Healing the Hurt is a two-part video series documenting Indigenous mothers’ experiences receiving health care in Hamilton, Ontario, Canada.
In sharing these traumatic memories, they hope that health care professionals will understand the consequences of anti-Indigenous racism, and commit to providing trauma-informed, culturally-safe care.
Continue scrolling to watch the full videos and learn more about how to provide safer and more accessible care to Indigenous families.
CHRISTENA’S STORY
SHAWNA’S STORY
The mothers who participated in this project had several suggestions for clinicians to promote safer, warmer, and more accessible care for Indigenous parents and their children:
Prioritize building trusting relationships
Take a sensitive and supportive approach to the involvement of child protection services
Eliminate financial barriers to health care access
Facilitate flexible appointments
Create welcoming and friendly clinics and provide holistic care
Below are several examples of how clinicians might implement these strategies in practice.
Prioritize building trusting relationships
Although the fast pace of health care may make it challenging, building trusting relationships with providers was important to mothers. Mothers who have experienced racism and discrimination may, justifiably, have difficulty trusting their providers.
Clinicians can begin to foster trusting relationships by the following:
Use effective communication skills: listen attentively to mothers’ concerns, explain assessments and treatments
Involve parents in decision-making
Validate parents’ concerns
Promote confidentiality: ensure safe and private areas are available for sensitive conversations, ensure confidential information isn’t audible from reception areas
Take a sensitive and supportive approach to the involvement of child protection services
(CPS)
The involvement of child services is particularly traumatic for Indigenous families. Indigenous children are over-represented in the care of CPS (Truth and Reconciliation Commission, 2015). This reflects the continuing colonial control on Indigenous ways of parenting, and the history of residential schools and the Sixties Scoop, in which Indigenous children were forcibly removed from their families.
Health providers can apply trauma and violence-informed care by the following:
Provide respectful and nonjudgmental care, regardless of past involvement with child services
Affirm parents’ strengths and abilities
Advocate for the family, ensure Indigenous representation is present at meetings with child services
Never threatening child services involvement as ‘punishment’ for missed or cancelled appointments.
Eliminate financial barriers to health care access
Fee-for-use health services, expensive transportation costs and other fees can be a barrier for Indigenous parents seeking health care for their infants.
These barriers might be mitigated by the following:
Avoid charging patients for seeking attention at walk-in clinics
Provide taxi vouchers, bus passes, or free parking when transportation costs are a barrier
Connect families to programming that can provide tangible resources such as groceries, diapers and transportation vouchers when needed
When possible, provide services that address contributors to social inequity. The Hamilton Regional Indian Centre is a fantastic example, providing an on-site high school program, free access to internet, and on-site employment counsellors.
Facilitate flexible appointments
Many of the mothers had several children, and busy, complex lives that sometimes made it necessary for appointments to be cancelled or re-booked.
Providers can make their practice more flexible by the following:
Avoid punitive measures like charging a fee or de-rostering patients who miss or cancel appointments
Offer home-visiting or virtual services so that parents do not have to worry about transportation or arranging child-care for their other children while they visit the clinic
Offer complimentary on-site child-care services
Provide alternative care options, such as same-day services, after-hours care, or on-call telephone or virtual triaging services to determine if urgent care is required.
Create welcoming and friendly clinics, and provide holistic care
Mothers in this study appreciated when providers made such effort in their practice settings, for example:
Warm, friendly receptionists who endeavour to remember family members’ names. Since receptionists are the first point of contact during a health visit, they set the tone for the clinic and the following healthcare encounter.
Well-maintained, clean, accessible clinic environments — mothers interpreted the clinic environment as a reflection of how the clinician valued their patients.
Acknowledging spiritual needs: offer access to spiritual care spaces and Indigenous Elders
Acknowledge Indigenous traditional medicine and spirituality as integral components of health: connecting families to community spiritual/ cultural resources such as those provided by the Hamilton Friendship Centre (HRIC).
Make cultural safety the standard in your practice setting.
Educate yourself and your colleagues about the legacy of colonial violence in Canada.
Ongoing Publications
