Mental health, substance use and suicidal behaviour among young indigenous people in the Arctic: A systematic review

doi:10.1016/j.socscimed.2009.07.045

Social Science & Medicine

Volume 69, Issue 8, October 2009, Pages 1194-1203

https://doi.org/10.1016/j.socscimed.2009.07.045 Get rights and content

Abstract

The Arctic has been a subject to various socio-cultural changes; indigenous people living in the region have experienced injustice and oppression in different forms. Furthermore, there are currently various new social, political and environmental challenges. It has been assumed that the continuous socio-cultural transition has an influence on indigenous people's wellbeing. We conducted a systematic literature review with regard to epidemiological mental health research on Arctic indigenous children and adolescents. The aim was to describe the nature and scope of research conducted and to explore for possible regional and ethnic differences in mental health. It was found that current epidemiological knowledge is based mainly on cross-sectional studies from selected regions and limited to substance use and suicidal behaviour. Youth suicide rates are alarmingly high in many parts of the Arctic, particularly in Greenland and Alaska. Differences between indigenous and non-indigenous groups are also most evident and uniform across suicide studies, with rates being systematically higher among indigenous youth. Substance use is common throughout the Arctic, however, regional and ethnic differences in usage vary considerably. Other psychosocial problems remain largely unexplored. In addition, very little is known about the causes of mental health problems in general and the impact of rapid socio-cultural changes in particular. There are several methodological limitations in the studies included here, many related to the validity of research instruments in different cultural contexts. There is a need for longitudinal comparative studies from the entire Arctic with culturally relevant instruments addressing mental health in early childhood as well.

Section snippets

Introduction (See the Picture in the Supplementary data)

The Arctic spans a large region distinguished by an exceptionally harsh climate, abundant natural resources and a population which includes diverse ethnic groups. “The Arctic” generally refers to an area which covers Alaska, northern Canada, Greenland, the Faroe Islands, Iceland, and the northern areas of Nordic countries and Russia. While this area comprises approximately 8% of the Earth's surface, it contains less than 1% of the world's population, a mere 4 million people (Young & Einarsson,

Inclusion criteria

The inclusion criteria for research publications reviewed were as follows: 1) Results are reported in original peer-reviewed articles, 2) Mental health is measured using standardised quantitative methods 3) Study samples are based on a general, non-clinical population, 4) The upper age limit of the sample is 25 years, or in cases where the range is wider, results are reported separately for people under 25, 5) Results are reported separately for indigenous and non-indigenous participants, the

Results

Thirty-four of the 4957 articles which were identified by the original search phrase from the electronic databases and also one which was picked from the reference lists were included in the review. See the flowchart in Picture 1 for further details.

Discussion

Current epidemiological knowledge concerning the mental health of Arctic indigenous children and adolescents is based mainly on cross-sectional studies from selected regions and is limited to substance use and suicidal behaviour. The highest number of studies, as well as most of the studies comparing indigenous and non-indigenous populations, and the only longitudinal studies, have been conducted in Norway. There are almost as many Greenlandic studies, but all were cross-sectional, based on

Conclusion

The epidemiological data available on the mental health of indigenous young people in the Arctic is rather limited. When it comes to younger children, it is almost nonexistent. It has been demonstrated that in parts of the Arctic suicide rates among young people are very high and substance use is common, but little is known about the causes of these problems. One could assume that other psychosocial problems are also common, because many of them are known to be related to suicidal behaviour and

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^☆: This work was financially supported by the Sigfrid Juselius Foundation (Finland).

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Mental health, substance use and suicidal behaviour among young indigenous people in the Arctic: A systematic review☆

Abstract

Section snippets

Introduction (See the Picture in the Supplementary data)

Inclusion criteria

Results

Discussion

Conclusion

International Journal of Intercultural Relations

Social Science & Medicine

Psychiatry Research

Social Science & Medicine

Global Environmental Change

Applied Preventive Psychology

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of Adolescence

Social Science & Medicine (1982)

Global Environmental Change

Community viability

Manual for the child behavior checklist/4–18 and 1991 profile

Manual for the youth self-report and 1991 profile

Multicultural assessment of child and adolescent psychopathology with ASEBA and SDQ instruments: research findings, applications, and future directions

Journal of Child Psychology and Psychiatry, and Allied Disciplines

Adolescent and pre-adolescent suicide in Newfoundland and Labrador

Revue Canadienne De Psychiatrie

Tobacco and other substance use among Alaska native youth in Western Alaska

American Journal of Health Behavior

Drug use patterns among American Indian and Alaskan native youth: special rural populations

Drugs Society

Acculturation and adaptation: health consequences of culture contact among circumpolar peoples

Arctic Medical Research

Rapid socio-cultural change and health in the arctic

International Journal of Circumpolar Health

Ethno-cultural adaptation of the peoples of the arctic region

Indigenous health in the Arctic: an overview of the circumpolar Inuit population

Scandinavian Journal of Public Health

Arctic demography

Completed suicides among the Inuit of Northern Quebec, 1982–1996: a case-control study

Journal De l'Association Medicale Canadienne

Methodological challenges in cross-cultural mental health research

Transcultural Psychiatry

Arctic geopolitics then and now

The history and effect of cultural and environmental changes on Scandinavia's indigenous Sami population

The history and effect of cultural and environmental changes on Scandinavia's indigenous Sami population

Societies and cultures: change and persistence

Young people's health in context: International report from the HBSC 2001/02 survey

Changing living conditions, life style and health

International Journal of Circumpolar Health

Economic systems

Suicide in Alaska from 1978 to 1985: updated data from state files

American Indian and Alaska Native Mental Health Research: Journal of the National Center

Climate change, health, and vulnerability in Canadian northern aboriginal communities

Environmental Health Perspectives

Temporal trends and geographic patterns of teen suicide in Alaska, 1979–1993

Suicide & Life-Threatening Behavior

A users' guide to the general health questionnaire

Culture, diagnosis and comorbidity

Culture, Medicine and Psychiatry

Russian child mental health–a cross-sectional study of prevalence and risk factors

European Child & Adolescent Psychiatry

Family as a child development context and smoking behaviour among schoolchildren in Greenland

International Journal of Circumpolar Health

Greenlandic family structure and communication with parents: influence on schoolchildren's drinking behaviour

International Journal of Circumpolar Health

The importance of northern dimension foreign policies in the geopolitics of the circumpolar north

Geopolitics

Self-reported behavioural/emotional problems in Norwegian adolescents from multiethnic areas

European Child & Adolescent Psychiatry

The ESPAD report 2003. Alcohol and other drug use among students in 35 European countries