We acknowledge that we are on the traditional territoryof the Ojiwe Obishikokaang (Lac Seul) First Nation, asignatory of the Treaty #3 signed in 1873 between theCrown and the people of the land.

INDIGENOUS MENTAL HEALTH IN
REMOTE COMMUNITIES IN CANADA

Joyce Timpson
Lydia Sherman
Sally Bunting

CANADA – 10 million sq km with 40 million people
ONTARIO – size of Japan with 14 Million people
rdNORTHWESTERN ONTARIO – 1/3 size of Japan,
30,000 people in 32 fly-in communities

Source: Canada - Ilike2learn.com; Nortwest Ontario – CKDR.net/news

WHERE WE ARE: Sioux Lookout, 6,000 people inthe middle of wilderness, hub of the northSource: Municipality of Sioux Lookout

There are Ojibway people in the southern part andCree people in the north. In between are “Oji-Cree”,
also the name of the language.

Source: Sioux Lookout First Nations Health Authority

Typical fly-in communities: Populations range
from 50 to 3,000

Typical fly-in community

Source: Photographs taken by Joyce Timpson

Canadian Indigenous people are very diverse:
different nations, different cultures
First Nations (formerly called Indians): About 1
Million and 70 distinct languages. 50% live on“reserves”, land set aside by the government, andthe rest live in urban settings
Inuit: about 70,000 in the high Arctic
Metis: about 700,000 persons of mixed raceHISTORY: European explorers looking for a shortersea route to India and China on the East coast ofthe Americas around 1500 AD.

Christopher Columbus - Facts, Voyage & Discovery | HISTORYThe white explorers met people with brown skin.
Thinking they had reached India, they called them“Indians”. “Indigenous” is more appropriate.

Indigenous people were viewed as “savages”
This view shaped government policies toassimilate the Indigenous people into White
society and destroy their culture. Even
practicing Indigenous ceremonies wasoutlawed.

THINGS CHANGED QUICKLY IN THE
NORTH SINCE CONTACT

Previous waysof travel and today
Source: flickr.com;

Source: Publicdomainpictures.net

Travel - then and now

Source:Dog sled: theworkofgodschildren.org; Snowmobiles photo taken by Joyce Timpson

Photo of Toyota: Toyota.ca

Housing then and now
TeePee made from material, formerly made from Birch bark Modern day buildings
Source: Unmarked source

Source: Photo by Joyce Timpson

Today, the north is a mix of traditional and the new:many land-based practices in a modern setting
living with technology
Preparing a moose for cooking, stretching and tanning beaver and polar bear hides, satellite

Source: All photographs taken by Joyce Timpson

RAPID CHANGES, MANY LOSSES AND
FAILED POLICIES HAVE SHAPED MENTALHEALTH PROBLEMSSOCIAL DETERMINANTS OF HEALTH: all apply toFirst Nations but we will address only a few*
Income and social status – large numbers of persons on social assistance
Employment and working conditions – unemployment is highEducation and literacy – 70% graduate from high school*Access to health services – distances*Childhood experiences - trauma

Gender – women vulnerable*Culture and *Race/Racism – Lack of understanding of culture and failure toconsider differences in policies

Mental health issues result from Colonizer’s
failed policies that were intended to help them.
Tuberculosis epidemic and new diseases emerged

Residential Schools
Extension of provincial services previously notavailable on reserves: Education, ChildWelfare and Social AssistanceTuberculosis
Early 20th century – Tuberculosis rampant. Many people flown to special
hospitals hundreds of miles away, often gone for years. Many died andbodies were not returned home for funerals resulting in much unresolved grief.
Old float planes

Old hospital in Sioux Lookout

Source: Float planes: pixneo.com; Hospital: slmhc.on.ca/about/our-history

Diabetes has emergedWith a drastic change in a diet of plants and gameharvested from the land to high carbohydrates andprocessed foods, the diabetes rate is extremely high.
Poverty and high price of good food is a contributor
Diabetes has resulted in amputations, vision problems,and premature deaths.

Church run Residential Schools
From 1880 to 1960’s - 150,000 children were forcibly
removed from parents and home communities to church-run
residential schools hundreds of kilometres away. The goal
was assimilation and destruction of Indigenous culture.
Attendance was voluntary after 1960 but the results weresimilar.

Church run Residential Schools
ca.images.search.yahoo.com/yhs/schoolsofsorrow

Above: Pelican
Residential
School, WikipediaBottom: left and right kathleenjonesblogspot.com

Residential school experiences have had amajor impact on mental health todayChildren were removed at vulnerable ages(sometimes 5 years), some returned for summers
only, some not at all for many years.

Their hair was cut when they arrived, weredeloused, given white people’s style clothes.
They were punished for speaking their languages.

Harms of residential schools (continued)
Churches demonized Indigenous spiritual
practices. Many First Nations rejected them.

Many children traumatized for life – by cruelpunishments, sexual and physical abused byclergy, staff and other students.

When the children returned home they: did not know the traditional ways and theirlanguage,difficulty relating to their culture, parents andgrandparents, andhad to relearn parenting due bad modellingat the schools.

1965 Services previously not available toindigenous communities were extended
Some communities were moved off their traditional land to
new locations for easier government ability to provide
services such as education.
Some communities forcibly moved to other locations whenHydro company flooded their land to build a dam.
Relocation disrupts natural kinship systems. It affected thenatural economy and ability to hunt and gather food fromthe land.

Eligibility for welfare after 1965
Moving off the land resulted in decline of
traditional economies of hunting, trapping,gathering.
Welfare payments previously denied to Indigenous
people were provided and are believed by many
Indigenous people to have major factor indestroying their culture.

The trauma of one generation is passed on
to the next.
The Indigenous people had many traumas
as a result of government policies. The
effects are felt by today’s generation

INTERGENERATIONAL EFFECTS

Intergenerational Trauma of relocation, residential
schools paved the way for further abuse such as sexual
predators resulting in disproportionate rates of:
Suicide among young Indigenous people is 5 to 6 times higher than the rest of Canada
Addictions to alcohol and in recent years addictions to opioid drugs.
Children in foster care – Indigenous children represent over 50% of all children in foster care
Incarceration – while 4% of Canadian population are Indigenous, 27% of the populations in prison isindigenous.
Murdered and Missing Indigenous Women and Girls: Violence against Indigenous women
Sources: Suicide: Canadianencyclopedia; Children in Care:, https://www.ohrc.on.ca/en/interrupted-childhoods; Incarceration:
Department of JusticeEffects of so many losses, unresolved griefand child sexual abuse on today’s situation
Suicides have traumatized entire communities. Imagine
losing 30 young members of a community of 500 people(where everyone is related) in 4 decades.

Often the suicides occur in clusters, sometimes several inconsecutive days.

Today’s situation (con’t)
Opioid addiction extremely high with estimates of 75%
adults in some communities addicted*
Multiple and complex losses and abuse results in somepeople describing some Indigenous people to be in achronic state of Post Traumatic Stress Disorder*Source: Joyce Timpson and Karen O’Gorman, ”Community Based Options for Addressing Opioid Abuse in
Remote Northwestern Ontario First Nations, Consultation and discussion paper prepared for Health Canada,First Nations and Inuit Health Branch, May 2010

SUMMARY OF MENTAL HEALTH ISSUES
Multiple losses often simultaneously – from illness, loss ofparents, language, children, accidents, drownings, planecrashes.
Loss associated with tragedy such as homicide and murder

Unresolved grief which results in more loss and tragedy
passed down to later generations

ADDRESSING THE ISSUESCultural specific approaches are necessary
1980’s – Services transferred to Indigenous
groups to deliver new approaches to the issues*
Mental health and social services to First Nations
in reserves are now Indigenous controlled.
*Source: Timpson, Joyce. Indian Mental Health: Changes in the Delivery of Care in Northwestern Ontario, Canadian
Journal of Psychiatry, April 1984.

Lack of knowledge of the culture, language,
made change necessary.
Non-Indigenous health workers often mistook culture
specific symptoms for a serious mental illness such as
schizophrenia when it may have been a reaction to a life
event like complex grief*.

*References: Timpson, Joyce et al. Depression in a Native Canadian in Northwestern Ontario: Sadness, Grief or Spiritual Illness? Canada's
Mental Health, June/September 1988.

Indigenous programs within mainstream agencies
were introduced in child welfare and mental healthand other social work settings.
A “paraprofessional” model was adopted:
Indigenous natural helpers with experience
working with people received training on thejob to provide social work and mental healthservices in child welfare and mental healthagencies.

Sally and Lydia were among the first Indigenous
mental health workers in our area, likely thelongest serving in our area.
Lydia at her desk

Sally with late elder community worker, Ethel Turtle

Source: Pictures taken by Joyce Timpson mid 1980s

After Indigenous workers were hired:Social work services now received in their language and more
disclosures or trauma were made to the workers
Non-Indigenous workers often misdiagnosed symptoms as mentalillness when Indigenous workers recognized symptoms as adifferent expression of reactions to a problem in living
Child welfare workers able to find alternate arrangements totaking children into care

KEY APPROACHES
Indigenous control and design of services is key

Consideration of Intergenerational effects
Trauma Informed approaches
Using Culture for healing
Use of Narrative Approaches

Control of Education
Indigenous language taught in schools on reserves as well insome public schools where there is a large Indigenous populationsuch as Sioux Lookout

Teaching youth how to survive by hunting and fishing andtraditional ways

CHANGES IN GOVERNMENT POLICYTO ADDRESS PAST MISTAKES

New Indigenous designed facilities replace olddecrepit structures
From this: Indian Zone Hospital

Source: www.facebook.com>menoyawin

To this: MenoYaWin Health Centre

Education, now under Indigenous control, isstrongly encouraged
Modern High School where old Residential School was. Students travel from the northto Sioux Lookout and live in group homes with support
From this:Pelican Falls High School Images

To this:Teachings of the ancestors are being revived
and taught
Pow Wow Dancing

Processing wild rice

Source: youtube.com/watch?v=XZYoeqyx10A; Taken by Joyce Timpson

Elders are teaching the children

This Photo by Unknown Author is licensed under CC BY-ND

Including making traditional crafts

Photo taken by Joyce Timpson

Adoptingteaching ofancestors
A whole person
approach tomental healthand healing

Source: ijboudreaux.com

SOME RECENT GOVERNMENT ACTIONS
Truth and Reconciliation Commission – made 97 recommendations
to correct the wrongs of Residential Schools and loss of Culture
Reparations for victims of residential schools and children removed
from parents and their culture into non-Indigenous foster andadoptive care
An Inquiry into Murdered and Missing Indigenous Women and Girls
Initiatives to find and return remains of children who died inResidential Schools and were not returned home
Increasing total control of services to Indigenous peopleINDIGENOUS ACTIVISM
Demanding action for Missing and Murdered women and girls

Marching for Ancestors

These Photos by Unknown Author is licensed under CC BY-NC-ND

STRATEGIES TO ADDRESS DETERMINANT OFHEALTH, POVERTY AND OTHER INEQUALITIES
Economic Development – Development ofIndigenous businesses, purchasing of existingbusinesses by a First Nation to address
employment, poverty and housing issues.
Development of more addictions treatment
centres controlled and staffed by Indigenouspersons

STRATEGIES (CON’T)
Strategies for different approaches to commitmentof criminal acts

Housing initiatives in urban areas
Increased educational opportunities in healthcareers and all areas

Partnerships are essential between government andIndigenous people to address Indigenous mental
health issues

Sources: en.wikepedia.org/wiki/PlymouthColony; parklandinstitute.ca

MEEGWITCH (“THANK YOU” IN OJI-CREE),
ARIGATOU

Source: Shapingyouth.org