Indigenous sweat lodges were recently introduced on the hospital grounds of the Centre for Addiction and Mental Health (CAMH) to facilitate the healing process for Indigenous patients. The significance of this first of a kind intervention strategy lies in its implications for future health and healing practices that should be established.

Indigenous peoples, in this context, are an ethnic group that identify as the original inhabitants of Canada. Such individuals currently represent about 4.3 % of the population. Despite representing an integral part of this nation’s early history and cultural roots, Indigenous peoples were the target of unjustified maltreatment enacted by both governmental actions and racialized stigma from society. The implementation of residential schools and colonization in the 19th century were the two major political actions that gave rise to the social divide that Indigenous individuals experience to this day. Forced to assimilate into western culture and abandon their heritage and cultural practices, the overall health status of the Indigenous population and their descendents was negatively impacted.

Specifically, the Indigenous population has been predisposed to an alarmingly high prevalence of mental illnesses and substance abuse. This is especially evident through the relatively recent epidemics of suicidality in certain indigenous communities. In fact, this population is prone to suicide rates that are twice the national average, with certain communities standing at an alarming suicide rate that is six to eleven times the country’s overall average. Moreover, findings from a recent survey revealed that 16% of Indigenous individuals are diagnosed with major depression, in comparison to the 8% of the overall Canadian population. Sources also indicate that 75% of Indigenous individuals expressed that alcohol use represents a major concern in their community.

Interestingly, as part of their unique set of cultural beliefs and worldview, Indigenous peoples interpret mental wellness specifically as a state of balance with one’s family, community and the environment. Spirituality and culture also play a vital role in allowing such individuals to reclaim their identity and a sense of control over their lives. As a result, mainstream forms of therapy employed for individuals with psychiatric illnesses are not commonly effective in alleviating psychiatric symptoms within this population.

The incorporation of sweat lodges as part of the treatment regime for Indigenous peoples in the CAMH psychiatric hospital has received widespread support due to its similarity to ancient healing traditions. Consisting of a historically conserved purification ceremony, this holistic form of therapy focuses on restoring balance and well-being for individuals afflicted with challenges pertaining to mental health and addictions. Moreover, this form of therapy represents a culturally appropriate and evidence-based approach, as it is reflective of the values, beliefs and traditions accepted by Indigenous peoples.  

Sweat lodges, in actuality, are physical, dome-like structures constructed by an inner frame consisting of  maple poles and overlain by a heavy tarp. The opening of this structure faces a fire pit, which serves the purpose of heating stone  for the purification ceremony. Inside the sweat lodge, another pit is dug to contain the stones for this ceremony. Before it begins, the stones, termed “ grandfathers “ and “grandmothers,” are washed with traditional medicines and “sacred water” to form a cleansing steam. This arrangement is symbolic of perpetual reverence towards Indigenous peoples’ early ancestors. Additionally, the structural organization of the sweat lodge has been historically believed to serve as a manifestation of re-birth, as the dome shape resembles the womb of Mother Earth, with the frame of the sweat lodge symbolizing her ribs. The detoxification of the mind, spirit and soul achieved through the entire process further adds to the perceived notion of re-birth.

Sweatlodge (Wikimedia)

As part of the purification ceremony, patients sit encircling the cleansing steam inside the sweat lodge and engage in religious prayer, hymns and other traditional rituals of healing. Additionally, upon the moderation of a ceremonial conductor, who is trained to lead such traditional  Indigenous practices, participants are prompted to take part in self-reflective discussions. For instance, they are urged to share aspects of their life they are most grateful for as well as their future goals.

Despite the relatively short time period for which this therapy has been introduced, many participants have expressed gratitude, personal improvement and progress towards healing. Accolades describing the experience as  a “miraculous adventure,” “spiritual milestone” and an “emotional shift”  have garnered increased speculation and interest into expanding this  form of culturally contextualized care in other hospitals and health care facilities.

In fact, many specialists and researchers in the field of Indigenous health realize the increasingly pressing need to incorporate traditional healing and health practices when implementing health interventions for this marginalized population. It has been further established that the negative repercussions of the trauma acquired via their non-ideal childhood circumstances accumulate and intensify throughout generations. Hence, health care delivery systems should be structured to address the impacts of multi-generational trauma by offering culturally relevant care.

Dr. Janet Smylie is a highly accomplished and respected leader in Indigenous health and through her involvement in research projects and community initiatives, she strongly advocates for quality healthcare for Indigenous populations. Moreover, as a family physician and director at the Well Living House – a research facility consisting of Indigenous health researchers and policymakers – Dr. Smylie strives to foster collaborations among health care agencies and institutions to increase the prevalence of culturally appropriate service delivery. In fact, one of her current projects aims to elucidate the psychosocial factors that affect Indigenous health, including poverty and feminism.

Consequently, the implementation of a sweat lodge in the CAMH hospital to accompany the pre-existing therapeutic interventions provides an exemplary framework for addressing health disparities among Indigenous and other at-risk populations. It further reiterates the importance of considering a population’s specific cultural history and the social challenges that are met when establishing an effective path for recovery.

By Ritika Arora

Please note that opinions expressed are the author’s own. They do not necessarily reflect the views and values of The Blank Page.