Culturally Centered Approaches for Indigenous Youth Accessing Mental Health Services as They Transition to Adult Mental Health

Abstract

This research study explores the experiences of Indigenous youth in British Columbia as they transition from the Indigenous Child and Youth Mental Health (ICYMH) services to adult mental health services. The purpose of this research is to assess how culturally appropriate the current transition process is and to identify service gaps that affect Indigenous youth and their families during this critical life stage.The study is guided by the Aboriginal Policy and Practice Framework (APPF), which emphasizes holistic, trauma-informed, and culturally safe services for Indigenous children and youth. The framework encourages collaboration with communities, the inclusion of Indigenous knowledge and healing, and support systems that are relationship-focused and community-driven. Indigenous understandings of health are holistic, emphasizing the emotional, physical, spiritual, and mental well-being of individuals, families, and communities. These worldviews also place strong importance on land-based healing, relationships with Elders, and cultural continuity. However, many mainstream services remain focused on Western medication and individual treatment models without incorporating these worldviews. This disconnection is particularly harmful in the context of a long history of colonization, including the legacy of residential schools and the overrepresentation of Indigenous children in the child welfare system. These experiences have contributed to intergenerational trauma and disengagement in government services. To better understand the transition experience, this qualitative study involved a focus group with ICYMH staff members from the Fraser region, including clinicians, outreach workers, and an Indigenous Elder was conducted. All participants had direct experience supporting youth aged 17–19 as they prepared for transitioning to adult services. Data was analyzed through two stages of coding to identify recurring patterns and meaningful insights. Four major themes emerged from the research. First, participants emphasized the importance of Indigenous worldviews and cultural healing practices. Ceremonies, land-based activities, and working with Elders play an important role in Indigenous wellness but are rarely integrated into adult services. Second, the research revealed widespread frustration with system navigation. Youth face long waitlists, unclear processes, and strict eligibility criteria that often exclude those who are struggling but not considered “severe enough” clinically for immediate intervention. Navigating the transition independently, especially when dealing with mental health challenges, can leave youth feeling overwhelmed and unsupported. Third, participants identified systemic barriers and service gaps in mainstream mental health care. Staff often lack the capacity or tools to find culturally appropriate services for youth, revealing difficulties in navigating. Service lists are vague, and adult services are often not designed with Indigenous cultural safety in mind. As a result, many youth are referred to the First Nations Health Authority (FNHA), but access may be limited due to bureaucratic complexity such as the need for a status card. Lastly, the theme of a need for creating doors and bridges for Indigenous youth to access adult mental health services was strongly reflected in participants’ experiences. Many youth are disconnected from their cultural roots and lack the information needed to verify their Indigenous identity. This creates emotional distress, reinforces feelings of not belonging, and limits access to culturally relevant care. Several limitations should be acknowledged. The research included only staff perspectives and was limited to one region. The views of Indigenous youth, families, and adult service providers were not represented, and future studies should include these voices. Nonetheless, the study offers clear recommendations. These include expanding Indigenous health liaison roles in adult services, improving access to cultural safety training for service providers, building stronger community partnerships, and enhancing the accessibility of culturally relevant healing practices.