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Mental health and substance use in an urban First Nations population in Hamilton, Ontario

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Abstract

OBJECTIVES: Mental health and substance use have been identified as health priorities currently facing Indigenous peoples in Canada; however, accessible and culturally relevant population health data for this group are almost non-existent. The aim of the Our Health Counts study was to generate First Nations adult population health data in partnership with the De dwa da dehs ney>s Aboriginal Health Access Centre in Hamilton, Ontario.

METHODS: Analysis involved data gathered through respondent-driven sampling. Prevalence estimates and 95% confidence intervals were generated for diagnosis and treatment of a psychological disorder or mental illness, depression, anxiety, post-traumatic stress disorder (PTSD) and suicide, alcohol and substance use, and access to emotional support.

RESULTS: Of the 554 First Nations adults who participated in the Our Health Counts study in Hamilton, 42% had been told by a health care worker that they had a psychological and/or mental health disorder. High rates of depression (39%) and PTSD (34%), as well as suicide ideation (41%) and attempts (51%) were reported. Half of the sample reported marijuana use in the previous 12 months, and 19% reported the use of cocaine and opiates.

CONCLUSION: First Nations adults living in Hamilton experience a disproportionate burden of mental health and addictions. By working in partnership with urban Aboriginal organizations, it is possible to produce policy- and service-relevant data and address the current deficiency in appropriate mental health and substance use services for urban Aboriginal people.

Résumé

Objectifs: La santé mentale et la consommation de substances sont considérées comme deux enjeux prioritaires pour la santé des peuples autochtones au Canada à l’heure actuelle; cependant, les données de santé des populations accessibles et culturellement appropriées sur ce groupe sont presque inexistantes. L’objet de l’étude Our Health Counts était de produire des données de santé des populations sur les adultes des Premières Nations, en partenariat avec le Centre autochtone d’accès aux soins de santé De dwa da dehs ney>s de Hamilton (Ontario).

Méthode: Nous avons analysé des données recueillies par échantillonnage en fonction des répondants. Des estimations de prévalence et des intervalles de confiance de 95 % ont été générés pour le diagnostic et le traitement d’un trouble psychologique ou d’une maladie mentale, la dépression, l’anxiété, l’état de stress post-traumatique (ESPT), le suicide, la consommation d’alcool et de substances et l’accès au soutien affectif.

Résultats: Des 554 adultes des Premières Nations ayant participé à l’étude Our Health Counts à Hamilton, 42 % avaient été informés par un travailleur de la santé qu’ils avaient un trouble psychologique et/ou de santé mentale. Des taux élevés de dépression (39 %) et d’ESPT (34 %), ainsi que d’idéation suicidaire (41 %) et de tentatives de suicide (51 %) ont été déclarés. La moitié de l’échantillon a dit avoir consommé de la marijuana au cours des 12 mois antérieurs, et 19 % ont dit avoir consommé de la cocaïne et des opiacés.

Conclusion: Les adultes des Premières Nations vivant à Hamilton portent un fardeau disproportionné de troubles mentaux et de toxicomanie. En travaillant en partenariat avec des organismes autochtones en milieu urbain, il est possible de produire des données utiles pour les politiques et les services et de répondre au manque actuel de services en santé mentale et en toxicomanie pour les Autochtones en milieu urbain.

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Authors and Affiliations

  1. Well Living House Action Research Centre for Indigenous Infant Child and Family Health and Wellbeing, Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON, 30 Bond Street, M5B 1W8, Canada

    Michelle Firestone PhD & Janet Smylie MD

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Janet Smylie MD

  3. Ontario Federation of Indigenous Friendship Centres (OFIFC), Toronto, ON, Canada

    Sylvia Maracle Hon. LL.D.

  4. De dwa da dehs ney>s Aboriginal Health Access Centre, Hamilton, ON, Canada

    Constance McKnight CAE & Michael Spiller PhD

  5. Department of Sociology, Cornell University, Ithaca, NY, USA

    Michael Spiller PhD

  6. Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, ON, Canada

    Patricia O’Campo PhD

Authors
  1. Michelle Firestone PhD
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  2. Janet Smylie MD
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  3. Sylvia Maracle Hon. LL.D.
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  4. Constance McKnight CAE
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  5. Michael Spiller PhD
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  6. Patricia O’Campo PhD
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Corresponding author

Correspondence to Michelle Firestone PhD.

Additional information

Funding: This project was funded by the Ontario Federation of Indigenous Friendship Centres (OFIFC), the Ministry of Health and Long-Term Care (MOHLTC) Aboriginal Health Transition Fund, and the Centre for Research on Inner City Health (CRICH) at St. Michael’s Hospital. J. Smylie was supported by a Canadian Institutes of Health Research New Investigator in Knowledge Translation award during the course of the project. Conflict of Interest: None to declare.

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Firestone, M., Smylie, J., Maracle, S. et al. Mental health and substance use in an urban First Nations population in Hamilton, Ontario. Can J Public Health 106, e375–e381 (2015). https://doi.org/10.17269/CJPH.106.4923

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