A Narrative Review of Mental Health Services for Indigenous Youth in Canada: Intersectionality and Cultural Safety as a Pathway for Change

Navisha Weerasinghe, Amy L Wright, Rachel VanEvery, Shan Mohammed
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Abstract

Objectives: Indigenous youth who identify themselves as First Nations, Métis or Inuit living in Canada between the ages of 12-25 experience higher rates of depression and suicide than non-Indigenous youth. Using narrative review, this paper provides a critical analysis of the scholarly literature to explore the current delivery and accessibility of mental health services among Indigenous youth and suggests areas for improvements in system recovery. Research Design and Methods: The narrative review selected papers from databases including Google Scholar, PubMed, APA PsychInfo, and Indigenous Peoples Atlas of Canada to capture literature from several academic disciplines between August 2020 to May 2022. Data was then synthesized to deliver broad perspectives on this topic. Results: Three categories describe how the accessibility of mental health services for Indigenous youth is impacted by (1) research, (2) current mental health practice, and (3) the location of care services. The medicalization of mental health services, and its emphasis on individual causation and intervention, grounded this discussion. Intersectionality and cultural safety offered a counterpoint to medicalization since these ideas encourage the consideration of social, political, economic, and historical forces. These concepts inform possibilities for change at the micro, mezzo, and macro system levels to address this growing issue. Conclusion: Future implications for improving mental health services and mental health recovery among Indigenous youth include advancing research and implementing innovative solutions that promote intersectionality and culturally safe care across multiple system levels. Keywords: Mental health, Indigenous youth, Intersectionality, Cultural Safety, Narrative Review, Medicalization, Canada
加拿大土著青年心理健康服务叙事回顾:作为变革途径的交叉性和文化安全
目标:生活在加拿大的 12-25 岁原住民、梅蒂斯人或因纽特人青少年的抑郁症和自杀率高于非原住民青少年。本文采用叙事回顾的方式,对学术文献进行了批判性分析,探讨了当前为土著青少年提供心理健康服务的情况和可及性,并提出了系统恢复方面需要改进的地方。 研究设计与方法:叙事性综述从谷歌学术、PubMed、APA PsychInfo 和加拿大原住民图集等数据库中选取论文,以获取 2020 年 8 月至 2022 年 5 月期间多个学科的文献。然后对数据进行综合,以提供有关该主题的广泛视角。 结果:三个类别描述了原住民青少年心理健康服务的可及性如何受到以下因素的影响:(1)研究;(2)当前的心理健康实践;(3)护理服务的地点。心理健康服务的医疗化及其对个人因果关系和干预措施的强调是本次讨论的基础。交叉性和文化安全与医疗化形成了对立,因为这些理念鼓励考虑社会、政治、经济和历史力量。这些理念提供了在微观、中观和宏观系统层面进行变革的可能性,以解决这一日益严重的问题。 结论:改善土著青少年心理健康服务和心理健康康复的未来影响包括:推进研究和实施创新解决方案,在多个系统层面上促进交叉性和文化安全护理。 关键词精神健康、土著青年、交叉性、文化安全、叙事回顾、医疗化、加拿大
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