Main Problem Areas
in Aboriginal Mental Health
by Ian Brown
by Star Horn)
/ Illness are very broad terms.
In this article, we will focus primarily on suicide, family violence
and the three main mental disorders of depression, anxiety and
[ 1] Suicide
Suicide amongst Aboriginal peoples has
been described as an epidemic. The suicide rate among Aboriginal
people of all ages is between three and four times higher than
among non-Aboriginals. This is a rate that is said to be the
highest reported for any culture in the world. Specifically,
the suicide rate is 3.3 times higher for Indians and 3.9 times
higher for Inuit. For Aboriginal youth between the ages of 10
and 19, the rate is five to six times higher than for their non-aboriginal
counterparts. The situation becomes still more alarming when
one considers the fact that 38 per cent of all registered Indians
are under the age of 15, meaning that if a remedy is not found,
the suicide rate may rise still further.
In addition, these statistics do not cover Métis or non-registered
Indians and consequently show rates that are lower than is believed
to be the case for the total Aboriginal population. It is also
estimated that 25 per cent of accidental deaths are
really unreported suicides, a fact that would result in further
In 1992, in the community of Big Cove, New Brunswick, there were
7 suicides and 75 attempted suicides. Community caregivers formed
a group to look into how the community could take responsibility
for improving the situation. A week-long community gathering
for mourning and healing was arranged. As an example of the widening
the circle approach, the process combined Migmaq
spirituality, Christianity and western psychotherapy.
Statistics are one thing. Hearing the voices
of those affected is another. Here are the words of one who lives
in a community that has a high rate of suicide:
My father committed suicide
Ive heard it and
Ive seen it before, in my brother, in my daughter and in
Ive seen my brothers writing
he wrote notes
and he tried to hang himself. My
daughter tried that too. She tried to hang herself. And my brother-in-law
has stabbed himself. I mean, cut himself up. My husband talks
about suicide. And I myself have thought about it. I know I wont
do it, but there are days and times that it comes to thinking
about it. For me, I dont say anything to anybody. I dont
say I want to commit suicide
I feel like disappearing,
maybe without dying or with dying, I dont know. I mean,
there are times when I think about how Im going to do it.
Am I gonna hang myself? Am I gonna overdose? Do I slash my wrists?
What, what, what? How will I do it? You just get tired of whats
happening around you.4
[ 2 ] Family Violence
Like the term mental illness, family violence is
broad in its meaning. It covers sexual abuse, physical abuse,
emotional and psychological abuse, and neglect in the area of
child care. A short time ago, in February 2003, the National
Indigenous Sexual Abuse Conference was hosted by the Mikisew
Cree First Nation and held in Edmonton, Alberta. The conference
coordinator, Allan Beaver, made the point that the prevention
of sexual abuse is a long-term effort and it requires fundamental
changes to attitudes and values of individuals and society as
a whole. We can start by talking about it and begin to take one
step at time.5
Within the last decade, the Canadian Panel on Violence Against
Women has surveyed both Aboriginal and non-Aboriginal communities
across Canada. Here are some of their findings:
and social service reports show an extremely high rate of violence
against women and children in both Aboriginal and non-Aboriginal
-In the 1990s, the occupancy rate at Iqaluits womens
-Sexual assault reports in the Northwest Territories are
four to five times higher than in the rest of Canada. Those at
highest risk for sexual abuse were females from 13-18 years old,
followed by girls aged 7-12.
-A Northwest Territories survey found that 80 per cent
of girls and 50 per cent of boys under the age of 8 had been
-A survey in southern Ontario found that 71 per cent of
an urban sample and 48 per cent of a reserve sample had been
assaulted by current or past partners.
-Seventy-five to ninety per cent of women in some Aboriginal
communities are physically abused.
-The Ontario Native Womens Association reported
that from a total of 104 completed questionnaires, 80 per cent
of respondents reported personal experience of family violence,
approximately eight times the rate estimated for Canadian women
as a whole.
-The kinds of abuse identified as features of family violence
were mental and emotional (89 per cent), physical (87 per cent),
and sexual (57 per cent).
-Serious effects of abuse included aggressive behaviour,
hyperactivity, antisocial behaviour, social withdrawal, learning
disabilities, somatic symptoms, low self-esteem, depression and
P.T.S.D. (post-traumatic stress disorder).
In a presentation called Surviving
the Abuse in Cree Society, Marilyn Bearskin makes these
additional points: Native women who are being abused often turn
to alcohol and drugs, neglect their children, households and
themselves, and often attempt suicide. There is a pattern of
abuse and neglect that continues from one generation to the next.
People within the community often do not take domestic violence
seriously. When women finally do leave their abusers, they are
often faced with harassment, rather than support from the community.
Finally, there is an absence of programs and counselling for
victims of abuse.7
[ 3 ] Depression
There is general consensus that there are
high rates of major depression among Native groups. For example,
a recent survey of leaders of 57 reserves in Manitoba found that
47 per cent of respondents considered depression to be a serious
problem in their community.8 In the Baffin region, Young and
colleagues (1993)9 reviewed records on 581 referrals for psychiatric
consultation and found that reasons for referral were:
suicidal thoughts / attempts: 24.4%
relationship / family problems: 14.7%
grief reactions: 10.5%
violent / abusive behaviour: 9.5%
psychotic or bizarre thinking: 7.5%
(summarized from The
Story Of Don,
published by the Aboriginal Health Association of BC)
Don lived in a run-down rooming house on
the East Side. His room consisted of only a foamy mattress -
filthy and rank, one chair and a box for clothes that resembled
Don wasnt always an alcoholic. He grew up in a home with
two hard-working loving parents and close-knit siblings who looked
after each other. Things changed for Don when he started school.
For him, school represented pain and confusion, and hurt. Along
with his friends and relatives he was ridiculed, called down,
pushed around and beaten up by the white boys. He did not know
how to tell his parents so he kept it a secret. He learned how
to withdraw into himself so he wouldnt feel the pain.
When he was ten years old his neighbour abused him. That fateful
day changed Don forever. He changed from a carefree, happy-go-lucky
boy into a quiet, lonely one. He entered the cold, dark, hopeless
world of depression. He kept to himself, did not do well in school,
experimented with drugs and alcohol and had his first suicide
attempt at the age of twelve. He did all these in vain - he could
not forget or talk about what happened to him.
Depression was a constant companion throughout his teenage and
young adult years. Dons emotions flipped in and out of
hopelessness, anger, fear and guilt. He did not know how to ask
for help. He could not even talk about what had happened to him.
He quit school in grade nine and ran away to the big city. His
parents did not know how to help him or what had changed him.
He refused to see his family.
Don tried to cover up his depression and suicidal tendencies
by self-medicating with drugs and alcohol. His days were spent
walking the streets begging for money and drinking cheap rice
wine. His little room became a flophouse for people he met on
the street. Don spent ten years on skid row. One day he woke
up and found he could not move. His body had become so badly
poisoned from alcohol he was barely recognizable. His face was
swollen and puffy, he had lost at least sixty pounds, his stomach
was distended because his liver was losing the battle to alcohol
and his body, including his eyes, was yellow. That was how his
parents found him.
This story illustrates
the realities of depression and
also how substance abuse, depression and suicide can become intertwined.
[ 4 ] Anxiety Disorders
Individuals with anxiety disorders experience
excessive fear or worry. This can cause them either to avoid
situations that might set off the anxiety or to develop compulsive
rituals that lessen the anxiety. Everyone feels anxious in response
to specific events - but individuals with an anxiety disorder
have excessive and unrealistic feelings that interfere with their
lives in their relationships, school and work performance, social
activities, and recreation.
Types of Anxiety
(a) Generalized Anxiety Disorder (GAD)
Excessive anxiety and worry about a number of events or activities
occurring for a period of at least six months with associated
symptoms (such as fatigue and poor concentration).
(b) Specific Phobia
Continuing fear of certain objects or situations (such as flying,
heights, cramped spaces, etc.).
(c) Post-Traumatic Stress Disorder
Flashbacks, persistent frightening thoughts and memories, anger
or irritability in response to a previous terrifying experience
in which physical harm occurred or was threatened (such as rape,
child abuse, war or natural disaster).
(d) Social Phobia, also known as Social
Exposure to social or performance situations, such as public
speaking, usually sets off an immediate anxiety response that
may include palpitations, tremors, sweating, gastrointestinal
discomfort, diarrhea, muscle tension, blushing or confusion,
and may cause a panic attack in severe cases.
(e) Obsessive-Compulsive Disorder
Obsessions: Persistent thoughts, ideas, impulses or images that
cause marked anxiety or distress. Individuals with obsessions
usually attempt to ignore or deny such thoughts or impulses or
to counteract them by other thoughts or actions (compulsions).
Compulsions: Repetitive behaviours (such as hand washing, ordering
or checking) or mental acts (such as counting or repeating words)
that occur in response to an obsession.
(f) Panic Disorder
Presence of repeated, unexpected panic attacks, followed by persistent
concern about having additional attacks. Worry about the meaning
of the attack or its consequences.
Panic disorders can come from a feeling of being trapped, for
example not being able to escape an unpleasant social situation.
The basic feature of the panic attack is an experience of intense
fear or discomfort that is accompanied by at least 4 of the
following 13 symptoms:
~ Palpitations, increased heart rate
or pounding heart
~ Trembling or shaking
~ Sensations of shortness of breath
~ Feeling of choking
~ Chest pain or discomfort
~ Nausea or abdominal distress
~ Dizziness, unsteadiness,
light-headedness or fainting
~ A sense of unreality and confusion
over who you are
~ Fear of losing control or going
~ Fear of dying
~ Numbness or tingling sensation in
hands and feet
~ Chills or hot flashes
[ 5 ] Schizophrenia
In a recent report from Health Canada,
schizophrenia is defined and described as follows:
Schizophrenia is a brain disease
and one of the most serious mental illnesses in Canada. Common
symptoms are mixed-up thoughts, delusions (false or irrational
beliefs), hallucinations (seeing or hearing things that do not
exist), and bizarre behaviour. People suffering from schizophrenia
have difficulty performing tasks that require abstract memory
and sustained attention. The signs and symptoms of schizophrenia
vary greatly among individuals. There are no laboratory tests
to diagnose schizophrenia. Diagnosis is based solely on clinical
observation. For a diagnosis of schizophrenia to be made, symptoms
must be present most of the time for a period of at least one
month, with some signs of the disorder persisting for six months.
These signs and symptoms are severe enough to cause marked social,
educational or occupational dysfunction. The Canadian Psychiatric
Association has developed guidelines for the assessment and diagnosis
Symptoms of Schizophrenia
- Delusions and/or hallucinations
- Lack of motivation
- Social withdrawal
- Thought disorders
Over the years, there has been much disagreement
about what schizophrenia is, and is not. For followers of Thomas
Szasz, R.D. Laing and the anti-psychiatry school, the symptoms
described above could all be indications of a transforming experience,
a breakthrough rather than a breakdown.
Laing suggested that the term schizophrenia be replaced
by metanoia meaning change of mind
or conversion. More recently, another famous psychologist,
Stan Grof, instigated an organization called the Spiritual
Emergency Network, to provide an alternative view and support
system for those in mental turmoil. Meanwhile, a Christian fundamentalist
might see these symptoms as signs of spirit possession.
According to traditional Inuit culture, some illnesses were considered
to be the result of an interaction between the soul of a person,
place or thing and the individual affected by the illness. Humans
are considered to have three types of souls the name soul,
the life breath, and the shadow soul. In the past, each type
of soul was subject to treatment by shamans to cure disease.
Certain types of abnormal behaviour and mental illness were seen
as due to the interaction between souls and spirits of other
people or animals.
Three types of possession resulting from these interactions have
been identified: Uuttulutaq, Nuliarsalik/Uirsalik and Christianized