Early Childhood Adversity in Indigenous Canadian Communities

It is no secret that how a person was raised and what they experience shape who they become. However, when we think of childhood experiences shaping a person, we often forget that the experiences they face in childhood can become a factor related to mental health issues they are experiencing as an adult. According to the Centre for Addiction and Mental Health (2018) there is a fifty percent chance of a Canadian experiencing mental health issues by the time they are forty years old. Also, mental health issues are more likely to occur during childhood or adolescence (Centre for Addiction and Mental Health, 2018) However, in the Indigenous population, mental health issues are more prevalent “First Nations youth die by suicide about 5 to 6 times more often than non-Aboriginal youth. Suicide rates for Inuit youth are among the highest in the world, at 11 times the national average” (Centre for Addiction and Mental Health, 2018). One factor that could be contributing to why some Indigenous young adults have mental health conditions today is childhood adversity (Northern Public Affairs, 2018). There are programs such as mental health counselling and resources but there should be more programs targeted around detecting early childhood adversity. In this paper I shall argue, using scholarly evidence, that traumatic or adverse childhood experiences have contributed to the mental health conditions in young Indigenous adults. I will make a policy proposal that more holistic interventions should be used to detect early childhood adversity in Indigenous communities. It is important to note that when mentioning Indigenous people in this paper it is about the general Indigenous population in Canada and not a specific group.

History of Childhood adversity in Indigenous communities and mental health

“Childhood adversity is a term used to describe negative experiences in childhood associated with factors such as trauma, physical or sexual abuse and many more adverse situations” (Davis, 2018). Why adversity in youth s are still occurring in the Indigenous population can be linked back generationally (Bombay, Matheson & Anisman, 2014). For example, the treatment of Indigenous youth in residential schools has caused intergenerational trauma in the families of those children once they became parents (Bombay et al., 2014). According to Bombay, Matheson & Anisman (2014) once those children became parents, they pass on trauma (unintentionally) through either physical factors like abuse/neglect or social factors such as living in poor housing conditions. “the 2008–2010 RHS revealed that 31.4% of First Nations youth living on-reserve who had a parent who attended IRS reported symptoms of depression, compared to 20.4% of youth with neither parent who attended” (Bombay, et al., 2014). These factors negatively affected the well-being of the youth which contributed to mental health issues or physical health problems as these children grew up (Bombay et al., 2014). The mental health issues that these youth experienced included depression which caused suicidal thoughts and psychological distress which contributed to anxiety.“The IRS offspring reported greater depressive symptoms as- sociated with stressors, such as childhood adversity, adult trauma and perceived discrimination (…)” (Boksa, Jobber & Kirmayer 2015) Again, this was because of intergenerational trauma that contributed to the youth being more prone to stress and adversity (Boksa, Jobber& Kirmayer 2015). This is not to say that intergenerational trauma is the cause of childhood adversity in Indigenous populations, but there is a correlation (Chachamovich,Kirmayer, Haggarty, Cargo, McCormick & Turecki, 2015) .

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A study was conducted by Brockie, Dana-Sacco, Wallen, Wilcox & Campbell (2015) related to Indigenous individuals living on reserves explored why adversity in youth and mental health conditions in Indigenous young adults were so prevalent. The authors investigated factors such as common exposures to adversity which included all forms of abuse and witnessing violence (Brockie, Dana-Sacco, Wallen, Wilcox & Campbell, 2015). As well as some experiences that are more unique to the Indigenous population such as “loss of history” symptoms due to colonization and PTSD caused by intergenerational trauma (Brockie et al., 2015). “We found a high prevalence of adverse experiences, and a significant dose–response relationship between the number of adverse exposures and mental health and risk behavior outcomes. These findings suggest a strong and cumulative impact of the number of types of ACE exposures among this sample of adolescents and young adults“(Brockie et al., 2015). It is expressed in the results that there is a strong relationship between adverse childhood experiences and mental health (Brockie et al., 2015). Although this study involved Indigenous Americans it can still be used to compare their experiences with Indigenous Canadians because their situations may be similar. In a sense that both groups of people experienced colonization, a loss of history and some form of residential schools (Brockie et al.,2015). The results of the study call for an intervention in these communities to detect early childhood adversity so that it does not progress into a mental health issue in the future. (Brockie et al.,2015). There have been various interventions in the Past that the Canadian government implemented (Leeuw, Greenwood & Cameron).

Past interventions

Previously, the types of interventions the governments of various provinces put into place to protect children in Canada, whether Indigenous or not, from adversity were child protection laws (Leeuw et al.,2010). These laws were used to inform the public and professionals to recognize signs of children who may be in an adverse situation (Leeuw et al., 2010). However, the child protection laws had a different meaning when it came to Indigenous youth. The child welfare system was used in the 1950s to 1970s to target Indigenous children (National Collaborating Centre for Aboriginal Health, 2017). “Social workers placed some of these children in Residential Schools, while many others were fostered

or adopted into non-Indigenous homes .(…) the IRS system started to lose its original purpose of educating and “civilizing” Indigenous children. Instead, the schools remained open primarily as centres for child welfare placements“ (National Collaborating Centre for Aboriginal Health, 2017). This meant that the children who had experienced adversity such as abuse, neglect and more were removed from their homes and put into non-Indigenous homes (National Collaborating Centre for Aboriginal Health, 2017). This type of intervention is known as the sixties scoop and did not improve any of the adverse experiences at all National Collaborating Centre for Aboriginal Health, 2017). Instead it created a larger issue by separating Indigenous youth from their communities and culture (National Collaborating Centre for Aboriginal Health, 2017). Carriere (2005) believes that social connectedness can help improve mental health that is caused by adversity in youth. Carriere (2005) conducted a study to investigate whether Indigenous adolesence experienced social connectedness in their new homes after being separated from their families and communities. The results expressed that Indigenous adolescence adopted by non-Indigenous families “felt like they lost their sense of identity” yet still had mental health issues such as anxiety (Carriere, 2005).

“This correlation supports the research on connectedness as a determinant of health and, in particular, how interconnectedness with the child's tribal family can be a protective factor for First Nations children and youth” (Carriere, 2005). Therefore, an intervention that involves removing an Indigenous child away from their community only harms them because they are also removed from their culture (Carriere, 2005).

Another child welfare intervention made by Indigenous people were self-government child welfare agencies. The agencies services were relevant to their culture and were introduced as a safety net for individuals while still being culturally inclusive (National Collaborating Centre for Aboriginal Health, 2017).“Although there have been some self-government gains with the creation of Native child welfare agencies (…) administrative control over child welfares services to aboriginal authorities does not mean that the practice orientation will change, as it is still guided by the dominant protection paradigm” (Simard, 2009)

However, some of these agencies did not receive enough funding from the government or they ultimately still had westernized approaches (National Collaborating Centre for Aboriginal Health, 2017).

The last intervention is called “Aboriginal Head Start” it is a Canadian Government created intervention to aid at risk toddlers and infants under the ages of five (Libesman, 2004).“research into the effects of early intervention programs indicates many benefits including some linked to child abuse and neglect issues, including: support for families; better relationships between parents and children; improved social and emotional stability in participating children; and enhanced community capacities” (Libesman, 2004). This program is an example of the effectiveness of early childhood interventions that included protection from adversity (Public Health Agency of Canada, 2017). However, there are limited case studies to express if there are long term benefits.

Current interventions

Currently, there are interventions and programs that help all Canadian youth in the population such as improved child protection laws (Leeuw et al., 2010). “when charted into the present day, many of the same interventionist logics appear alive and well in the form of state child “welfare” and child protection legislations” (Leeuw et al., 2010).

In Saskatchewan, there is a child protection law specifically for Indigenous populations. This law recognizes Indigenous culture and the welfare of Indigenous youth (National Collaborating Centre for Aboriginal Health, 2017). Along with the child protection laws that protect both non-Indigenous and Indigenous children in Canada, “there are child welfare home-visits made by social workers or a professional that works with child welfare” (heretohelp,2004). The professional will come in and visit the home to make sure the home environment is safe (heretohelp,2004). MacMillan, Thomas, Jamieson, Walsh, Boyle, Shannon and Gafni (2005) studied one non-Indigenous home visitation intervention. The study involved a public health nurse who specialized in child welfare, and their visits to families that had children who experienced adversity such as abuse (MacMillan, Thomas, Jamieson, Walsh, Boyle, Shannon and Gafni, 2005). The study found that the visits did not have a long term positive effect for the children (MacMillan et al., 2005). “Despite the positive results of home visitation by nurses as an early prevention strategy, this visit-based strategy does not seem to be effective in prevention of recidivism of physical abuse and neglect in families associated with the child protection system” (MacMillian et al., 2005) This study shows that the current home visit interventions are not as effective because these programs are introduced after the adversity has already become a strong part of the children’s lives. “Childhood abuse can cause suicidal behaviours into adulthood, which can be precipitated by certain stressful or tragic events, such as loss.” (Crawford, 2016). Therefore, having an intervention to detect early childhood adversity before the adversity becomes second nature would be beneficial. Also, due to past history of the Indigenous population with the child welfare system removing their children and placing them into non-Indigenous homes, it would be different for families to trust a non-Indigenous professional to come into their homes to aid in the child adversity (Northern Public Affairs, 2018). This could mean that home visitation interventions may not apply to or be beneficial for the Indigenous community.

Mental health issues are prevalent in the Inuit community “the suicide follow-back study conducted in Nunavut found that those who died by suicide were significantly more likely to have experienced childhood abuse, compared with age-matched controls” (Northern Public Affairs, 2018). One Indigenous program that is currently implemented for Inuit youth in Nunavut is the Nunavut Suicide Prevention strategy which focuses on trying to tackle early childhood adversity as well as prevent youth suicides in the community (Northern Public Affairs, 2018). This strategy is beneficial because it is created by the Indigenous communities for the Indigenous communities. They are able to provide mental health resources and understand the perspective of the indigenous youth through a holistic approach (Northern Public Affairs, 2018).

Recommendations

It is important to understand that western programs to child welfare and Indigenous programs are different. In Indigenous communities, child welfare is through a holistic approach which requires a community involvement while western interventions are about the individual causing the individual to seek help. “The conventional individually focused models applied by child and family service agencies and treatment services are often culturally inappropriate for use with Indigenous client groups due to differences in the nature of personal and communal identity (…)” (Libesman, 2004). Furthermore, in order for interventions to detect early childhood adversity in Indigenous communities it is recommended that the approach is holistic.

WEECHI-IT-TE-WIN is an Anishinaabe nation family services agency (Simard, 2009). The agency implements a holistic approach to childhood adversity. The first step to aid with the childhood adversity in the WEECHI-IT-TE-WIN agency is cultural restoration (Simrad, 2009). This involves bringing awareness to cultural identity that the children and community may have lost (Simard, 2009). The second step is to protect the family structure “The Anishinaabe family structure was a resilient mechanism in which the community all had sacred responsibility in raising of a child and the mentoring of a fellow community member” (Simard, 2009). The community is a large part of an Indigenous child’s life everyone in the community work together to raise and care for the child. “The community is aware of a child and family in need, typically the community will work with the family and attempt to mitigate risk of harm for the child. if intervention is needed, it is based on the resources that exist with the family system” (Simard, 2009). The last step is governance by the elders and chiefs in the community, ultimately all the decisions of the community is decided by the elders (Simard, 2009). Once all of these steps are followed there is protection from childhood adversity for children in their community.

it is understood that each indigenous community has their own culture and different sets of rituals and practices, but the WEECH-IT-WIN agency can be used as an example of what a holistic approach to childhood adversity interventions can do to improve the situation for Indigenous children.

Another indigenous community-based approach is the “Pathway to Hope”. A study conducted by Payne, Olson & Parrish (2013) mentions a holistic approach used by an Indigenous community. Due to childhood adversity there was a correlation with mental health issues in the community (Payne, Olson & Parrish, 2013). This intervention is more of an educational tool for the community. It teaches the members of the community how to help heal children from adversity such as sexual abuse (Payne et al.,2013) the program provides various resources for individuals to seek support and introduces a sense of connectedness (Payne et al., 2013). The program ensures that everyone in community is involved because ultimately anything that occurs is a community issue (Payne et al.,2013). “some resulting changes include the establishment of child advocacy centres, Tribal governments legislating ‘‘Children’s Bill of Rights’’ and annual ‘‘Protecting and Honoring Our Children’’ conference” (Payne et al., 2013). Furthermore, this program has become integrated into the community and it is effective. However, the program was implemented in Alaska and it can be used as an example of what could be implemented in Indigenous communities in Canada as it is a holistic approach.

Another program that could be implemented are interventions at schools to prevent childhood adversity. Children attend school majority of the time so teachers should be trained to detect signs of child adverse experiences (Government of Alberta, 2018). Such as physical signs, aggression or anxiety (Udesky, 2018). Although this program is more western there are still holistic approaches to it as well. “When staff understand how trauma affects the brain and the lives of students, they can avoid unknowingly causing a student to feel unsafe or distressed (Government of Alberta, 2018). The overall goal is to join the school as one community to aid students who are experiencing adversity with the support they require (Udesky, 2018). A middle school in the United States integrated a “trauma informed school model” (Udesky, 2018). The school experienced prevalent suspensions and students who seemed to always get into trouble. The school shifted their attention childhood adverse experiences because they found an association between childhood experiences and mental health issues such as anxiety. (Udesky,2018). The teachers at the school were trained through a “Sanctuary Model” which is a model to help teachers use non-judgemental approaches when speaking to the students who may be experiencing adversity (Udesky,2018). “The ability of students and teachers to pay attention to what triggers them and pause and reflect before they react didn’t just happen. It has been made easier by a rich array of new practices” (Udeksy, 2018). This intervention was ultimately effective because it brought the school together as a community. Although this intervention was in the United States this type of intervention can also be brought into Indigenous schools for Indigenous youth in Canada that do not attend non-Indigenous schools. The intervention can involve Indigenous cultures that are relevant to their community. As well as using more holistic approaches to the practices.

Discussion

New policies that involve the holistic approach can aid in detecting early childhood adversity in Indigenous populations so that the adversity does not progress into mental health conditions of young Indigenous adults. Although there are limited case studies available to analyze the effectiveness of the holistic approach to early childhood adversity it can still be taken into consideration. It is still important to note that the holistic approach is practiced in Indigenous communities. Western practices can still be implemented to detect early childhood adversity in Indigenous communities if they involve Indigenous culture and practices.

References

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