IMPROVING MENTAL HEALTH WITHIN INDIGENOUS COMMUNITIES

In many places in the world, there are communities of Indigenous Peoples—the first Peoples that inhabited those lands. Each community has its own unique history, culture, practices, spiritual beliefs, and worldviews. I work as a psychologist in Indigenous Peoples’ communities in northern Canada, exploring how we can use scientific methods, combined with the traditional wisdom of communities and culture, to improve mental health. In this article, I will tell you about Indigenous Peoples, how many view health and wellness, and what I do to support their mental health—specifically with groups of young people who are having trouble with substance use. I hope that this article will inspire you to find ways to combine scientific approaches with traditional wisdom, to improve your own wellbeing.


Mushquash
Indigenous Mental Health

WHO ARE INDIGENOUS PEOPLES?
Do you know who lived on the land you live on , years ago?Or , years ago?There are three broad groups of Peoples that have been living in Canada (where I live), for thousands of years.These groups are called First Nations, which is the group I come from (Figure A); Inuit, who are the original inhabitants of the northernmost parts of Canada (Figure B); and Métis, who have a distinct culture with combined ancestry of both First Nations Peoples and European settlers (Figure C).Collectively, these groups are called Indigenous Peoples.According to the

INDIGENOUS PEOPLES
The original inhabitants of an area.government of Canada, Indigenous Peoples is "a collective name for the original Peoples of North America and their descendants."In other words, Indigenous Peoples are considered the first people who inhabited the lands that make up many of the countries that exist today.In Canada, there are Indigenous Peoples who live in urban centers and there are Indigenous Peoples who live in smaller, rural communities.Some Indigenous Peoples live in remote communities that are only accessible by airplane, or accessible by roadway only in the winter when the lakes are frozen! in which people from Europe came to settle in Canada.As part of colonization, a lot of the traditional cultural practices of Indigenous Peoples were disrupted.Some cultural practices were made illegal, and people were physically threatened or harmed for engaging in them.This contributed to some of the mental and emotional health di culties that Indigenous Peoples in Canada are now experiencing [ ].A big part of my work is to become familiar with Indigenous Peoples' stories, cultures, and practices, and to find new ways to contribute to their mental health.

WHOLISTIC MENTAL HEALTH
Many non-Indigenous communities in Canada often think about health functionally, as simply being free from any type of physical illness.In contrast, for many Indigenous Peoples, health is understood in the context of being well, or having a sense of wellbeing in all aspects of human experience.Many Indigenous Peoples, including myself, view health and wellbeing as keeping a balance between the mental, emotional, physical, and spiritual areas of our lives.We also include social and environmental factors as part of health.In other words, we believe that people's health is also determined by life circumstances, including education and income, whether they can regularly access enough healthy food and clean water to drink, what kinds of spaces they live in and whether their housing is enough for them and the other people they live with, and whether their physical environments are polluted.These are broad understandings of health, which Indigenous Peoples have held for hundreds to thousands of years, and these understandings are now spreading to non-Indigenous communities-and I am glad for it.
The focus of my work is mental health.I try to understand how we can use culture-based approaches-approaches that honor the

CULTURE-BASED APPROACHES
These are techniques that are rooted in the cultural wisdom of the community that the psychologist is working with.cultural wisdom, knowledge, and practices-to help address current mental health and substance use di culties faced by some Indigenous Peoples [ ].A big part of my work is to try to understand how to combine my knowledge and training in psychology with traditional practices and customs, to best benefit the health of Indigenous Peoples and communities.To do so, I must understand the bigger context of how each community views health in general, and mental health in particular, and I must be familiar with the common practices and ceremonies held in that community.This knowledge, along with a close relationship with the Indigenous community, helps me to come up with new ways of harmoniously weaving contemporary approaches and practices into the practices traditionally used by that community, to give people more tools with which to address their mental health di culties.

HOW I WORK WITH INDIGENOUS PEOPLES
When I conduct a new study with Indigenous Peoples, I work very closely to understand their values.This helps me to develop trust and make sure that our goals are aligned.I then take the shared wisdom from both modern psychology and Indigenous culture-based methods, and collaborate with partners from community to generate research questions for mental health studies, such as how can we help young Indigenous Peoples in your community to regulate their emotions?Finally, I use my findings to improve wellness, to promote the use of certain practices and treatments, or to demonstrate how things might work di erently and why that might be the case.
I am fortunate to work in a psychology clinic that is part of a community-based organization.This means that I work with the local community, and I learn about peoples' needs, priorities, and experiences.I do my best to understand people as deeply as I can and shed light on their experiences based on my clinical training and knowledge.Often, direct exposure to people's experiences helps me to get a general idea of the common di culties that many people in that community are experiencing.Then I can use current, science-based psychology tools to o er a new service that could help people while also respecting their cultural beliefs and practices.Finally, I evaluate how e ective the services are, for example by asking the people to fill out questionnaires (some of which we have developed in collaboration with people from the community!)report on whether the new treatment helped them to deal with their di culties [ ].I also collect data using sharing circles, where I hear stories that people communicate about their experiences and the meaning a specific treatment has for them.

HELPING YOUNG PEOPLE DEAL WITH SUBSTANCE USE DIFFICULTIES
My colleagues, students, and I are working on a study with First Nations Peoples who are having trouble with substance use [ ].We

SUBSTANCE USE
The use of substances, such as drugs, tobacco, or alcohol, that could have negative e ects on the person and/or the people around them.
wanted to understand the role of adverse childhood experiences,

ADVERSE CHILDHOOD EXPERIENCES
Di cult experiences that people had in childhood, that might have e ects on health and wellness in adult life.which are di cult, sometimes traumatic experiences that people have in childhood.Scientists have studied adverse childhood experiences since the s, but this type of work has not typically been done in close collaboration with First Nations Peoples.So, our close relationships and collaboration with the First Nations community is unique and significant.
In this study, we also wanted to understand the e ects of colonization and intergenerational trauma on the experiences of young children

INTERGENERATIONAL TRAUMA
Emotional challenges, or traumatic experiences, that are passed between generations-through families.(Figure ).Intergenerational trauma is trauma that has been passed down through the generations.When European settlers came to Canada and cultural practices of Indigenous Peoples became disrupted, it negatively a ected mental wellbeing.We found various connections between colonization, intergenerational trauma, and the disruption of relationships between children and parents.When early attachment is disrupted through colonial processes, children's abilities to regulate their emotions and control their impulses can also disrupted.This can lead to an increase in the risk that an individual experiencing emotional challenges might use substances to manage those di cult feelings.We also found that the di culties First Nations Peoples experienced through childhood were, on average, larger than the di culties experienced by non-Indigenous Peoples, due to the intergenerational trauma that resulted from colonization.Finally, we found that, unfortunately, such di cult experiences are increasing in some First Nations communities.To support young Indigenous Peoples in dealing with substance use, we developed ideas from psychology to include specific di culties experienced by First Nations Peoples.Then we worked with the First Nations Peoples who experienced these di culties to develop new understandings about how to cope with trauma and the challenging emotions they might experience.This kind of understanding gives Individuals the power to develop new skills that can have positive e ects on their health.We also help people to learn about how emotional injuries from past trauma can be healed by cultural practices.For example, people who are trying to regulate their emotions and deal with di cult past experiences might be helped by participating in cultural and spiritual practices like sweat lodges or smudge ceremonies.These traditional practices can help people to process what they have experienced and help them to focus on the current moment-which can help them to regulate their emotions and lead to new ways to manage strong feelings in di cult moments.
I am happy to say that I am hopeful about the future.I think that there is more national and international attention on Indigenous Peoples' mental health and wellness today than there has ever been before.Many people in our communities are working to improve the mental health of Indigenous Peoples, including Elders, cultural teachers, community members, health professionals and researchers; and many young people who are joining these professions have a lot to contribute.My vision for the future is that the next generations of young scientists and clinicians (like you!) will be confident in their ability to help answer questions that are important to Indigenous Peoples.This career is very meaningful to me, and I believe many young Peoples will find it incredibly meaningful as well.Whichever route you choose along your life's path, remember who you are and where you came from, and lean on the things from your own unique background and experience that bring you strength.

FigureFigure
Figure My name is Henry, and I am a student at the Harrow School in the U.K. I am planning to be a doctor and am currently studying Biology, Chemistry, Philosophy, and Russian at the A-Level.NORAH, AGE: My name is Norah.I am years old.I like to experiment with expired things (shampoo, lotion, baby powder, toothpaste etc.) to see if I can create anything useful (which never happens).I also like to bike in my spare time.My favorite subjects in school are History and Science.One of my biggest goals are to learn five languages and earn a black belt in the style of karate that I learn.AUTHORS CHRISTOPHER MUSHQUASH Dr. Christopher Mushquash, HBSc., M.A., Ph.D., C.Psych., is Anishinawbe (Ojibway), and a member of Pawgwasheeng (Pays Plat First Nation).He is a Professor in the Department of Psychology at Lakehead University, and the Northern Ontario School of Medicine University, Clinical Psychologist at Dilico Anishinabek Family Care, Vice President Research at the Thunder Bay Regional Health Sciences Centre, and Chief Scientist at the Thunder Bay Regional Health Research Institute.He is also Director of the Centre for Rural and Northern Health Research at Lakehead University.Dr. Mushquash is a Canada Research Chair in Indigenous Mental Health and Addiction, with expertise in rural and northern clinical practice and the development of culturally appropriate interventions for mental health and addiction di culties in First Nations children, adolescents, and adults.He is a researcher, clinician, and First Nation scholar who was born and raised in rural Northwestern Ontario.* chris.mushquash@lakeheadu.ca