Elsevier

Social Science & Medicine

Volume 74, Issue 10, May 2012, Pages 1560-1569
Social Science & Medicine

Trauma and suicide behaviour histories among a Canadian indigenous population: An empirical exploration of the potential role of Canada's residential school system

https://doi.org/10.1016/j.socscimed.2012.01.026 Get rights and content

Abstract

It has been theorized that suicide behaviours amongst indigenous peoples may be an outcome of mass trauma experienced as a result of colonization. In Canada, qualitative evidence has suggested that the Indian Residential School System set in motion a cycle of trauma, with some survivors reporting subsequent abuse, suicide, and other related behaviours. It has been further postulated that the effects of trauma can also be passed inter-generationally. Today, there are four generations of Canadian First Nations residential school survivors who may have transmitted the trauma they experienced to their own children and grandchildren. No empirical study has ever been undertaken to demonstrate this dynamic. This study is therefore the first to investigate whether a direct or indirect exposure to Canada's residential school system is associated with trauma and suicide behaviour histories. Data were collected in 2002/2003 from a representative sample of Manitoba, Canada, First Nations adults (N = 2953), including residential (N = 611) and non-residential school attendees (N = 2342). Regression analyses showed that for residential school attendees negative experiences in residential school were associated with a history of abuse, and that this history and being of younger age was associated with a history of suicide thoughts, whereas abuse history only was associated with a history of suicide attempts. For First Nations adults who did not attend a residential school, we found that age 28–44, female sex, not having a partner, and having a parent or grandparent who attended a residential school was associated with a history of abuse. This history, along with age and having had a parent or grandparent who attended residential school was associated with a history of suicide thoughts and attempts. In conclusion, this is the first study to empirically demonstrate, at the population level, the mental health impact of the residential school system on survivors and their children.

Highlights

► First study to explore the empirical relationship between Canada's Indian residential school and pathways of risk for suicide. ► Canada's residential school, experienced individually or multigenerationally, predicated a history of abuse. ► This exposure and having a history of abuse was associated with a history of suicide thoughts and attempts.

Introduction

It has been theorized that suicide behaviour amongst indigenous peoples, worldwide, is a major outcome of the mass trauma experienced as a result of colonization (Beautrais & Fergusson, 2006; Bryant-Davis, 2007; Duran, 2006; Durie, 2001; Gagné, 1998; Hunter & Harvey, 2002; Hunter & Milroy, 2006; Kirmayer, Brass, & Tait, 2000; Koolmartie & Williams, 2000; Lawson-Te Aho, 1998; Lawson-Te Aho & Liu, 2010; Willmon-Hague & Bigfoot, 2008). Post-colonial theory situates such experience and cycle of trauma as one of persistent ethnic cleansing and psychic wounding (Duran & Duran, 1995). Historical trauma theories liken the impact of indigenous genocide, ethnic cleansing, and forced government acculturation policies to that of the intergenerational trauma experienced by holocaust survivors and their families (Braveheart, 1998, Braveheart, 1999a, Braveheart, 1999b; Braveheart & Debruyn, 1998). What differentiates the experience of indigenous peoples from that of holocaust survivors and families is that the trauma experienced by indigenous peoples was not confined to a single distinct, large-scale event limited in time. The experiences of indigenous peoples has been ongoing, and always present, making historical trauma a part of a common experience, subtly shaping the lives and futures of individuals, families and communities (Evans-Campbell, 2008; Fast & Collin-Vézina, 2010; Menzies, 2006; Wesley-Esquimaux & Smolewski, 2004). According to Braveheart (1998), manifestations of such cumulative emotional and psychological wounding over generations have included high rates of suicide and the major correlates of suicide – abuse, poor social support and difficulty forming and maintaining relationships.

In Canada, compelling qualitative evidence suggests that the federal colonial Indian Residential School System set into motion this cycle of trauma (Fournier & Crey, 1997; Furniss, 1992; Gagné, 1998; Haig-Brown, 1988; Kirmayer, Simpson, & Cargo, 2003; Milloy, 1999). As early as 1892, indigenous children were removed from their families and communities and sent to schools operated by the Roman Catholic Church, Church of England, United Church, or Presbyterian Church, and later by the Government of Canada. The removal of children from families and communities was a lawful government practice, intended to delimit the social and cultural identity of indigenous children. By christianizing, civilizing, and then re-socializing these children, the Federal government hoped that these children, and subsequent generations, would contribute economically to a modernizing Canada. This vision was not realized (Milloy, 1999; Royal Commission of Aboriginal Peoples, 1996).

While the failure of the system was evident early on, the residential school policy remained in effect until 1996 when the last government – run residential school closed. In one century, the Government of Canada exposed tens of thousands of indigenous children to a system fraught with structural and systemic problems, impacting their wellbeing and that of their families, communities and future generations. The legal, archival and narrative record suggests that the removal of children from families and communities and their placement in residential schools had altered family and community bonds (RCAP, 1996). Many residential school children experienced a loss of culture, language, traditional values, family bonding, life and parenting skills, self-respect, and the respect for others. Their parents, in turn, lost their roles as caregivers, nurturers, teachers, and family decision-makers. Overtime, the residential school system had loosened the emotional bond between parent and child, which Morrissette (1994) has likened to a residual holocaust effect. The loss of language and ties to Elders and traditional and spiritual teachings further isolated children from their cultural and spiritual roots. This loss disrupted the transmission of indigenous knowledge to subsequent generations. Upon release from the schools, survivors reported a legacy of alcohol and drug abuse problems, feelings of hopelessness, dependency, isolation, low self-esteem, suicide behaviours, prostitution, gambling, homelessness, sexual abuse, and violence. For women survivors, this exposure coupled with other forms of systemic and structural discrimination had placed them at even greater risk for such negative outcomes (Evans-Campbell, Lindhorst, Huang, & Walters, 2006; Réaume & Macklem, 1994; Stout & Peters, 2011). Today, there are four generations of First Nations residential school survivors in Canada who may have transmitted the trauma they experienced to their own children and the children of their children, and to non-descendents by way of indirect trauma effects at the level of the community (Evans-Campbell, 2008).

Life trajectories of survivors of mass trauma have been well documented amongst holocaust survivors, including second-generation impacts and more recently intergenerational processes of trauma in third and succeeding generations of survivors (Danieli, 1998; Felsen, 1998). The evidence suggests that survivor and victimization-related pathology does occur but that some survivors and children of mass trauma survivors are free of this pathology (Kellerman, 2001; Levav, Levinson, Radomislensky, Shemesh, & Kohn, 2007). Concerning indigenous populations generally, there is an emerging theoretical literature on how best to distinguish between historical trauma, secondary traumatization, intergenerational grief, lifetime trauma, and the impact such histories have on mental health generally and suicidal behaviours specifically (Dion Stout & Kipling, 2003; Evans-Campbell, 2008; Kirmayer et al., 2007; Leven, 2009; Sotero, 2006). While research shows that trauma and traumatic experiences are just as highly prevalent in both indigenous and non-indigenous populations (Manson, Beals, Klein, Croy, & AI-SUPERPFP Team, 2005), the multigenerational implications of trauma are thought to be greater within indigenous populations since a higher proportion of the population was affected by a large-scale and sustained traumatic exposure (Braveheart, 1998; Duran & Duran, 1995; Gagné, 1998). Very limited empirical research has looked into this trajectory among indigenous people (Sotero, 2006), particularly in relation to suicide behaviour, and no published work is apparent in Canada.

In the U.S., studies conducted among American Indian boarding school students had found that the poor quality of boarding schools, isolation from families and negation of American Indian identity might have contributed to high suicide rates among students (Dinges & Duong-Tran, 1994; Klienfield & Bloom, 1977; Manson, Beals, Dick, & Duclos, 1989). In Canada, a series of reports produced through the Aboriginal Healing Foundation suggested that suicidal behaviours had originated from the mass trauma experienced by residential boarding school survivors, who in turn transmitted these experiences and histories, directly or indirectly, to their offspring (Castellano, 2006). Nonetheless, the link between residential school exposure (direct or indirect), abuse, and suicide, has not been easy to establish empirically suggesting the need for more studies to understand these pathways of risk (Sotero, 2006).

The objective of this study was to investigate whether a direct or indirect exposure to Canada's residential school system was associated with trauma and suicide behaviour histories in a Canadian indigenous adult population, comprised of residential school survivors, their offspring, and individuals potentially exposed to effects of this mass trauma. Since direct residential school exposure was not randomized to all community members in the First Nation population, a level approach represented by cohorts would better disentangle the various effects of historical trauma (Evans-Campbell, 2008). In Canada, for instance, the last residential school closed in 1996 and in some provinces in 1974–1975, which means that in some regions individuals 18–27 years of age in 2002/2003 could not have attended a residential school. As noted from our review of the literature, a cohort approach would best reveal trauma effects from attending a residential school, having a family member who attended, or an exposure to historical trauma (second order).

Given these levels and cohorts, this study was designed to investigate impacts between two distinct groups – community members who were residential school survivors (attendees) and community members who did not attend a residential school (non-attendees). In First Nation communities, the first cohort was comprised of community members who had a direct exposure to a residential school (or schools). In this cohort, some survivors may be resilient whereas others may have felt that their wellbeing was negatively impacted because of a range of abuses they experienced in a residential school.

The other distinct cohort in First Nations communities were members who did not attend a residential school themselves, but may have been a descendent of a parent or grandparent who was a residential school survivor. First Nation community members who did not attend a residential school, but were descendents of residential school survivors, may therefore have associated psychological problems somewhat mirroring that of their parents (but less so) or may have experienced abuse or neglect due to poor parenting styles (Stout & Peters, 2011). First Nation community members who did not attend a residential school and did not have any parents or grandparents who attended may have also experienced abuse, neglect or poor mental health outcomes as a result of the historical trauma operating at the community level (Evans-Campbell, 2008).

In a Canadian First Nations On-Reserve population, we hypothesized that after adjusting for age, sex, and relationship status (H1) the odds of having an abuse history were more likely for those who (a) attended a residential school and (b) who had a parent or grandparent who attended a residential school (here in referred to as multigenerational residential school exposure); that (H2) the odds of having a history of suicide thoughts were more likely for those who reported (a) attending a residential school, and (b) had a multigenerational residential school exposure; and that (H3) a suicide attempt history were more likely for those who reported (a) attending a residential school, and had a (b) multigenerational residential school exposure.

Among a cohort of First Nation residential school attendees, we hypothesized that after adjusting for age, sex and relationship status (H4) the odds of having an abuse history were more likely for those who reported (a) negative experiences of residential school and who experienced (b) multigenerational residential school exposure; that (H5) a history of suicide thoughts were more likely for those who reported (a) negative experience of residential school, (b) multigenerational residential school exposure, and (c) an abuse history; and that (H6) a history of suicide attempts were more likely for those who reported (a) negative experiences of residential school, (b) multigenerational residential school exposure, and (c) an abuse history.

Among a cohort of First Nations adults who did not attend a residential school (non-attendees), we hypothesized that after adjusting for age, sex and relationship status (H7) the odds of having an abuse history were more likely for those who reported (a) multigenerational residential school exposure; that (H8) the odds of having a history of suicide thoughts were more likely for those who reported (a) multigenerational residential school exposure, and (b) for those with an abuse history; and (H9) a history of suicide attempts were more likely for those who reported (a) multigenerational residential school exposure, and (b) an abuse history.

Section snippets

Design and sample

In-person interview data from the Manitoba First Nation Regional Longitudinal Adult Health Survey conducted 2002/2003 were used to explore the potential predictors of a lifetime history of abuse, suicide thoughts and suicide attempts among residential and non-residential school attendees. Ethical approval for the survey study was obtained from the Health Research Ethics Board, Faculty of Medicine, at the University of Manitoba.

The survey used a multi-stage stratified random sampling approach

First Nations living On-Reserve

Table 1 describes the association (unadjusted odds ratios) between each explanatory variable and each of the three outcomes for the entire sample. Nearly 39% of First Nations living On-Reserve reported having a history of abuse. Being female, non-partnered, having attended a residential school, and having a multigenerational exposure were significantly associated with having an abuse history. Twenty-eight percent of the sample had a history of suicide thoughts. Characteristics significantly

Discussion

To our knowledge, this study is the first to use a representative indigenous population sample (Manitoba First Nation adults living On-Reserve) to empirically explore trauma pathways of suicide ideation and attempt history, with an emphasis on understanding the hypothesized link between a lifetime of abuse and a history of suicidality and a direct or indirect exposure to the residential school system.

In our full sample of On-Reserve First Nation adults, we found that females were more likely

Conclusion

These findings make a major contribution to the literature and also have important policy and mental health service research implications for First Nation individuals, families and communities, above and beyond current efforts underway in Canada to make amends for the residential school system. In June 2008, the Canadian federal government publically apologized to Canada's Indigenous peoples for the harm indigenous peoples experienced as a result of the federal government residential school

Acknowledgements

This research was supported by the Canadian Institutes of Health Research (MOP-79372). Dr. Brenda Elias is supported by a CIHR New Investigator award, and Dr. Jitender Sareen is supported by a Manitoba Health Research Council Chair award. The Manitoba First Nations Regional Longitudinal Health Survey was a joint initiative of the Assembly of Manitoba Chiefs and the Manitoba First Nations Centre for Aboriginal Health Research (Dr. Brenda Elias). The results and conclusions are those of the

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