Promoting Mental Health in Indigenous Populations. Experiences from Countries. A collaboration between PAHO/WHO, Canada, Chile and Partners from the Region of the Americas 2014-2015

Abstract

[Executive Summary]. In 2007, the countries of the Region of the Americas approved the Health Agenda for the Americas 2008-2017 establishing a priority for mental health. In 2014, the Pan American Health Organization’s Plan of Action on Mental Health (2015-2020) identified cross-cutting themes including ethnicity, equity and human rights, in line with the World Health Organization’s Global Mental Health Action Plan (2013). Specialized literature indicates that the rates of mental health problems among indigenous communities are growing consistently around the world. Common issues include high suicide and substance abuse rates among indigenous youth. These, combined with numerous unfavourable social determinants result in high psychosocial vulnerability. Notwithstanding these circumstances, indigenous populations are the least likely to have access to adequate mental health services. Such realities have motivated several projects addressing issues related to indigenous wellbeing since 2009. The current collaborative project furthers work initiated by PAHO/WHO aimed at finding solutions to this complex health situation. The first goal of this project was to exchange experiences on indigenous mental health issues among participating countries from the Americas. The hope was that comparing initiatives and practices used to approach common mental health issues in different indigenous communities would yield useful new ideas. Furthermore, there was interest in exploring the potential relevance and adaptability of a standardized WHO mental health training tool – the Mental health Gap Action Programme Intervention Guide - in Nunavut. The project reported here was set up as a series of meetings and opportunities to facilitate attaining these aims, coordinated by PAHO in 2014-15. Two of these meetings, held in Chile (Santiago) and in Canada (Iqaluit), involved the active participation of representatives for indigenous healthcare. As expected, different indigenous groups are grappling with an array of common mental health issues. They have different ways of conceptualizing their problems and of organizing care, as determined by historical, geographic and cultural factors. While local, culturallyrooted solutions were not unanimously proposed, some successful intercultural interventions were reported. Representatives from the different indigenous groups expressed support for the usefulness of this project and enthusiastically requested that PAHO continue bridging indigenous mental health and global mental health. Preliminary discussions outlined possible future actions focusing on training and interventions in mental health.