Abstract
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Background
National information about acute care hospitalizations for mental/behavioural disorders among Aboriginal people in Canada is limited.
Data and methods
This study describes acute care hospitalizations for mental /behavioural disorders among First Nations people living on and off reserve. The 2006 Census was linked to the Discharge Abstract Database from 2006/2007 through 2008/2009 for all provinces (except Ontario and Quebec) and the three territories. Hospitalizations for seven types of disorders were identified. “Most responsible” diagnosis and secondary diagnoses were examined separately. Age-standardized hospitalization rates (ASHRs) per 100,000 population and rate ratios were calculated.
Results
ASHRs for most responsible and secondary diagnoses of mental/behavioural disorders were significantly higher for First Nations people living on and off reserve than for non-Aboriginal people. The leading diagnoses were the same for each group, but the rank order differed. Among First Nations people, the most common diagnoses were substance-related disorders, mood disorders, and schizophrenic/psychotic disorders. Among non-Aboriginal people, mood disorders were the leading most responsible diagnosis, followed by schizophrenic/psychotic disorders and substance-related disorders. The greatest rate differences between First Nations and non-Aboriginal people for both most responsible and secondary diagnoses were for substance-related disorders.
Interpretation
The higher burden of hospitalizations due to mental/behavioural disorders among First Nations people provides benchmarks and points to the need of considering every hospital admission as an important opportunity for intervention and prevention. The Truth and Reconciliation Commission of Canada (2015) has recognized that the poorer health outcomes of Aboriginal people in Canada were rooted in the legacies of colonization. Further research is required to better understand the direct impacts on mental health.
Keywords
Aboriginal, census, data linkage, hospital records, Indigenous, substance-related disorders
Findings
Each year, one in seven Canadians is treated for mental illness. Research on population mental health, addictions, and treatment attracts considerable attention, but as noted in federal reports, data relevant to the development of policies and programs are required in several key areas. Notably, national statistics about the use of mental health services by Aboriginal people, particularly First Nations people who live on reserves, are lacking. The need to address data gaps is underscored by recent information documenting a higher prevalence of suicidal thoughts among First Nations people living off reserve, Métis and Inuit, compared with the non-Aboriginal population. [Full Text]
Authors
Gisèle Carrière (gisele.carriere@canada.ca), Evelyne Bougie and Dafna Kohen are with the Health Analysis Division at Statistics Canada, Ottawa, Ontario.
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What is already known on this subject?
- Elevated rates of acute care hospitalization among First Nations people relative to non-Aboriginal people have been reported for mental/behavioural disorders overall.
What does this study add?
- This study reports acute care hospitalization rates for seven groupings of mental/behavioural disorders for First Nations people, compared with non-Aboriginal people.
- Age-standardized acute care hospitalization rates were higher among First Nations people than among non-Aboriginal people for each grouping of mental health/behavioural disorders except organic disorders.
- Among First Nations people, the leading most responsible mental/behavioural diagnostic groupings were substance-related, mood, and schizophrenic/psychotic disorders. Among non-Aboriginal people, mood disorders ranked first, followed by schizophrenic/psychotic and substance-related disorders.
- The Truth and Reconciliation Commission of Canada (2015) has recognized that the poorer health outcomes of Aboriginal people in Canada were rooted in the legacies of colonization. The higher burden of hospitalizations due to mental/behavioural disorders among First Nations people provides benchmarks and points to the need of considering every hospital admission as an important opportunity for intervention and prevention.
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