Implications 86

Implications for practice. The results of this study suggest a need for veteran health services and programs to be tailored with an understanding of the historical realities of

Aboriginal veterans adopted and/or fostered during the Sixties Scoop. Like the residential school period, the Sixties Scoop is a “historically situated phenomenon” and one that is directly

influenced by the Indian Act (Menzies, 2006; Smith, Varcoe, & Edwards, 2005, p. 40). It is important that health program service providers are knowledgeable of the unique experiences of Aboriginal veterans adopted and/or fostered during this period and the impact this may have on their health and wellbeing as adults.

Although most of the participants in this study noted a preference for Western medical approaches, some mentioned a need for traditional Aboriginal ways of healing. Therefore, a “flexible approach to healing” is critical, and this should include options of both Western ways and/or traditional Aboriginal ways of doing (Vukik, et al., 2011, p. 70).

All CF, Regular, and reserve members are entitled to an interview with a case manager upon their release of the military to help them navigate and plan their transition from the military to civilian life (Veteran Affairs Canada, 2014). VAC case managers work in conjunction with a larger interdisciplinary team comprising of a pension officer, doctors, nurses, mental health and rehabilitation specialists (VAC, 2014). In their contact and practice with these veterans, it is critical that the interdisciplinary health team also include options such as: elders, traditional Aboriginal healers, Aboriginal counselors, Aboriginal social workers, Aboriginal health centres,

gay, bisexual, transgender, two-spirit, and queer (LGBTTQ) veterans should be provided with accessible support, services, and/or referrals by their VAC to resources/and health care

professionals competent and informed by LGBTTQ veteran issues and health needs. The term two-spirit is used to refer to Aboriginal people who possess “both male and female spirit” and sexual identities (Garrett & Barret 2003, p. 133).

Mental health professionals working with Aboriginal veterans adopted and/or fostered during the Sixties Scoop should also adopt a holistic approach in their analysis and care, focusing not only on individual health needs but also on the impact of government policies, “family”, “culture”, the “community” in their health outcomes (Menzies, 2006). This is important since holistic approaches attend to relational Aboriginal worldviews pertaining to health and wellbeing (Vukik et al., 2011). Understanding Aboriginal worldviews is critical to communicating and counseling Aboriginal clients (McCormick, 2009).

According to Jiwa, Kelly, and Pierre-Hansen (2008), “treating the whole community honours the holistic approach of the interrelatedness of individuals and their communities” (p. 1000e4). Community based approaches have been shown to be effective in the treatment of addiction disorders in Aboriginal populations (Jiwa, Kelly, & Pierre-Hansen, 2008). An example of an effective community based addiction treatment involving Aboriginal populations is the “community mobile treatment” model (Jiwa, Kelly, & Pierre-Hansen, 2008, p. 1000e4).

Developed in 1984, this treatment approach involves a team of addiction health workers and the local community in the healing process requiring them to develop local solutions to substance abuse issues in their community (Jiwa, Kelly, & Pierre-Hansen, 2008). Further research is needed examining the efficacy of culturally appropriate forms of community based health

approaches, such as the community mobile treatment in the treatment of substance abuse health needs in the study population.

Many of the participants in this study described experiences of childhood abuse and the adverse impact it had on their lives. According to Whelan (2013), “Childhood trauma has been identified as a stable predictor of adult-onset psychological distress, including depression, sexual disturbances, PTSD, substance use disorders, high PTSD symptom severity, and poor treatment outcomes” (p. 182). Mental health assessments of Aboriginal veterans adopted and/or fostered during the Sixties Scoop should incorporate a “life course perspective” (Elder & Rockwell, 1979, p.1). This perspective includes a developmental analysis of an individual’s lifespan, connecting age to time (“history”) and space (“social structures”) (Elder & Rockwell, 1979, p.1). A life course perspective to mental health enables mental health professionals to explore topics such as childhood abuse, as well as any other contextual and/or developmental factors related to their clients health and wellbeing.

A coordinated effort must be made by the VAC, NAVA, RCL, AVA, as well as Aboriginal agencies and services, emergency shelters, to address the health needs of these veterans, relating to substance use and mental health. A framework for appropriate course of action needs to be developed through the engagement of all these organizations to address the health needs of Aboriginal veterans adopted and/or fostered during the Sixties Scoop. More research is needed in this area regarding best practices for addressing these issues.

Implications for future research. Given the lack of available research regarding the experience of Aboriginal veterans, it is difficult to compare health outcomes of different groups within the Aboriginal veteran community and non-Aboriginal Canadian veterans. More research is needed to examine the health needs of Aboriginal veterans across Canada, those living on

rural/reserve, and in urban settings. The experience of Aboriginal veterans and the resilience of those who have experienced other forms of intergenerational trauma, such as, forced attendance to residential schools also needs to be investigated. There is also a need for further future research to explore the experience of female Aboriginal veterans.

In this study, one participant identified as transgender. This participant noted experiences such as: homophobia, racism, and sexual assault in the military. The perspectives of lesbian, gay, bi-sexual, transgender, two-spirit, and queer Aboriginal veterans adopted and/or fostered during the Sixties Scoop are yet to be explored.

This study highlighted two major health needs, mental health care and support to fight substance abuse. Research into different treatment options such as, Aboriginal traditional

methods and/or Western biomedical approaches is needed to help determine the efficacy of these treatment options to address these identified health needs.