The purpose of this study was to document the perspectives and experiences of five Indigenous Elders on the potential for Indigenous and Western healing paradigms and practices to be integrated in mental health service delivery for Indigenous peoples. Semi-structured qualitative interviews were held with each participant, and a narrative analysis was used to generate research themes and findings. Results indicated that all five Elders perceived a potential for Indigenous and Western approaches and practitioners to work collaboratively together in the future, and Elders reported varying levels of experience with integrated healthcare delivery. However, all five Elders identified numerous issues requiring attention and steps to be taken prior to integrated practice taking place. These included the need to reclaim Indigenous knowledge, an acceptance and respect for Indigenous knowledge and practices by the Western healthcare system, and the need for increased and formalized education related to Indigenous knowledge and healing approaches.

The purpose of this study was to document the perspectives and experiences of five Indigenous Elders on the potential for Indigenous and Western healing paradigms and practices to be integrated in mental health service delivery for Indigenous peoples. Semi-structured qualitative interviews were held with each participant, and a narrative analysis was used to generate research themes and findings. Results indicated that all five Elders perceived a potential for Indigenous and Western approaches and practitioners to work collaboratively together in the future, and Elders reported varying levels of experience with integrated healthcare delivery. However, all five Elders identified numerous issues requiring attention and steps to be taken prior to integrated practice taking place. These included the need to reclaim Indigenous knowledge, an acceptance and respect for Indigenous knowledge and practices by the Western healthcare system, and the need for increased and formalized education related to Indigenous knowledge and healing approaches.

The Labrador Innu lived for millennia in the Quebec-Labrador Peninsula as nomadic hunters. Commencing in the 1950s, successive policies imposed on the Innu by federal and provincial governments brought significant disruptions to their traditional way of life. Today, the Labrador Innu are settled in the communities of Sheshatshiu and Natuashish in the province of Newfoundland and Labrador, Canada. They have maintained their language and culture, anchored in their understanding of territory and their relationship with their ancestral land, and have increasingly asserted their self-determination, including in research. The Innu articulated a Healing Strategy in 2014 after extensive community consultations. The Strategy states that a contemporary return to culture would provide healing to individuals and communities. Healing is important due to the social suffering experienced through sudden forced settlement and schooling in a non-Innu system. These abrupt changes altered the social fabric that had sustained Innu society for millennia. As part of the Strategy, the Innu decided to undertake a study to articulate their concept of wellbeing (minuinniuin) and their process of healing. Wellbeing and healing are intrinsic concepts for Innu; however, these concepts need to be uncovered for health and service providers, and policy makers. Having lived in Labrador and worked for the Innu, I was invited to be part of this community-initiated research. The Grand Chief of the Innu Nation directed that the research involve Innu researchers and utilize Innu ways-of-knowing and knowledge as fully as possible. Innu knowledge, like all Indigenous knowledges, is specific to the place where Innu live and to their experiences. Indigenous concepts of health and wellbeing, connections to land, and cultural identity are wholistically connected and culture-specific. The main objective of this dissertation is to articulate the Labrador Innu understanding of wellbeing and their distinctive process of healing. This qualitative study involves interviews and focus groups with 39 participants older than 16 years of age. This is a dissertation by articles. It consists of a general introduction to Indigenous health inequities, a literature review, a description of the methods, and the results as three separate manuscripts. It concludes with a summary of findings and implications. The first manuscript focuses on the process of developing an Innu framework for health research involving a partnership between Innu and non-Innu researchers. An Innu community-based participatory research (CBPR) framework for health research is proposed where Innu knowledge is foundational to the study. The framework is based on the metaphor of Innu and non-Innu canoeing together in one canoe. Within the space that joins all researchers, Indigenous knowledges are uncovered. This CBPR framework is used in the following two manuscripts. The second manuscript describes the contemporary process of healing of the Labrador Innu. Healing practices have been developed to deal with the historical and contemporary effects of colonialism and Innu people consider them effective. Healing is grounded in self-determination, culture, and non-reliance on bio-medicine. Five stages of healing are described: being “under the blanket”; finding spiritual strength; extending hands out; finding strength and power; and helping others. The findings highlighted the enablement of healing through spiritualities, support from Elders, return to culture, and resistance to negative stereotypes. The third manuscript aims to understand Innu views of wellbeing, and the influence of the land on health and wellbeing. Findings highlight that the experience of being on the land with family and community, learning cultural knowledge, and enacting Innu identity play a major role in enhancing wellbeing. For the Innu, the land sustains wellbeing by emplacing knowledge systems and cultural identity. The work presented in this dissertation contributes to the literature on Labrador Innu population health by highlighting that access to and experience of land build up health and wellbeing by providing and facilitating togetherness, fostering a relationship to all living beings, and enacting culture and a positive Innu identity. The findings add new knowledge to Indigenous health studies literature, particularly Innu health studies – holding promise for reducing health inequities. Implications for research, practice, and policy are also addressed.

abstract: This dissertation describes a qualitative research study that was conducted in order to deconstruct the notion of trauma using a resiliency framework in one Pueblo Indian community in New Mexico. Trauma is widely discussed in relation to mental health issues impacting Indigenous peoples worldwide, as demonstrated in my review of the literature and throughout this work. Yet, the result of most research tends towards pointing out deficiencies in Indigenous communities. Rarely, if ever, is trauma explored through a strengths-based and resiliency approach. This study represents the first attempt to do so in and with a Pueblo Indian community. As a Pueblo researcher working with my own community of Kewa, my goal was to go back to the very people consistently being studied, that is, the Indigenous community, and to re-examine what is trauma, including its definitions and with a focus on local culturally-based interventions. This work is broken down into three components that are woven together through the common theme of understanding, deconstructing, and addressing trauma: a journal article, book chapter and policy brief. The journal article is titled: “Walking the Path: A Pueblo Journey through Trauma and Healing.” The journal article begins by reviewing concepts on trauma and resilience documented in a literature. I both review the literature and offer critiques from the perspective of a Pueblo Indian researcher working in the field of health. This segues into my dissertation study. A series of eight qualitative, semi-structured interviews were conducted using an interview guide with open-ended questions. I found that participants reported ample evidence of both trauma and resilience, documenting the need for further research in this area and, most importantly, a values-based intervention. Critical in my research findings is that participants revealed the types of trauma relevent to Pueblo people, which points to our understanding of local issues that may also resonate with the experiences of other Indigenous peoples but that are intended to speak to Pueblo communities. Through my research, I consistently assert that understanding trauma also includes the need to document how Pueblo people have coped and overcome their trauma. These forms of resilience were also documented in the findings. The book chapter is titled, “Using Pueblo Values to Heal from Trauma.” This section of the dissertation details Pueblo values and the implications on trauma. Pueblo values are described in detail based on my research and explicated in relation to theory that I propose. In this book chapter, I argue that these Pueblo values play an integral role in how we cope and heal from trauma. To summarize what participants explained, the idea is proposed that following these values will lead you to “the right path.” Suggestions for an ideal intervention based on participant interviews include the development of a values-based curriculum whose success is contingent on following Pueblo values that teaches values as defined by the Pueblo community. My dissertation concludes with a policy section that focuses on “Finding the Path when you have Fallen Off.” This section talks about “cultural freezing” and the need to integrate positive cultural identity in youth, who are especially vulnerable in Indigenous communities, through the development of a values-based curriculum. The policy section will focus on the implications of trauma concepts defined for Native People that have demonstrated the need to process trauma. In order to process trauma, culturally-relevant frameworks and curricula such as “Transcending the Trauma” or “Gathering of Native Americans” (GONA) have been developed to help guide communities to begin the conversation around trauma. These discussions help to raise awareness around trauma and help people begin their healing journey. However, these developed concepts, frameworks and curricula have only started the journey and now there is a significant need for interventions to sustain recovery from trauma. These interventions also must include levels of individual and community readiness to address trauma and align with the values of the community and individual. It is a step we need to take to decolonize education and unfreeze culture / Dissertation/Thesis / Doctoral Dissertation Justice Studies 2018