Contextual Study of Mental Health Services in the Cree Iiyiyiu Aschii

  • The CBHSSJB has for the past several years identified mental health as an intervention priority.
  • The lack of infrastructures within the community for individuals in crisis situations, the lack of supervised accommodation for clients suffering from severe mental health problems and the housing shortage for personnel all contribute to an increased frequency of transporting clients outside of Iiyiyiu Aschii and add to the risk of clients becoming lost in the system.
  • Youth and women must be identified as priority target groups by the MHP. All individuals suffering from severe mental health problems would benefit from improved follow-up aimed at social reintegration.
  • Several factors affect the mental health of the Eenou, including absence of cultural continuity, lack of housing, drug and alcohol use, widespread prevalence of chronic illness and lack of activities. A mental health program must adopt a global approach to intervening in these areas.
  • Promotion and prevention activities in mental health must be aimed both at family and community ability to take action.
  • Many individuals are reluctant to resort to services because of the lack of adequate staffing available between services to meet the level of needs and the risk in a small community of being labeled.
  • Sustained, adequate financing and constant, recognized leadership are necessary for the long term survival of the QMHAP.
  • The Government of Quebec must make an effort to adapt its national policies to the realities facing northern regions. A starting point would be the translation of its action plans, including the Action Plan for Mental Health (QMHAP), into English.
  • The interprofessional collaboration essential for offering quality mental health services is hampered by many factors, including the absence of unique files, instability of resources and lack of formalized modes of communication. Added to this is a level of confusion and misinformation due to many other factors: lack of integration of the various services, including traditional approaches, persistent ambiguity surrounding the notion of confidentiality, few interdisciplinary meetings, confusion in leadership and misinformation on all sides regarding roles that leads to lack of confidence between health and social services providers.
  • The notion of collaboration between health and social services must be extended to schools, community, church, traditional services, families, community.
  • Very little exists in the way of statistics related to the state of mental health of the Eenou.
  • The goal in integrating traditional resources is to diversify the current service offering. Documenting this body of knowledge before those who hold it disappear has therefore become an urgent priority. There is at the same time a parallel need for the nonaboriginal healthcare providers to improve their understanding of issues of a cultural nature and their knowledge of community initiatives and resources.
  • The setting up of a systematic method for following up on clients and implementing preventive mental health approaches would potentially contribute to diminishing the incidence of crises. Such services however cannot be supported by the current primary healthcare providers who are busy looking after crisis situations, overworked, and needing to respond to emergencies and man the clinic. Furthermore, they lack the necessary experience and training in mental health, show little interest in mental health and lack the necessary support, which is not surprising considering the absence of agreements with psychiatric services and the lack of continuity of presence of psychologists in the region.
  • Individual psychological services are appreciated by healthcare practitioners and clients alike. Group approaches would also be welcomed.
  • A good number of healthcare providers are dealing with their own personal wounding or are constantly exposed to difficult situations in the course of their professional practice. An employee support program and group verbalisation sessions could offer an essential service in this regard.
  • In the field of mental health, the training needs are considerable, especially in the areas of screening, traditional approaches, mental health problems and management, and follow-up aimed at both rehabilitation and social reintegration.
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