Bringing research to First Nation communities

In brief

RHOC Five Views mobile research lab

Mental illness, substance misuse, and violence are problems in communities across Ontario, including urban, rural, and Northern communities. Some First Nation communities suffer disproportionately from these problems. In partnership with First Nation communities, researchers at the Centre for Addiction and Mental Health (CAMH) are exploring why this is so and what can be done to address these issues.

Dr. Julie George, a Postdoctoral Fellow at CAMH, is working on two related projects in First Nation communities. With her team, she has been working with Kettle & Stony Point First Nation and Aamjiwnaang First Nation to define research questions, incorporate culturally appropriate measures, and develop methods and procedures.

EENet asked Julie, herself a member of Kettle & Stony Point First Nation, to explain the research. This issue of Research As It Happens looks at two studies: Researching Health in Ontario Communities and Five Views on a Journey.

Research As It Happens offer a plain-language look at the research process.

Read it below or download the PDF.

Background: Researching Health in Ontario Communities and Five Views on a Journey

Mental illness, substance misuse, and violence are problems in communities across Ontario, including urban, rural, and Northern communities. Some First Nation communities suffer disproportionately from these problems. In partnership with First Nation communities, researchers at the Centre for Addiction and Mental Health (CAMH) are exploring why this is so and what can be done to address these issues.

Researchers and community partners are looking at a broad range of contributing factors of particular relevance to First Nations, such as historical trauma, unresolved grief, marginalization, and racism. Their research also explores protective factors, including resilience and community resources that support and strengthen its members.

Dr. Julie George, a Postdoctoral Fellow at CAMH, has been working with Kettle & Stony Point First Nation and Aamjiwnaang First Nation to define research questions, incorporate culturally appropriate measures, and develop methods and procedures.

What is the research about?

Aamjiwnaang's Research Assistants Candida
Wemigwans, Lynn Rosales, Animikeence Plain and
Ada Lockridge

We are conducting two related projects in First Nation communities. The first project, Researching Health in Ontario Communities (RHOC), seeks to better understand problems that relate to mental health, substance use/addiction, and violence (MSAV) in communities across Ontario.

RHOC is looking at the extent and nature of these problems and the challenges that people face when dealing with mental illness, substance misuse, and violence. This five-year project is funded by the Canadian Institutes of Health Research and uses a mobile research lab equipped with computers, data collection equipment, and an interview area for study participants.

The second initiative, known as Five Views on a Journey, builds on RHOC to better understand the system of services and informal supports that are available to people who have MSAV problems and to work with community knowledge users to improve this system.

Five Views is looking at the system from five different perspectives: individuals who have MSAV problems, their family members, the general population, service providers, and existing data on patterns of service use using the Institute for Clinical Evaluative Sciences (ICES) data and the Drug and Alcohol Treatment Information System (DATIS).

Together, RHOC and Five Views make for a comprehensive program of research that will advance our understanding of complex factors that contribute to mental illness, substance misuse, and violence. This is particularly timely as First Nation communities move to better integrate mental health care with primary health care and other community-based support services. To do this will require services providers to work with each other more closely but also a foundation of good quality research.

Who is conducting the research?

The RHOC project is led by Dr. Samantha Wells and the Five Views project is led by Dr. Kathryn Graham. I am the lead researcher for the projects in Kettle & Stony Point First Nation and Aamjiwnaang First Nation.

Our project team works with local research advisory committees to define research questions, interpret the findings, and apply the new knowledge. These committees represent the unique interests, perspectives, and concerns of each community and include band councillors, health directors, community health nurses, mental health and addiction support workers, and volunteers from the local communities.

Working with these local committees, we modified and refined research procedures and tools so that we use sound methods that respect First Nation perspectives.

Consistent with this, we employ First Nations researchers who have a lot of experience working with First Nations people, both in research and as community-based workers. This helps to ensure a strong community perspective in the research and give staff strong research skills that can be applied in other work settings.

What is being done?

Julie George and her kids.

First, a survey of the general population captures information on rates and types of mood and anxiety disorders, levels and sources of stress, substance use, violence, stigma, as well as the types of services that people use for MSAV problems, including primary care, community programs, and informal supports. We also collect hair samples to examine cortisol levels (a stress hormone) and saliva to identify genetic factors related to mental health and substance use problems.

Second, we will do in-depth interviews with people who have MSAV problems and their families to identify barriers and supports they encounter as they seek help in their community. This information, combined with knowledge from the general population survey, as well as interviews with service providers and existing databases, will give us a full picture of how the system of care is working for people who have MSAV problems, key factors that affect their need for services, and how they use these services.

Once data are collected and analyzed, we will prepare reports on the findings, which can help community stakeholders improve local services. Also, we will hold forums in each community to answer their questions, and will meet with community leaders, managers, and front-line staff to identify ways that they can use the findings to improve the system of care for MSAV problems. We will also work with provincial-level knowledge users (e.g., managers and policy makers) to apply what we learned from these and other communities to improve the system in general.

What is the intended outcome of this project?

Kettle Point

The main purpose of the RHOC/Five Views project is to find ways to improve how we care for people with problems related to MSAV. An important element of this is to ensure that the knowledge and system innovations that come out of the research are shared across Ontario communities.

But at the community level, the results of the research can provide meaningful information on the nature and extent of MSAV in these First Nation communities and factors that are associated with these problems. By examining broad systems of care (including mental health care, primary health care, emergency services, and informal supports, etc.), we will be able to determine each system’s strengths and weaknesses, the factors that influence the needs of community members with MSAV problems, and how individuals move through the system. We will also be able to map referral patterns to better understand how the system works and how individuals rely on services outside their community. Communities can then use this information to improve how they plan and provide services.

What are the limitations of the research?

Although the lab can be moved from community to community, it has to be connected to a sufficient electrical source, so it can’t be moved easily within communities. This means that it may be difficult for members of the First Nation who live far from the lab to participate in the research. This means that the data that is collected may not be represent fully all the people who live in a specific community. We try to deal with this problem by providing taxi vouchers and making other travel arrangements for those who may find it difficult to get to the lab.

Are there any future areas to expand or build on this research?

Our project team recently submitted a research proposal for funding to examine how genes and factors in the social environment (such as stress and social support) may interact to influence a person’s risk for MSAV problems. We’re also working on another proposal for a project that would allow us to work more closely with First Nations men and other partners to develop a demonstration program to:

  1. Increase dialogue and raise awareness about First Nations men’s mental health;
  2. Provide support to First Nations men with mental health conditions, as well as their families; and
  3. Address the impact of colonization on First Nations men.

We expect that this program of research, integration, and development will help direct policy and provide a model that can be adapted by similar communities across Canada.

For more information on this project please contact Julie George at julie [dot] george [at] camh [dot] ca.

Author: Rossana Coriandoli