Colonialism, resistance, and mental health inequities
This summary comes from Parts 4 and 5 of our publication “Pathologize the systems and not the people:” Decolonizing BC’s mental health law. We are grateful for the expertise and leadership shared with us to shape this work and encourage people to read the publication in full.
The effects of genocide, colonialism, and racism have undermined – and continue to actively undermine – the fundamental human rights of Indigenous people to maintain access to traditional approaches to wellness and to enjoy an equal opportunity to be healthy.
“Understand that colonial systems are sources of vulnerability, vulnerability is not inherent in being Indigenous. Avoid pathologizing being Indigenous and understand how colonial trauma shows up in mental health.”
— Dr. Sarah Hunt / Tłaliłila’ogwa
Colonial tools, including the Indian Act, residential and day schools, and Indian hospitals, were all fundamentally designed to erode and remove self-determination. They were about breaking down systems of government and community, breaking kinship, and removing identity and community membership from community control. BC’s history of genocide, colonization, and racism against Indigenous people is rooted in this intentional eradicating, limiting, or suppressing of Indigenous rights, relationship with the land, cultural and familial practices, and systems of health and wellness.
Some examples of these colonial tools include:
Land theft and forced displacement
Assault on children and families
Segregated, low-quality, racist health services
Violations of community and individual autonomy
Many specific colonial tools have had and continue to have direct impacts on Indigenous wellness systems by undermining traditional ways of staying well and access to health knowledge and practices.
Yet, in the face of genocide, colonization, and racism, First Nations, Métis, and Inuit people have and continue to resist the systemic suppression of Indigenous community and centre understandings of health and wellbeing.
There is immense diversity in approaches to wellness among different Indigenous communities however, a core concept of health and wellness common to First Nations, Métis, and Inuit people is that people, earth, and everything around us are deeply interconnected and that wellness comes from holistic internal and external balance that goes beyond the absence of illness.
“We rely on a colonial model, entrenched in western diagnosis.”
— Indigenous Leadership Group member
Current mainstream conceptions of mental health and mental health treatment have roots in colonialism, and those roots shape mental health services today. These conceptions include the medicalization of difference. What might be seen as a normal practice that promotes wellness in one culture may be viewed as different and therefore incorrect in a Eurocentric medical context.
In recent decades, there has been growing mainstream acceptance of the idea that our health and wellness is shaped by more than just our individual actions or biological traits. These factors outside of individual and biological traits that influence our health are often called the social determinants of health. For example, living in poverty negatively impacts your health regardless of your own choices and biological traits. The social and economic context in which a person lives greatly impacts their health.
Importantly, this understanding that health and well-being is shaped by the holistic context of our lives has always been included in Indigenous understandings of health.
Despite this, research on social determinants of health is often written by non-Indigenous people, and the social determinants of the health of Indigenous people is often a subset of that work.
“We need to support determinants of health – increases in robust supports, a prevention focus. We can’t wait until we’re in crisis. We don’t need cops, maybe we need an Elder and some tea, a smudge. It can sometimes be that simple (and sometimes not).”
— Bizaan Bimose (Tonya Robitaille)
Holistic social determinants of health that better reflect the diversity of Indigenous worldviews reflect that fact that the health of Indigenous people and communities is deeply interconnected with many factors, including:
community and individual self-determination
relationship to land and resources
culture
language
spirituality
They also connect to much more and come together to form a holistic understanding of health and wellbeing that reflects the worldview and practices of Indigenous people. Eurocentric, medicalized approaches to health and health care do not, on their own, adequately support the health and wellness of Indigenous people.
To support the health equity of Indigenous people in BC, we need to build upon existing ideas of the social determinants of health with Indigenous-led understandings of the determinants of Indigenous health and well-being. BC’s mental health law, in addition to other law and policy, can be used to build this into the structures of BC’s health care system:
“We need to be looking at the work as obligations, not recommendations.”
— Goodingaay Guud Jaad / Stephanie Watkins
This summary from Parts 4 and 5 of our publication was strongly shaped by many sources, including:
Determinants of Indigenous Peoples’ Health in Canada: Beyond the Social 2nd ed (2018), Greenwood, de Leeuw & Lindsay
For an in-depth list of sources that shaped this work please see the Expanded Sources section of “Pathologize the systems and not the people:” Decolonizing BC’s mental health law.