On the move: Exploring Inuit and non-Inuit health service providers’ perspectives about family participation in care in Nunavik, a qualitative study.
Abstract Background Literature on participation in health and social services suggests that youth, and more specifically Indigenous youth, are difficult to engage within health and social services. They are less likely to access services or to actively participate in decision-making regarding their personal care. Service providers play a crucial role in engaging youth based on the ways in which they seek, establish, and maintain relationships with them and their families. The way in which they do so will depend on various factors including their own perceptions of roles and relationships of the various people involved in the life of youth. This article analyzes health and social service providers’ perspectives, experiences and expectations regarding the roles of a particular group of Indigenous youth, families and community in care settings in Nunavik, Quebec.Methods: A snowball sampling method was used to recruit participants. A total of 58 participants were interviewed including psychiatrists, general practitioners, nurses, social workers, school principals, teachers, student counsellors, representatives of local committees (education committee, health committee), and police officers. Of the 58 participants, 39 were non-Inuit and 19 were Inuit. All interviews focused on three broad areas: 1) participants’ current and past positions/roles; 2) participants’ perceptions of the clientele (youth and their families) they work with; and 3) participants’ understanding of collaborations taking place within and between services (who works with whom) and community. Inductive applied thematic analyses were conducted on the entirety of relevant data and then verbatim of Inuit and non-Inuit were analyzed separately to explore similarities and differences in perceptions based on positionality.Results: We organized findings around three themes: I) The most commonly described interventions, II) different types of challenges to and within participation; and III) what successful participation can look like according to service providers. Participants speak of the challenges for families to go towards services as well as the challenges for services providers to go towards youth and families, including personal, organisational and historical factors.Conclusion: We adopt a critical lens to reflect on the key findings in order to tease out points of tension and paradoxes that might hinder the participation of youth and families and more specifically in a social context of decolonization and self-governance of services.