Indigenous and gender informed approaches to understanding health, social, and mental wellness among indigenous people experiencing homelessness and mental illness in two Canadian cities

Background: Indigenous people are overrepresented in urban homeless populations internationally, a consequence of racialized policies and structural violence. As a step toward reconciliation Canadian and international policies have recently affirmed Indigenous rights to self-determination. The objective of this dissertation was to identify distinct service needs, gender differences and trajectories to homelessness among Indigenous people in Canada, and to undertake an Indigenous-led process to develop recommendations for action. Methods: Data were drawn from the Vancouver and Winnipeg sites of Canada’s At Home/Chez Soi study. Retrospective analyses were conducted on baseline data from both study sites. Transcripts of interviews with Indigenous participants in Vancouver were thematically analyzed. A traditionally-inspired sharing circle was facilitated by an Indigenous elder and comprised of Indigenous people who had experienced homelessness as well as Indigenous service providers. The sharing circle dialogue employed imagery and symbols to express major themes related to the past and possible future of housing and inclusion among Indigenous peoples. Results: When compared to non-Indigenous participants, Indigenous peoples were more likely to have been homeless at a younger age, to experience ongoing symptoms of trauma, and to have young children. Among Indigenous participants, Indigenous women experienced significantly more symptoms of trauma, higher suicidality, and more experience as victims of violence. Indigenous narratives described situations of intense violence, family disconnection and the lasting harms of generational trauma. Recommendations for action affirmed that government action to promote self-determination is essential. Conclusions: This dissertation documents the distinct historical and current character of Indigenous homelessness, and the need to transform colonial practices that oppress Indigenous Canadians, particularly women and young people. Community developed recommendations for action emphasized the urgent need for practices that promote self-determination and strengthen the resurgence of Indigenous culture.