Des facteurs protecteurs cernés dans des éléments d'intégration et de connection chez les praticiens et dans leur motivation pour le travail qu'ils font se sont dégagés de l'étude. The qualitative phase is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods. Supports for longevity included team collaboration, knowledgeable supervisors, managers, leaders and more opportunities for formal education, specific training and continuity of care to support clients. Protective factors found in elements of embeddedness and connectiveness of practitioners and their motivation for doing the work they do emerged from the study. The intent of developing a survey was to include more participants in the research and access those working in small communities who would be concerned regarding confidentiality and anonymity due to their high profile within smaller populations.
Six métathèmes ont été interprétés à partir des données : l'aide absorbant la vie, l'humanité, l'engagement respectueux, l'investissement et l'intégration, le praticien profondément affecté, et la croyance. Six metathemes were interpreted from the data: helping takes over life, humanity, respectful engagement, invested and embedded, profoundly affected, and belief. The focus of this article is on the final expanded qualitative findings and meta-analysis of a northern Canada study involving a four-phase, 3-year research design. The main objective of the 3-year study was to document the situation of formal and informal helpers in providing mental health support in isolated northern communities in northern British Columbia, northern Alberta, Yukon, Northwest Territories and Nunavut. The results explored included helping professional and paraprofessional development within remote settings, visions for the provision of community supports to assist them in providing services, and components of a conceptual model of mental health practice in the Canadian North. This survey is part of a multi-year research study on informal and formal mental health support in northern Canada involving the use of qualitative and quantitative data collection and analysis methods in an effort to better understand mental health in a northern context.
Elementary and special education teachers and school counsellors currently provide support to children presenting learning disabilities and behavioural problems symptomatic of the more hidden diagnosis of complex trauma resulting from abuse or severe attachment disruption. The reviewed literature presents the unique challenges of formal professional and informal para-professional and other mental health practice in northern communities including: isolation related to the principle of confidentiality, geography, and lack of supervision; high visibility and lack of anonymity; and the struggle of negotiating membership in a community with professional and para-professional practice. Suggestions for the non-aboriginal counsellor in facilitating the healing process for First Nations women are offered. The need for revised codes of ethics relevant to the reality of northern work was a major category, as was insight on how to best sustain northern practice. The specific context of northern mental health support needs to be considered when practitioners use various construct labels to describe what is happening to them.
First Nations women's health needs to be viewed in a holistic framework that considers multiple levels of oppression, poverty, colonization, and life as a minority in a dominant culture. En utilisant une analyse narrative en trois étapes, on s'est servi de 10 catégories pour structurer les thèmes générés par les huit narrations. Hope is a vital component of psychological healing and plays a critical role in counselling. Practitioners who work in isolated settings are often removed from other professionals, training opportunities, clinical supervision, and family support, with this seclusion contributing to feelings of professional and personal isolation.
Protective factors found in elements of embeddedness and connectiveness of practitioners and their motivation for doing the work they do emerged from the study. This review explores the unique conditions found in northern-based mental health support in on-going efforts to develop a practice model for mental health support in the North and to better understand the connection between isolated practice and secondary trauma. Secondary trauma is defined under the constructs of burn-out, compassion fatigue, secondary traumatic stress, and vicarious trauma. It is proposed that a conceptual and practice model be developed specifically for isolated mental health support in the North, and broadened to include informal mental health providers as well as formal practitioners. Thirty-two participants identified various challenges, supports and client issues relevant to their mental health support work.
Empowering communities by building community capacity to educate, supervise and support formal and informal mental health workers may be the best approach to overcoming the lack of external resources. Reduced mental health services have resulted in more responsibility and stress for the remaining formal mental health practitioners including counsellors, psychologists, social workers and nurses and on informal mental health support, such as lay counsellors, Elders, family members, and community-identified helpers. Defining elements of northern practice included the need for generalist knowledge and cultural sensitivity. Research on brain-based effects of early trauma and work from the field of epigenetics may contribute other components to the complex, intergenerational impact of multiple trauma contexts. Northern-based research on mental health support, no matter the specific profession, helps to inform instruction of new practitioners and practitioners already working in rural or isolated conditions. A vast majority of the respondents felt prepared for northern practice and had some level of formal education.
Informed support for individuals and families combined with political advocacy at a systems level is critical in intergenerational trauma work in order to break historic patterns affecting family development and interactions. . Differing views and definitions on the phenomenon of secondary trauma continue to be espoused. Aspects of isolation as well as the requirements of empathic engagement with clients leave practitioners vulnerable to various constructs of secondary trauma. Drawing on decades of work as allies with Indigenous families and communities in Canada, the authors present a review of literature on intergenerational, historical trauma and the effects of early trauma.
The results from the survey emphasise the need for team collaboration, interdisciplinary practice and working with community strengths as a way to sustain mental health support workers in the North. Parents, whether adoptive, foster or biological, raising alcohol-affected children contend with the exhaustion of the care taking role. This article maps the historical background of First Nations women focusing on the residential school system, subsequent intergenerational trauma, and the effects of the Indian Act. The qualitative findings from interviews with twenty informal and formal mental health practitioners focus on the broader themes found within the meta-analysis in an attempt to answer a recent call for more proactive literature emphasizing opportunities for counselling and mental health support. Six metathemes were interpreted from the data: helping takes over life, humanity, respectful engagement, invested and embedded, profoundly affected, and belief. Social constructionism provides a new lens from which to question and re-conceptualize ways of working with First Nations women.