Perceptions des hommes québécois de leurs besoins psychosociaux et de santé ainsi que de leur rapport aux services

Perceptions des hommes québécois de leurs besoins psychosociaux et de santé ainsi que de leur rapport aux services

détails de la fiche synthèse

Réalisée: David Guilmette Mise en forme: Justin Sirois-Marcil Juillet, 2014

Evaluation of the initiation and training expedition program for young Inuit men led by the UNAAQ Menʹs Group.

Référence complète de l'étude

Tremblay, G. & Villeneuve, P. (2008). Evaluation of the initiation and training expedition program for young Inuit men led by the UNAAQ Menʹs Group. Québec : Centre de recherche sur lʹadaptation des jeunes et des familles à risque (JEFAR) & QAJAQ Network.

Préblématique et cadre théorique

The project took place in Inukjuak, Nunavik. […] There are approximately 11000 inhabitants living in 14 communities, all isolated from each other, without any road between them and boats can only be used during the short summer time. Thus, the only real way of transportation is by plane. Most people speak Inuktitut and few speak English or French. […] According to the 2002 Canadian census, 1294 persons live in Inukjuak. Traditionally, this community was nomadic, relying on fishing, trapping and hunting. Commercial activities led a few White people to establish homes and to open the first school in 1951. In 1953, the Canadian Government, wanting to establish its sovereignty on the region, forcibly relocated Inuit inhabitants and split up families. […] Therefore, in less than 50 years, this community has undergone a radical change in its way of life: from staying in temporary igloos during winter, or tents during summer, to permanent and furnished houses, including video games, computers with Internet, and so on. This has led to a deep sociocultural fragmentation.

According to an epidemiological study conducted by the federal government in 2003, the health situation of First Nations and Inuit people is worse than for other people in Canada. There are more people who abuse alcohol and drugs, more binge drinking, and twice as many people smoking cigarettes (Santé Canada). Most recent data indicate that 19.2% of deaths in Nunavik are due to suicide compare to 2.2% on average in the Province of Quebec, and 87.1% of suicides between 2001 and 2005 were committed by youngsters from 10 to 29 years old compared to 20.7% for the other regions of Quebec (Roos & François, 2007). According to the Ministry of Education, in 2005, only 35.6% of teenagers have completed high school before age 20 compared to 70.2% for rest of Quebec (MELS, 2006). Usually, after having dropped out of school, youngsters have nothing to do but play video games, surf on the Internet, and/or behave delinquently: robbery, fighting, etc. According to an individual interviewed: young men, especially those who have problems at school and drop out of school soon, are lost between two worlds: they are not in touch with their traditional Inuit culture and values and, they do not have access to the “modern” world. Many do not attend school, have no job, have nothing else to do than playing videogames, watching tv or doing bad things. As this person said, they lack identity and have no hope in the future. As another interviewee said, some have no parents or they live in single-parent homes, without a father. […] The main goal of the UNAAQ Men’s Group is to mobilize the Inukjuak community regarding the problems young men are facing, particularly to reduce the rates of suicides, delinquency, substance abuse and violence. More specifically, the purposes are (Élie, 2004): To increase personal and social skills of multi problematic young men as a protection factor; To make youngsters aware of traditional cultural values and discuss the transition to modern life; To help men in supporting children and young men; To make participants aware of personal and community issues in regards to suicide prevention, substance abuse, and interpersonal violence; To promote exchanges between generations; To raise awareness and inform men about how to seek help and make use of social and health services in place. They pointed out two means by which these goals could be achieved: 1) monthly discussion meetings and 2) initiation and training expeditions for young men with psychosocial problems. Involving young men in these expeditions, they wanted to initiate and train them in survival skills in the northern territory: how to prepare an expedition (equipment, clothes), how to orient and navigate, how to build a winter camp (igloo) and summer camp (big tent), and how to hunt, trap, use a gun for hunting, fish, etc. They also wanted to initiate discussions on psychosocial problems young Inuit men are facing: substance abuse, alcohol abuse, gas sniffing; self-esteem, interpersonal relationships, violence; personal skills, community, suicidal ideas, etc. (Élie, 2004).

Méthodologie de l'étude

Description de la ou des méthodes utilisées

This research uses qualitative data as well as quantitative data.

Échantillon(s) et période(s) de collecte des données

This research uses data from four groups of participants. These four groups are: 1) Young Inuit men who participated in the expeditions program. They were met three times: before the first expedition (n = 14), a short time after the second expedition (n = 11), and one year and a half after the last expedition (n = 13). Some were met once, some twice and other three times (N=19). 2) Elders and organizers: at the beginning of the program, a first interview was realized with the leaders of the UNAAQ Men’s Group and the coordinator of QAJAQ Network (n=4). This interview was followed by a meeting with members of UNAAQ Men’s Group. The group was met a second time one year and a half after the last expedition (12 to 15 participants at each time). 3) Parents: A focus group with youngsters’ parents was led during the last visit (one year and a half after the end of the program). 4) Community leaders: With the goal to have some external points of view, six leaders in the community, not involved in the program, were interviewed after the end of the program. In total, little over 40 people were interviewed at least once in the process. These four different types of information were compared providing a strong triangulation to confirm the validity of the results.

Principaux résultats

All participants reported having multiple psychosocial problems. They dropped out of school early with only a mean of 8.8 years of schooling (SD = 1.8); seven of them were still in school at the beginning of the program, but they reported having missed many school days (up to 50%). However, four of them were planning to go back to school. Nine had a job, usually part-time (M = 16 hours per week), four received welfare, three had money from their parents, and two made handicrafts. Almost half of those who worked (4/9) reported having missed work days in the last month (1 to 7 missed days). On a Likert scale from 1 (strongly agree) to 6 (strongly disagree), they reported having many problems in their families (M = 3.27). They said they spent time watching TV or playing video games (M = 3.7 hours per day, from 0 to 13), and, to the contrary, they reported having little or no time to play sports with a mean of 3.8 hours per week (from 0 to 20). Eleven out of 18 boys reported having been drunk, used drugs, or sniffed gas, glue or other such substances during the last 12 months, the mean ranging from many times to very often. Four of them reported they have never used such substances and four others, once or twice. Four out of 18 said they had stolen something from a store or a house, once or twice, during the last 12 months, and five said they had done the same thing many times or often. During the same period, 10 out of 18 reported having hung around or “fooled around” at night when they were supposed to be home and four out of 18 had fist fights with another person once or twice, and six many times or often. In general, this portrait reveals that the program recruited the type of participants it was expected to in the planning, except for the fact that some of them who were slightly older (more than 30 years old). Moreover, one of them reported having been bullied by other teenagers, and a parent talked about the isolation that her son was facing before. One participant revealed having been a victim of sexual abuse when he was younger, whereas another admitted that he had tried to commit a sexual abuse on a young girl. Some of them have no parents. This portrait is also, in some aspects, the same as described by many respondents when they talked about the problems young Inuit men are facing in this community.

Organizers explained they faced many difficulties in mobilizing the young men to participate in the expeditions. The reaching out took a lot of effort: each boy needed to be mobilized one-by-one, with many steps. […] The authors know from other projects with young people from low socioeconomic background that the mobilization remains a big issue. Each participant needs to be recruited one-by-one; many things have to be in place to facilitate their participation like the transport in front of their house, etc. Changing a routine in which someone does almost nothing else than watching tv or playing videogames requires much effort and support. The researchers understand by these results that the UNAAQ Men’s Group will have to pay more attention to the recruitment in planning of other expeditions. A possible alternative would be the integration of a former participant in recruiting new participants.

Regarding practical skills, the participants were asked […] to evaluate […] their abilities regarding most practical skills used during the expeditions: the preparation of an expedition, the navigation on the land (landmarks, winds, sun and stars, GPS), the building of a shelter (tent, igloo or emergency shelter), the repairs of a snow mobile, the capture (fishing, hunting, trapping) and the cooking of the food, and the avoidance of dangerous hazards on the land. Most of them reported having gained skills. […] Most of them noted they especially appreciated hunting. Some of them, at the first comment, expressed that they had not learned so much, a few things only. But, when they were asked to explain those few things, they were able to point out learning something about many of the main practical skills. A third of respondents had many positive comments, telling us that they had learned a lot and had improved their knowledge about hunting, fishing, navigating, avoiding dangerous situations, etc. Some expressed that they missed going hunting and hoped to participate in new expeditions in the future. For their part, the organizers have almost the same appreciation: “they learned a lot”, “they have now more hunting skills”, “they know how to orientate on the land”, “they are more confident in their skills”. Consequently, the researchers say that this goal was relatively very well achieved. […] Finally, some youngsters reported they had previously been thought some skills but they had no opportunity to practice them because they do not have a snowmobile to go hunting on their own. For them, UNAAQ offered a good opportunity to go hunting and fishing which would have been difficult for them otherwise.

Youngsters had to answer 10 questions concerning the respect of the Inuit culture. Two questions were related to the language, two on the relationship with Nature, three on the relationship with Elders, one on being a young Inuit man in today’s world, and finally, two on the culture in general. […] Generally speaking, the youngsters seem to have not changed their point of view on cultural matters. On the total score, the mean was 45.6 at Time 1 and quite similar at Time 3 (44.3). If we look more attentively at some items, we can observe that, in general, at Time 3, the participants improved their evaluation of the role youths have to play in preserving the Inuit culture compared to Time 1 (4.8 c. 5.4). On the other hand, they felt it was harder being an Inuit young man in today’s world at Time 3 compared to Time 1 (2.2 c. 3.5).

According to the quantitative data, […], they did not change their perception of Elders, but, in fact, it was relatively good at the beginning. On the contrary, in the qualitative data, many of them said that they have better relationships with Elders now than before the expedition program. One of them noticed that his relationships with Elders have positively changed. This is for him a kind of replacement for the loss of his parents. The Elders involved in the program also feel closer to the participants than previously. One of them said that, now, sometimes, some youngsters come to eat at his home. They also think that the participants remembered well the Inuit values they talked about during the expeditions. Few participants said they need to learn more from Elders about Inuit manhood and more specific language related to hunting. Another one noted that he liked to listen to stories about the “old times”.

Effects on the psychological problems of the participants: […] most of the participants were facing different psychosocial problems when the program started. The project expected to have a positive influence in helping young men to face some problems like: low self-esteem, drug and alcohol abuse, delinquency, domestic violence, psychological distress and suicidal ideas, and finally poor leisure times. In fact, the intervention on these topics was double. A first one was indirect: in engaging young Inuit men in Inuit traditional activities (hunting, fishing, etc.), it was expected to have a positive effect and help young men to stay away from drug and alcohol, delinquency, as well as having hope for the future. A second one was more direct: during the expeditions, Elders addressed these issues in giving advice, explaining the importance of the respect for oneself, for the family and the community. But, contrary to practical skills and transmission of Inuit culture that they had learned since their childhood from their own parents and other Elders, they did not receive any specific training on psychosocial matters, except lessons learned from their own lives […].

Social Environment: The questionnaire was built with different aspects of the social environment of the youngsters: two items were linked to their evaluation of the community (if something can be done to improve the situation and the importance for the community to stick together), one item on having someone to confide in, three items on their appreciation of relationship with their family (many problems or not, go hunting with a relative, and informing the family when being outside), and two items on their relationship with their partner, if they have one. In general, their perception of the community has improved after the program (7.17 c. 9.85). There was only one item to evaluate the use of the social network when a problem occurs. At the beginning of the program, the participants said they usually tried to find someone to talk with when they faced a problem and the situation was quite similar one year and a half after the end of the program (4.00 c. 4.31). On the other hand, the relationships with their parents seemed to have improved according to them (11.33 c. 13.08) as well as the one with their partner, when they had one (7.9 c. 9.5). Most respondents had several positive comments. A thankful mother praised the program. She said her son was isolated before his participation in the expeditions, now he is happier and has friends to go with. Being a single parent, UNAAQ offers her son relationships with mature men. She reported that she feels closer to her son. A participant reported that he was often bullied by other teenagers before the expeditions, but now he has new friends and is not being bullied anymore. Another one had similar comments about being rejected often by other youngsters. Many participants reported that they feel closer and more at ease with their family now, especially their parents. One even noted that his respect for other people comes easier now. According most participants’ comments, they have a better sense of the community than previously.

Activities and leisure times: The questionnaire had six questions on activities and leisure times. The first one was on the importance awarded to school. The second was on their appreciation on opportunities available in the community. Following these questions, the youngsters were asked about the importance given to 1) watch TV or play video games and 2) play sports. They also had to indicate how many hours they usually spent per week for each of these two activities. Generally, the participants said that they considered school important and the situation did not really change (4.8 c. 4.9). In the same way, in general, they did not change their idea according to the opportunities available in the community (3.92 c. 3.9). But there were many disparities between them on this topic and it is difficult to have a clear interpretation of this result. Unfortunately, they reported spending more time in watching TV and playing video games and, on the contrary, less time in playing sports at Time 3 compared to Time 1 (8.64 c. 6.46). However, when asked how many hours per week (one year after the end of the program) they spent playing sports, they noted an increase. And so, less time watching TV than they did at the beginning of the program (TV = 3.8 c. 3.25; sports = 3.7 c. 4.5). There is a contradiction between the answers to these two sets of questions; then, it is difficult to interpret these data. The qualitative data do not really give more information on this topic. A few participants noted that they do not have a lot to do. For them, the UNAAQ’s expeditions and meetings are an interesting alternative now. A parent emphasized the new opportunity for young Inuit men offered by the UNAAQ Men’s Group.

Psychological distress: […] The participants have improved their point of view about their self-image as a good role-model (2.08 c. 3.15). They think they have improved their general mood after the program compared to before (8.62 c. 9.77), but their interest in life has not increased so much according to their ratings (7.85 c. 8.08). Generally speaking, they considered their psychological distress slightly less one year after the program than what it was at its beginning (19.54 c. 21). One organizer considered that the most important thing they tried to give to the participants was hope in the future. Organizers, as well as some youngsters, explained how the killing of the first caribou or the first seal gives pride and a feeling of accomplishment. It is like a rite of passage for young Inuit men. A mother reported how, one year and a half after the expedition, her son was still proud of himself and liked to remember that moment when he killed his first caribou. Unfortunately, the UNAAQ Men’s Group was faced with the suicide of two participants. Although the expeditions seemed to give a sense of community and other opportunities to young men, some of them probably needed more specific help. It remains that expeditions gave the participants an opportunity to enhance their self image and be appreciated by other people, youngsters as well as Elders.

Delinquency and drug and alcohol abuse: This part of the questionnaire was based on items selected from Total Delinquency Scale (LeBlanc & Tremblay, 1988) often used in studies on delinquency. This scale covers different categories of delinquent behaviours. The authors selected and adapted the most relevant items for the […] study: the use of gas sniffing, drugs and alcohol, stealing from a store or a house, hanging around or fooling around at night while supposed to be at home, and finally fist fighting. […] The participants have not change their point of view regarding drug and alcohol abuse or gas sniffing (5 c. 5), but they have changed their minds concerning fist fighting (2.69 c. 5). Accordingly, they reported having had slightly less frequent such behaviours at Time 3 compared to Time 1 (8.57 c. 7.08). Globally, they reported having used slightly more alcohol, drug or gas sniffing after the programme than before (2.85 c. 2.23), but having less often stolen something from a house or a store (2.08 c. 1.25), hung around or fooled around while supposed to be at home (2.18 c. 1.54), and fist fighting with another person (2.08 c. 1.54). The qualitative questionnaire did not have specific questions on this topic although the answers suggest that they improved their sense of being part of the community. They improved their behaviours linked to their social environment (stealing, fooling around, fist fighting), but they have not changed their point of view about more personal delinquent behaviours like alcohol and drug abuse or gas sniffing. Drug abuse seems to be particularly frequent. In fact, it was difficult for the organizers to avoid it during the expeditions.

Self-esteem: For the last scale, researchers used the well known Rosenberg Self-Esteem Questionnaire without any modification. This scale has 10 items. On the total scale, the researchers found no difference between the boys’ ratings at Time 3 compared to Time 1 (41.92 c. 41.62). In summary, globally, the program seems to have had some effects on the boys’ evaluation of their psychosocial problems. They reported having a better perception of their community, better relationships with their family and with their partner (when they have one). However, they reported more disagreement concerning delinquent behaviours except about drug and alcohol abuse. The program seems not to have had the anticipated effects on their self-esteem and their psychological distress when these topics are measured in the quantitative scales. On the contrary, qualitative data, especially those from the organizers and the parents, but also from some participants, suggest that the participants feel more confident in themselves and more proud when they have achieved killing of a caribou or a seal. It is like a rite of passage to manhood for them. In summing up, the program seems to have had more positive effects on psychosocial problems than […] expected, particularly on giving a feeling of accomplishment and being a part of a community. According to most respondents, the relationships with Elders and parents have improved, and delinquent behaviours have decreased except for drug and alcohol abuse which remains an important issue. Young Inuit men are facing many psychosocial problems and it is impossible that such specific and limited program, with few means, can reverse the situation completely.

Besoins identifiés

As a few leaders in the community said, it would be important to develop a more specific program against drug and alcohol abuse, which is a big issue.

Population cible

Jeunes hommes inuit (16 ans-38 ans).

Objectifs et hypothèses

The program evaluation has two main goals (Tremblay, Villeneuve & Élie, 2004): To identify personal and social skills gained by young Inuit men who have participated in expeditions; and to verify if the program had an impact on psychosocial difficulties of youngsters such as substance abuse, suicidal ideas, delinquency and self-esteem. Two sets of variables were identified: 1) proximal variables such as survival skills and cultural inheritance; and 2) distal variables regarding psychosocial aspects: psychological distress, suicidal ideas, substance abuse, delinquency, and self-esteem (Tremblay, Villeneuve & Élie, 2004).

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