In addition, the mental health service types available for Indigenous people include both mainstream services via Medicare Benefits Scheme and special mental health programs exclusive to Indigenous populations, which needs to be taken into account when measuring accessibility to mental health services for Indigenous people. Some accessibility studies discussed strategies to enhance access to mainstream mental health services for Indigenous people but did not specify how the services would be funded 17, 44. Secondary mental healthcare providers are psychologists, psychiatrists, mental health nurses, community support workers, social workers, occupational therapists, psychotherapists, and counsellors, who offer services at mental health clinics, counselling centres, hospitals, community mental centres, or specialised treatment centres . Existing studies on the mental healthcare access for Indigenous people lack a geographical dimension and fail to capture potential accessibility, as they rely on service utilisation data. Also, these studies usually emphasised on how mental health services were delivered by providers and did not consider how patients travelled to access health facilities, which could also influence the accessibility for Indigenous people .

Services such as recreational supports, homework clubs, school programs, support groups, cultural ceremonies and drop-in services are often much quicker to access than psychiatric services. A variety of health centres, clinics, mental health agencies, psychiatric hospitals and psychiatric units at general hospitals provide mental health Suicide and young Black men awareness services in Ontario for both Indigenous and non-Indigenous youth. Some community services are culture-based specifically for Indigenous peoples. This evolution in behavioral healthcare delivery and management is changing the face of behavioral health services in Indian Country. In the ongoing effort to meet behavioral health challenges in Indian Country, support for tribal management and delivery of behavioral health services in their communities has grown.

Traditional healing

Anyone who wants to find support can get started through the resources on Psych Central’s hub on finding mental health and support. A 2018 study conducted at a tribal-owned Alaska Native primary care clinic surveyed AIAN people with depression about their preferred treatments. Research from 2020 on depression and anxiety in AIAN communities emphasized the protective role of families and social support. Elder Native Americans often have higher rates of mental health conditions and type 2 diabetes than other groups, according to a 2019 study. A 2022 research paper notes that there are a number of distinct hallmarks of AIAN communities that can also act as protective forces against depression and other mental health conditions.

• “But, before the 19th-century, suicide was extremely rare in North American Native communities.”
• Indigenous Peoples often face considerable barriers in accessing medical services and suffer from worse health outcomes than non-Indigenous populations.
• Inequities in access to culturally safe and effective care remain a pressing concern for those Indigenous peoples who live with mental health and/or substance use issues and, in particular, for people whose lives also are shaped by the intersecting issues of poverty, trauma, and violence, and other social and health inequities 5,6.
• Unique challenges have been documented for Indigenous communities across Canada, particularly elders who are most at risk, and northern and remote communities that have limited access to services and other types of supports 78,79,80.

Missing and Murdered Indigenous Women and Girls Health and Cultural Support Program

In the case of MMT, the particular pharmacist, as referred to above, often sent someone out to get people who may be having difficulty getting to the service, a form of assistance greatly appreciated by several participants. In a similar vein, several providers noted that clients who were no longer using substances and particularly vulnerable to using drugs faced ongoing harassment by persons selling drugs as they accessed services in the area. Being free of substance use is a prerequisite for many treatment and housing programs, yet detoxification (detox) was one of the most difficult services to access in a timely fashion. This reality renders people particularly vulnerable to negative experiences and encounters in the health care system. These experiences, in many ways, represented an extension of the marginalizing experiences that many participants described in everyday interactions outside of health care. Most of the participants shared stories about the way everyday health care practices created discomfort or distress.

Mental health institutions and policies support, often unwittingly, the embeddedness of an assimilationist ethos, putting Indigenous people at risk of not having their mental health care needs recognized and met 16,50,51. In this paper, we present findings from a qualitative study that explored Indigenous people’s experiences of mental health and addictions care in the context of an inner-city area in Western Canada. By creating a local workforce, indigenous community mental health workers also represent self-determination and sovereignty over economy and health care. The needs of Native communities require imminent solutions given continued mental health and substance use disparities and underresourced services.

For Indigenous population, understanding the barriers that hinder their access to mental health services as needed is the critical first step to fully quantify their service demand and measure the accessibility for them. To quantify access to mental health services by Indigenous people, it is important to also understand the service demand and how Indigenous individuals gain access to the services. Online mental health services have been gaining popularity, especially since the COVID-19 pandemic 76, 83, and measuring accessibility to such services would be different from that of traditional therapies that require physical access. Measuring geographical accessibility to mental health services needs to consider service types, especially in relation to service locations and availability. Nonetheless, mental health services provided by private practices are neither free nor low cost for Indigenous people, even when the service is in the closest proximity, potentially making the service inaccessible for them. It should be noted that GPs working as the first point of contact to provide mental healthcare are only required for Medicare-subsidised sessions of the secondary and tertiary mental health services.