Higher rates of anxiety, depression, and attempted suicide are reported among First Nations, Inuit, and Métis people compared with non-Indigenous people in Canada. This systematic review summarises the key components of mental health interventions among Indigenous Peoples in Canada. We searched MEDLINE, PubMed, PsycINFO, and Web of Science between January 1,1970, and August 30, 2019. Studies needed to be an intervention addressing suicide, depression, or anxiety. There were 14 studies: 8 quantitative, 2 qualitative, and 4 mixed methods. By geographical location, 5 were urban, 5 non-urban, and 4 included multiple areas. Beneficial interventions included ceremony, being on the land, engaging in traditional food gathering, culturally grounded indoor and outdoor activities, and the sharing of Indigenous knowledge by Elders.

Indigenous peoples in Canada experience disproportionately higher rates of chronic disease than their non-Indigenous counterparts. Previous research has identified structural racism as a powerful determinant of health and wellbeing. Mounting evidence demonstrates that First Nations are disproportionately over-represented, compared to other Canadians, in several domains that have been used to measure structural racism in other countries. Despite growing concern of the impact of structural racism on health, there remains little empirical evidence on the impact structural racism has on chronic disease health outcomes of First Nations. This qualitative study examines the complex and intersecting ways in which structural racism can influence chronic disease health outcomes and the overall health and wellbeing of First Nations in Canada. In-depth semi-structured interviews were conducted with twenty-five participants, including subject matter experts in health, justice, education, child welfare, politics, and researchers in racism scholarship and First Nations who have lived experience with a chronic condition(s). Thematic analysis was used to analyze the data collected. Six themes on how structural racism influences chronic disease and the health of First Nations were identified: (1) multiple and intersecting pathways; (2) systems of failure, harm, and indifference; (3) impacts on access to healthcare; (4) colonial policies of structural deprivation; (5) increased risk factors for chronic disease and poor health; and (6) structural burden leading to individual-level outcomes. Structural racism creates an ecosystem that negatively impacts chronic diseases and the health of First Nations. The findings illuminate how structural racism can have micro-level influences at an individual level and can influence one’s chronic disease journey and progression. Recognizing how structural racism shapes our environments may help to catalyze a shift in our collective understanding of the impact of structural racism on health.

Independent oversight of Canadian police has increased over the past decade in response to a number of high-profile cases of police misconduct and public dissatisfaction with internal police investigations. To date, however, the dynamics of the oversight process have not been subjected to critical analysis. This study examines the benefits and challenges of the oversight systems for the Royal Canadian Mounted Police (RCMP) and municipal police in British Columbia, Canada, as well as the role of oversight in increasing police accountability, improving public confidence, and modifying police behavior. Drawing on semi-structured interviews with persons (n = 13) from oversight agencies, police unions, special interest groups, and professional standards units, the study found that despite having one of the most progressive oversight models in Canada, the system faces major challenges. These include slow processing of complaints, the administrative burden of minor complaints, the difficulty in determining return on investment, and the two-tier complaint model.

In Canada, the health research funding landscape limits the self-determination of Indigenous peoples in multiple ways, including institutional eligibility, priority setting, and institutional structures that deprioritize Indigenous knowledges. However, Indigenous-led research networks represent a promising approach to transforming the funding landscape to better support the self-determination of Indigenous peoples in health research. The British Columbia Network Environment for Indigenous Health Research (BC NEIHR) is one of nine Indigenous-led networks across Canada that supports research leadership among Indigenous (First Nations, Métis, and Inuit) communities, collectives, and organizations (ICCOs). In this paper, we share three best practices to support the self-determination of ICCOs in health research based on three years of operating the BC NEIHR: (1) creating capacity-bridging initiatives to overcome funding barriers; (2) building relational research relationships with ICCOs (“people on the ground”); and (3) establishing a network of partnerships and collaborations to support ICCO self-determination. Supporting the self-determination of ICCOs and enabling them to lead their own health research is a critical pathway toward transforming the way Indigenous health research is funded and conducted in Canada.

In Canada and across the globe, indicators play a fundamental role in measuring, tracking, and reporting on the overall health of the population. Mainstream population health indicators used to measure the health and well-being of First Nations peoples are constrained by the Western biomedical paradigm which focuses solely on illness and disease. These indicators are limited and fail to capture aspects of cultural, spiritual, and interconnected aspects of Indigenous health such as spirit, ceremony, and the connection to land. To advance First Nations self-determination in the healthcare system, it is essential for Indigenous narratives and knowledges to thrive in population health data and reporting. Five promising practices are shared to guide the development of First Nations health and wellness indicators and reporting: (1) be culturally relevant and centred on First Nations worldviews on health and wellness (2) must honour Indigenous knowledges and methods; (3) must involve respectful relationships & meaningful engagement with Indigenous peoples’; (4) “Nothing about us, without us”- Indigenous leadership and self-determination at all stages of indicator development; and (5) taking a strength-based approach & contextualizing indicators within historical, socio-political contexts. The co-development of indicators between the [First Nations Health Organization] and the [Office of the Executive Health Officer] in the Province of [Name of Canadian Province] are discussed as promising practices in action. Celebrating the strength and resilience of First Nations health which is required to pave a new way forward in Indigenous grounded population health.

Indigenous peoples have been engaged in research since time immemorial, and have always acknowledged the power of their own knowledge systems, ways of being, and approaches. However, Indigenous peoples continue to be underrepresented in health research within academic institutions. There is an increased need for Indigenous leadership in health research, including greater Indigenous autonomy, mentorship, and self-determination in health research. This scoping review aims to explore Indigenous mentorship within Indigenous health research in post-secondary institutions in Canada, the US, New Zealand, and Australia. A review of empirical studies, case studies, reviews, commentaries, and grey literature was conducted. Four databases were used: Web of Science, PubMed, Native Health, and Google Scholar. Out of 1594 articles, 11 articles met the inclusion criteria. Four overarching themes were identified: (1) reciprocity: giving back to community; (2) supporting the development of research skills to build research capacity; (3) fostering a sense of belonging; and (4) building student ownership and confidence. The findings suggest that Indigenous mentorship is vital to creating supportive research environments for Indigenous students in the area of health sciences. Indigenous mentorship holds promise to address challenges faced by Indigenous scholars within post-secondary institutions, including intellectual, social, and cultural isolation, and can help to foster greater integration of Indigenous worldviews in Western-dominated academic settings and research systems. Future research should examine place-based mentorship opportunities for Indigenous students in community-based health research environments. Fostering Indigenous mentorship in health sciences is essential for advancing the health and wellbeing of Indigenous peoples and communities.