Biigajiiskaan: Pathways to Mental Wellness

Biigajiiskaan is meant to enhance existing care and services that exist within Parkwood Institute’s Mental Health Care Program. The aim of this program is to combine Traditional Healing as part of the clinical services that are offered. The goal is to validate and honour Indigenous culture and identity, enhance the care currently provided at St. Joseph’s and create a more positive experience for the Indigenous population.

Traditional healing practices are skills based in Indigenous knowledge and beliefs, used for holistic health care through the use of sacred medicines, ceremonies and traditional teachings to promote spiritual, mental, physical and emotional well-being.

This initiative is unique because it incorporates traditional medicine, Indigenous elder-guided care, and ceremony with Western psychiatric treatment and hospital care. Biigajiiskaan is guided by the Thunderbird Partnership’s Foundation’s First Nations Mental Wellness Continuum Framework. The goal is to provide a hostile-free environment, and services that are culturally-safe and Indigenous-led with a focus on meeting the individual, cultural and health care needs of each client. Biigajiiskaan is about creating a new Indigenous wellness model of care that transforms health care and mobilizes knowledge to other interested communities, organizations and institutions.

The Biigajiiskaan program is available to Indigenous inpatients, outpatients and community outreach clients of Parkwood Institute’s Mental Health Care Program, which is part of St. Joseph’s Health Care London. Participants at Atlohsa also have access to these services and Biigajiisakaan is growing referrals through other local Indigenous agencies and organizations in the London-Middlesex and St. Thomas-Elgin County regions.

Not at present, as the program is still in its early days. A growth opportunity would be to expand to the non-Indigenous community in a future phase if/when possible.

This program offers traditional Indigenous healing services in a hospital setting – making internal hospital referrals more convenient and comfortable for Indigenous community members. Biigajiiskaan staff are also developing and nurturing networks with mental health and addictions workers both in urban and First Nation settings, opening lines of communication for seamless referrals for those in need of support. In addition, the mobile outreach team allows for follow-up to ensure continuous care for outpatients and those who are transitioning from hospital to community.

The Biigajiiskaan Team is comprised of eight specialists (both Indigenous and non-Indigenous) including: a project lead (MSW/RPN), coach/team administrator, addictions specialist, clinical lead (MSW), Indigenous Knowledge Keeper, Shkaabewis (Helper), registered practical nurse and a psychiatrist. Together with other Atlosha staff, the team reaches out to area Indigenous communities and Indigenous-serving agencies with the goal of making connections and helping to facilitate access to Biigajiiskaan.

Program care is guided by an Indigenous Governance Circle (IGC) comprised of local Elders/Knowledge Keepers from Anishinabek, Haudenosaunee, and Lene-Lenape nations, Indigenous and non-Indigenous agency representatives, and the Biigajiiskaan Team. The IGC utilizes a strengths-based approach to facilitate decision-making and set standards of practice. It also ensures that all processes and outputs are Indigenous-informed.

Indigenous people have experienced institutional trauma – loss of language, culture and community– through Canada’s Residential School system and Indian hospitals, and continue to experience systemic discrimination and stereotyping in institutions to this day. These experiences have led to the loss of language, culture, a sense of safety and community. Today, community members continue to experience systemic discrimination and stereotyping in institutions. As a result, many Indigenous people are reluctant to go to hospital or access help from Canadian health care agencies.

At the same time – and as a result of colonization and government programs such as the residential school system – Indigenous people experience mental health and addictions at rates that are more than double those among non-Indigenous people in Canada. The impact is crippling. Suicide rates among Indigenous youth are more than five times higher than among non-Indigenous youth in Canada.

Indigenous peoples face barriers to equitable health care as a result of a history of colonization. By ensuring that the mental health care and wellness services of Biigajiiskaan are Indigenous-led, we can begin to break down these inequities and barriers, which will lead to culturally-safe care and hostile-free environments. This is important because there is strong evidence that providing culturally-safe care improves health outcomes.

The goal is to raise awareness about Biigajiiskaan among care providers in and out of hospital settings so they can facilitate culturally-safe care. Equitable, mental wellness in a hostile-free environment requires removing barriers to care and being accessible to offer people the help they need.

Biigajiiskaan is partnering with Western University and Lawson Health Research Institute on a program evaluation that includes both qualitative (stories, narratives) and quantitative methods (e.g., client satisfaction and engagement) to capture key outcomes as defined by the communities of practice. The process and formative evaluation will draw upon the experiences and perceptions of Indigenous community members, mental health care providers, and leadership, as well as other stakeholders (e.g., Elders and Knowledge Keepers) who work within mental health care settings.