A Q&A WITH DR. JENNIFER MERVYN, MA, PhD, REGISTERED PSYCHOLOGIST

(*This interview has been edited for brevity and clarity.)

WHAT ARE SOME OF THE MENTAL HEALTH CHALLENGES BEING FACED BY THE INDIGENOUS COMMUNITIES TODAY?

My background is in the neuroscience of trauma, especially pertaining to the legacy of intergenerational trauma our Indigenous people experience as a result of colonization, residential schools, and other atrocities, like racism and discrimination, that still exist in our systems of care. So, I really see most of the roots of mental health challenges in Indigenous peoples today, through that lens of the legacy of trauma.

HOW HAS THE RECENT, HORRIFIC DISCOVERY OF THE REMAINS OF 215 CHILDREN AT THE KAMLOOPS INDIAN RESIDENTIAL SCHOOL IN BRITISH COLUMBIA HELPED TO RAISE AWARENESS ABOUT INDIGENOUS MENTAL HEALTH? AND WHAT WOULD YOU LIKE US TO LEARN FROM THIS?

I’m so struck by the weight and heaviness of it. I was in that very residential school a number of years ago facilitating a youth conference, and at that time I felt the darkest energy I’ve ever felt. I walked through it with young teenagers at the time, and one fourteen-year-old girl told me her aunty had gotten raped in the very room we were standing in. I just felt this heaviness in my heart over what we as Indigenous people have to face; the trauma and mental health challenges that are going to obviously be the ripple effects of this discovery.

I guess the question is what else will this unearth with new technology and at what other residential schools? To me, this is just the very beginning.

HOW DO INDIGENOUS PEOPLES PERCEIVE RACISM IN THE HEALTHCARE SYSTEM AND HOW DOES IT IMPACT THEM?

I think this is a big one. I still don’t believe that there’s a lot of education and knowledge around the fact that historically, Canada had a segregated healthcare system for Indigenous people. We had Indian hospitals where you had to go if you were Indigenous. Instead of the regular, well-funded hospitals that had adequate care, we were offered sub-standard care. We literally put patients with TB next to birthing mothers in our Indian hospitals.

I gave a series with our Indigenous Homelessness Steering Committee a few years ago; we did a small tour to bring this knowledge and information to physicians and other healthcare providers. One of the tours had husband and wife physicians in the audience. He had done his residency at an Indian hospital, and he had never learned in his entire medical career about the history. And I thought, how are we going through medical school, how are we even going through just our public education system without having been taught about what’s happened in our history?

If we look at some of the epigenetic studies, [which study how behavior and environment can affect gene expression], we learn how things like fear can be conditioned and passed down intergenerationally through your epigenomes. Not in your DNA, but through epigenetics. Epigenetically, we can actually transmit fear – learned, conditioned fear – from one generation to the next. We’ve proven this in laboratory studies, so think about what’s happened in our Indian hospital system, and how that fear would be transmitted through our generations.

It’s so sad that our Indigenous peoples face such drastically higher rates of chronic disease and illness, and yet they tend to be the last ones through the door to the doctor or anywhere in the healthcare system to be able to receive the support and help that they so desperately need. By the time they actually get it, it’s too late. I do wonder about this in our history and how not much has changed.

As an example, I have a good friend who had a very recent experience with racism and discrimination in our healthcare setting. A very young kidney transplant survivor was at the emergency room at a hospital, and she told me, “I was wearing my sweatpants and I didn’t have my makeup on, and my hair was up in a ponytail.” And she’s usually very poised, a gorgeous businesswoman who always looks perfect, she’s never used drugs in her life, and a nurse came and said, “Get out of that seat, that’s not for drug addicts, that’s for patients who are really sick.” And now she feels like she must get all dressed up to go to the emergency room when she’s ill. It’s just heart-breaking.

Misdiagnoses, assumptions, and judgments are something that we still see to this day; we’re fighting daily experiences of racism and discrimination in both our education setting and in our healthcare system. And that really impacts a person’s wellness. As an Indigenous person myself, we really believe in mind, body, and spirit; all aspects of medicine ultimately reflect the mental, emotional, spiritual, and physical aspects of care, when it comes to wellness. These aspects of discrimination and racism, and this history and legacy of trauma, are absolutely the roots of the unbalance right now in Indigenous health.

HOW WOULD YOU DESCRIBE THE INDIGENOUS HOLISTIC APPROACH TO MENTAL HEALTH AND WELLNESS?

In the last 15 years, we have had an incredible wealth of research that looks at neuroimaging studies, and we have a better understanding of what’s going on in the brain. We’re looking at the brain science of trauma and how it possibly influences and impacts health and wellbeing in the long run. Studies like the ACEs (Adverse Childhood Experiences) study on the neuroscience of trauma and resilience reveal what Indigenous people have known for time immemorial about healing and living a balanced, healthy life. The importance of balancing family and mental health, our feelings, our physical exercise, diet, language and land, culture, purpose and meaning, and spirituality, are all such an important part of wellness.

The mind-body connection is not just something that psychologists have talked about for years, we actually have proof with neuroscience. This is something that Indigenous people have always honored and respected, this is Indigenous wisdom that’s always existed. There’s hope in the fact that we have the science to be able to prove and understand why our different rhythmic practices like drumming, and dancing, pow wow, and singing, are so good for us. We know that the brainstem responds to these vesicular activities in a way that actually helps us heal and recover from trauma.

Studies show that being connected with nature also benefits our physical health and wellbeing. Indigenous people have always known this. They say 120 minutes outdoors a week can drastically improve your heart health, decrease your resting heart rate, and promote positive feelings. It’s amazing, the benefits! And so, to me, this is the holistic approach that Indigenous people have long respected and honored in their traditions, and that’s why we’re trying to connect people back to it because we know this is what works.

I do think it’s funny that contemporary doctors get all the credit for this research when, if you look back at Indigenous peoples’ traditional ways to heal, especially from traumatic experiences, they’ve honored these concepts for a very long time. And now we have the science to be able to say, “Guess, what? We’re moving in the right direction.” If we come back to our lands, our culture, our traditions, our ceremonies, and our healing practices, we’re going to be ok, we really, really are. It might take six-seven generations, but we will get there.

HOW CAN THE EFFORTS OF THE ELDERS, KNOWLEDGE KEEPERS, AND HEALERS BE SUPPORTED BY THE LARGER MEDICAL COMMUNITY?

I think one of the challenges of the traditional medical community is that – I’m going to just say it like it is – there is a lot of ego, and I think the answer truly is cultural humility. I don’t really believe in cultural competency; I’ve been teaching a graduate-level, multicultural counseling course at a university for fifteen years, and all of the textbooks are still very saturated in cultural competencies. We need to be training our healthcare professionals in cultural humility, knowing that this is not a destination but a lifelong journey and that there is so much diversity even within a culture, that we need to be humble, curious observers and learners. And the biggest challenge to us in healthcare is truly going to be unmasking the power differentials.

WHAT IS NECESSARY FOR FIRST NATIONS FAMILIES AND COMMUNITIES TO ENJOY OPTIMAL LEVELS OF MENTAL WELLNESS?

I think that they already have all of the knowledge necessary, but there’s been a huge separation or disconnect from a lot of that knowledge and the teachings and families. We’re not even talking today along the lines of Covid, so we’re going to need reconnection. Reconnection with family, with language, and with the culture. We are going to need to bring in our culture with the Wisdom Keepers and remunerate them at their levels of expertise. They absolutely deserve to be able to teach us and share with us those teachings that we’ve lost through the generations as a result of colonization.

And we do need resources. I work on a Treaty Nation, and I also work in a private practice, and I have a 7 to 8-month wait right now, and that is so unacceptable. I work so many Saturday mornings, and I feel bad because I need to have that balance for my own wellness and my own children and to support the people I have. But my heart is crushed under the weight of the need right now with Covid. It’s pretty traumatizing to lots of people to not be able to gather or engage in ceremonies, and the disconnection is eerily reminiscent of a dark period in our history for so many. If I had more resources right now, I’d be taking the kids up into the mountains and on the ocean all summer long. We need land-based access for wellness, not just for young people, but for all our families. We need family gatherings. I do think that we would benefit from more support, and from raising our young people up in our Indigenous communities so that they are able to be leaders and provide these services one day.

WHAT MAKES YOU OPTIMISTIC ABOUT THE FUTURE?

The young people that I work with are what make me hopeful and optimistic. I see young people who have faced such significant adversity, and yet they are still demonstrating such exemplary resilience, strength, and integrity in their lives.

As for systemic racism and being able to fight that, I think that we’re still a little lost. However, what gives me hope on a daily basis are the young people and the families that I support, that continually astound and amaze me with their stories of resilience and strength in spite of these terrible things that they face and that they’ve overcome.

HOW WILL YOU BE CELEBRATING NATIONAL INDIGENOUS PEOPLES DAY THIS YEAR?

In our household, we will definitely be celebrating! We’ll get our drums out and do some singing and I’ll probably make some traditional foods. Typically, the kids get all dressed up in their regalia and they go to school where there’s an honoring ceremony. Because of Covid, it’s going to look a little different, but we absolutely will make sure that we honor.

The most important thing for me is that I raise kids who are proud to be Indigenous. They’re proud of their ancestry and their culture, and so whatever we do on that day, however it looks with the restrictions, it will be something that absolutely fosters and supports those kids in finding their sense of cultural pride.

DR. JENNIFER MERVYN, MA, PhD, Registered Psychologist, Dr. Jennifer Mervyn was acknowledged by CAMH as one of the 150 Canadians making a difference in mental health. She is a Registered Psychologist offering individual, family, and group counseling and mental health treatment. She has an extensive background in trauma and substance abuse and utilizes innovative, culturally informed, therapeutic approaches in her work. Jennifer is Métis, a mother of four, and a strong advocate for the indigenous community. She consults, teaches, and trains on Trauma-Informed Practice and policy nationwide.