William Mussell’s scientific contributions

This article reports on the findings of a larger study that explored urban Indigenous providers’ experiences with contracting in mental health and addictions care. The study was undertaken with seven Indigenous and one non-Indigenous non-profit organizations based in diverse large and mid-size cities (off reserve) in British Columbia, Canada. Indigenous and critical theoretical perspectives provided the lens for this ethnographic inquiry. In-depth interviews were the primary data source. Participants’ narratives provide an account of the ideological embeddedness of contracting and how a New Public Management operates to perpetuate colonial power imbalances and structural barriers to culturally safe and equity-oriented care within urban Indigenous communities. Policy and practice implications for government funders are discussed.

In this paper, we present findings from a qualitative study that explored Indigenous people’s experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples’ lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples’ lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized.

This article describes the experience of a pan-Canadian health organization that led a quality improvement collaborative focused on suicide prevention and life promotion with Indigenous communities in northern and remote regions of Canada. Working in partnership with a Guidance Group, it became clear that working in a relational way that is culturally safe and acknowledges "two-eyed seeing" helps to create an ethical space in which open dialogue and collaboration can occur. Relational work enabled the improvement teams in the Promoting Life Together Collaborative to co-develop life promotion activities within their communities. The primacy of building relationships is at the core of reconciliation with Indigenous peoples and is a key enabler of system transformation required to support the health and wellness of Indigenous communities across Canada.

This paper introduces the concept of micro-reconciliation as a pragmatic action to support cultural safety and humility work. Similar to cultural safety and humility, micro-reconciliation practices aim to challenge and diminish racism, inequality and inequity experienced by Indigenous peoples. In arguing for changes to the human service sector, micro-reconciliation exists at the intersections between entrenched structural racism and the psychological and emotional roots of discrimination that play out in every day service delivery. Three organizing practices are discussed; acknowledment, witnessing and moral courage, as the basis of micro-reconciliaion work and the advancement of cultural safety and reconciliaton.