Melro Carolyn M, Gilfoyle Meghan, Ballantyne Clifford, Augustine Lacey, Brass Gregory, Rabbitskin Norma, Hutt-Macleod Daphne, Iyer Srividya N, Mushquash Christopher J
Department of Psychology, Lakehead University, Thunder Bay, ON, Canada.
ACCESS Open Minds Indigenous Youth Mental Health and Wellness Network, Thunder Bay, Montreal, ON, QC, Canada.
Res Involv Engagem. 2025 May 13;11(1):47. doi: 10.1186/s40900-025-00721-3.
Health research and service delivery often fail to incorporate Indigenous worldviews and local community protocols, as well as historic experiences and knowledge of harmful research practices leaving Indigenous individuals wary of participating in research. Meaningfully engaging with Indigenous stakeholders (e.g., youth, family/carers, decision-makers, and service providers) in research partnerships offers a promising pathway toward better access and quality health care and improved mental health and wellness outcomes that better meet Indigenous youths' needs. This paper traces the development of a national research network, ACCESS Open Minds, a network of youth, family members/carers, clinicians, decision-makers and academics focused on transforming youth mental health services in Canada. The context for this network is one in which diverse Indigenous stakeholders have been engaged in health systems and service transformation against the historical and ongoing backdrop of colonialism. Within this paper, we will focus on the network's past and on-going activities for engaging Indigenous partners to provide a critical lens on the partnership development process. We will also underscore key activities/reflections central to the development of trust and ultimately, the sustained engagement of Indigenous youth and community partners within mental health service transformation. Both trust development and sustained engagement are integral to building momentum in developing, implementing and evaluating health systems and service transformation in collaboration with Indigenous youth and community partners. We propose a framework for engaging Indigenous community partners and youth within service transformation. Trust is highlighted as the context, mechanism, and outcome. We conclude with the need to build an evidence base of what works and - and what does not work - in achieving and sustaining trust within the process of engaging Indigenous partners in health system transformation.
卫生研究和服务提供往往未能纳入原住民世界观和当地社区的规范，以及有害研究行为的历史经验和知识，这使得原住民个体对参与研究持谨慎态度。在研究合作中与原住民利益相关者（如青年、家庭/照顾者、决策者和服务提供者）进行有意义的互动，为实现更好的医疗保健服务可及性和质量以及改善心理健康和幸福感提供了一条有前景的途径，从而更好地满足原住民青年的需求。本文追溯了一个全国性研究网络“ACCESS Open Minds”的发展历程，该网络由青年、家庭成员/照顾者、临床医生、决策者和学者组成，专注于变革加拿大的青年心理健康服务。该网络所处的背景是，在殖民主义的历史背景和持续影响下，不同的原住民利益相关者一直参与卫生系统和服务变革。在本文中，我们将聚焦该网络过去及正在开展的让原住民合作伙伴参与其中的活动，以批判性地审视合作关系的发展过程。我们还将强调信任发展的关键活动/反思，以及最终原住民青年和社区合作伙伴在心理健康服务变革中的持续参与。信任发展和持续参与对于与原住民青年和社区合作伙伴合作开展、实施和评估卫生系统及服务变革的进程中积累动力都至关重要。我们提出了一个在服务变革中让原住民社区合作伙伴和青年参与进来的框架。信任被视为背景、机制和成果。我们在结论中指出，有必要建立一个证据基础，说明在卫生系统变革过程中与原住民合作伙伴建立并维持信任方面哪些做法有效，哪些无效。
