Design and Delivery of Public Mental Health Programming for First Nations Youth: Federal, Provincial, Regional, and Community Approaches to Youth Engagement in Northwestern Ontario

Abstract

Public mental health programming aims to address mental health at a population level, and must therefore consider the interconnectedness of determinants of health, and their distinctions between First Nations communities. In Ontario, public mental health programming on-reserve has been described as a piecemeal of policies and legislation between governments, regional authorities, and community-based services. Regional organizations publish publicly about their program development processes, many of which highlight the importance of youth engagement.Youth engagement in decision-making that affects their lives can improve program relevance, and influence participating youths' wellbeing.This project was guided by three lines of inquiry: how federal, provincial, regional, and community-level organizations approach public mental health programming for First Nations youth living on reserve in northwestern Ontario; the ways in which they each use youth engagement methods, and; the experiences from engagement opportunities as perceived by both youth and adults. Interview data were collected between May 2019 and January 2022 to unpack programmatic approaches to public mental health and youth engagement methods used as defined by the McCain Model of Youth Engagement (Heffernan et al., 2017). The Youth-Adult Survey (Jones & Perkins, 2006) and the Youth Experiences Survey (Hansen & Larson, 2002) were administered to First Nations youth and youth workers in community between June and July 2021 to compare engagement experiences between participating youth and adults.Findings from this project reveal that public mental health programming is mostly designed and delivered by regional and community-level organizations, though rigorous reporting and iii evaluation requirements to sustain funding were significant challenges. Funding and designing programs for youth living on-reserve must be rooted in strengths-based approaches, as well as informed by challenges in community contexts. Regional and community-level organizations in northwestern Ontario most often engaged with youth, and used various methods of engagement; however, contextual factors, as well as historical and ongoing trauma, influenced both youth and adult allyship. Renewing the approach to public mental health for First Nations living on-reserve in northwestern Ontario will require renewed relationships between First Nations and governments that ensure inclusion of Indigenous epistemologies throughout design and decisionmaking.I found myself quickly sewing up a medicine bag that had been abandoned by a young girl in Eabametoong during a summer youth wellness camp in 2019. As soon as I finished the first sewing round, I brought it to the Elder, and asked for guidance on the next step. She spoke to me in the language, and my co-worker turned to me: "She says stop being lazy and do it the right way from the beginning." There were many times during this dissertation where I would need to remind myself of that advice. Turns out, there aren't many corners that can be cut in...