Department of Sociology and School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Can J Psychiatry. 2011 Feb;56(2):75-83. doi: 10.1177/070674371105600202.
First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.
第一民族和因纽特青年中滥用溶剂者是加拿大受污名化程度最高的滥用物质群体之一。本文借鉴了一种基于文化韧性模型的住院治疗反应，讨论了精神病学针对精神障碍采用个体化方法时所涉及的文化问题。对过去十年中《加拿大精神病学杂志》上发表的文章进行系统回顾，并结合对加拿大和国际文献的回顾，揭示了西方基于精神疾病的和以原住民文化为基础的治疗方法与治疗和治愈物质滥用和精神障碍之间在理解和实践方面存在差距。本文从西方精神病学和原住民世界观的角度讨论了心理健康和物质滥用的不同概念化，并重点关注与自我、社区和政治背景的联系。原住民知识转化方法——故事讲述——青年溶剂滥用治疗中心一线工作者的经验，讲述了将西方方法应用于原住民治疗所面临的困难。这引发了关于精神病学如何利用关于文化在治疗滥用溶剂的原住民青年中的作用的日益激烈的辩论的讨论。非常需要针对第一民族和因纽特青年滥用物质（包括溶剂）进行具有文化能力的精神病学研究。对于一线精神病医生来说，了解这些内容对于改进实践是必要的。健康促进的观点可能是理解这一点的一个有价值的起点，因为它将精神病学治疗精神障碍的方法置于原住民病因学范围内。
