Themes of Healing Among Squamish Nation Members After a Loss to Suicide
Keywords:Suicide, Healing, Postvention, Community Based Research, First Nations
This research was a response to the disproportionately high suicide rates, risk for suicide clusters, and need for a suicide postvention plan in the Squamish Nation community. Using a community-based research approach and working collaboratively with Squamish Nation, I interviewed 8 community members who had lost a loved one to suicide within the past 1–10 years to understand what helped in their healing journey, as well as their recommendations for helping families after a loss to suicide. Findings indicate 5 themes of helpful postvention supports: healing self, social supports, formal community supports, wider world supports, and culture. Culture was found to aid healing across all levels. These themes do not exist in isolation, but are interrelated, both individually and communally helping community members in their healing journey. Recommendations for suicide postvention highlight the integration of healing supports from dominant mental health models and an Aboriginal wellness model. These findings should be considered with caution due to the small sample size; however, they are in line with the available Aboriginal suicide postvention literature and an Aboriginal worldview. Aboriginal communities across Canada are not homogenous, therefore generalizability to other communities is unknown.
Adelson, N. (2005). The embodiment of inequity: Health disparities in Aboriginal Canada. Canadian Journal of Public Health, 96, S45–S61. http://journal.cpha.ca/index.php/cjph/article/download/1490/1679/
Boyd, M. (2014). Community-based research: Understanding the principles, practices, challenges, and rationale. In P. Leavy (Ed.), The Oxford handbook of qualitative research. Oxford Handbooks Online. https://doi.org/10.1093/oxfordhb/9780199811755.013.006
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Breton, J., Boyer, R., Bilodeau, H., Raymond, S., Joubert, N., & Nantel, M. (2002). Is evaluative research on youth suicide programs theory-driven: The Canadian experience. Suicide & Life-Threatening Behavior, 32(2), 176–190. https://doi.org/10.1521/suli.184.108.40.20697
British Columbia Ministry of Healthy Living and Sport, Office of the Provincial Health Officer. (2007). Pathways to health and healing: 2nd report on the health and well-being of aboriginal people in British Columbia. Retrieved from http://www.health.gov.bc.ca/pho/pdf/abohlth11-var7.pdf
Caldwell, D. (2008). The suicide prevention continuum. Pimatisiwin, 6(2), 145–153. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936581/
Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, & Social Sciences and Humanities Research Council. (2018, December). Tri-Council policy statement: Ethical conduct for research involving humans: TCPS2 2018. https://ethics.gc.ca/eng/documents/tcps2-2018-en-interactive-final.pdf
Castellano, M. B. (2008). A holistic approach to reconciliation: Insights from research of the Aboriginal Healing Foundation. In M. B. Castellano, L. Archibald, & M. DeGagné (Eds.), From truth to reconciliation: Transforming the legacy of residential schools (pp. 385–400). Aboriginal Healing Foundation. http://www.ahf.ca/downloads/from-truth-to-reconciliation-transforming-the-legacy-of-residential-schools.pdf
Centers for Disease Control and Prevention. (1988). CDC recommendations for a community plan for the prevention and containment of suicide clusters. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001755.htm
Centre for Suicide Prevention. (2013a). Aboriginal suicide prevention resource toolkit. https://suicideinfo.ca/LinkClick.aspx?fileticket=MVIyGo2V4YY%3D&tabid=516
Centre for Suicide Prevention. (2013b). Info exchange 10: Suicide contagion and suicide clusters. https://suicideinfo.ca/LinkClick.aspx?fileticket=WXg70KbEYsA=
Cerel, J., Padgett, J. H., Conwell, Y., & Reed, G. A. (2009). A call for research: The need to better understand the impact of support groups for suicide survivors. Suicide and Life–Threatening Behavior, 39(3), 269–281. https://doi.org/10.1521/suli.2009.39.3.269
Creswell, J. W. (2008). Educational research: Planning, conducting, and evaluating quantitative and qualitative research (3rd ed.). Pearson.
Duran, B., & Duran, E. (2000). Applied postcolonial clinical and research strategies. In M. A. Battiste (Ed.), Reclaiming indigenous voice and vision (pp. 86–100). UBC Press.
Dyregrov, K., & Dyregrov, A. (2005). Siblings after suicide—“The forgotten bereaved.” Suicide and Life–Threatening Behavior, 35(6), 714–724. https://doi.org/10.1521/suli.2005.35.6.714
Elias, B., Mignone, J., Hall, M., Hong, S. P., Hart, L., & Sareen, J. (2012). Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada’s residential school system. Social Science & Medicine, 74(10), 1560–1569. https://doi.org/10.1016/j.socscimed.2012.01.026
First Nations Health Authority. (2015). Hope, help, and healing: A toolkit for First Nations and Aboriginal communities to prevent and respond to suicide. http://www.fnha.ca/wellnessContent/Wellness/FNHA-Hope-Help-and- Healing.pdf
Health Canada. (2008). Guide to the national Aboriginal youth suicide prevention strategy. Retrieved from http://publications.gc.ca/pub?id=9.650983&sl=0
Health Canada. (2013). National Aboriginal youth suicide prevention strategy (NAYSPS) program framework. Retrieved from http://www.hc-sc.gc.ca/fniah-spnia/alt_formats/pdf/pubs/promotion/_suicide/strat-prev-youth-jeunes-eng.pdf
Jordan, S. (2008). Participatory action research. In L. M. Given (Ed.), The SAGE encyclopedia of qualitative research methods (Vol. 2, pp. 601–603). Sage.
Joshi, P., Damstrom-Albach, D., Ross, I., & Hummel, C. (2009). Strengthening the safety net: A report on the suicide prevention, intervention and postvention initiative for BC. The Suicide Prevention, Intervention and Postvention Initiative. https://suicidepipinitiative.files.wordpress.com/2009/05/suicide-pip-initiative-full-report.pdf
Hernán, M., Hernández-Díaz, S., & Robins, J. (2004). A structural approach to selection bias. Epidemiology, 15(5), 615–625. http://www.jstor.org/stable/20485961
Kazdin, A. (2003). Research design in clinical psychology. Allyn and Bacon.
Kirmayer, L. J., Boothroyd, L. J., Laliberte, A., & Simpson, B. L. (1999). Suicide prevention and mental health promotion in first nations and Inuit communities (Culture & Mental Health Research Unit, Report No. 9). https://files.eric.ed.gov/fulltext/ED460324.pdf
Kirmayer, L. J., Brass, G. M., Holton, T. L., Paul, K., Simpson, C., & Tait, C. L. (2007). Suicide among Aboriginal people in Canada. Aboriginal Healing Foundation. http://www.ahf.ca/downloads/suicide.pdf
Kirmayer, L. J., Fraser, S. L., Fauras, V., & Whitley, R. (2009). Current approaches to aboriginal youth suicide prevention (Cultural and Mental Health Research Unit working paper, 14). Jewish General Hospital. https://www.mcgill.ca/tcpsych/files/tcpsych/Report14.pdf
Kirmayer, L., Simpson, C., & Cargo, M. (2003). Healing traditions: Culture, community, and mental health promotion with Canadian Aboriginal peoples. Australasian Psychiatry, 11, S15–S22. http://web.mnstate.edu/robertsb/306/Healing%20traditions%20culture,community%20and%20mental%20health%20promotion%20with%20Canadian%20Aboriginal%20Peoples.pdf
Kral, M. J. (2012). Postcolonial suicide among Inuit in Arctic Canada. Culture, Medicine and Psychiatry, 36, 306–325. https://doi.org/10.1007/s11013-012-9253-3
Lavallee, L. F., & Poole, J. M. (2010). Beyond recovery: Colonization, health and healing for Indigenous people in Canada. International Journal of Mental Health and Addictions, 8, 271–281. https://doi.org/10.1007/s11469-009-9239-8
Loomba, A. (2005). Colonialism/postcolonialism (2nd ed.). Routledge.
MacNeil, M. S. (2008). An epidemiologic study of Aboriginal adolescent risk in Canada: The meaning of suicide. Journal of Child and Adolescent Psychiatry Nursing, 21(1), 3–12. https://doi.org/10.1111/j.1744-6171.2008.00117.x
McCormick, R. M. (1997). Healing through interdependence: The role of connecting in First Nations healing practices. Canadian Journal of Counselling, 31(3), 172–184. https://files.eric.ed.gov/fulltext/EJ555251.pdf
McMenamy, J. M., Jordan, J. R., & Mitchell, A. M. (2008). What do suicide survivors tell us they need? Results of a pilot study. Suicide and Life-Threatening Behavior, 38(4), 375–389. https://doi.org/10.1521/suli.2008.38.4.375
Melhem, N. M., Day, N., Shear, M. K., Day, R., Reynolds III, C. F., & Brent, D. (2004). Traumatic grief among adolescents exposed to a peer’s suicide. American Journal of Psychiatry, 161, 1411–1416. https://doi.org/10.1176/appi.ajp.161.8.1411
Poonwassie, A., & Charter, A. (2001). An Aboriginal worldview of helping: Empowering approaches. Canadian Journal of Counselling, 35(1), 63–73. https://files.eric.ed.gov/fulltext/EJ622699.pdf
Prigerson, H. G., Bierhals, A. J., Kasl, S. V., Reynolds, C., Shear, M. K., Day, N., Beery, L. C., Newsom, J. T., & Jacobs, S. (1997). Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry, 154(5), 616–623. https://www.researchgate.net/profile/Andrew_Bierhals/publication/14081472_Traumatic_grief_as_a_risk_factor_for_mental_and_physical_morbidity/links/0fcfd511556768fc07000000.pdf
Royal Commission on Aboriginal Peoples. (1995). Choosing life: Special report on suicide among Aboriginal people. Canada Communication Group. http://data2.archives.ca/rcap/pdf/rcap-459.pdf
Spiwak, R., Sareen, J., Elias, B., Martens, P., Munro, G., & Bolton, J. (2012). Complicated grief in Aboriginal populations. Dialogues in Clinical Neuroscience, 14(2), 204–209. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384449/
Squamish Nation. (n.d.). Our land. https://www.squamish.net/about-us/our-land/
Tester, F. J., & McNicoll, P. (2003). Isumagijaksaq: Mindful of the state: Social constructions of Inuit suicide. Social Science & Medicine, 58, 2625–2636. https://doi.org/10.1016/j.socscimed.2003.09.021
Walls, M. L., Hautula, D., & Hurley, J. (2014). “Rebuilding our Community”: Hearing silenced voices on Aboriginal youth suicide. Transcultural Psychiatry, 51(47), 47–72. https://doi.org/10.1177/1363461513506458
Wexler, L. M., & Gone, J. P. (2012). Culturally responsive suicide prevention in indigenous communities: Unexamined assumptions and new possibilities. American Journal of Public Health, 102(5), 800–806. https://doi.org/10.2105/AJPH.2011.300432