Development and implementation of digital health solutions should also adhere to these guiding principles. With shared learning, interesting and novel partnerships and approaches can be developed and fostered for improved community outcomes and programs which can be carried onward by local citizens. Digital health solutions for Indigenous mental well-being depicted around the Indigenous Medicine Wheel with the individual located at the center
Well, it’s just the people down here, you know everything in this area is accessible within a two-block radius. Most participants had co-occurring illness, mental illness, and substance Suicide and young Black men awareness use, and difficulty in accessing treatment for one or both issues. These experiences often created discomfort, fear, shame, and a sense of alienation from those services.
Managing pain and withdrawal in patients who are experiencing opioid use disorder in acute care
Three of five studies examining psychological distress and two of four studies on the impact on stress showed statistically significant improvements. Three of the six studies that assessed PTSD symptoms showed statistically significant improvements. Depression was the most frequently examined outcome and 8 of 14 studies observed statistically significant improvements. Meta-analysis could not be conducted due to the heterogeneity of the study designs. Another pre–post study with comparison showed a statistically significant improvement in positive motivational state immediately post-intervention (Tosa et al., 2018).
The research setting was limited to Canada, the United States, New Zealand or Australia which share similar histories of colonization and racism against Indigenous peoples (Paradies, 2016). Study participants’ age were greater or equal to 16 years or 16 years on average. Indigenous peoples have been displaced from their ancestral lands (United Nations, 2009). However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment.
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This article draws on findings from a Canadian ethnographic study in which we explored Indigenous peoples’ experiences of mental health and substance use services in an urban context. To foster the development of policies and practices that are more responsive to the mental health concerns and service needs of Indigenous peoples, it is important to examine how structural violence manifests institutionally to affect Indigenous mental health and well-being and access to care. Despite these realities, mainstream mental health, substance use, and social welfare services, programs, and policies in Canada have tended to evolve without an awareness of the impact of structural violence and social suffering on people’s lived realities 12,13,14,15,16. 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. The combination of a growing workforce of Native mental health professionals (e.g., psychologists) alongside indigenous community mental health workers has the ability to widen scope, increase local and cultural assets, improve a continuum of care, and work to reduce disparities. This single example illustrates ways in which community health workers’ training and impact can reverberate and foster culturally based wellness for themselves, their families, and entire villages/communities.
- The causes of this inequality are due to the structural disadvantage brought about by social policy, economic systems and the distribution of power and resources.
- For example, “sharing a room with a guy” in a hospital is not an innocuous event for many people, and for some, it carries more risk than for others.
- Inclusive Therapists also offers a service in which you can fill out a form with your preferences and get matched with up to three providers for free.
- Indigenous populations have experienced inequality of accessing mental health services compared with their non-Indigenous counterparts, although the way of measuring mental health service accessibility for Indigenous populations is unclear.
- A review of telemental health services for Indigenous Australians identified the potential to reduce the disparity in the health status of Indigenous rural populations and achieve cost savings from reduction of travel time and greater access to specialist care 13••.
Relationship with country
The National Agreement has also recognised that strong Aboriginal and Torres Strait Islander cultures are fundamental to improved life outcomes for Indigenous Australians and that all activities to be implemented under the Agreement need to support, promote and not diminish these cultures. Mental health and substance use disorders were also the leading contributor to the gap, accounting for one-fifth (20%) of the gap in disease burden between Indigenous and non-Indigenous Australians (AIHW 2021c). Mental health and substance use disorders were the leading cause of the total burden of disease for Indigenous Australians, accounting for almost one-fourth (23%) of the total burden. Among the most disadvantaged Indigenous Australians including the Stolen Generations, children out-of-home care and those who experienced incarceration.
Tighe et al.’s (2017) trial delivered educational modules based on acceptance-based therapies delivered through an app (Shand et al., 2013). Another intervention used brief motivational care planning with principles of problem-solving therapy, motivational therapy and self-management (Nagel et al., 2009). Brave Heart et al. (2020) incorporated psychoeducation on trauma and grief, and cultural healing practices with interpersonal group therapy. Supplemental Tables S3 and S4 describe the studies according to the TIDieR checklist and guide (Hoffmann et al., 2014). Only nine studies reported response rates ranging from 9% to 97% and 19 studies had follow-up rates between 16% and 100%.
