Cultural Safety as an Outcome of a Dynamic Relational Process: The Experience of Inuit in a Mainstream Residential Addiction Rehabilitation Centre in Southern Canada

Abstract

Few addiction treatment options are available in Arctic Canada, leading many Inuit to seek treatment programs in southern cities. We conducted a case study to understand what contributes to a culturally safe experience for Inuit in a mainstream addiction rehabilitation centre in Southern Canada. We carried out more than 700 hours of participant observation, in addition to semi-structured interviews and member-checking activities with 20 Inuit residents, 18 staff and four managers. Data were analysed using an inductive interpretative process. Throughout their journey in the program, Inuit navigated through contrasting situations and feelings that we grouped under six broad themes: having Inuit peers, having limitations imposed on one’s ways of being and doing, facing ignorance and misperceptions, having conversations and dialogue, facing language barriers and being in a supportive and caring environment. This study highlights how cultural safety varies according to people, context and time, and relates to developing trustful relationships.

Mental health implementation research in Indigenous communities: creating culturally safe space to enhance collective strengths

“…To address these deep-seated issues, implementation research requires a reflective and decolonizing approach to establish a culturally safe space. Since university research partnerships with Indigenous communities are vulnerable to issues related to conflicting agendas or priorities, inequities in resource access, and differences in cultural values and contexts, the research team needs to engage in reflective discussion with community partners to establish and maintain trusting relationships (Brockie et al, 2022; Chandna et al, 2019; Lauzière et al, 2022). Decolonization in research involves challenging the traditional power dynamics between researchers and communities through a commitment to joint learning, in which collaborative creation of knowledge recognizes Indigenous priorities, agendas, methodologies, and politics as key aspects of the research process (Bird-Naytowhow et al, 2017; E.…”

“…In this context, fostering cultural safety also entails a process of un-learning, re-learning, and embracing the complexities and tensions that occupy the relational space and are inherent in transformation (Blanchet- Cohen & Richardson/Kinewesquao, 2017). Recent research has shown that the relational dimension is central to the promotion of cultural safety in complex intervention settings with longitudinal engagement (Lauzière et al, 2022). Workshop participants noted that building and maintaining authentic relationships requires ongoing engagement with community partners throughout the project's phases, characterized by transparency, truthfulness, compassion, and emotional openness.…”

“…I automatically assume when it is a second language, we have to pause and think if what we are saying is safe to say. (Program Facilitator, Nova Scotia) Previous research has indicated the importance of understanding and interpreting communication cues including verbal, bodily and gestural language in maintaining cultural safety in health research and servicedelivery settings (Lauzière et al, 2022). Moving at a pace that respects the emotional significance of particular topics, as well as local protocols is crucial to maintain safe space.…”

A cross-sectional study exploring community perspectives on the impacts of COVID-19 in Nunavut and recommendations for a Holistic Inuit Qaujimajatuqangit approach to emergency response

“…Limited access to culturally appropriate and evidence-based treatment options exacerbates these issues [ 30 ]. Research underscores the importance of community-based and culturally sensitive interventions, incorporating traditional healing practices and involving local communities in programme development [ 31–33 ]. Additionally, studies emphasise the need for trauma-informed care that addresses the underlying causes of addiction [ 34–36 ].…”