EVALUATION OF THE ONTARIO COMMON ASSESSMENT ... - CCIM

OCAN Evaluation for Aboriginal Mental Health Programs
This approach allowed for clear comparisons of the implementation of OCAN in mainstream and
Aboriginal programs on several levels.
Identifying unique aspects of Aboriginal services: While some aspects of the implementation of
OCAN apply to Aboriginal programs as well as mainstream programs, there are other aspects that
are unique to the Aboriginal service context. We therefore developed a research plan that
included a review and examination of differences in the implementation of OCAN in Aboriginal
mental health programs that may be a result of the diversity of Aboriginal peoples, cultures,
service environments and geography. In addition, we examined potential differences in service
provision in First Nations communities, funding and jurisdictional issues, cultural safety in mental
health as well as historic issues.
Cultural Safety: Cultural awareness, competence, sensitivity and safety have different meanings
that their use is not always consistent in the academic literature. The concept of cultural safety
originates with the Maori People of New Zealand, and embodies a concept that goes beyond
providers learning about cultural differences. It describes an approach to service provision that
incorporates provider self-reflection and understanding of power differentials that often exist
between Aboriginal clients or patients and health services providers. Therefore it is vital that in
culturally safe services, it is the client who defines "safe services” 3 4 . Of great importance to many
Aboriginal people in the North Eastern Ontario is service provider acceptance of beliefs, religions,
backgrounds, and history, and a focus on building on the strengths of Aboriginal people 5 .
Respect for Aboriginal perspectives on research: Aboriginal people often feel that they have
been over researched and are thus frequently critical of government or university interests in
conducting research within their communities. Research initiated by outsiders may raise concerns,
particularly when the topic of research is sensitive such as mental health research. Researchers who
work in Aboriginal communities often come in contact with communities and individuals who have
participated in research projects and have felt harmed or violated, despite the fact that research
protocols received ethics approval from a university or hospital-based research ethics board (REB).
Aboriginal people commonly see the lack of collaboration and community focus in research design
and implementation as an ethical issue that must be resolved.
Our evaluation team was committed to a research approach, informed by and respectful of cultural
values of the Aboriginal people and communities who participated in this evaluation. We strived
for transparency in the research process and sought feedback on evaluation instruments and
methods from each participating organization. For example, we encouraged review and feedback
on interview questions for clients from representatives from the Aboriginal community and partners
3 Ramsden I: Cultural safety. N Z Nurs J 1990, 83(11):18-19.
4 Varcoe C, McCormick J: Racing around the classroom margins: Race, racism and teaching nursing. In Teaching nursing:
Developing a student-centred learning environment. Edited by: Young L, Paterson B. Philadelphia: Lippincott, Williams &
Williams; 2006:437-466.
5 2009 Maar, M.. , B. Erskine, L. McGregor, M. Sutherland, D. Graham, T. Larose, M. Shawande, and T. Gordon. Innovations on
a shoestring: A Study of a Collaborative Community-based Aboriginal Mental Health Service Model in Rural Canada.
International Journal of Mental Health Systems 3:27. Accessible at www.ijmhs.com/content/3/1/27
Sutherland & Maar - March 2010 Page 11