Incorporating First Nations, Inuit and Métis Traditional Healing Spaces within a Hospital Context: A Place-Based Study of Three Unique Spaces within Canada's Oldest and Largest Mental Health Hospital

Abstract

Globally and historically, Indigenous healthcare is efficacious, being rooted in Traditional Healing (TH) practices derived from cosmology and place-based knowledge and practiced on the land. Across Turtle Island, processes of environmental dispossession and colonial oppression have replaced TH practices with a colonial, hospital-based system found to cause added harm to Indigenous Peoples. Growing Indigenous health inequities are compounded by a mental health crisis, which begs reform of healthcare institutions. The implementation of Indigenous knowledge systems in hospital environments has been validated as a critical source of healing for Indigenous patients and communities, prompting many hospitals in Canada to create Traditional Healing Spaces (THSs). After ten years, however, there has been no evaluation of the effectiveness of THSs in Canadian hospitals in supporting healing among Indigenous Peoples. In this paper, our team describes THSs within the Center for Addiction and Mental Health (CAMH), Canada's oldest and largest mental health hospital. Analyses of 22 interviews with hospital staff and physicians describe CAMH's THSs, including what they look like, how they are used, and by whom. The results emphasize the importance of designating spaces with and for Indigenous patients, and they highlight the wholistic benefits of land-based treatment for both clients and staff alike. Transforming hospital spaces by implementing and valuing Indigenous knowledge sparks curiosity, increases education, affirms the efficacy of traditional healing treatments as a standard of care, and enhances the capacity of leaders to support reconciliation efforts.

Keywords: Indigenous geographies of health; environmental repossession; healthcare; hospital; mental health; reconciliation; sweatlodge; traditional healing; traditional healing spaces.

Figure 1

Pictured is the Queen Street campus location (historic). (a) The Provincial Lunatic Asylum, the first iteration of CAMH, sits on lands described as the council grounds and camping site of the Mississaugas of the Credit First Nation. (b) Pictured is the original structure of CAMH located on Queen Street (1850).

Figure 2

Map of CAMH’s THSs within the City of Toronto. The THSs are centrally located in the downtown City of Toronto, with the CR and CG located on White Squirrel Way, within CAMH’s main campus on Queen Street West. The third space, the ECHO RM, is located several blocks north, at the 33 Ursula Franklin Way site. At the time of publication, the ECHO RM had moved from this location to the main campus, on the second floor of 60 White Squirrel Way (2022).

Figure 3

Pictured is a timeline (not to scale) of distinct and important events related to CAMH advancing spaces and programs for Indigenous clients, patients, and staff. Documentation about the evolution and development of the THSs at CAMH is limited; however, timelines were indicated through reports and formal public communiques on CAMH’s website and through participants’ stories. (This timeline offers a bird’s eye view of the evolution of Indigenous spaces within CAMH and serves as an important contextual point of reference.) Green circles have been placed around three years in the timeline, signifying the year that each of the three THS was established.

Figure 4

Asin Vern Harper baa (1936–2018) pictured in 2011, during his time at CAMH. Image courtesy of R.L. (5th author).

Figure 5

The Ceremony Room (CR) at CAMH. Pictured is the Ceremony Room, located at 60 White Squirrel Way, on the main campus on Queen Street West in Toronto, Ontario. (a) Indigenous artists transformed this space by painting the medicine wheel mural in the centre of the floor as pictured (2013). Tables were removed, and chairs are often placed around the mural to support talking circles. (b) The CR features walls lined with cedar planks and house Indigenous artwork; the only tables used are for traditional medicines/objects for ceremonial use.

Figure 6

Pictured is the current room at CAMH, once it was relocated to the main campus at 60 White Squirrel Way in 2021. (a) The custom blue-painted wall serves a focal point for virtual participants and is adorned with Indigenous artwork. (b) The central feature of the room is a custom round table that ties in natural elements into the space, such as wood, stones, and water.

Figure 7

Pictured are the Ceremony Grounds at CAMH, one of the THSs. (a) The Sweatlodge ready for ceremony and covered with a black canvas, located south of the Sacred Fire pit, used to heat the stones used in the ceremonial lodge. The oblong shape of the Sweatlodge is intentional, “The lodge represents the womb of our mother, Mother Earth, as our first mother” (White 2021, 5:00). (b) The medicine gardens, used to grow plants (sacred medicines) such as traditional sacred tobacco, cedar, sage, and sweetgrass, used as part of these Traditional Healing ceremonies.

Figure 8

Pictured is the Sweatlodge ceremony preparations. (a) The bare willow tree frame of the Sweatlodge as it is being prepared by participants for ceremony. (b) The Sweatlodge covered with black canvas located adjacent to the Sacred Fire, where the stones are heated for the ceremony. Visible to the right of the Sweatlodge is the original stone wall from the 1850s asylum.