Grant: Project Grant

First Nations, Inuit, and Métis Peoples face numerous inequities in health care, including experiences of racism and discrimination due to the lasting effects of colonialism, systemic racism, and institutional practices. Indigenous cultural safety reflects the extent to which people feel safe from experiences of racism, discrimination, and stigma. Canada has made commitments to promoting cultural safety in health care settings, but Indigenous defined plans for embedding cultural safety into care pathways remain undeveloped. The aim of this project is to improve our ability to assess, monitor and support Indigenous cultural safety at Canada's largest mental health hospital, the Centre for Addiction and Mental Health (CAMH). We will: 1) Examine how Indigenous patients, family members, and clinical staff define and experience cultural safety and institutional processes within hospital-based mental health care; 2) Identify institutional enablers and systemic barriers shaping access to culturally safe care and inform the development of hospital-based standards grounded in cultural safety and health justice; 3) Co-develop a culturally grounded measurement guide to support Indigenous-led monitoring and evaluation of cultural safety. Guided by an Indigenous Advisory Council, our team of Indigenous scholars and allies will focus on Indigenous patient, family and staff experiences and perspectives. Data collection will include sharing circles, interviews, digital storytelling, surveys, document review, care pathway mapping and co-designed workshops to develop a guide informing future assessments of cultural safety. The findings will be used to inform recommendations for hospital standards of care, health system planning, care pathway improvements, as well as future assessments of cultural safety. Beyond CAMH, the project contributes a transferable Indigenous-governed approach for examining cultural safety and advancing evidence-informed accountability in hospital settings.