First Nations kids more likely to experience pain, less likely to get treatment

New research conducted in Atlantic Canada has found First Nations children are more likely to suffer painful conditions, but are less likely to see specialists or access mental-health services.

IWK, Dalhousie and Mi'kmaw researchers examined Nova Scotia health data from 18-year period

This was painted by an 11-year-old Indigenous child. A study on pain released this month ties into previous work that asked Indigenous children and teenagers from four First Nations communities to express their hurt through art. (Aboriginal Children's Hurt and Healing Initiative)

Researchers examining children's experiences with pain say their new data reflects what communities have been saying for years — that First Nations children are more likely to suffer painful conditions, but are less likely to see specialists or access mental-health services.

A study published this month in the Canadian Medical Association Journal compared health records related to 2,631 First Nations children born in Nova Scotia between 1997 and 2015 with the same number of non-Indigenous kids in the province.

It found 24.4 per cent of First Nations newborns were admitted to neonatal intensive care units, compared to 18.4 per cent of non-First Nations babies. It also determined First Nations children have higher rates of other painful conditions, including headaches, dental problems, and throat and ear infections.

The research, "Occurrence of and referral to specialists for pain-related diagnoses in First Nations and non–First Nations children and youth," was published in the December issue of the Canadian Medical Association Journal. (CMAJ)

Sharon Rudderham, the health director in Eskasoni First Nation who co-authored the research, said it highlights that it's more challenging to identify and get treatment for health problems in Mi'kmaw communities in Nova Scotia.

"It's validating everything we've been saying for all these years. Finally we have the research, we have the data to now show government they need to act and they need to begin to provide services at the community level for First Nations," she said. 

"There are significant gaps … the same level of services are not available and don't exist in our communities." 

Sharon Rudderham is the health director in Eskasoni First Nation who co-authored the research into the pain of First Nations children. (Submitted)

Among those gaps, Rudderham said it's hard to access preventive dental care. Schools don't always conduct psycho-educational needs assessments and many Mi'kmaw communities lack early intervention services that help support children. 

Communities have high rates of poverty so travel to access services can also be a challenge for families, she said. 

John Sylliboy hangs one of 22 pieces of art by Indigenous youth during a 2016 art exhibit at Toronto's Sick Kids hospital. (Ed Ou/CBC News)

This most recent study is part of the Aboriginal Children's Hurt and Healing partnership between researchers at the IWK Health Centre, Dalhousie University and Mi'kmaw communities in Nova Scotia.

It was funded by the Canadian Institutes of Health Research and aimed to determine why so few First Nations children were being referred to the pediatric pain centre at the IWK, the Atlantic region's largest children's hospital. 

The group has previously conducted sessions with elders, youth, clinicians, parents and children in Mi'kmaw communities. One study incorporated painting in an effort to capture the emotions experienced by a group often stoic about painful experiences.

A 16-year old described her painting as being 'about pain and the black represents how she feels inside. But she has, like, this white kind of atmosphere and it separates it from her pain.' (Aboriginal Children's Hurt and Healing Initiative)

However, the new research found the number of First Nations youth with mental-health diagnoses was "surprisingly low" given past work that has established high suicide rates and mental-health conditions among Indigenous youth. 

"Taken together, it shows us that they're not getting access to timely, equitable mental-health services. And it's not just access, it's access to culturally safe services, services that are administered by people who understand Indigenous people's history," said co-author Margot Latimer, who has a doctorate in nursing and did post-doctoral studies in neuroscience.

"It sort of matches up that they may not feel comfortable going to our health-care institutions to talk about their mental-health issues because they may not feel we're ready or able to understand the depth of those issues or help them in a way that's meaningful or reflects their cultural beliefs and understandings."

Latimer, a professor at Dalhousie University, said this winter the group is also piloting a first-year course that will teach medical, nursing and dentistry students at Dalhousie about Indigenous history and culture.

Rudderham said Eskasoni is taking steps to try to ensure young people — which account for roughly half of the community's population — feel comfortable accessing mental-health supports. 

The Access Open Minds mental health centre in Eskasoni, N.S. (Facebook)

She said there's still plenty of stigma about mental-health problems even though the trauma of residential schools continues to affect generations of families.

In order to try to improve the statistics though, she said Eskasoni is trying to ensure mental-health workers are available in schools, through recreation programs and at the local youth centre

An appointment could involve going for a trip to Tim Hortons or a drop-in at home.

"Having a provider sitting there twiddling their thumbs is not what we wanted to replicate," she said. "They work hand-in-hand with young children and with families and with the entire community and focus on a community wellness model."

About the Author

Elizabeth McMillan

Elizabeth McMillan is a journalist with CBC Nova Scotia. Over the past nine years, she has reported from the edge of the Arctic Ocean to the Atlantic Coast and loves sharing people's stories. She can be reached at elizabeth.mcmillan@cbc.ca