Why St. Joe’s is prioritizing traditional healing practices for Indigenous patients
St. Joe’s is working toward the Truth and Reconciliation Commission of Canada's Call to Action #22, – We call upon those who can affect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients. |
Canada’s health care system is considered to be among the best in the world. Unfortunately, healthcare is not equally accessible to all – and this is particularly true for Indigenous communities.
Poor health outcomes in First Nations, Inuit, Métis, and Urban Indigenous (FNIMUI) peoples are a direct result of racism and intergenerational trauma caused by colonization. Systemic discrimination led to the forced removal of children from families, the residential school system, and resulted in a loss of culture and language – all leading to unjust health outcomes. The Truth and Reconciliation Commission of Canada has charged those who can affect change in the Canadian health care system to work alongside FNIMUI communities to address these underlying issues to offer inclusive health care.
Indigenous communities have always held important knowledge about healing and wellness, passed down through generations, which include psychological, emotional, physical, and spiritual aspects of being. As health care providers, we have a responsibility to provide culturally safe care, which respects and recognizes the value of traditional medicines and ceremonies alongside western medicine (Learn more about this through the Indigenous Primary Health Care Council's cultural safety training).
Three important ways St. Joe’s accepts and provides access to traditional healing practices:
1. Smudging
Encouraging and helping to facilitate smudging can make all the difference for many Indigenous patients. For those who often smudge at home, bridging the gap while staying in the hospital is critical for their wellbeing.
2. Indigenous Patient Navigators
Through a partnership with the De dwa da dehs nye>s Aboriginal Health Centre, St. Joe’s patients can connect with an Indigenous patient navigator to support their care.
3. Enhancing and building on our existing partnerships with Indigenous-led local organizations such as the De Dwa da dehs nye>s Aboriginal Health Centre and the Hamilton Regional Indian Centre to connect patients to their culture.
Indigenous clinicians’ innovative solution to address inequities in mental health care
It started with a question: can we fast track Indigenous patients into our mental health program, for those who want it? This inquiry from St. Joe’s Clinical Psychologist and Haudenosaunee woman Dr. Caitlin Davey became the catalyst for an innovative approach to address a growing gap in mental health care for Indigenous people during the COVID-19 pandemic.
Western mental health care can be difficult to access during the best of times, but the pandemic exacerbated that gap. St. Joe’s mental health leadership supported Dr. Davey’s inquiry, and she quickly dedicated part of her own clinical time to spearhead this pathway to provide care for Indigenous patients. Initially referrals were slow.
“There will be Indigenous people who will never come to St. Joe’s for various reasons,” says Caitlin. “But early on we connected with the community and they brought up valid concerns: Who knows about this pathway? How can they be referred? Up until that point, it was really word of mouth through people that I knew. It was designed to be safe and equitable, but at that point, it wasn’t there yet.”
Dr. Davey took that feedback to heart and implemented changes. She handpicked clinicians from St. Joe’s Mental Health and Addictions Program who had cultural safety training and would be respectful of Indigenous ways of being, and once again consulted with Indigenous communities.
Before she knew it, they had more than 50 referrals. “That’s really exciting because it means to me that these relationships and trust are growing. Everyone on the team is eager, which has been meaningful. I see the respect they have for Indigenous ways and the importance of culture. That’s major, because historically that has been dismissed by the health care system.”
The key to providing better care for Indigenous patients: Building relationships
There remains a deep, historical distrust of the health care system among Indigenous communities. The only way to ensure culturally-safe care is by building trust that has been broken over generations, and recognizing that Western solutions may not be the best or only answer. While progress may seem slow, we know building relationships and trust takes time. But we can’t skip this step.
“Indigenous communities already know how to take care of their members when it comes to healing mental health struggles,” Dr. Davey says. “The challenge is access to resources. The mainstream system is not designed for Indigenous patients. One of my goals is to push for change, drawing from amazing work that Indigenous communities are already doing and really seeing those two worlds come together.”
Dr. Davey believes these “two worlds” – Indigenous and Western ways of life – can work together, called a “two-eyed seeing approach.” She says that while they can feel divided, they can join in a meaningful and respectful way where western ways can learn from Indigenous ways of knowing and vice versa.
In addition to her work at St. Joe’s, Dr. Davey is the Provincial Clinical Lead, Indigenous, Depression & Anxiety-Related Disorders at Ontario Health’s Mental Health and Addictions Centre of Excellence. She has made remarkable progress in building relationships with Indigenous communities across the province. This includes creating a clinical advisory table, with Indigenous clinical experts who have expertise in both Western mental health models and traditional healing practices.
“Culture is treatment. But not every Indigenous person who walks through our doors are in the same place. Everyone is different with respect to their identity and cultural connection. We need to make sure that we’re meeting the individual where they’re at. Understanding what’s important to them, what they value in their own personal healing journey.”
What’s next at St. Joe’s?
We recognize that there is still much work to be done. In partnership with St. Joe’s EDI council, we are committed to accepting and integrating Indigenous healing practices to improve health care services to action the Truth and Reconciliation Call to Action. Feedback is being gathered from health care workers through an Equity, Diversity and Inclusion listening tour and an engagement survey, and we are taking guidance from local Indigenous leaders to:
- Incorporate Truth and Reconciliation actions to our EDI framework
- Develop a guide for meaningful and thoughtful land acknowledgements
Compassionate care can take on many forms. Creating accessible opportunities for Indigenous health concepts will build a community that shows respect, trust and equality to improve care and outcomes for Indigenous people.