8 Decolonizing Mental Health Services in Prisons

Title: Decolonizing Mental Health Services in Correctional Settings: Is Indigenous Self-Governance and Healing the Answer?

Abstract

Canadian correctional institutions, such as prisons, have an overpopulation of racial minorities and disproportionately high rates of mental illness. It’s no secret that more and better mental health supports are needed, especially in areas with large populations of racial and cultural minorities. Decolonization, for which there are multiple definitions and theories, offers a way to build more inclusive, holistic, and therefore effective approaches to mental health care.  This chapter will highlight the work of key scholars in the field of decolonization and initiatives around the world aimed at decolonizing mental health programs and supports in prisons. Colonization has impacted the field of mental health and the prison institution in Canada. Additionally, psychology and correctional systems have been used as methods of assimilation throughout Canadian history. Ultimately, this chapter argues that decolonizing mental health in correctional facilities is necessary to ensure community and individual healing.

Introduction

On October 19, 2007, Ashley Smith, after a lengthy and well-known history of self-harm and suicidal ideation, died by suicide in her prison cell while being videotaped and in sight of correctional officers who were told not to intervene if she was still breathing. Although Ashley Smith’s death was ruled a homicide and charges were laid against the guards and supervisor, these charges were later dropped (CBC, 2010). On August 23, 2010, Edward Christopher Snowshoe was pronounced dead by suicide on his 162nd day locked in solitary confinement which Correctional Services Canada deemed a necessary precaution to protect himself and others (White, 2014). Snowshoe’s death followed multiple suicide attempts in his three years of incarceration during which he battled multiple mental illnesses. On December fourth, 2016, Soleiman Faqiri was arrested during a schizophrenic episode and was taken into custody, rather than hospital, where he was killed 11 days later by correctional guards’ excessive use of force; his family is still fighting for justice (Nasser, 2019) five years later. These tragic realities highlight the failings of correctional institutions regarding mental health treatment and services. This is due in part to the inherently colonial nature of correctional institutions that aim to punish rather than heal and do not implement adequate or culturally competent mental health services and policies.

Prison populations are known to have an overrepresentation of both individuals with mental illness (Bakken & Visher, 2018) and racialized groups (Malakieh, 2020). Given the large overrepresentation of minority groups in correctional institutions, especially of Indigenous people, it is right to infer that these populations are also disproportionately affected by mental health concerns. Despite this, mental health practices, research methodologies, and policies remain rooted in colonial ideology. This chapter will discuss the importance of recognizing how colonization has impacted the mental health of many Indigenous people in Canadian correctional institutions through intergenerational trauma from colonization, the colonial lens in which research and program creation appear, and the limited access to quality and culturally appropriate services for racialized populations.  Lastly, promising practices will be discussed in relation to multicultural family counselling, the Kunga Stopping Violence Program, and healing lodges.

Impacts of Colonization

The impact of colonization on Indigenous peoples in Canada is far-reaching and particularly harmful to their mental health. Many mental health professionals, scholars, and Indigenous communities have noted that colonization continues to directly affect the mental well-being of Indigenous people (Gone, 2013). This has led to the acknowledgement of historical or intergenerational trauma, a term that encompasses the complex and self-perpetuating trauma caused by the colonial economic agenda and assimilation practices. These practices were implemented with the specific purpose of destroying Indigenous culture, and therefore an entire way of life, in an inherently violent way. The modus operandi of the colonial system includes stolen lands, the Canadian Residential School system, the Sixties scoop, and methods of clearing the plains using starvation and disease. These acts of government-sanctioned genocide now contribute to a loss of identity and culture, resulting in greater mental distress across an entire group of people, generation after generation. Studies on the psychological impact of residential schools show that individuals who attended have higher rates of depression, suicidal ideation and attempts, and are more likely to have survived childhood abuse and neglect (Boksa et al, 2015). Additionally, negative social determinants of health such as poverty, unemployment, and homelessness are also linked to colonization and contribute to both mental health outcomes and criminal offending (Boksa et al, 2015). Therefore, colonization is a root cause of the disproportionate mental health issues in Indigenous communities and the overrepresentation of Indigenous individuals in Canadian prisons.

Colonization has also impacted the way mental health issues are identified and treated; not only has colonization lead to mental health concerns among Indigenous people, but it continues to perpetuate harm through colonial models of healing. Meanwhile, the history of psychology itself is also linked to the systematic colonial oppression and assimilation of Indigenous peoples. This is shown most clearly through the biomedical model once used to classify and blame minority groups by claiming the perceived issue was inherent to the person or their culture, which led to inappropriate, forced treatment or criminalization of the behaviour. Treatments were often physically and/or psychologically harmful, adding to the distress suffered by the individual (Joseph, 2014). It is important to note that little research exists on forced psychological treatment of minority populations, which Joseph (2014) suggests is due to the political and social context in which these practices were performed. There is clear evidence, however, of an overrepresentation of racialized individuals in forensic mental health systems that is believed to be the result of both racist diagnostic processes and treatment services (Mackenzie, 2004). Being a person of colour with a mental illness increases the likelihood of contact with the Canadian justice system, and this is because the justice and mental health systems and practices were largely used for the purpose of securing colonization and assimilation.

 The overrepresentation of racial minorities in Canadian prisons is a known fact. In the 2018/2019 fiscal year, 31% of provincial and 29% of federal prison admissions were Indigenous despite comprising only 4.5% of the general Canadian population. Moreover, Indigenous women accounted for almost half of provincial and federal prison admissions (42% and 41% respectively), almost double that of their male counterparts (Malakieh, 2020). It must also be noted that overrepresentation is especially high in the prairie provinces with 75% of adult admissions to Saskatchewan correctional facilities in 2018/2019 being Indigenous despite the local Indigenous population comprising only 14% of the province’s total population (Malakieh, 2020).

Monchalin (2017) notes that this overrepresentation is due to the inherently colonial nature of the Canadian Justice System which has insidiously worked to criminalize and assimilate Indigenous peoples since its conception. Current policies increase the likelihood of Indigenous people being incarcerated as they have a greater likelihood of living below the poverty line, making it difficult to pay fines or hire their own lawyers (Monchalin, 2017) among other impacts. Monchalin (2017) insightfully argues that the overrepresentation of Indigenous individuals as both victims and prisoners is often presented as an issue inherently internal to Indigenous communities, rather than as a legacy of historical and modern-day colonial practices implemented to achieve “Indigenous people’s silent surrender” (p. 145). The complex and multi-faceted impacts of colonization on Canadian prisons is beyond the scope of this chapter; however, it is important to understand that colonial roots underlie all aspects of correctional institutions and, therefore, how forensic mental health treatments are created, implemented, and accessed.

 Popular mental health practices stem from European clinicians and research from primarily White study participants. Existing policies and governing structures within the psychology profession continue to promote the colonization of mental health services. Therefore, a top-down decolonized approach is required, beginning with the full implementation of the United Nations Declaration of Indigenous Peoples and a strategic diversification of psychology governing boards and structures (Lucero, 2011).  Despite current calls within the mental health and justice communities for culturally competent clinical and research practices, more extensive work must be done to decolonize the field. This is evidenced by the quantitative data supporting the perceived need of decolonized mental health services for successful outcomes in treating mental illness and distress (Hatcher et al., 2016). The need is also shown by the insufficient research on Indigenous mental health and a lack of funding available for these projects (McIntyre et al., 2017), racism within offender support programs and justice institutions responsible for ensuring access to healing services (Thompson et al., 2016), and the justice system’s slow response to informed recommendations for decolonization and lack of long term funding for culturally competent healing initiatives (Shepherd & Phillips, 2016). Therefore, institutional change must occur to shift the fields of psychological research, justice interventions, and forensic mental health practices towards a decolonized approach.

Defining Decolonization

Before one can address how to decolonize existing systems and institutions, an operational definition of decolonization must be established. While a general definition of decolonization has historically been understood as colonies becoming independent of the colonizer, the required method of decolonization is now a subject of scholarly debate. For instance, McNamara and Naepi (2018) define decolonization as the removal of all colonial influences. However, the authors argue that taking a decolonial stance means there are no redeemable qualities within the existing system, and it therefore must be dismantled and reconstructed. This perspective is seen by some to be too extreme, potentially harmful, and perhaps even unrealistic. Therefore, McNamara and Naepi (2018) argue for the Indigenization of existing systems, which they define as implementing Indigenous elements into existing structures to build integrated institutions that balance the diverse Indigenous and colonial-centered practices and values. Indigenization has proven a popular tool in courts and correctional institutions, leading to the implementation of sentencing circle practices and healing lodges.

 An opposing school of thought on decolonization has become more popular in recent years. It views Indigenization as harmful and counterintuitive to the intended goals of those seeking to decolonize. McGuire and Palys (2020) define decolonization as being free of responding to colonial structures and restraints in all areas of being and continuously engaging in the act of rejecting and resisting mechanisms of colonization. In the authors’ view, Indigenization has only served to reinforce internalized colonization within oppressed groups while appearing to contribute to reconciliation through accommodation rather than genuine change. Internalized colonization as addressed by Victor (2007) shows how the colonial methods succeed in convincing colonized individuals that justice can only be achieved through the current Canadian systems. This reinforces a belief that self-governance and differential methods of Indigenous justice are impossible while promoting one-size-fits-all Indigenous accommodation within current systems (McGuire & Palys, 2020). Therefore, McGuire and Palys (2020) advocate for Indigenous self-governance and argue that systems must be separate and distinct from colonial structures to be truly decolonial.

Monchalin (2017) interprets decolonization as the “unlearning and undoing of colonialism” (p. 293) which consists of understanding and engaging with colonial systems, structures, and notions to effect change through a resurgence of Indigenous culture and traditions and a simultaneous devaluing of colonial knowledge, values, and practices. This requires decolonization on a macro level through changes in governance structures, justice systems, and policy as well as on a micro level with the decolonization of minds, relationships, social values, and practices (Asadullah, 2021). Monchalin (2017) embraces Dr. Michael Yellow Bird’s belief that cultural traditions and ceremonies are imperative to collectively healing from colonial trauma and that this is the first step in decolonization on a macro scale; individuals must know about and believe that decolonization is possible for it to occur. This approach to decolonization incorporates McNamara and Naepi (2018)’s argument that current colonial systems must be changed by promoting and respectfully incorporating Indigenous traditions and practices; however, it also stresses the need of McGuire and Palys (2020) to be free from responding to and acting within colonial systems and structures. Ultimately, the importance of self-determination and cultural reclamation is always paramount. This aspect of decolonization is reflected in the Two-Eyed Seeing approach, which recognizes that Indigenous knowledge can co-exist with Western approaches by understanding each other as equals in research methodology, program creation, and system implementation (Marsh et al., 2015). This chapter will primarily adopt a Two-Eyed Seeing approach to decolonization to review current literature and program initiatives.

Decolonizing Mental Health in a Correctional Setting

Now that definitions of decolonization have been discussed, it must next be understood in the specific context of mental health. As has been previously established, colonization has contributed to the greater likelihood that Black, Indigenous, & People of Colour (BIPOC[1]) will experience a mental illness, and it also underlies the methods used to treat mental health concerns. Western psychotherapy models dominate mental health practices around the world, which poses many issues; primarily, the fact that psychotherapy models are influenced by, and greatly reflect, the culture in which they were created making multicultural use without informed modifications problematic (Koç & Kafa, 2019). Attitudes and approaches to  mental health differ across cultures as they are informed by cultural context, history, values, and practices (Koç & Kafa, 2019). Therefore, decolonized approaches to mental health treatment must come from the communities they intend to serve, and this requires practitioners who understand the consequences and realities of intergenerational trauma caused by historical and perpetuated mechanisms of colonization. This is especially true in correctional settings where inmates are disproportionately Indigenous and thus have often experienced some form of trauma and are more likely to experience mental illness. The decolonization of mental health must occur at both the micro and macro levels. In the micro, this includes decolonizing therapeutic interactions between clients and professionals as well as working with clients to deconstruct conditioned colonial thinking and decolonize their own mindset. In the macro, decolonization must occur in and be the focus of research practices, boards and accreditation requirements, mental health laws and policies, and program development.

While decolonizing mental health practices in correctional settings is the focus of this chapter, it must be understood that decolonizing prisons is a foundational step in this process. Mental health care within correctional institutions, whether directly through individual counselling or in a program setting such as substance abuse treatment, is designed for and by the institution. Therefore, the operations of mental health treatment are dependent on the policy and structure of the institution served. Accordingly, correctional institutions such as prisons must either be decolonized first or in tandem with the mental health services they provide. From the perspective of scholars like McGuire & Palys (2020), this means the acceptance and implementation of distinct Indigenous justice systems created by and for Indigenous communities. As Monchalin (2017) points out, this would require the implementation of culturally competent practices and programs created, implemented, and controlled by Indigenous peoples. Until this is realized, changes to mental health interventions will likely continue to reflect Indigenous accommodation rather than decolonization.

Current Research on the Need for Decolonized Mental Health Practices

The justice system is often critiqued for its slow and reluctant response to numerous recommendations on improving mainstream services for Indigenous peoples. Institutional change and a cultural shift within justice systems is needed to successfully implement culturally appropriate programs and educate staff (Shepherd & Phillips, 2016). Shepherd and Phillips (2016) add to the growing support for the need to decolonize and diversify institutions before meaningful change to services can begin. Moreover, the involvement of Indigenous communities and individuals at all levels of program conception, creation, and deliverance is highlighted as a key component to purposeful, long-lasting structural change (Shepherd & Phillips, 2016). Additionally, the need for culturally appropriate mental health services in corrections is a known fact and acknowledged in the Mental Health Strategy for Corrections in Canada (Correctional Service Canada, 2012); yet much work lies ahead. For meaningful change to occur, decolonization is needed at both macro and micro levels to reshape mainstream justice and psychology practices.

Macro Decolonization Needs

The most foundational step in decolonizing any system or institution is recognizing which legal and human rights are not being met. Lucero (2011) emphasizes the role of policy in regulating mental health practices, and how legal change is needed to decolonize mental health by acknowledging Indigenous sovereignty rights. Indigenous sovereignty as outlined in official government legislation and documents must be embraced and implemented, allowing Indigenous peoples access to all forms of treatment including traditional options within their communities (Lucero, 2011). In the Canadian context, relevant documentation includes the United Nations Declaration of Indigenous Peoples (UNDRIP), The Canadian Charter of Rights and Freedoms, and treaty agreements. UNDRIP, which was ratified by Canada in 2016, includes clear language on the rights of Indigenous peoples to be actively involved in the development of social institutions such as health and justice (Article 34), traditional medicines and healthcare practices (Article 24.1), and access to the highest quality of mental health services (Article 24.2) to name only a few (United Nations General Assembly, 2007). The commitment to UNDRIP by the Canadian government reveals that officials recognize the Indigenous right to create their own justice and mental health systems but have yet to acknowledge these rights in any meaningful way.

Lucero (2011) emphasizes the need to decolonize psychological research methods and diversify decision-making boards and bodies. In this way, decolonizing mental health requires a top-down approach that includes accreditation organizations, funding opportunities, and research methods to move beyond a frontline clinical focus (Lucero, 2011). As accreditation organizations determine the qualifications and training required to practice as a psychologist, therapist, or social worker, they are best positioned to make using decolonized methods and Indigenous-informed practice mandatory for all mental health workers. Accreditation criteria created by specific Indigenous communities would ensure cultural relevancy and be a step towards self-governance in relation to mental health services, extending to Indigenous individuals in Canadian or Indigenous justice systems. Including accreditation for decolonized practice would also help ensure it makes its way into the mental health curriculums of accredited post-secondary programs. Additionally, long-term funding must be made available for research into Indigenous mental health and forensic mental health programs (Shepherd & Phillips, 2016). Without adequate funding, prison initiatives lack longevity and true decolonial intent. However, as McGuire and Palys (2020) acknowledge, funding bodies are also problematic as they influence what research is done and how programs operate. Therefore, opportunities and initiatives for Indigenous communities to fund and direct their own research and services must be supported.

McIntyre et al. (2017) examined existing surveys on Indigenous mental health in Australia, Canada, New Zealand, and the United States of America (U.S.) to determine whether the information needed for quality health services is being collected. The results of this study were disconcerting, revealing the quality of information collected to be inadequate and disproportionate to that of non-Indigenous, despite the disproportionate mental health issues faced by Indigenous individuals compared to non-Indigenous populations in all four countries (McIntyre et al., 2017). This means one of the most at risk and affected communities is not being accurately assessed, and their unique needs are not being met. Therefore, greater assessments are needed to ensure that barriers to care are identified and solutions implemented. These findings are important to decolonizing mental health in justice systems going forward; without information on what barriers Indigenous individuals face and the unique needs that must be met, change will not occur inside or outside of a correctional facility.

Micro Decolonization Needs

A study analyzing parole officers’ perspectives on mental health services available to individuals on parole found that racial minorities are less likely to receive mental health interventions and aid than their White counterparts (Thompson et al., 2016). Previous research exposed the many access barriers to adequate and culturally competent mental health treatment for racial and ethnic minorities. This is especially concerning given the disproportionate rate of Black, Indigenous, and People of Colour in the justice system. The study’s results also counter previous research findings where parole officers reported adequate mental health and substance abuse resources with little to no racial discrimination. There has always, however, been an agreement over the lack of cultural diversity exists in programs and service providers (Thompson et al., 2016). This suggests a colonized mindset within the parole system, making it harder for parole officers to fathom the need for culturally appropriate counselling in order to provide adequate mental health services. This is evidenced by the study’s findings that White parole officers did not see issues of racism in accessing mental health supports, but parole officers of Colour did (Thompson et al., 2016). Therefore, this research showcases not only the need to decolonize justice systems surrounding mental health, but also how the colonial mindsets of those working with mentally ill offenders can impact development and access to needed services.

In terms of decolonizing individual therapeutic practices and relationships, Nuttgens and Campbell (2010) highlight multicultural counselling routed in self-awareness, knowledge of the Other, and therapeutic practice. The authors state that historic colonial harm combines with current Western models of service delivery to make Indigenous peoples less likely to seek or continue accessing mental health services. Nuttgens and Campbell (2010) rightfully claim that implementing culturally competent therapy is an ethical obligation of all mental health workers. Therefore, the onus is also on individuals to ensure they engage with clients in a decolonized manner. This includes understanding ingrained colonial and racial bias on the part of the service worker as well as all existing power differentials within each therapeutic relationship with a client. Mental health workers must understand how colonization has impacted their client’s life and how this has contributed to their current state of mental health and relative inability to access treatment services.

Finally, mental health interventions must ingrain understanding and be respectful of the relevant cultural beliefs and values around healing (Nuttgens & Campbell, 2010). This can be difficult to achieve as many Indigenous people identify with multiple cultures or have diverse needs (Weaver & Yellow Horse Brave Heart, 1999). The perspective on decolonization taken by Monchalin (2017), however, includes the incorporation of traditional ceremony and the involvement and leadership of Elders from the client’s own cultural group. In a correctional setting, multicultural competence in mental health professionals is crucial given the disproportionate representation of racial minorities. Moreover, since prisons continue to deny operating under a mere guise of rehabilitation, it is therefore the duty of the institution and all those who work within it to implement the appropriate services best suited to treating mental illness in the prison population – in other words, a decolonized approach to care.

Two-Eyed Seeing

Two-Eyed Seeing can be used to decolonize at both the macro and micro levels of a national society and structure. Integrating a Two-Eyed Seeing approach into research is becoming a more common means of decolonizing research. This is seen in the way it combines Western and Indigenous ways of knowing and knowledge translation while promoting inclusion and trust that has been severely lacking in forensic psychology (Marsh et al, 2015). Additionally, when applied to program development the Two-Eyed approach fosters a relationship of mutual intercultural respect and utilizes or merges the best of both cultural views on healing (Marsh et al, 2015). This way of seeing can also be beneficial to individual therapy practices as it provides a framework for culturally competent counselling and healing practices. Overall, Two-Eyed Seeing acknowledges both cultures as distinct but not opposing; therefore, an acceptance of the co-existence of these worldviews may provide an important foundation for decolonization work in the field of forensic mental health.

Promising Praxis

While there is ample academic evidence that the field of psychology must be decolonized, especially in relation to forensic mental health services, there is little research available on current initiatives being implemented in correctional settings. Shepherd and Phillips (2016) attribute this in part to the lack of funding and long-term planning for Indigenous initiatives as many programs are piloted but few permanently implemented. However, common themes in research pertain to methods of decolonizing services in the form of multicultural counseling practices, Indigenous wellness, and intervention programming in prisons, and healing lodges. Lastly, the practices discussed are largely forms of Indigenizing existing correctional practices, which in the view of McGuire and Palys (2020) will not sustain decolonization. Unfortunately, when discussing a colonized system within the colonial institution of prison, mental health services are reliant on the direction and functions of the institution. This means that forensic psychology programs will never be fully decolonized until the prison institution is decolonized or the programs are created as separate and distinct systems from the mainstream.

Multicultural Couple and Family Counselling in Prison

Multicultural Couple and Family Counseling is a promising theory of a practice that could be implemented in prisons. Tadros et al. (2019) discuss this method of counselling in response to the overrepresentation of minority groups in incarcerated settings. Multicultural Couple and Family Counseling also addresses the negative effects, such as emotional and financial strain, that incarceration can have on family members when it separates an individual from the family unit (Tadros et al., 2019). This is an important factor to consider in terms of decolonization, given that the Canadian Justice System has been separating Indigenous families since its conception through legislation like the Indian Act which mandated compulsory attendance at residential schools. Therefore, group counselling could aid in building and maintaining family cohesion during a significant period of separation.

Multicultural counselling adapts to the specific cultural needs of the client while remaining informed and culturally competent, rather than remaining mired in Eurocentric and colonial ways of thinking (Tadros et al., 2019). Additionally, this method looks to support the family unit and the individual’s support system as a whole and recognizes the need to move from an individualistic to a collectivist approach in order to repair and strengthen the relationships damaged by crime and incarceration. Therefore, a holistic approach to healing is provided when treating the mental health of the individual and preparing them for life outside the institution (Tadros et al., 2019). A multicultural approach to counselling allows offenders to express the cultural and spiritual needs required for healing and encourages the incorporation of traditional practices into counselling sessions. This should include the presence of chosen family members, beyond the immediate family if desired, the inclusion of traditional prayers and/or practices, and the guidance of Elders and community leaders. It is crucial that multicultural practices be specific to the individual and not take the one-size-fits all approach, which McGuire and Palys (2020) remark often happens with current Indigenization initiatives in the justice system. Lastly, the theory of multicultural family and couple counselling in prison could be implemented in Canada if a Two-Eyed Seeing approach to structure is ensured, meaning that Indigenous communities are consulted, have leadership roles in implementation, and their worldviews are incorporated and respected.

Kunga Stopping Violence Program in Australia’s Alice Springs Correctional Centre

The Kunga Stopping Violence Program (KSVP) provides a strong example of decolonizing mental health services in prison for Indigenous women (Atkinson, 2020). The program, approved by the North Australian Aboriginal Justice Agency, is a month long and runs twice a year at the Alice Springs Correctional Centre. The Kunga Stopping Violence Program (KVSP) works with Indigenous women in the prison who have a history of, or are currently incarcerated for, a violent offence with the aim of operating with an educational approach, what Atkinson (2020) deems educaring. Educaring revolves around the idea that education on colonial history and how colonization has affected the lives of Indigenous peoples, specifically those in the program, is an essential part of healing from intergenerational trauma. The program was created under three assumptions: firstly, that the ways of life for Indigenous peoples have been attacked by colonization; secondly, reclamation of practices and pride in Indigenous self and culture is imperative to a successful educational approach; and thirdly, that the program must be trauma-informed and incorporate culture-specific Indigenous healing methods such as reflection, conversation, and storytelling (Atkinson, 2020).

The KVSP consists of three vital components of healing. The program begins with a circle of wellbeing aiming to create a sense of safety while grounding participants in the cultural process, and each day starts with a mediative practice to foster personal reflection (Atkinson, 2020). This self-contemplation and inner listening are ceremonial practices associated with cultural healing. Conversations are part of this and pertain to the circle’s eight points of wellbeing: spirituality, environment, relationships, emotions, physical body, sexuality, stress, and life purpose (Atkinson, 2020). The program thus creates a safe and non-threatening space to reflect on the aspects of emotional pain or trauma of each participant.

Next, the Kunga Stopping Violence Program addresses issues of anger, violence, boundaries, and safety through visual artwork of the tree and its components created on a board or a wall. It was initially called “the violence nonviolence tree” (p. 299) later becoming the “feeling-healing tree” (p. 299), a name suggested by some participants while adding words onto the displayed tree to describe their emotions (Atkinson, 2020). In the original violence nonviolence tree, roots reflect the causes of violence, the trunk the contributing factors, the branches the outcomes or impacts of violent acts, and the leaves the feelings emitted under the influence of all these factors. As the tree metamorphosed into the feeling-healing tree, flowers were added with participant’s written reflections on healing intentions. Given the mainly oral traditions within many Indigenous cultures – not only handing down knowledge but making it relevant to the new generations – it is no surprise to see the use of stories on this section of the tree. As Atkinson (2020) so aptly states, “working with stories is meaning making, transformative political healing action” (p. 300) as participants come to recognize the injustices they have faced and discover auto-motivation to create change. Talking circles were used throughout the program to ensure everyone had the opportunity to speak and be heard (Atkinson, 2020).

Lastly, the KSVP program addresses loss and grief through a process of history mapping (Atkinson, 2020). This is carried out individually with a program staff worker supporting participants reflecting on instances of loss in their life. This was followed by creating artwork, through painting, of their life story from birth to present day as a timeline of memorable experiences, both positive and negative. This revealed that many of the women had experienced significant trauma including common themes of witnessing abuse, community violence, feeling unsafe, racism, sexual assault, and fractured relationships. The participants were provided the opportunity to discuss their feelings about the reflective exercise and memories identified  throughout the process in a sharing circle with the group providing support. Moreover, they were able to revisit their timeline throughout the program to add additional reflections or fill in gaps previously too difficult to acknowledge (Atkinson, 2020).

Alice Springs Correctional facility’s Kunga Stopping Violence Program (KSVP) promotes a decolonized approach to mental health programs in prison through the incorporation of Indigenous values and practices while addressing the impacts of colonization on the lives of individual participants. The continued reflection and group discussion facilitated group learning by engaging the participants in mutual understanding, growth, and in educating each other and acknowledging themselves as the experts of their own lives and healing processes (Atkinson, 2020). Moreover, the women are encouraged to speak their preferred language when talking to each other, rather than being discouraged to do so as often happens with prison guards (Atkinson, 2020). This not only recognizes that English is not the mother tongue of many participants, but also encourages a celebration of culture and reclamation of Indigenous languages that colonizers attempted to silence. The KSVP provides a safe and decolonized space within the colonial structure of prisons. It fosters personal healing through a process of reflecting on  life experiences that contributed to the participant’s offending. This in turn facilitates confrontation of injustices faced and harm caused, thereby moving away from a purely punitive approach, towards holistic healing.

Healing Lodges in Canada

Healing lodges aim to incorporate Indigenous practices and values into prison settings while taking a holistic approach to rehabilitation and healing. These facilities emphasize the need to address intergenerational trauma and reconnect with Indigenous cultures and traditions (Nielsen, 2016). Some Indigenous scholars promote participation in cultural practices as a holistic form of healing, especially the effects of colonial trauma (Gone, 2013). In this way, healing lodges are an example of one attempt to decolonize mental health practices in prison. They provide a holistic approach grounded in culturally rooted services. Healing lodges are widely praised for their implementation of Indigenous culture and healing practices and have shown to increase feelings of safety, control, and support by inmates (Hart-Mitchell & Pfeifer, 2003).  However, reviews of state- and community-run lodges have shown a disparity of funding and resources for Indigenous operated facilities (Nielsen, 2016), revealing how colonial institutions continue to undermine attempts at self-governance and decolonization within the scope of the justice system. Some view the community-run facilities as an enhanced decolonized practice because they are run by Indigenous communities and offer greater cultural programming within the extent allowed by Correction Services Canada regulations (Nielsen, 2016). Therefore, community-run Healing Lodges constitute a best practice.

 The Stan Daniels Healing Centre, a community run facility opened in Edmonton, Alberta in 1999, is one of the first and longest-operating healing lodges in Canada (Nielsen, 2003). Programming at Stan Daniels includes education and employment preparation, life-skills training, guidance from Elders, and education on Indigenous history and issues as part of an individualized healing plan for each resident (Nielsen, 2003). Moreover, Indigenous values –including balance, healing, autonomy, and interconnectedness – underlie all activities and interactions. These programs are examples of a decolonized approach to healing that aims to improve mental health but also general well-being. Saskatchewan’s Spiritual Healing Lodge is operated by the Prince Albert Grand Council, which includes an advisory group of Elders from all four sectors of the council (Prince Albert Grand Council, 2014). Programs at the Spiritual Healing Lodge include weekly sweats, talking circles, pipe ceremonies, individual conversations with Elders, smudging, traditional parenting teachings, and other traditional ceremonies and knowledge sharing (Prince Albert Grand Council, 2014). The involvement of Elders from all sectors of the Grand Council reveals how Indigenous-run facilities do not take a one-size-fits-all approach to cultural teachings and counselling, a common criticism of federal initiatives according to Boyce (2017), McGuire & Palys (2020), and Nielsen (2016).

It is important to recognize that Healing Lodges face much criticism, including concerns that the justice system uses the concept of healing to distract public opinion away from the current injustices against Indigenous peoples (Boyce, 2017), and federally run lodges have disproportionately less Indigenous programming (Nielsen, 2016). Current scholarly study stresses the importance of these facilities being Indigenous operated and controlled with programming specific to individual cultural needs (Boyce, 2017; Nielsen, 2003; Nielsen, 2016). Regardless, community operated Healing lodges are an example of a decolonized carceral setting that itself allows the type of mental health services that can be implemented to be more culturally specific and trauma informed. As many Indigenous scholars have stated, healing mental health issues often requires the revival of and participation in cultural practices and ceremonies (Gone, 2013).  Moreover, to overcome the issue of Correctional Services Canada regulating healing lodges which limits Indigenous self-governance, Nielsen (2016) proposes the creation of private Indigenous prisons which would allow Indigenous communities to have significantly more control over how they operate and the type of mental health and cultural programming provided. This would engender a move away from Indigenization and accommodation practices within inherently colonial systems and allow Indigenous communities to rehabilitate and heal Indigenous offenders according to traditional means. In Canada, this may present as Indigenous governments implementing and regulating their own correctional facilities, which would require true Indigenous self–governance with recognition of their own power to enforce Indigenous justice practices at their discretion. Implementing a Two-Eyed Seeing approach to healing lodges ensures the active involvement of Indigenous communities to temper the current Western theories of clinical psychology practice. Both models of healing are available to promote the healing of all. Overall, healing lodges, when executed properly and in a culturally competent manner, have been shown to provide a decolonized approach to forensic mental health services in Canada.

Summary

Multicultural family counselling in prisons, the Kunga Stopping Violence Program (KSVP), and Indigenous-operated healing lodges provide examples for decolonizing forensic mental health services at both the micro and macro levels. Multicultural family counselling can be used by individual therapists to decolonize their own practice and with individual clients, while the KSVP and healing lodges exemplify system-based approaches to decolonization. Additionally, the KVSP reveals a possible structure for decolonized mental health and well-being programs within the existing prison structure while healing lodges aim to decolonize prison settings and in turn the mental health interventions provided. Each case study recognizes the necessity of Indigenous and culturally specific traditions and ceremony in the healing process and illustrates the importance of addressing multiple areas of the individual’s life rather than looking at mental health as a silo. Such initiatives reflect a holistic approach that takes the family, history, and culture of each individual into account.

Limitations and Future Research

This chapter is not grounded in any specific method of research but rather provides a review of existing literature on decolonizing mental health practices in correctional settings. The greatest limitation of this chapter is that the decolonization of mental health in prisons is reliant on the decolonization of correctional institutions. Because the institution regulates and mandates the types of treatment and programming offered in corrections settings, no truly decolonized approach is viable until the colonial perspective underlying prisons is dismantled. Until then, Indigenous initiatives continue to be accommodations within the colonial system rather than steps towards decolonization and self-governance (McGuire & Palys, 2020). Additionally, the focus of this chapter on Indigenous perspectives is a limitation to analyzing decolonization in Canada as a whole. While Indigenous populations are certainly a major group that has been ceaselessly and deeply impacted by Canada’s colonial history, other racialized groups not discussed in this chapter are also uniquely affected. Future research should include the effects of colonization on forensic mental health services for these other groups including, but not limited to, African Canadians who are also impacted by colonization but often left out of decolonization literature and practices in Canada.

Conclusion

Colonization has affected all parts of Canadian society and mental health is no exception. The residual European and colonialist values and practices in psychology and calls for decolonizing clinical and research practices are becoming harder to ignore as studies reveal the harm caused by lack of access to culturally competent practices. Impacts of the colonial initiatives to assimilate Indigenous peoples, such as the Canadian Residential School System, the Indian Act, and the Sixties Scoop, have created a loss of Indigenous culture, resulted in intergenerational trauma, and thus contributed to increased mental health issues among Indigenous populations. Moreover, the impacts of intergenerational trauma as well as the inherent colonial nature and history of Canada’s justice system has also fostered the overrepresentation of Indigenous individuals in prisons. Clearly, there is an urgent need to decolonize the treatment of mental health as well as the institution of prison.

There are many views of what decolonization should look like. Two-Eyed Seeing promotes the belief that Indigenous and Western worldviews and governing structures can co-exist and provide a strong theoretical framework for decolonizing practice, policy, and program creation. Regardless of the decolonization method, all efforts must involve Indigenous communities and work towards fostering self-determination and healing. Multicultural family counselling, the Kunga Stopping Violence Program (KSVP), and healing lodges provide insight into possible methods of decolonizing mental health within correctional facilities. Review of these initiatives provides greater insight into the work being done and the continued need to ensure a truly decolonized mental health framework for research and practice. Decolonization saves lives, and with the growing mental health epidemic and ever-increasing prison populations in Canada, decolonization is not a suggestion but a necessity.

Discussion Questions

1. Discuss the impacts of colonization on mental health. How has it shaped mental health supports in prison? What other justice institutions are affected by the impacts of colonization on mental health?
2. What does decolonization mean to you? What do you believe is the best approach to decolonizing mental health in prisons? Is this even possible within the prison system as it exists today?
3. Discuss the case studies presented in this chapter. How do they implement or differ from the theoretical frameworks of decolonization?

Recommended Activities

1. Using any method (e.g., chart, mind map, illustration/creative piece), compare and contrast colonized and decolonized approaches to mental health and mental health supports. How do we see these differing approaches in our correctional systems and methodology?
2.  Research local initiatives and programs working to decolonize mental health in prisons and invite them to share their knowledge and experience of the field.

Recommended Readings

1. Gone, Joseph P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for indigenous culture as mental health treatment. Transcultural Psychiatry, 50(5), 683-706. https://doi.org/10.1177/136346151348766
2. Monchalin, L. (2017). The colonial problem: an indigenous perspective on crime and injustice in Canada. Ontario: University of Toronto Press (UTP).
3. Nielsen, M. O. (2016). Aboriginal healing lodges in Canada: still going strong? Still worth implementing in the USA? Journal of Legal Pluralism and Unofficial Law, 48(2), 322–345. https://doi-org.libproxy.uregina.ca/10.1080/07329113.2016.1157377
4. Shepherd, S.M., & Phillips, G. (2016). Cultural ‘Inclusion’ or Institutional Decolonisation: How should prisons address the mental health needs of Indigenous prisoners? Australian and New Zealand Journal of Psychiatry, 50(4), 307–308. doi: 10.1177/0004867415616696

References

Asadullah, M. (2021). Decolonization and Restorative Justice: A Proposed Theoretical Framework. Journal of Decolonization of Criminology and Justice, 3(1), 27-62.

Atkinson, J. (2020). Symptom as history, culture as healing: Incarcerated Aboriginal women’s journeys through historic trauma and recovery processes. In Wale K., Gobodo-Madikizela P., & Prager J. (Eds.). (2020). Post-Conflict Hauntings. Palgrave Studies in Compromise after Conflict. Cham: Palgrave Macmillan. https://doi.org/10.1007/978-3-030-39077-8_12

Bakken, N. W., & Visher, C. A. (2018). Successful reintegration and mental health: An examination of gender differences among reentering offenders. Criminal Justice and Behavior, 45(8), 1121-1135. doi:10. 1177/0093854818774384

Boksa, P., Joober, R., & Kirmayer, L. J. (2015). Mental wellness in Canada’s Aboriginal communities: striving toward reconciliation. Journal of Psychiatry and Neuroscience, 40(6), 363. doi:10.1503/jpn.15030

Bartlett, C., Marshall, M. & Marshall, A., (2012). Two-Eyed Seeing and other lessons learned within a co-learning journey of bringing together indigenous and mainstream knowledges and ways of knowing. Journal of Environmental Studies and Science, 2, 331–340. doi:10.1007/s13412-012-0086-8

BIPOC: Black, Indigenous, & People of Colour. (2021). The BIPOC Project: A Black, Indigenous, & People of Colour Movement. The BIPOC Project https://www.thebipocproject.org/

Brown, G. P., Hirdes, J. P., Fires, B. E. (2015). Measuring the prevalence of current, severe symptoms of mental health problems in a Canadian correctional population: Implications for delivery of mental health services for inmates. International Journal of Offender Therapy and Criminology, 59(1), 27-50. doi:10.117/0306624X13507040

Boyce, M. (2017). Carceral recognition and the colonial present at the Okimaw Ohci healing lodge. Sites: New Series, 14(1), 13-33. DA3: http://dx.doi.org/TN.TTTUO/sites-volTRissTid2

CBC. (2010, November 12). Timeline: The life & death of Ashley Smith. The Fifth Estate. Retrieved from https://www.cbc.ca/fifth/blog/the-life-and-death-of-ashley-smith

Correctional Service Canada. (2012). Towards a continuum of care: Correctional service Canada mental health strategy. Government of Canada. https://www.csc-scc.gc.ca/health/002006-2000-eng.shtml#_Toc267041271

Gone, Joseph P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for indigenous culture as mental health treatment. Transcultural Psychiatry, 50(5), 683-706. https://doi.org/10.1177/1363461513487669

Hart-Mitchell, R. D., & Pfeifer, J.E. (2003). From jails to healing lodges: evaluating the impact of correctional facilities on offender adaptation. Canadian Journal of Police and Security Services, 1(2), 59-67.

Hatcher, S., Coupe, N., Wikiriwhi, K., Durie, M., & Pillai, A. (2016). Te Ira Tangata: a Zelen randomised controlled trial of a culturally informed treatment compared to treatment as usual in Ma ̄ori who present to hospital after self-harm. Social Psychiatry and Psychiatric Epidemiology, 51, 885-894. doi:10.1007/s00127-016-1194-7

Joseph, A. J. (2014). A prescription for violence: The legacy of colonization in contemporary forensic mental health and the production of difference. Critical Criminology, 22, 273–292. doi:10.1007/s10612-013-9208-1

Koç, V., & Kafa, G. (2019). Cross-cultural research on psychotherapy: The need for a change. Journal of Cross-Cultural Psychology, 50(1), doi:100-115 10.1177/0022022118806577

Lucero, E. (2011). From tradition to evidence: Decolonization of the evidence-based practice system. Journal of Psychoactive Drugs, 43(4), 319-324. doi:10.1080/02791072.2011.628925

Mackenzi, K. (2004). Commentary: Ethnicity, race, and forensic psychiatry–is being unblinded enough? The Journal of the American Academy of Psychiatry and the Law, 32(1), 36-39.

Malakieh, J. (2020). Adult and youth correctional statistics in Canada, 2018/2019. Juristat, 85-002-X. https://www150.statcan.gc.ca/n1/pub/85-002-x/2020001/article/00016-eng.pdf

Marsh, T. N., Cote-Meek, S., Toulouse, P., Najavits, L. M., & Young, N. L. (2015). The application of two-eyed seeing decolonizing methodology in qualitative and quantitative research for the treatment of intergenerational trauma and substance use disorders. International Journal of Qualitative Methods, 14(5), doi:10.1177/1609406915618046

McGuire, M., & Palys, T. (2020). Toward sovereign Indigenous justice: On removing the colonial straightjacket. Decolonization of Criminology and Justice, 2(1), 59-82. https://doi.org/10.24135/dcj.v2i1.16

McIntyre, C., Harris, M. G., Baxter, A.J., Leske, S., Diminic, S., Gone, J.P., . . . Whiteford, H. (2017). Assessing service use for mental health by Indigenous populations in Australia, Canada, New Zealand and the United States of America: A rapid review of population surveys. Health Research Policy and Systems, 15(1), 67. doi:10.1186/s12961-017-0233-5

McNamara, R. A., & Naepi,S. (2018). Decolonizing community psychology by supporting Indigenous knowledge, projects, and students: Lessons from Aotearoa New Zealand and Canada. American Journal of Community Psychology, 62(3-4), 340-349. doi:10.1002/ajcp.12296

Monchalin, L. (2017). The colonial problem: an indigenous perspective on crime and injustice in Canada. Ontario: University of Toronto Press.

Nasser, S. (2019, December 16). 3 years, no answers: Family of Soleiman Faqiri marks sombre anniversary as police tight-lipped. CBC. Retrieved from https://www.cbc.ca/news/canada/toronto/soleiman-faqiri-investigation-death-anniversary-1.5397386

Nielsen, M. O. (2003). Canadian Aboriginal healing lodges: A model for the United States? The Prison Journal, 83(1), 67-89. doi:10.1177/0032885502250394

Nielsen, M. O. (2016). Aboriginal healing lodges in Canada: still going strong? Still worth implementing in the USA? Journal of Legal Pluralism and Unofficial Law, 48(2), 322–345. doi:10.1080/07329113.2016.1157377

Nuttgens, S.A, & Campbell, A.J. (2010). Multicultural considerations for counselling First Nations clients. Candian Journal of Counselling, 44(2), 115-129. https://dev.journalhosting.ucalgary.ca/index.php/rcc/article/view/58905

Prince Albert Grand Council. (2014). Spiritual healing lodge. Retrieved April 03, 2021, from https://www.pagc.sk.ca/spiritual-healing-lodge/

Shepherd, S.M., & Phillips, G. (2016). Cultural ‘Inclusion’ or Institutional Decolonisation: How should prisons address the mental health needs of Indigenous prisoners? Australian and New Zealand Journal of Psychiatry, 50(4), 307–308. doi:10.1177/0004867415616696

Tadros, E., Fye, J.M., McCrone, C.L., & Finney, N. (2019). Incorporating multicultural couple and family therapy into incarcerated settings. International Journal of Offender Therapy and Comparative Criminology, 63(4), 641-658. doi:10.1177/0306624X18823442

Thompson, M., Newell, S., & Carlson, M. J. (2016). Race and access to mental health and substance abuse treatment in the criminal justice system. Journal of Offender Rehabilitation, 55(2), 69-94. doi:10.1080/10509674.2015.1112867

United Nations General Assembly (2007). United Nations Declaration on the Rights of Indigenous Peoples. Department of Economic and Social Affairs Indigenous Peoples. https://www.un.org/development/desa/indigenouspeoples/declaration-on-the-rights-of-indigenous-peoples.html

Victor, W. (2007). Indigenous justice: Clearing space and place for Indigenous epistemologies. National Centre for First Nations Governance. http://fngovernance.org/ncfng_research/wenona_victor.pdf

Weaver, H. N., & Yellow Horse Brave Heart, M. (1999). Examining two facets of American Indian identity: Exposure to other cultures and the influence of historical trauma. In H. N. Weaver (Ed.), Voices of First Nations people (pp. 19–33). Haworth Press.

White, P. (2020, July 28). Confined: The death of Eddie Snowshoe. The Globe and Mail. Retrieved from https://www.theglobeandmail.com/news/national/confined-the-death-of-eddie-snowshoe/article21815548/