Aboriginal Mental Healthcare in Canada: The role of alternative service delivery in transforming the provision of mental health services

Danika Kowpak, Lynne Gillis


With growing complexity surrounding the issue of mental health, there is increased pressure for healthcare providers to engage in Alternative Service Delivery (ASD) and collaborative service delivery. Moreover, Aboriginal mental health has historically been an area of high concern and controversy, due to the high incidence of mental illness within this population. The unique social and cultural contexts that impact the type of healthcare services provided, and how these services are organized and delivered, require special consideration to be made when designing ASD models for Aboriginal mental healthcare. This paper seeks to identify current ASD initiatives being undertaken in Canada, while exploring the need for innovative and collaborative service delivery initiatives related to Aboriginal mental health, identifying current gaps and potential barriers to service delivery. 

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Alberta Health Services. (2009). Aboriginal mental health: A framework for Alberta. Retrieved from: http://www.albertahealthservices.ca/MentalHealthWellness/hi- mhw-aboriginal-framework.pdf

Assembly of First Nations. (2005). First Nations action plan for non-insured health benefits. Retrieved from: 20Plan_Fe.pdf

Australian Bureau of Statistics. (2012). 2075.0 – Census of population and housing – counts of Aboriginal and Torres Strait Islander Australians, 2011. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2075.0main+ features32011

Australian Indigenous HealthInfoNet. (2013). HITnet kiosk [12 audiovisual health messages] (2010). Retrieved from http://www.healthinfonet.ecu.edu.au/key- resources/promotion-resources?lid=24385

BC Partners for Mental Health and Addictions Information. (2014). The facts. Retrieved from www.heretohelp.bc.ca/visions/aboriginal-people-vol5/aboriginal-mental-health-the-statistical-reality

British Columbia Ministry of Health. (2005). eHealth strategic framework. Retrieved from http://www.health.gov.bc.ca/library/publications/year/2005/ehealth_framework.pdf

Byrne, M. (2001). Grounded theory as a qualitative research methodology. Association of Operating Room Nurses Journal, 73(6), 1155-1156. Retrieved from ProQuest.

CBC News. (2010, July 9). Robot helps connect Labrador patients, doctors. Retrieved from http://www.cbc.ca/news/canada/newfoundland-labrador/robot- helps-connect-labrador-patients-doctors-1.975104

Canada Health Infoway. (2013). Telehealth expansion project to benefit BC First Nations. Retrieved from https://www.infoway-inforoute.ca/index.php/news-media/2013-news-releases/telehealth-expansion-project-to-benefit- bc-first-nations

Canadian Mental Health Association (CMHA). (n.d.). Meaning of mental health. Retrieved from: http://www.cmha.ca/mental_health/meaning-of-mental- health/

Canadian Mental Health Association (CMHA). (n.d.). Understanding mental illness. Retrieved from: http://www.cmha.ca/mental-health/understanding-mental- illness/

Carrier Sekani Family Services. (2011). Carrier Sekani Nations. Retrieved from http://www.csfs.org/files/carrier-sekani-nations.php

Centre for Rural & Remote Mental Health. (2009). Building bridges: Learning from the experts. Retrieved from http://www.acrrmh.com.au/assets/Uploads/Building-Bridges-Learning-From-the-Experts.pdf

Centre for Suicide Prevention. (2013). Aboriginal, Inuit, First Nations & Métis suicide prevention resource toolkit. Retrieved from: https://suicideinfo.ca/LinkClick.aspxfileticket=MVIyGo2V4YY%3D&tabid=563

Chandler, A. (2013). The future of health care. Best Health Magazine. Retrieved from http://rchfoundation.com/wp-content/uploads/Best-Health-Magazine-Mar- Apr-2013.pdf

Dunn, W. (2012). Public Policy Analysis (3rd ed.). Boston: Pearson Education.

Gibson, K.L., Coulson, H., Miles, R., Kakekakekung, C., Daniels, E., & O’Donnell, S. (2011). Conversations on telemental health: listening to remote and rural First Nations communities. Rural and Remote Health, 11, 1-19. Retrieved from http://www.rrh.org.au

Glaser, B.G. & Strauss, A.L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.

Government of Alberta. (2014). First Nations telehealth portal. Retrieved from http://www.firstnationsth.ca/

Government of Manitoba. (2014). MBTelehealth. Retrieved from http://mbtelehealth.ca/

Government of Yukon. (2009). Yukon telehealth network (YTN). Retrieved from http://www.hss.gov.yk.ca/telehealth.php

Health Canada. (2014). A tool to help people from far away: The IIU telehealth network. Retrieved from http://www.apps.hc-sc.gc.ca/hcs-sss/phctf-fassp.nsf/WebFactSheet/0063?OpenDocument〈=eng&

Health Canada. (2011). Atlantic tele-robotic. Retrieved from http://www.hc- sc.gc.ca/ahc-asc/media/video/atlant-telerobot-eng.php

Health Canada. (2012). First Nations and Inuit health strategic plan: A shared path to improved health. Retrieved from: http://www.hc-sc.gc.ca/fniah-spnia/pubs/strat-plan-2012/summary-sommaire-eng.php

Health Canada. (2013). National Aboriginal youth suicide prevention strategy: Program framework. Retrieved from: http://sciencessociales.uottawa.ca/crecs/eng/ documents/EvaluationFramework-NAYSPS-07-10-26.pdf

Health Interactive Technology Network. (2010). HITnet kiosk data report. Retrieved from http://www.hitnet.com.au/files/KioskDataReport.pdf

Health Interactive Technology Network. (2011). Bringing culturally relevant health information to disadvantaged Australians. Retrieved from http://www.hitnet. com.au/files/NTChronicDiseasesArticle.pdf

Hunter Institute of Mental Health. (2012). Aboriginal and Torres Strait Islander Australians. Retrieved from http://www.mindframe-media.info/for-mental-health-and-suicide-prevention/talking-to-media-about-suicide/priority-population-groups/aboriginal-and-torres-strait-islander-australians

Jong, M. (2013). Impact of robotic telemedicine in a remote community in Canada. Proceedings of the Fifth International Conference on eHealth, Telemedicine, and Social Medicine, 168-171. Retrieved from thinkmind.org

Keewaytinook Okimakanak. (2000). Telepsychiatry pilot project. Retrieved from ftp://storage.knet.ca/pub/cdrom/Websites/health/telepsychiatry.html

Kirmayer, L.J., Brass, G.M. & Tait, C.L. (2000). The mental health of Aboriginal peoples: Transformations of identity and community. Canadian Journal of Psychiatry. 45(7), 607-616. Retrieved from PsycINFO.

Kirmayer, L.J., Gill, K., Fletcher, C., Ternar, Y., Boothroyd, L., Quesney, C., Smith, A., Ferrara, N. & Hayton, B. (1993). Emerging trends in research on mental health among Canadian Aboriginal peoples: A report prepared for the Royal Commission on Aboriginal peoples. Retrieved from: https://www.mcgill.ca/files/tcpsych/Report2.pdf

Kirmayer, L., Simpson, C. & Cargo, M. (2003). Healing traditions: Culture, community and mental health promotion with Canadian Aboriginal peoples. Australasian Psychiatry, 11(s1), 15-23. doi: 10.1046/j.1038-5282.2003.02010.x

Kumar, S. (2003). Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study. British Medical Journal, 326(7381), 138-141. doi: 10.1136/bmj.326.7381.138

Lincoln, Y. & Guba, E. (1985). Naturalistic Inquiry. Thousand Oaks: Sage.

Lips, A, O’Neill, R. & Eppel, E. (2011). Cross-agency collaboration in New Zealand: An empirical study of information sharing practices, enablers and barriers in managing for shared social outcomes. International Journal of Public Administration, 34(4), 255-266. doi: 10.1080/01900692.2010.533571

Local Health Integration Network. (2011). North East Aboriginal / First Nation and Métis mental health and additions framework. Retrieved from: http://www.nelhin.on.ca/home.aspx

Malterud, K. (2001). Qualitative Research: Standards, challenges, and guidelines. The Lancet, 358(9280), 483-488. doi: 10.1016/S0140-6736(01)05627-6

McCracken, G. (1988). The Long Interview. London: SAGE Publications.

Mental Health and Addictions Strategy Advisory Committee. (2012). Come together: Report and recommendations of the mental health and addictions strategy advisory committee. Retrieved from: http://novascotia.ca/dhw/mental- health/reports/Come-Togather-Summary.pdf

Mental Health Commission of Canada. (2012). Changing directions, changing lives: The mental health strategy for Canada. Retrieved from: http://strategy.mentalhealth commission.ca/pdf/strategy-text-en.pdf

Mood Disorders Society of Canada. (2009). Quick facts: Mental illness and addiction in Canada. Retrieved from: http://www.mooddisorderscanada.ca/page/quick-facts

Muttitt, S., Vigneault, R., & Loewen, L. (2004). Integrating telehealth into Aboriginal healthcare: The Canadian experience. International Journal of Circumpolar Health, 63(4), 401-414. Retrieved from DOAJ.

National Aboriginal Health Organization. (2003). Ways of knowing: A framework for health research. Retrieved from: http://www.naho.ca/documents/naho/ french/pdf/research_waysof.pdf

National Aboriginal Health Organization. (2008). Internet Connectivity Among Aboriginal Communities in Canada. Retrieved from: http://www.naho.ca/documents/naho/english/2008_Aboriginal_connectivity_rates.pdf

National Collaborating Centre for Aboriginal Health. (2013). An overview of Aboriginal health in Canada. Retrieved form: http://www.nccah-ccnsa.ca/Publications/Lists/ Publications/Attachments/101/abororiginal_health_web.pdf

National Institutes of Health. (n.d.). mHealth: Mobile health technologies. Retrieved from http://obssr.od.nih.gov/scientific_areas/methodology/mhealth/

Ontario’s Comprehensive Mental Health & Addictions Strategy. (2011). Open minds, healthy minds. Retrieved form: http://www.health.gov.on.ca/en/common/ ministry/publications/reports/mental_health2011/mentalhealth_rep2011.pdf

Pal, L. (2010). Beyond Policy Analysis: Public Issue Management in Turbulent Times. Ottawa: Nelson Education Ltd.

Queen’s University. (2002). Evaluation of the Keewaytinook Okimakanak telepsychiatry pilot project. Retrieved from http://knet.ca/documents/KO-Telepsychiatry-Report-2002-12-21.pdf

Randell, A. (2010, July 15). A robot called Rosie. The Labradorian. Retrieved from http://www.thelabradorian.ca/News/2010-07-15/article-1569214/A-robot-called- Rosie/1

Rojas, M. & Stubley, T. (2014). Integrating mainstream mental health approaches and traditional Aboriginal healing practices: A literature review. Advances in Social Sciences Research Journal, 1(1), 22-43. doi: 10.14738/assrj.11.64

Rural Coordination Centre of British Columbia. (2013). Pioneering telehealth for BC’s rural and remote First Nations communities. Retrieved from http://rccbc.ca/ enews/2013/06/pioneering-telehealth-for-bcs-rural-and-remote-first-nations-communities/

Scott, J.E. (2000). Facilitating interorganizational learning with information technology. Journal of Management Information Systems, 17(2), 81-113. Retrieved from ABI/Inform.

Shore, J.H., Bloom, J.D., Manson, S.M., & Whitener, R.J. (2008). Telepsychiatry with rural American Indians: Issues in civil commitments. Behavioral Sciences and the Law, 26(3), 287-300. doi: 10.1002/bsl/813

Shore, J.H., Brooks, E., Anderson, H., Bair, B., Dailey, N., Kaufmann, L.J., & Manson, S. (2012). Characteristics of telemental health service use by American Indian veterans. Psychiatric Services, 63(2), 179-181. doi: 10.1176/appi.ps.201100098

Silverman, D. (2000). Doing Qualitative Research. London: SAGE Publications.

Social and Emotional Wellbeing and Mental Health Services in Aboriginal Australia. (n.d.). Support services for those with a mental illness or suicide risk. Retrieved from http://www.sewbmh.org.au/page/3672

Star, S. L. (1998). Grounded classification: Grounded theory and faceted classification. Library Trends, 47(2), 218-232. Retrieved from EBSCOhost.

Statistics Canada. (2011). Aboriginal peoples in Canada: First Nations, Métis and Inuit. Retrieved from: http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99- 011-x2011001-eng.cfm

Strauss, A. & Corbin, J., eds. Grounded Theory in Practice in Practice. London: SAGE Publications, 1997.

Treasury Board Secretariat (2002). Policy on Alternative Service Delivery. Retrieved from: http://www.tbs-sct.gc.ca/pubs_pol/opepubs/tb_b4/asd-dmps01-eng.asp

Vukic, A., Rudderham, S., & Misener, R.M. (2009). A community partnership to explore mental health services in First Nations communities in Nova Scotia. Canadian Journal of Public Health, 100(6), 432-435. Retrieved from ProQuest.

Williams, E., Guenther, J., & Arnott, A. (2011). Traditional healing: a literature review. Working paper series 2: Evaluation and policy. No. 2, Covaluator Network. Retrieved from: http://www.covaluator.net/docs/S2.2_traditional_healing_ lit_review.pdf.

World Health Organization. (2007). What is mental health? Retrieved from http://www.who.int/features/qa/62/en/

Wright, B. & Barling, J. (1998). The Executioners’ song: Listening to Downsizers reflect on their experiences. Canadian Journal of Administrative Sciences, 15(4), 339-355. doi: 10.1111/j.1936-4490.1998.tb00176.x

Yurkovich, E.E., Clairmont, J., & Grandbois, D. (2002). Mental health care providers’ perception of giving culturally responsive care to American Indians. Perspectives in Psychiatric Care, 38(4), 147-156. doi: 10.1111/j.1744-6163.2002.tb01565.x

DOI: https://doi.org/10.5931/djim.v11i0.5531


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