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

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Chapter 6there’s like a program set up where you like, go in and meet with someone and talk tosomeone that’s there for you, that you don’t necessarily know on a one-on-one time, likethat would be really helpful (First Nation youth).As a result of community size, family ties, and shared history there is little opportunity for the sort ofprivacy and confidentiality that is part of the professional mental health or social service practitioners’role in big cities. This confidentiality has both ethical and practical uses: it provides privacy and safetyfor clients who wish to talk about potentially embarrassing or stigmatizing issues and it allows the helperto have some respite from being constantly “on the job.” In small communities, helpers are often relatedto the people they are helping and have no way to step back for a while from their role. This can lead toconflicts of interest and untenable situations and contributes to emotional “burnout.”Cultural and Linguistic DiversityLanguage is a basic conveyor of culture, and most people are connected to their emotions and intimatethoughts most readily in their first language or language of everyday life. To be most useful, help should beavailable in a language the person is comfortable with and take into account aspects of cultural backgroundand social milieu. Few health professionals have made the effort to learn Aboriginal languages and littleinformation has been translated. Interpreters rarely receive systematic training in interpreting mentalhealth, nor are professionals trained in how to work with interpreters. Translation is not just a matter offinding roughly equivalent words, but of exploring and understanding the different connotations of wordsand specific cultural meanings.Culture is a broader issue than language and includes popular conceptual models of how people function,patterns of social interaction, and basic values that are central to any mental health program. Culture isnot simply tradition since all communities evolve and change to meet new circumstances. For example,Aboriginal spirituality and new expressions of Christianity or other religions are all important in thecomplex cultural mix of contemporary communities. These ways of life influence both the way in whichsuffering is expressed and the process of healing (Adelson, 2000; O’Nell, 1996). Ongoing dialogue amonghealth providers and access to a variety of forms of help are needed to address the growing diversity withincommunities.Some forms of psychotherapy or other mental health interventions for high-risk individuals may not fitwell either with traditional Aboriginal values or contemporary realities of settlement or reserve life. Familyand social network approaches may be more consonant with Aboriginal culture, particularly if they areextended to incorporate some notion of the interconnectedness of person and environment (LaFromboise,1988; Fleming, 1994). Direct involvement of respected Elders as advisors and caregivers in the developmentof counselling methods and associated psychotherapeutic techniques is essential for the development ofculturally appropriate care that will also contribute to a valued sense of collective identity (Duran andDuran, 1995).Aboriginal notions of spirituality are at the centre of the renaissance of traditional healing practices(Absolon, 1994; Mawhiney, 1993; Dion Stout, 1994; Young, Ingram, and Swartz, 1989). These valuesare being reclaimed after centuries of active suppression by religious, educational, and governmentalinstitutions. Traditional healing practices invoke spirituality as a link between individual suffering andthe health of the community as a whole. Suicide is then seen as closely related to other forms of sickness103
Chapter 6of the spirit, and the aim of healing is to restore the balance of physical, mental, emotional, and spiritualdimensions of self and community (Dion Stout, 1994). While the term “spiritual” is intuitively andexperientially understood by many people, it has specific interpretations under different social contexts(Waldram, 1993). The value of promoting spiritual values and healing cannot be understood simply interms of symptoms, behaviours, or outcomes as it is an essential element in the current reconstructionand revitalization of Aboriginal identity both at individual and community levels.Rapidity of Social and Cultural ChangeAs discussed at length in Chapter 4, the most striking fact about the recent history of most Aboriginalcommunities is the rapidity with which social and cultural change has occurred. This change has beenlargely forced on people by governments and other forces beyond their control. In recent years, newtechnologies of communication and transportation have introduced the realities of globalization evento remote communities. Rapid change has challenged Aboriginal identity and resulted in profoundgeneration gaps among youth, adults, and elders. Many youth may feel more strongly identified witha global youth culture purveyed through television and the Internet than they do to their families andcommunities.Best Practice Guidelines for Suicide PreventionThis section summarizes guidelines for developing best practices for suicide prevention programs thatare adapted to the characteristics of specific Aboriginal communities or populations. Figure 6-2 outlinesthe major sites or levels of intervention to be included in a comprehensive suicide prevention program.104
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Suicide Among Aboriginal Peoplein C
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Aboriginal Healing Foundation75 Alb
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Table of ContentsPreface...........
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Table of ContentsCultural and Lingu
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PrefaceThis report was prepared und
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GlossaryAmbivalence - Ambivalence r
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GlossaryParasuicide - Any acute, in
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Chapter 1IntroductionWhen I was 14
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Chapter 1Definitions of Suicide and
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Chapter 1Methods of Studying Suicid
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Chapter 1suicide attempts (Marttune
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Chapter 1A central problem for cros
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Chapter 2The Epidemiology of Suicid
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Chapter 2the economic status of Abo
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Chapter 2No study to date has syste
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Chapter 2Despite the overall patter
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Chapter 2Figure 2-6) Average Annual
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Chapter 2are only a portion of thos
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Chapter 2Figure 2-9) Suicide Rates
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Chapter 2Indeed, the rising rate of
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Chapter 2Figure 2-11) Number of Dea
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Chapter 2Rate per 100,000 populatio
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Chapter 2There are only a handful o
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Chapter 3Origins of Suicide: Indivi
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Chapter 3Anxiety disorders also car
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Chapter 3Many of the factors associ
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Chapter 3American Indians compared
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Chapter 3genetic and constitutional
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Chapter 3Single-parent families are
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Chapter 3Hopelessness, Problem Solv
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Chapter 3higher rates of suicidal b
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Chapter 3Physical EnvironmentSuicid
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Chapter 31990; Chandler, 1994). Thi
Page 70 and 71: Chapter 3Risk FactorsDepressionSubs
Page 72 and 73: Chapter 4Origins of Suicide: Social
Page 74 and 75: Chapter 4Reserves, Settlements, and
Page 76 and 77: Chapter 4Traditionalism versus accu
Page 78 and 79: Chapter 4are equivalent in seriousn
Page 80 and 81: Chapter 4society (Levy and Kunitz,
Page 82 and 83: Chapter 4those of mother and homema
Page 84 and 85: Chapter 4Duncan Campbell Scott, Dep
Page 86 and 87: Chapter 4Traditional Aboriginal com
Page 88 and 89: Chapter 4Feehan, 1996; Grant, 1996;
Page 90 and 91: Chapter 4The Child Welfare System a
Page 92 and 93: Chapter 4Aboriginal communities and
Page 94 and 95: Chapter 4had extremely high rates.
Page 96 and 97: Chapter 4Figure 4-2) Transgeneratio
Page 98 and 99: Chapter 5What Works in Suicide Prev
Page 100 and 101: Chapter 5Table 5-1) Strategies of I
Page 102 and 103: Chapter 5Effective Suicide Preventi
Page 104 and 105: Chapter 5closet rods that give way
Page 106 and 107: Chapter 5The American Indian Life S
Page 108 and 109: Chapter 51) school-based and commun
Page 110 and 111: Chapter 5reduce suicides that follo
Page 112 and 113: Chapter 5Although they may visit a
Page 114 and 115: Chapter 6Conclusion: Understanding
Page 116 and 117: Chapter 6Figure 6-1) An Integrative
Page 118 and 119: Chapter 6in large urban settings th
Page 122 and 123: Chapter 6Figure 6-2) Levels of Inte
Page 124 and 125: Chapter 6Planning and CoordinationA
Page 126 and 127: Chapter 62) The response to the cri
Page 128: Chapter 6Often, suicide is a respon
Page 131 and 132: Appendix AASIST participants receiv
Page 133 and 134: Appendix AThe Training for Youth Ed
Page 135 and 136: Appendix AThe program has continued
Page 137 and 138: Appendix Awith the creation and imp
Page 139 and 140: Appendix AContact Information for R
Page 142 and 143: Appendix BAdditional Resources: Man
Page 144: Appendix BAboriginal Healing and We
Page 147 and 148: Appendix CNational Aboriginal Healt
Page 149 and 150: References——— (1987). Unravel
Page 151 and 152: ReferencesBeck, A.T., R.A. Steer, M
Page 153 and 154: ReferencesBrent, D.A., J.A. Perper,
Page 155 and 156: References——— (1995). The Pro
Page 157 and 158: ReferencesDevereux, G. (1961). Moha
Page 159 and 160: References——— (2005b). In wha
Page 161 and 162: ReferencesGardiner, H. and B. Gaida
Page 163 and 164: ReferencesGuo, B. and C. Harstall (
Page 165 and 166: ReferencesHoberman, H.M. and B.D. G
Page 167 and 168: ReferencesJong, M. (2004). Managing
Page 169 and 170: ReferencesKouri, R. (2003). Persona
Page 171 and 172:
References——— (1997). Suicide
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ReferencesMatheson, L. (1996). The
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ReferencesNeimeyer, R.A., B. Fortne
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ReferencesPirkis, J.E., C.E. Irwin,
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ReferencesRutz, W. (2001). Preventi
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References——— (1992). Marriag
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ReferencesTrimble, J. and B. Medici
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ReferencesWebb, J.P. and W. Willard
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