Indigenous Mental Health in the time of COVID-19: A Hidden Crisis
Policy Brief by Vrinda Agnihotri.
The impact of COVID-19 has been largely disproportionate on the Canadian population, drawing attention to the federal government’s failure to adopt an intersectional approach to the healthcare system. The intensity of the pandemic has profoundly impacted the economic and social wellbeing of Indigenous communities. Statistics Canada conducted a crowdsourcing survey which revealed that 60% of Indigenous participants indicated worsening mental health conditions. The percentage of Indigenous people indicating severe anxiety is almost double that of non-Indigenous people [1].
It is important to note that the Indigenous response to the pandemic has been exceptionally organized as communities collaborate to create unique approaches. Indigenous communities must have control over their responses to the pandemic for cultural and ceremonial management. The diligent response should not deter from the exacerbated realities of the socio-economic gaps in Indigenous communities. A long history of colonization has impacted the course of Canada’s healthcare system in its policy creation and implementation. Canada’s Indigenous Services Minister, Marc Miller, describes that the mental health crisis "has claimed more Indigenous lives than COVID has during the same time period [2]." On top of heightening COVID-19 cases, Indigenous communities must also deal with pre-existing issues that continue to worsen, including the opioid crisis, a lack of infrastructural funding, food insecurity, and limited access to safe drinking water.
Decades of discrimination within jurisdictural decisions and the healthcare system continually attempt to assimilate Indigenous practices to mainstream healthcare. This treatment results in disconnected policies that are very ineffective in their implementation, such as the failure to support cultural practices that are integral in Indigneous healing. Furthermore, poorly made policies contribute to cultural erosion in many communities, damaging Indigenous identity, and, consequently, their health [3]. In March, the Canadian Government released an initial funding of $305 million to support Indigenous reserves with efforts to minimize COVID cases [4]. The initial amount proved to be inadequate and the federal government increased it to $650 million to fund medical supplies and support community-driven responses. Certain gaps in longstanding health and social disparities cannot be solved by immediate sums of government funding.
For example, Indigenous women have been especially vulnerable to high stressors and anxiety with caregiving pressures, economic vulnerabilities, and gender based violence. Statistics Canada revealed that Indigenous women experienced a large hike in generalized anxiety conditions with the pandemic [5]. Safety groups and shelters that work with Indigenous women revealed a large increase in domestic violence. As a response, the Canadian government launched a five year funding plan to support the shelters that have been facing long term inaccessibility for years [6]. The issue of domestic violence goes beyond a simple funding fix. Research has proven that the main social determinants of health for Indigenous peoples are colonization and assimilation because they result in intergenerational factors that deeply impact families and mental health conditions [7]. Another key issue in the time of COVID-19 is the increased alcohol consumption as a result of factors such as social isolation, anxiety, layoffs, and financial distress - an issue that continues to lack coordinated policy action [8].
The Indigenous health crisis is not a sudden news. Disconnected policies and a long history of injustices have set the stage for a disastrous healthcare system which fails to recognize and support the needs of Indigenous communities. In particular, mental health conditions have not been adequately supported and are closely linked with pre-existing socio-economic disparities. The deep rooted nature of damage within social and health systems are a dark reminder of government mandated discrimination and cannot be undone by sums of funding in times of immediate emergency. Crises within Indigenous communities have prevailed for much longer than the duration of the pandemic. This issue requires consistent dialogue and policy making decisions made with Indigenous communities to tackle the factors that have failed to ensure equal and equitable access to a healthcare system.
Arriagada, Paula, Tara Hahmann, and Vivian O’Donnell. “Indigenous People and Mental Health during the COVID-19 Pandemic,” June 23, 2020. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00035-eng.htm. [2] Alhmidi, Maan. “COVID-19 Cases Rising in Indigenous Communities.” CTV News, September 30, 2020.
Alhmidi, Maan. “COVID-19 Cases Rising in Indigenous Communities.” CTV News, September 30, 2020. https://www.ctvnews.ca/health/coronavirus/covid-19-cases-rising-in-indigenous-communities-1.5126098.
Matthews R. (2016). The cultural erosion of indigenous people in health care. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(2), E78–E79. Advance online publication. doi:10.1503/cmaj.160167
Arriagada, Paula, Tara Hahmann, and Vivian O’Donnell. “Indigenous People and Mental Health during the COVID-19 Pandemic,” June 23, 2020. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00035-eng.htm.
The Canadian Press. “Canada Giving Another $650M in COVID-19 Aid to Indigenous Communities.” Global News, May 29, 2020.
Ibid.
Klingspohn, Donna M. “The Importance of Culture in Addressing Domestic Violence for First Nation's Women.” Frontiers in psychology vol. 9 872, doi:10.3389/fpsyg.2018.0087, 24 Jun. 2018.
Ali, Shehzad, Jürgen Rehm, et al. Alcohol Consumption and the COVID-19 Pandemic: Synthesizing Knowledge for Policy Action. Draft CIHR Knowledge Synthesis Report, January 22, 2021. https://cihr-irsc.gc.ca/e/documents/SHIELD_CMH-KS-Knowledge-Synthesis__2020-09-22.pdf