Acute care hospitalizations for mental and behavioural disorders among First Nations people.

Background: National information about acute care hospitalizations for mental/behavioural disorders among Aboriginal people in Canada is limited. Data and methods: This study describes acute care hospitalizations for mental /behavioural disorders among First Nations people living on and off reserve. The 2006 Census was linked to the Discharge Abstract Database from 2006/2007 through 2008/2009 for all provinces (except Ontario and Quebec) and the three territories. Hospitalizations for seven types of disorders were identified. "Most responsible" diagnosis and secondary diagnoses were examined separately. Age-standardized hospitalization rates (ASHRs) per 100,000 population and rate ratios were calculated. Results: ASHRs for most responsible and secondary diagnoses of mental/behavioural disorders were significantly higher for First Nations people living on and off reserve than for non-Aboriginal people. The leading diagnoses were the same for each group, but the rank order differed. Among First Nations people, the most common diagnoses were substance-related disorders, mood disorders, and schizophrenic/psychotic disorders. Among non-Aboriginal people, mood disorders were the leading most responsible diagnosis, followed by schizophrenic/psychotic disorders and substance-related disorders. The greatest rate differences between First Nations and non-Aboriginal people for both most responsible and secondary diagnoses were for substance-related disorders. Interpretation: The higher burden of hospitalizations due to mental/behavioural disorders among First Nations people provides benchmarks and points to the need of considering every hospital admission as an important opportunity for intervention and prevention. The Truth and Reconciliation Commission of Canada (2015) has recognized that the poorer health outcomes of Aboriginal people in Canada were rooted in the legacies of colonization. Further research is required to better understand the direct impacts on mental health.