Arthur Labatt Family School of Nursing, Western University, 1151 Richmond Street, London, ON N6A 3K7, Canada.
School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada.
Int J Environ Res Public Health. 2023 Feb 13;20(4):3288. doi: 10.3390/ijerph20043288.
In this paper, we present findings from a qualitative study that explored Indigenous people's experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples' lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples' lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized.
在本文中，我们呈现了一项定性研究的结果，该研究探讨了在加拿大西部一个内城区的背景下，原住民在心理健康和成瘾护理方面的体验。采用民族志设计，共采访了 39 名接受 5 个社区心理健康护理机构服务的客户，包括 18 次深度个人访谈和 4 个焦点小组。还采访了医疗保健提供者（n=24）。数据分析确定了四个相互交叉的主题：社会苦难的正常化；创伤的再现；调和受限制的生活与减少伤害之间的挑战；以及通过关系实践减轻痛苦。研究结果突出了处于贫困和其他形式社会不平等边缘的原住民在获取护理系统方面的体验的复杂性，以及由于忽视人们生活的交叉社会背景而产生的潜在危害。旨在解决原住民心理健康问题的服务提供必须在意识到并对结构性暴力和社会苦难对人们生活现实的影响做出回应的情况下进行设计。关系政策和政策视角是缓解社会苦难模式和对抗将社会苦难正常化时无意中造成的危害的关键。
