Suicide Among Aboriginal People in Canada - Institut universitaire ...

Chapter 6in large urban settings that are quite different in the context of most Aboriginal communities. Little workhas been done to adapt interventions to the social and cultural particulars of Aboriginal communities.In the face of these limitations of available information, the decision of what constitutes “best practice”becomes a pragmatic choice among available options based on expert consensus and careful considerationof the specific context of Aboriginal communities.While many of the goals and objectives of standard suicide prevention practices are pertinent to Aboriginalcommunities, most require some modification or reconsideration to fit the social and cultural realitiesfaced by the communities. The programs discussed in Chapter 5 and listed in Appendix A as beingrelevant to the situation of Aboriginal people in Canada were either developed by and for Aboriginalcommunities or have been adapted for Aboriginal communities with the help of the community itself.Despite this fact, there are many features of Aboriginal communities that may make the adaptation orcreation of suicide prevention programs a challenging undertaking. Models of mental health servicesand professional training developed in large-scale urban environments for a Euro-Canadian populationrequire systematic rethinking to be adapted and applied to the wide range of Aboriginal contexts.Distinctive features of Aboriginal communities and populations that may affect the effectiveness of anyspecific prevention program include the scale and location of communities, the lack of mental healthservices, the lack of Aboriginal professionals, the difficulty of maintaining professional anonymity andconfidentiality, and cultural and linguistic diversity.Scale and Location of CommunitiesMany Aboriginal people live in small communities that are geographically distant from major urbancentres. This distance results in problems of resource availability and transportation, with communitieshaving fewer human and material resources for medicine and social services, and multiple roles being playedby a few individuals. The remoteness of some communities may contribute to feelings of isolation anduncertain identity among youth. On a practical level, it makes hospitalization and involvement in aftercaredifficult. The geographic location of many Aboriginal communities also goes along with cultural values thatemphasize a close relationship to the land and the seasons that shape ideas about self and community.Up to half of the Aboriginal population live in urban settings (Statistics Canada, 2003) where they maybe widely dispersed within the general population as well as forming ethnic enclaves. There is considerableheterogeneity in the urban Aboriginal population in terms of cultural background, socio-economicstatus, educational attainment, employment status, and the number of years spent in urban settings.However, inner-city poverty, high unemployment, racism, and associated social problems are very realconcerns in most major Canadian cities, particularly in the western provinces. In some cities, a highproportion of the homeless are Aboriginal, and high-risk Aboriginal youth far too often become streetinvolvedat a young age and are overrepresented in the drug/sex trade. While most major Canadian citieshave friendship centres, Aboriginal housing, and other resources for Aboriginal people, these services areneither adequately funded nor well integrated with other mental health and social services. The urbanAboriginal population may have distinct needs in terms of their social support and health care problems.Recent federal, provincial, and regional initiatives, such as the National Homelessness Initiative and theUrban Aboriginal Strategy, to improve housing and services for Aboriginal people have begun to respondto this complexity, but no one solution will fit the diverse needs of urban Aboriginal populations.101