Hearing (unheard) voices : aboriginal experiences of mental health policy in Montreal
Bibliographic record
Abstract
The focus of this dissertation is the mental health experiences of Aboriginal people in Montreal as they interface with health policy, and lack thereof, for this population. Drawing on anthropological fieldwork from Montreal, Eastern Quebec, and Ontario, this thesis endeavours to unravel the jurisdictional tapestry that Aboriginal clients must negotiate when seeking services in Montreal. Using an ethnographic methodology, this project provides an understanding of the ordering of health services for Aboriginal clients from street-level to policy offices. This thesis draws on three theoretical areas (theories of illness, aboriginality, and public policy) to explicate four themes that emerge from the data. Analysis moves along a continuum between the illness experience and the macro-social determinants of politics and bureaucracy that impact the health of the individual as well as support and organize systems of care. Discussion of Theme #1 (evolution of mental health and wellness categories in health theory, policy and practice) and Theme #2 ( the culture concept in health policy) demonstrates that despite the progressive evolution of concepts in health theory and policy, Aboriginal people generally do not find services in Montreal that provide culturally-sensitive, holistic care. Discussion of Theme #3 (barriers to wellness created by jurisdiction) argues that jurisdictional barriers prevent clients' access to even the most basic and rudimentary services and that such barriers can actually disable and increase distress. Discussion of Theme #4 ( Aboriginal-specific services) looks at the pros and cons of creating an Aboriginal-specific health centre in Montreal. Together, these four themes show that understanding Aboriginal people in Montreal requires contextualizing their embodied experience within the colonial history and institutional racism which characterizes many healthcare interactions, and clarifying the bureaucracy that complicates the search for well-being. Montreal's Aboriginal problematic is located in a system characterized by entrenched bureaucracy, jurisdictional complexity and injustice, these elements mapping onto Aboriginal reality with serious repercussions for individual identity and well-being. Hearing the voices of Aboriginal people in Montreal as they seek out care for mental health problems requires the resolution of jurisdictional and policy clashes that currently silence their suffering. This thesis endeavours to advance this crucial social agenda.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.042 | 0.021 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".