Biigajiiskaan: Indigenous Pathways to Mental Wellness - Services

The program model

Biigajiiskaan adapts the current health care system with Indigenous-led and informed pathways, and combines Traditional Healing medicine and knowledge with hospital-based health care practices.

The program development was guided by an Indigenous Governance Circle and is rooted in the Thunderbird Partnership Foundation’s First Nations Mental Wellness Continuum Framework. Biigajiiskaan’s focus is to create a hostile-free environment that provides culturally-safe care, meeting the individual and cultural needs of each client. 

Services provided in-hospital operate out of a dedicated Indigenous Healing Space at Parkwood Institute’s Mental Health Care Building (Okwari: Kowa Healing Space, Rm F3-240) for use by clients of Biigajiiksaan. In this space, Indigenous clients have access to a culturally safe team of Indigenous and non-Indigenous providers who facilitate specialized care for Indigenous people using a two-eyed seeing approach. 

Clients have access to Indigenous Elder-guided care and teachings from knowledge keepers where they can learn and celebrate Traditional Indigenous practices, including healing circles, ceremony and smudging, as well as traditional and culturally relevant programming including; Indigenous art expression, husk doll making and beading, as well as dress and drum making, all with the aim of supporting wellness and healing trauma by building a positive Indigenous identity.

Services 

Biigajiiskaan works in tandem with community care providers, as well as cultural and social service providers to deliver wrap-around, wholistic care and healing pathways for Indigenous clients, including; Atlohsa Family Healing Services, London InterCommunity Health Centre, Southwest Ontario Aboriginal Health Access Centre, and N'Amerind (London) Friendship Centre. Our model ensures that all of our clients are connected and have access to primary care.

Intensive Case Management Service: An Indigenous-led mobile outreach team working in-hospital and in the community provide consultation, assessment, treatment planning, case management, discharge planning and ambulatory services. The outreach team is designed to provide an exceptional level of care to Indigenous peoples experiencing severe and persistent mental unwellness. The model takes a preventative approach, in that it strives to keep people well in the community.

• Should a person need to be hospitalized for mental unwellness, they will be supported by the Biigajiiskaan team while in hospital, to help develop a sense of trust. Ultimately, the goal is for Indigenous community members to feel safe coming to hospital when they need treatment and to not delay or avoid care.
• Ambulatory Biigajiiskaan clients within the community can expect to receive intensive support through an approach that includes elements of Traditional healing in tandem with Western mental health care. This ‘two-eyed seeing’ approach to care ensures clients have access to as many health and wellness opportunities possible, while learning and growing as an Indigenous person in a culturally safe, trauma and violence informed care setting.

Holistic Assessment: In order to provide exceptional care, Biigajiiskaan staff will work with the client to complete a culturally safe, holistic assessment to determine the individual’s mental, physical, emotional and spiritual needs. 

• Holistic assessments are completed with an elder, a psychiatrist, a social worker and a nurse. 
• To ensure there is sufficient time to gather necessary information without overwhelming the client, holistic assessments will occur over two or three appointments.
• Once completed, a follow-up ‘recommendations circle’ will be scheduled with the client where staff will share assessment results and provide comprehensive recommendations specific to cultural/spiritual needs, social, psychological and physical interventions, as well as medication. These recommendations will serve as the primary content for the client’s pathway to wellness care plan.

Enhanced Care: Biigajiiskaan provides culturally safe care to existing inpatients and outpatients of Parkwood Institute’s Mental Health Care Program, who already have a care team to support their wellness. Clients in this group have access to our healing space, elders and knowledge keepers, and group programming.

What to expect upon referral

1. Referral and screening interview: Within two to three days of receiving a client referral, a Biigajiiskaan staff member will set up a screening interview in order to determine eligibility. From there, the clinician will discuss the referral with the team. 
2. Meet and Greet: If the individual is eligible, a meet and greet will be scheduled either virtually, in-person at Biigajiiskaan’s Healing Space within Parkwood Institute Mental Health Care Building, or at a specified place within in the community. During the meet and greet, clients can expect to sign necessary consents and learn more about Biigajiiskaan as well as their rights and responsibilities. A number of follow-up appointments will also be scheduled for a holistic assessment and recommendations circle. Biigajiiskaan staff will also take time at this meeting to plan or act on, any safety issues/urgent referrals that may be necessary.
3. Care Planning: Biigajiiskaan staff, the client and any others the client would like present (e.g. informal caregivers, primary care providers, traditional healer) will partner together to create a wellness care plan. Staff members and the client will discuss their respective responsibilities in alignment with identified goals.
4. Ongoing support: Clients can expect to be provided a high level of support to ensure their wellness needs are met. This means clients can expect to interact with staff multiple times per week if necessary to support wellness. Clients will have access to traditional healing, counseling, referrals, life skills, and nursing support in relation to medication, psychiatric consultation and advocacy. 

The program also provides educational and mentoring opportunities for health care professionals and students.

* Please be advised: Due to COVID-19 guidelines, group circles, group ceremonies and student mentoring are temporarily on hold; however one-on-one support is available both in person (utilizing COVID-19 specific protocols to maintain safety) and virtually (online and by phone) through St. Joseph’s Parkwood Institute and Atlohsa Family Healing Services.