Mental Health Management in Indigenous People

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Summary

As the case study of Marcus Tommy, an aging Native American male, demonstrates, social welfare policies and the relevant efforts must be geared toward collaboration between local, culture-based mental health support systems, such as Tribal Support Counselors, and healthcare experts. Addressing the mental health needs of indigenous populations represents a major challenge for healthcare practitioners and social workers due to the cultural gap between them and their patients. Specifically, the lack of cultural competence regarding the needs of indigenous people leads to an inevitable failure to cater to the needs in question (Ormston, 2005). As a result, the efficacy of the relevant services drops, causing the target audience to continue experiencing distress.

Social Welfare Policies

In order to enhance collaboration between healthcare experts on a cross-cultural level and introduce opportunities for traditional and spiritual health practices along with the established Western healthcare framework, changes must be made on a policymaking level. Namely, social welfare policies for improving the quality of indigenous people’s lives must be designed. The policies in question will have to promote active cooperation between tribal healthcare authorities, such as Tribal Support Counselors, and healthcare professionals representing Western approaches to mental health management.

The policies in question must reflect the needs of indigenous people directly, primarily, by establishing a connection between their spiritual, mental, and physical health. Furthermore, specific factors that affect the mental well-being of minority groups, such as the prevalence of alcohol misuse among Native Americans, must be taken into account as well (Clark, 2006). Thus, proper guidance will be provided for mental health experts.

Services Received through the Tribal Mental Health Service and the Ability to Achieve a Better Quality of Life

Furthermore, when addressing mental health concerns of indigenous people, particularly members of the Native American community, one must examine the phenomenon of tribal mental health specifically. Defined as the set of practices designed within tribal communities for the purpose of addressing health concerns while allowing patients to maintain their spirituality, the specified practices represent a crucial part of the healing process (Kirmayer et al., 2000).

Though from the Western perspective, the practices in question might seem irrelevant, they bear crucial significance for Native American people, which is why they must be incorporated into the framework for managing Native American people’s health needs (Kirmayer et al., 2000). Particularly, the available evidence shows that the specified options contribute to patients’ social well-being and enable them to develop coping mechanisms that lead to better health sustenance (Chandler & Lalonde, 1998). For this reason, the concept of tribal mental health must be actively introduced into the relevant healthcare practices and the associated health policies.

Legal and Ethical Considerations

In the case at hand, legal and ethical considerations regarding the subject matter must be incorporated into the policymaking process. As the case indicates, the current legal framework for addressing the needs of people belonging to ethnic minorities and indigenous populations are extremely lacking (Bay, 2006).

Namely, the absence of guidelines for cross-cultural collaboration among mental health experts of the indigenous population and the Canadian health services is glaring. Thus, among the legal considerations, repercussions for causing a patient harm or, in the worst-case scenario, a fatal outcome will cause health experts to be legally liable and, therefore, subject to the relevant legal punishments, including the possibility of a jail sentence (Bay, 2006). Likewise, the ethical repercussions of failing to promote cross-cultural collaboration among experts will lead to healthcare professionals bearing moral responsibility for adverse and fatal outcomes among indigenous people. Therefore, appropriate measures must be undertaken to promote collaboration among healthcare experts on a cross-cultural level.

Especially, in the case under analysis, the patient displayed a rapid and unmanageable decline in his physical health status despite the evidently sensible interventions provided by members of the healthcare services. In turn, the intervention of the tribal mental health experts has contributed to an immediate improvement in the patient’s health status. The observed phenomenon can be ascribed to the intuitive understanding of the intricate nature of the sociocultural and socioemotional needs of Native American people among their healthcare authorities (Bay, 2006). The case illustrates that, unless the support of the tribal mental health expert had been introduced, a fatal outcome could have been a possibility, which further proves the need for cross-cultural collaboration within the mental healthcare system.

How Do the Various Acts and Legislations Presented Affect You?

The presence of acts and legislations related to the management of indigenous people’s needs is indicative of legal authorities recognizing the issue, yet there is an evident gap in the understanding of the needs in question. Particularly, as Marcus, one might be affected by the acts and legislations under analysis since they tend to prioritize the use of standardized healthcare strategies as opposed to focusing on patient-specific needs associated with the patient’s cultural and ethnic backgrounds. The current regulations overlook the importance of spiritual practices associated with the management of health-related issues within indigenous and especially Native American communities (“A practical guide to mental health and the law in Ontario, revised edition,” 2016).

Indeed, reports point to the lack of insight into culture-oriented practices in the current legal standards (“A practical guide to mental health and the law in Ontario, revised edition,” 2016). Additionally, there is a deplorable absence of emphasis on collaboration between healthcare officials and tribal healthcare experts representing the community in question (“A practical guide to mental health and the law in Ontario, revised edition,” 2016). Therefore, immediate changes must be introduced into the specified context to advance the efficacy of care and ensure that patients are provided with the necessary support and care.

Impact of These Acts and Legislations on the Family

The existing legislation affect the family of Indigenous people to a significant extent. Namely, due to the lack of consistent communication and cross-cultural exchange, families are forced to choose between their belief systems and the proposed interventions. Without the required health awareness and health literacy among most general audiences, the specified choice becomes exceptionally complicated (Bill 68, Mental Health Act, Health Care Consent Act, n.d.). Therefore, there is an active need for families to remain in contact with both local healthcare experts practicing traditional health strategies and official healthcare authorities that promote innovative, research- and evidence-based care (Bill 68, Mental Health Act, Health Care Consent Act, n.d.). Thus, the adverse effects of the current legal standards will be minimized, whereas the positive aspects of cooperation between the two cultures will be enhanced.

Legal and Ethical Constraints

As a mental health worker, I will have to comply with essential ethical and legal provisions when offering Marcus and his family members the relevant services. Clearly, the case under analysis features an instance of a geriatric patient’s health concerns being addressed. Therefore, the issue of consent and the appropriate assessment of Marcus’ mental health should have taken place according to the existing legal standards (Bill 68, Mental Health Act, Health Care Consent Act, n.d.). In turn, the specified measures were not taken, which indicates the lack of concern for the needs of indigenous populations within the Canadian healthcare service.

In addition, the case features several ethical issues that should have been addressed, the problem of misunderstanding and the healthcare expert’s failure to ensure clarity in communication being the prime example. The case details that, due to the daughter’s misunderstanding of the healthcare provider’s description of the case, namely, the choice of words such as “overwrought,” she could not infer the proper course of action to be taken to assist her father. In turn, the doctor’s failure to clarify whether the daughter as Marcus’ prime caregiver could understand the instructions correctly is illustrative of the healthcare expert’s poor ethics.

Explaining to the Government Funding Body That Successful Treatment and Follow-Through Depends upon Meeting the Needs of the ‘Identified Patients’ as Well as Family Needs

Therefore, I will have to draw attention to the issue of miscommunication between healthcare providers and indigenous communities. The failure of the current healthcare policies and the relevant legal provisions to reinforce the importance of meeting indigenous people’s needs should be isolated as one of the core concerns to be addressed in the nearest future. Furthermore, I will need to enhance cultural safety by introducing adequate strategies for encouraging the dialogue between indigenous populations and healthcare experts.

In addition, the specified communication must be maintained on several levels, namely, between official healthcare authorities and community healers; healthcare officials and patients; and healthcare experts and patients’ family members. The specified communication framework will allow for a comprehensive approach toward identifying core health concerns among members of indigenous populations, isolating cultural barriers to health management, and introducing tools for overcoming the barriers in question while offering patients the required support.

Most importantly, the role of cultural safety must be introduced into the framework for addressing the needs of indigenous people as one of the principal standards of care. Currently, the notion of cultural safety is integrated into the healthcare policies associated with managing the needs of indigenous populations, yet the specified standard lacks proper reinforcement (Bay, 2006). Particularly, as a healthcare provider, one must ensure the patient’s and the patient’s family participation in the treatment process, therefore, maintaining active collaboration with the specified stakeholders and encouraging the development of health literacy in the population in question. At the same time, the process in question must promote active cultural exchange, implying that healthcare providers will also receive relevant information regarding the nuances of health management for specific vulnerable minority communities, such as Native Americans.

Plan of Care

With the specified information in mind, I must incorporate strategies geared toward building a rapport it the patient and his family into the plan of care for Marcus and allow him to embrace his culture and traditions while accepting the proposed treatment. The specified process will be split into several crucial steps. First, I must build a conversation with the tribal healthcare experts, namely, the Tribal Support Counselors. The specified step will allow identifying Marcus’ essential spiritual needs, as well as those of his family, and structure the intervention accordingly. Afterward, a rapport between Marcus and me as a healthcare expert, as well as me and Marcus’ daughter, will have to be established.

The specified step is vital in promoting trust as the basis for successful treatment. With the enhancement of trust, the patient and his family members will be significantly more cooperative, which, in turn, will increase the probability of successful treatment. Furthermore, the described change will help me promote patient education more actively, therefore increasing Marcus’ and his daughter’s understanding of the rationale behind the choice of specific treatment options.

Next, the therapy session will start, with me encouraging Marcus to recognize his current mental health issues. Specifically, the trauma of losing his wife, as well as the substance misuse disorder, will have to be acknowledged as the core concerns to be managed. The therapy process will be geared toward supporting Marcus in identifying his emotions through talk therapy (“Harm reduction policies and programs for persons or Aboriginal descent,” n.d.).

The specified approach will help him reconcile with his trauma by recognizing it and accepting his emotions, primarily those of pain and guilt. Afterward, during the therapy process, I will have to focus on helping Marcus relieve himself of the feeling of guilt and introduce a healthier mechanism for managing negative emotions. For this purpose, active communication with his family members, particularly his daughter, will have to be introduced as a way for Marcus to heal emotionally and mentally.

Additionally, Marcus’ family members will also have to be provided with appropriate guidance and support. Pointedly, Marcus’ daughter will be offered the relevant therapy and counseling opportunities in order to overcome the trauma of losing her mother. Furthermore, given my understanding of the specifics of Native American culture, particularly the role of family connections in it, strategies for helping her to reconnect with her father and rebuild the rapport between them will be incorporated into the treatment process. The specified changes will have to take place with the supervision of the Tribal Support Counselors, who will offer spiritual support for Marcus and his family. Thus, the case under analysis will be resolved, Marcus and his daughter are overcoming the pain of losing a family member and developing the ability to support each other.

To address the needs of indigenous people, active collaboration between local mental health support systems, such as Tribal Support Counselors, and healthcare experts will be required. The emphasis on cooperation between experts will help build the cross-cultural dialogue needed to combine indigenous and Western practices, thus achieving the best outcomes for the patients. The proposed framework will allow them to meet their spiritual needs along with health-related ones, therefore improving their well-being and creating prerequisites for faster recovery.

References

A practical guide to mental health and the law in Ontario, revised edition, 2016. Web.

Bay, M. (2006). Making the law match reality, making reality match the law. Journal of Ethics in Mental Health, (1)1. Web.

Bill 68, Mental Health Act, Health Care Consent Act (n.d.). Web.

Chandler, M. J. & Lalonde, C. (1998). Cultural continuity as a hedge against suicide in Canada’s First Nations. Transcultural Psychiatry 35(2), 191. Web.

Clark, R. L. (2006). Healing the generations: Urban American Indians in recovery. In T. M. Witko (Ed.), Mental health care for urban Indians: Clinical insights from Native practitioners (pp. 83–99). American Psychological Association.

Harm reduction policies and programs for persons or aboriginal descent. (n.d.). Youtube. Web.

Kirmayer, L., Brass, G. M. & Tait, C.L. (2000). The mental health of Aboriginal peoples: Transformations of identity and community. Canadian Journal of Psychiatry 45(7), 607-616.

Ormston, E. F., (2005), Mental Health Court in Ontario. Visions Journal (2)8. Web.

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