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“我想听你发自内心地倾诉”:关于加拿大第一民族社区在新冠疫情期间接受和提供心理健康支持的观点

"I want to hear you talk with your heart": perspectives on receiving and providing mental wellness supports during the COVID-19 pandemic within a First Nation community in Canada.

作者信息

Brubacher Laura Jane, Tanner Bryan, George Ningwakwe, Bernards Sharon, Morton Ninomiya Melody E, Cornect-Benoit Ashley, Linklater Renee, Wells Samantha

机构信息

Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.

School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.

出版信息

BMC Public Health. 2025 Aug 14;25(1):2780. doi: 10.1186/s12889-025-23723-y.

Abstract

BACKGROUND

The COVID-19 pandemic presented unprecedented challenges to local health systems, widening gaps in support and disrupting available care. Within Canada, First Nations communities have been disproportionately affected by the pandemic, which exacerbated an already strained system of appropriate services and supports. As part of a broader community-based participatory research project (The First Nations Wellness Initiative), the aim of this research was to explore how the COVID-19 pandemic affected people seeking and providing mental wellness supports within a First Nations community, with an eye to informing ways to enhance community strengths to better address pandemic-related challenges and develop community-identified opportunities for mental wellness promotion.

METHODS

From September 2020 to March 2022, one-to-one interviews with people with lived experiences with mental health and/or substance use challenges (n = 2) and individuals supporting loved ones with lived experiences (n = 7) as well as two focus group discussions (i.e., with community youth (n = 5) and frontline service providers (n = 5)) were conducted in Saugeen First Nation, Ontario, Canada by a local research coordinator/Knowledge Holder. Individuals shared experiences with mental wellness and/or substance use challenges and experiences accessing/providing mental wellness supports during the pandemic. Recommendations for improving supports during and beyond the pandemic were also provided. These qualitative data were analyzed thematically, using a hybrid inductive-deductive approach.

RESULTS

Challenges faced during the pandemic included difficulties finding and navigating available supports; problems connecting via virtual services; and lack of access to cultural and/or spiritual supports. Participants described relational supports (kinship, friends, the broader community) as well as formal supports (culturally-embedded programs, group supports, youth support group) as key community strengths drawn upon during the pandemic to promote mental wellness. In terms of service provision, challenges balancing differing community needs and concerns were highlighted. Participants shared ideas for expanding and adapting mental wellness promotion and supports to develop a stronger system of care for mental wellness and substance use challenges.

CONCLUSIONS

The findings point to opportunities for building on existing community strengths and promoting locally-led, culturally-grounded supports for mental wellness and substance use challenges to enhance capacity of First Nations communities to support their members in the face of public health crises.

摘要

背景

新冠疫情给当地卫生系统带来了前所未有的挑战,扩大了支持方面的差距并扰乱了现有护理。在加拿大,原住民社区受到疫情的影响尤为严重,这加剧了本就紧张的适当服务和支持体系的压力。作为一个更广泛的基于社区的参与性研究项目(原住民健康倡议)的一部分,本研究的目的是探讨新冠疫情如何影响在一个原住民社区中寻求和提供心理健康支持的人们,以期为增强社区力量以更好地应对与疫情相关的挑战及开发社区确定的促进心理健康的机会提供信息。

方法

2020年9月至2022年3月期间,加拿大安大略省索金第一民族的一名当地研究协调员/知识持有者对有心理健康和/或物质使用挑战生活经历的人(n = 2)、支持有生活经历的亲人的个人(n = 7)进行了一对一访谈,并开展了两次焦点小组讨论(即与社区青年(n = 5)和一线服务提供者(n = 5))。参与者分享了心理健康和/或物质使用挑战的经历以及在疫情期间获得/提供心理健康支持的经历。还提供了关于在疫情期间及之后改善支持的建议。这些定性数据采用混合归纳 - 演绎方法进行了主题分析。

结果

疫情期间面临的挑战包括难以找到并利用现有支持;通过虚拟服务建立联系存在问题;以及无法获得文化和/或精神支持。参与者将关系支持(亲属关系、朋友、更广泛的社区)以及正式支持(文化嵌入项目、团体支持、青年支持小组)描述为疫情期间为促进心理健康而利用的关键社区优势。在服务提供方面,强调了平衡不同社区需求和关切的挑战。参与者分享了扩大和调整心理健康促进及支持的想法,以建立一个更强大的心理健康和物质使用挑战护理体系。

结论

研究结果指出了利用现有社区优势以及促进由当地主导、基于文化的心理健康和物质使用挑战支持的机会,以提高原住民社区在面对公共卫生危机时支持其成员的能力。

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