Benefits (NIHB).

“There is now coverage for a licensed therapist or psychologist directly through NIHB,” [which] is fantastic, ”she said, adding that it is possible to speak to an aboriginal service provider if you wish.

In a statement, Indigenous Services Canada said the program has been around for almost two decades. This means that every 12 months, an eligible client (Canadian resident who is First Nations or Inuit) can receive up to 22 hours of counseling from an approved provider.

“The fact that we have the opportunity to have ongoing care that renews itself every year is extremely helpful, and it has a direct impact on me personally and then as a mom,” she said.

If you or someone you love is struggling, AHS recommends the following resources:

Read more stories from the Kids in Crisis series: