Truth and Reconciliation: Approaching Mental Health
written by Fran Westwood
Photo by Andreas Rasmussen on Unsplash
Canada’s National Truth and Reconciliation Day on September 30 is an invitation to recognize one’s relationship to colonization and participate in a better way forward; for those of settler heritage, this could look like many things, including reflecting on the power and privilege one carries, learning about the impacts of Canada’s residential school system, or simply becoming curious about the history of the land one’s life is built on.
Experiences of mental health are also deeply connected to colonization; an important part of Truth and Reconciliation involves addressing the drastically unequal mental health outcomes in First Nations communities across Turtle Island. The Truth and Reconciliation Commission of Canada (TRC) reveals a long history of trauma, child abuse, deliberate destruction of language and culture, and ongoing dysfunctional power dynamics that directly contribute to the increased suicide rates and mental health challenges many Indigenous communities face. Truth and Reconciliation require an acknowledgement of this trauma and the continued limited access to culturally appropriate mental health care. Without this, even in settings meant for healing, harm can happen instead.
An anti-oppressive lens reminds us that every individual is connected deeply to their world, and is formed within the systems and structures around them. These structures and systems shape a person’s experience of themselves, society and their access to power. Mental health is formed within the family context, within cultures, and within societal structures, and mental health outcomes are certainly connected to historical trauma and the ongoing realities of colonization. Moreover, ideas about mental health, psychopathology and the practice of therapy itself were developed within Western European culture. Many mainstream approaches to therapeutic work and conceptualizations of recovery and mental health are therefore shaped by Western values such as individualism, rationalism and materialism. Very often this is to the exclusion of Indigenous and other cultures’ ways of knowing and approaches to healing.
What might it look like to practice Truth and Reconciliation within healing contexts like therapy, on a structural and societal level? This is a massive and important question, likely with many answers. Of note, the Truth and Reconciliation Commission of Canada’s 94 Calls to Action outlines action steps called for by Indigenous communities to the Canadian government in response to the harms caused by the residential school system. Call to Action 19 requests that attention be placed on unequal health outcomes in Indigenous communities, including indicators such as “infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence.”
Through its Calls to Action, this vital report offers an implicit critique of our current system, exposing its gaps. It does this by asking that the staggering mental health impacts shouldered by Indigenous communities every day as they process colonial trauma be recognized. The lack of connection between these health outcomes and the traumas enacted through the colonization of Canada is a form of harm that the TRC Calls to Action seeks to address. Action 18 states:
“We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.”
This is a request that the ongoing mental and physical health challenges experienced by First Nations communities be understood as directly connected to harmful and traumatizing colonial practices. Action 22 states:
“We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.”
This call to action specifically addresses the need for respect and recognition of Indigenous ways of knowing and cultural healing practices that may not fall within the bounds of mainstream mental health support. Government officials and healthcare practitioners are being asked to take the importance of cultural practices seriously in our processes and structures.
The 94 Calls to Action also request that there not only be an increase in the number of Aboriginal professionals working in health care fields (Call to Action 23) but also that there be “cultural competency training for all health-care professionals.” To reduce harm and promote healing, mental health care professionals such as therapists, along with all health care professionals, must take the need for cultural competency seriously, including cultural humility.
This reflection highlights the 94 Calls to Action as they relate to mental health. The field of psychotherapy in Canada has a responsibility to recognize and participate in Truth and Reconciliation. We are invited to listen and learn from Indigenous practitioners about different ways of understanding mental health and healing; we are invited to reflect on our experiences of power, and how these connect to the society we’ve been shaped within—that exists within the context of colonization. We are all invited to consider how this impacts how we experience our own mental health, and how we participate in the psychotherapy and wellness field, as therapist, client or layperson.
