The other thing that I have here is trauma and violence because trauma and
violence is something that we see affecting indigenous communities both
from the inside and the outside and this create, creates environments that of
course, have an effect on people's mental health.
But this paper wants us to understand that looking at just these immediate
social determinants is too shortsighted of view.
It's actually a demonstration of how the social determinants can be limited in
terms of not taking into account. The full range of determinants that
effects specific populations. If we want to understand the determinants
of mental health in indigenous communities, she suggested that you need
to start with colonialism. You need to recognize that colonialism is
this overarching, organizing policy that started in continuous to orchestrate the
processes that eventually lead to those negative social determinants of health.
Colonialism and its operation of things like systemic racism, cultural genocide.
Here I'm referring to the assimilation processes that interrupted culture,
language and family ties. community and family disruption as I've
already mentioned and then also the removal of self determination.
These are all strategies or tactics that are part of colonialism.
And colonialism essentially puts control in other people's hands.
It has consequences for those social determinants.
So, if you look at all of these things, the systemic racism, the cultural,
genocide, the disruption, and the lack of self-determination, all are connected to
the things that we are identifying as social determinants of health here in
this row. If we keep moving on,
one of the consequences of having no self determination is that there are not
appropriate services to address the problems that are promoting ill health.
In the paper the author refers to an ecocentric approach that is consistent
with indigenous perspectives. There are others of course but the
removal of self determination has meant that this has not been available to
indigenous peoples. What has been available are services that
are inappropriate and at times actually harmful.
When we get to the lecture on culture and mental health, I'll be, I'll be talking
more about the work that indigenous people around the world have done to
address the harm that has been inflicted by health and mental health services and
the need to develop the services that are culturally safe.
your paper does refer to this a bit in terms of how there has been an accepted
discourse around the idea of the depressed Indian, the disordered Indian,
the the addicted Indian. These are all parts of the type of,
of harm, of harm that we see resulting from inappropriate services and frankly
services that are actually dangerous in some ways to certain communities.
In the absence of these culturally safe services or even a belief that there is a
need for culturally sensitive services, it means that people do not get the help
they need for either health problems or for the conditions that lead up to health
problems like the ones that we see here. This isn't addressed in your article but
I have added oppression related stress as a negative health code outcome that
results from colonialism as well. Literature in this area has been mostly
developed around racism in the context of the United States.
and the thing is that what that literature talks about is how it's not
just that the, the exposure to explicit, violent, and over racism that takes a
toll on people. But the daily exposure to what they refer
to as microaggressions, small acts and experiences, small everyday acts and
experiences that reinforce your status as a person that is not valued or that is
even held in contempt. These microaggressions have a cumulative
effect that materializes in things like cardiovascular disease and mental
illness. Indigenous people certainly face what we
could call racism related stress but because it's in the context of this wider
experience of colonialism, it's much bigger than just racism, so I name it as
a pressure related stress here. I suppose you could also call it
colonialism related stress. Finally, I want to mention that as well
has having as well as these determinates having an effect on mental health they
have an effect on physical health. Indigenous communities have higher rate
of infection, injury, chronic disease. It's not surprising of course that things
that negatively affect mental health also have an affect on physical health.
This may be hinting at that false division between mind and body that I
mentioned earlier. So, there are these physical health
outcomes that take, to take into account. And they also have mental health
consequences. As there is a lot of co-morbid anxiety
and depression with physical illnesses. Another consideration is the mental
health consequences for caregivers of people with mental and physical
disorders. Caregivers can experience high levels of
psychological distress, depression, anxiety, and their own physical health
consequences as a result of it being in the caregiver role and of course we'll
talk about that when we get to the lecture on families.
So, why are some people mentally healthy and why is it harder for some other
people to stay mentally healthy? I hope that thinking through the
situation that's described in your paper helps you see that there's definitely a
connection between the social environment that people are in and their health.
It, it has to do with attitudes, it has to do with tensions.
It has to do with the level of violence and trauma.
It has to do with things like whether you have drinking water, and you, what you
have to go through to get it. All of that has an effect on people's
health. Both physical and mental.
But what that paper also shows us so well is that there are broader issues that are
also implicated. That it doesn't just stop or start at
this place of well, if you have the right kind of housing, if you have the right
kind of education, employment and all that, that if all these things are in
place then your chances of being healthy are much better.
That's certainly true but there are things that promote and undermine the
ability to have those things in place. And that's what I think that paper
demonstrates so beautifully and so unfortunately.
So, we've talked now quite a bit about how the social context affects mental
health. But how is it that, that social context
somehow turns into something that affects the way that your brain is functioning or
effects the way that you're feeling and behaving and, and thinking.
what we're going to try to do is answer that question by looking at the bio
physchosocial perspective and seeing if it can give us some answers.
That's coming up next.
