Biigajiiskaan: Indigenous Pathways to Mental Wellness
Co-delivered by St. Joseph’s Health Care London (St. Joseph’s) in partnership with Atlohsa Family Healing Services (Atlohsa), Biigajiiskaan (bee-gaw-jees-gawn) is a referral-based mental wellness program that aims to provide accessible, culturally-safe, specialized care for Indigenous people with serious mental illness, addictions and concurrent disorders.
Based at St. Joseph’s Parkwood Institute, Biigajiiskaan offers both Traditional Healing services and Western psychiatric treatment to Indigenous individuals experiencing mental health and addiction issues using a two-eyed seeing approach to care, as well as addressing common barriers and bridging care transitions for inpatients, outpatients and community outreach clients in the London-Middlesex region.
The name Biigajiiskaan is an Ojibway concept that describes how a broken or rotting tree stump feeds new life. It acknowledges the importance of all living things working together in harmony for the greater good.
A history in need of healing
Indigenous people in Canada experience mental health and addictions at rates that are more than double those among non-Indigenous people. The impact is crippling. Suicide rates among Indigenous youth are more than five times higher than among non-Indigenous youth in Canada.
Yet many Indigenous people are reluctant to come to hospital for treatment, fearful of discrimination and maltreatment after generations of systemic discrimination created by government policies including Canada’s residential school system and Indian hospitals. These experiences have led to the loss of language, culture, a sense of safety and community.
The program aims to address immediate mental health needs as well as intergenerational trauma and violence experienced by Indigenous people. Biigajiiskaan recognizes systemic racism as well as institutional trauma caused by residential schools, Indian hospitals, and other institutions and validates the loss of Indigenous identity, knowledge and culture. The program creates a more positive experience for Indigenous people, within the health care system, by reinstating the importance of Traditional Healing.
By providing culturally safe and accessible mental health care to Indigenous peoples through an Indigenous lens, Biigajiiskaan creates connections with and beyond the Western notion of mental wellness and seeks ways to support the community through relationships with the self, land and all of creation. It is through this holistic approach that Biigajiiskaan will improve the experience and quality of care that Indigenous patients and families receive. By dismantling the barriers of distrust and bridging Traditional Healing and Western modalities through a two-eyed seeing approach to care, Atlohsa Family Healing Services and St. Joseph’s Health Care London have the ability to transform the mental wellness design and service delivery model.
1. What is Biigajiiskaan?
Biigajiiskaan (Bee-Gaw-Jees-Gawn) is a referral-based mental wellness program that aims to provide accessible, culturally safe, specialized care for Indigenous people with serious mental illness, addictions and concurrent disorders.
Based at St. Joseph’s Health Care London’s Parkwood Institute, and co-led by Atlohsa Family Healing Services (Atlohsa), Biigajiiskaan offers Indigenous-led Traditional Healing services combined with psychiatric treatment. Services are provided in-hospital and in the community to the Indigenous population in the London-Middlesex region.
The program aims to address immediate mental health needs as well as intergenerational trauma and violence experienced by many Indigenous people. Biigajiiskaan recognizes systemic racism as well as institutional trauma caused by Residential Schools and Indian hospitals and validates the loss of Indigenous identity, knowledge and culture. The program creates a more positive experience for Indigenous people, within the health care system, by reinstating the importance of Traditional Healing. Biigajiiskaan is the only program of its kind in Canada, within a faith-based hospital.
2. What is Traditional Healing?
Traditional Healing practices are skills based in Indigenous knowledge and beliefs, used for holistic health care through the use of sacred medicines, ceremonies and traditional teachings to promote spiritual, mental, physical and emotional well-being. Biigajiiskaan prioritizes the use of local healers and knowledge keepers wherever possible, providing clients with access to teachings and ceremony that is grounded in their own community.
3. Who is Atlohsa and what is its role in the program?
Atlohsa Family Healing Services is an Indigenous-led, non-profit and charitable organization dedicated to strengthening community through programs and services that offer holistic healing and wellness. Since 1986, Atlohsa has been serving individuals and families across Southwestern Ontario, providing low-barrier services to community members with complex needs, including mental wellness, substance use, homelessness, domestic violence, and trauma. Atlohsa specializes in providing strength-based healing and wellness supports, utilizing trauma-informed and harm reduction approaches.
Atlohsa and St. Joseph’s Health Care London have come together to co-design and co-deliver Biigajiiskaan, in order to transform health care and mental wellness services for Indigenous peoples in both urban and rural areas of the London-Middlesex region.
4. What does the Biigajiiskaan name mean?
Biigajiiskaan (Bee-Gaw-Jees-Gawn) is an Ojibway concept that describes how a broken and rotting tree stump feeds new life. It acknowledges the importance of all living things working together in harmony for the greater good.
5. What makes Biigajiiskaan unique from existing mental health strategies?
This initiative is unique because it incorporates traditional medicine, Indigenous elder-guided care, and ceremony with Western psychiatric treatment and hospital care. Biigajiiskaan is guided by the Thunderbird Partnership Foundation’s First Nations Mental Wellness Continuum Framework. The goal is to provide a hostile-free environment, and services that are culturally-safe and Indigenous-led with a focus on meeting the individual, cultural and health care needs of each client. Biigajiiskaan is about redesigning health care by creating a new Indigenous wellness model of care that transforms health care and mobilizes knowledge to other interested communities, organizations and institutions.
6. What does the Biigajiiskaan program consist of?
- An Indigenous-led mobile outreach team working in-hospital and in the community providing consultation, assessment, treatment planning/management, discharge planning and ambulatory services. View Biigajiiskaan’s Care Team
- A dedicated Indigenous Healing Space at Parkwood Institute’s Mental Health Care Building (Okwari: Kowa Healing Space, Rm F3-240) for use by inpatients and outpatients of St. Joseph’s Mental Health Care Program
- Indigenous Elder-guided care and teachings from knowledge keepers
- Traditional Indigenous practices, such as healing circles, ceremony, smudging and drumming circle
- Educational and mentoring opportunities for health care professionals and students
- Indigenous wellness methodologies and opportunities for community organizations via a care-for-the-caregiver approach
7. How can Indigenous community members access these services?
To access Biigajiiskaan services, Indigenous adults in need of mental health and addictions services will require a referral from a care provider at either St. Joseph’s Health Care London, Atlohsa Family Healing Services, the Southwest Ontario Aboriginal Health Access Centre, London Intercommunity Health Centre, or London Health Sciences Centre. At this time, referrals are only accepted through the above care partners. Further pathways with partnering agencies are in development and will be added to our websites as they become confirmed. View our How to access page.
8. Can patients of St. Joseph’s Southwest Centre for Forensic Mental Health Care access these services?
Currently, group programming is available for inpatients at Southwest Centre on a biweekly basis and will soon be delivered in a new Indigenous Healing Space that is currently under development.
9. Is this team and these services available to individuals who are NOT patients/clients of St. Joseph’s Mental Health Care Program?
Yes. Indigenous people can access Biigajiiskaan services, via referral, through the following agencies:
- Atlohsa Family Healing Services
- Southwest Ontario Aboriginal Health Access Centre
- London Intercommunity Health Centre
- London Health Sciences Centre
- N’Amerind Friendship Centre
- Oneida Nation of the Thames
- Chippewa of the Thames First Nation
- Munsee Delaware Nation
10. Can non-Indigenous individuals access the program?
Not at the present time.
11. How will this program work with existing mental health care services at St. Joseph’s?
Because Biigajiiskaan is a program delivered in partnership with St. Joseph’s, it provides clients the opportunity to access the best of what both organizations have to offer. In many instances, depending on the needs of the client, Biigajiiskaan will be the primary support, with enhanced care provided by clinical teams at Parkwood Institute Mental Health Care. In other instances, Parkwood Institute staff will be the primary support team, with Biigajiiskaan staff enhancing care.
12. How will this initiative improve mental health pathways to care?
This program offers Traditional Indigenous Healing services in a hospital setting – making hospital referrals more convenient and comfortable for Indigenous community members. Biigajiiskaan staff are also developing and nurturing networks with mental health and addictions workers both in urban and First Nation settings, opening lines of communication for seamless referrals for those in need of support. In addition, the mobile outreach team allows for follow-up to ensure continuous care for outpatients and those who are transitioning from hospital to community.
13. Why do we need a special program for Indigenous people?
Indigenous people have experienced, and continue to experience, institutional trauma through Canada’s residential school system, Indian hospitals and continue to experience systemic discrimination and stereotyping in institutions to this day. These experiences have led to the loss of language, culture, a sense of safety and community. Today, community members continue to experience systemic discrimination and stereotyping in institutions. As a result, many Indigenous people are reluctant to go to hospital or access help from Canadian health care agencies.
At the same time – and as a result of colonization and government programs such as the residential school system – Indigenous people experience mental health and addictions at rates that are more than double those among non-Indigenous people in Canada. The impact is crippling. Suicide rates among Indigenous youth are more than five times higher than among non-Indigenous youth in Canada.
In acknowledgement of these realities, Canada’s Truth and Reconciliation Commission has called on health care institutions to build culturally-safe care and offer Traditional Healing services for Indigenous patients in an effort to create change and support the journey to reconciliation. The goal is to ensure equity of care for everyone in this country.
14. But doesn’t everyone has access to the same services in Ontario hospitals?
Despite having access to the same services as all Ontarians, Indigenous peoples face barriers to equitable health care as a result of a history of colonization, as well as institutional and interpersonal discrimination in hospitals and other care settings. By ensuring that the mental health care and wellness services of Biigajiiskaan are Indigenous-led, we can begin to break down these inequities and barriers, which will lead to culturally-safe care and hostile-free environments. This is important because there is strong evidence that providing culturally-safe care improves health outcomes.
15. How will the success of Biigajiiskaan be measured?
Biigajiiskaan has partnered with Western University and Lawson Health Research Institute on a program evaluation that includes both qualitative (stories, narratives) and quantitative methods (e.g., client satisfaction and engagement) to capture key outcomes. Wise practices will also be captured as defined by service users, care staff from local Indigenous communities and staff from partnering organizations. The process and formative evaluation will draw upon the experiences and perceptions of Indigenous community members, mental health care providers, and leadership, as well as other stakeholders (e.g., Elders and Knowledge Keepers) who work within mental health care settings.
19. Who can I contact to learn more?