Glossary

Activities of daily living (ADLs) refers to basic self care activities including feeding, washing, dressing, and mobility. This may also be used more broadly to refer to productivity and leisure activities.

Ancestral territory refers to the lands traditionally occupied, used, and often spiritually connected to by Indigenous peoples over generations. It encompasses the geographic areas where Indigenous communities historically lived, hunted, fished, gathered resources, and practiced their cultural traditions.

Anti-racism is the practice of actively identifying, challenging, preventing, eliminating, and changing the values, structures, policies, programs, practices, and behaviours that perpetuate racism. It is more than just being “not racist” but involves taking action to create conditions of greater inclusion, equality, and justice.

Caregiver burden is the subjective experience of stress associated with the care-giving role. Caregiver burnout is the stage of extreme fatigue of a caregiver, where continuation of care becomes risky or impossible. The risk may be to caregiver health or the care recipient's. 

The term “client” has been identified as a more humane term than ‘patient’ whereby the client is acknowledged as bringing their own expertise to bear in decision making about service needs and use. In the mental health context, practice settings have influenced the terminology commonly used; i.e. “patients” are seen to receive care in a hospital, while “clients” receive care from the community. However, others argue that the term patient and client are synonymous; both have choices and can be collaborative in their treatment planning. Throughout the website, we aim to use “person” or “client”.

Some people experience both mental health and substance use disorders at the same time. This is called a concurrent or co-occurring disorder. Co-occurring disorders can happen with symptoms occurring at the same time or at different times with varying levels of intensity. Often, patients with a concurrent disorder require higher levels of care, given the complexity of their diagnosis and difficulty determining whether symptoms are related to the mental illness or the substance use. 

Cultural humility is a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.

Cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.

Elder is a sacred title that one earns from their community for their depth of knowledge and understanding of First Nations teachings, practices, and ceremonies and through the harmony and balance of their actions. Elders possess wisdom gained through time and life experience, but the honour is not defined by age. All older adults have important roles within First Nations communities and hold vital knowledge and experiences of resilience. However, not all older adults are Elders. - Sacred and Strong: Upholding our Matriarchal Roles (p.92) FNHA-PHO-Sacred-and-Strong-Adulthood.pdf

A decision making approach to health care practice that involves the use of current best (research) evidence, clinical expertise, & patient preferences. Evidence-based practice involves critical appraisal of information used to answer a clinical question.

A person or persons who have been identified by the Client, the Client’s representative or the Client’s care provider as being in a relationship of importance to the Client and who provides support or care for the Client on a regular basis.

To ensure ACT is implemented as intended, researchers have developed “Fidelity Assessment Tools.” Fidelity assessments provide overall operational guidance, administrative direction, organization of the team/role function and assurance of evidence based practice with minimal drift from the original model.

First Nation refers to an indigenous community, group or individual in Canada that is recognized under Canadian law as having specific rights and status. These communities are distinct in terms of their cultural heritage, traditions, and ancestral territories.

A process of embedding or intertwining Indigenous peoples, ways of being, ways of doing, and values into the infrastructure of an organization.   

Indigenous is a comprehensive term encompassing First Nations (both status and non-status), Métis, and Inuit peoples.

A group of Indigenous peoples of northern Alaska, arctic Canada, and Greenland used especially for those of the Canadian Arctic and Greenland. The majority of the Inuit population lives in 51 communities spread across Inuit Nunangat, the Inuit homeland encompassing 40% of Canada’s land area and 72% of its coastline. The Inuit have lived in their homeland since time immemorial. 

A First Nations person who is recognized by their community as holding traditional knowledge and teachings taught by an Elder or senior Knowledge Keeper within their community.

What is a Land Acknowledgement? According to UBC X̱wi7x̱wa Library 

 A land acknowledgement (or territorial acknowledgement) is considered a respectful, yet political statement that acknowledges the colonial context of the Indigenous territory/territories where a gathering is taking place. It recognizes relationships between land and people, and in particular Indigenous peoples' continued presence on the lands being acknowledged.
Land acknowledgements are formal statements usually performed at the beginning of a gathering by the host of the gathering, to insert awareness of history of land into daily life. When doing a land acknowledgement, some individuals may also situate themselves in relation to the land by mentioning their ancestry or the nation or community they belong to. Over the past decade, land acknowledgements have become more mainstream as awareness of reconciliation and Indigenous issues has grown.  

For more information on Land Acknowledgements visit:  FNHA-Territory-Acknowledgements-Information-Booklet.pdf

Land Acknowledgement Worksheet: Document linked here

Women are highly respected in First Nations cultures as matriarchs, Knowledge Keepers, caretakers of the water, and sacred givers of life. Matriarchs hold positions of power and are leaders in their communities – presiding over feasts, leading ceremonies to mark key life transitions such as birth and coming-of-age as well as nurturing and teaching children, the leaders of tomorrow. Many Nations are traditionally matrilineal, meaning that peoples’ identities – including clans and roles – are passed down through mothers. - Sacred and Strong: Upholding our Matriarchal Roles (p.69)  FNHA-PHO-Sacred-and-Strong-Adulthood.pdf

There are many terms used to describe mental health and substance use disorders. Mental illness and mental health are often used inappropriately as interchangeable concepts. Further, there is controversy around the classification of mental disorders given the subjective nature of diagnosis. The World Health Organization (WHO) uses the International Classification of Diseases (ICD10) to define mental illness, but the Canadian health care system uses the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to diagnose mental illness. The DSM-V defines mental disorders as “a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with present distress, disability or significant increased risk of suffering” (American Psychiatric Association, 2013). Conversely, ‘mental health’ is defined by the WHO (2014) as “a state of well-being in which every individual realizes [their] own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to [their] community.” With a focus on recovery-orientated language, throughout this website, we use the terms “mental health or substance use challenges” to identify the spectrum of conditions listed in the DSM-V.

Métis identity is not an individualized identity, rather it is formed and expressed through Métis community. Métis are not simply a mixed ancestry people; they come from historic communities that emerged before Canada was Canada. There were distinct networks of communication from Western Ontario across the homeland and into BC. Although connected to both the Fur Trade and to First Nation’s communities, Métis are recognized as being distinct and separate from their First Nation and European relatives.

Care/practices that are based on the principle that each individual is unique and autonomous, in both their illness and health. Providing all options and respecting autonomy and agency in decision making is at the forefront of person-centred care. The use of “person” over “patient” captures a wider dimension of the individual as a human being, including social, cultural, religious, economic, and environmental elements, focusing on the totality of the person. 

Psychosocial rehabilitation (also termed psychiatric rehabilitation or PSR) promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental illness or a mental health and/or substance use concern.

Racism is the belief that a group of people are inferior based on the colour of their skin or due to the inferiority of their culture or spirituality. It leads to discriminatory behaviours and policies that oppress, ignore, or treat racialized groups as “less than” non-racialized groups.

The Truth and Reconciliation Commission of Canada Report defines reconciliation as a continuous effort to build and sustain respectful relationships. Its core themes of respect, relationships, and cultural safety are integral to the work of reconciliation.

A singular definition of recovery from mental illness does not exist. Clinical recovery, institutional recovery, and personal recovery have emerged as different concepts in an attempt to provide clarity to the idea of recovery understood as reaching optimal well-being in and despite a mental health challenge(s). ‘Clinical recovery’ is defined as the complete alleviation of symptoms, while ‘institutional recovery’ has emerged as the absence of mental health resource utilization. A frequently cited definition of personal recovery is: “a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills, and roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by the [mental] illness. Recovery involves the development of new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness” (Anthony, 1993, p. 15) ACT teams acknowledge that recovery concepts overlap; that recovery is an individual, subjective experience that is influenced by an interaction between (1) contextual factors (for example, health policies, employment opportunities), (2) individual factors (for example, diagnoses, history, personal identity) and (3) choice. ACT teams do not interpret recovery as sobriety or abstinence.

The Mental Health Commission of Canada outlines six dimensions of recovery-oriented practice: 

1. Creating a culture and language of hope
2. Recovery is personal 
3. Recovery occurs in the context of ones life
4. Responding to the diverse needs of everyone 
5. Working with First Nations, Inuit and Metis
6. Recovery is about transforming services and systems

Describes the services to be provided under a specific model of care, including who provides the services, where it is delivered, and  what resources are required to meet the health needs of the population the model is meant to serve. 

Systematic racism, is defined as policies and practices that exist throughout a whole society or organization that result in and support a continued unfair advantage to some people and unfair or harmful treatment of others based on race or ethnic group.

Systemic racism is enacted through routine and societal systems, structures, and institutions such as requirements, policies, legislation, and practices that perpetuate and maintain avoidable and unfair inequalities across racial groups including the use of profiling and stereotyping.

There is no commonly accepted definition for adult tertiary care in B.C. In general, this level of care refers to a range of services for patients who require more intensive care than primary or secondary services. Adult tertiary care is only one level of care within the broader mental health and substance use system of care. Patients often move through several levels of care in the course of their lives, depending on the severity of their condition and intensity of services they require. ACT is one service that falls under tertiary care.

A traditional territory is the geographic area identified by a First Nation as the land they and/or their ancestors traditionally occupied and used.

A traumatic event involves a single experience, or enduring repeated or multiple experiences, that completely overwhelm the individual’s ability to cope or integrate the ideas and emotions involved in that experience. 

A way of providing service to people in a manner that is welcoming and appropriate to the special needs of those affected by trauma. Core Trauma-Informed principles are about: Trauma Awareness; Emphasis on Safety and Trustworthiness; Opportunities for Choice, Collaboration, and Connection; Strengths Based and Skill Building

Refers to land that was not turned over to the Crown (government) by a treaty or other agreement.