Substance abuse among urban Aboriginals: association with a history of physical/sexual abuse

This paper reports findings of a study of mental health among urban Aboriginal peoples. Both qualitative and quantitative techniques were used to explore the relationship between substance abuse and physical/sexual abuse in a sample of Aboriginal peoples living in an urban community. Open-ended interviews were conducted in a sample of 30 Aboriginals that included Aboriginal social service providers (from health, legal and family services). Forty percent of the sample had been abused and many experienced social, psychological and emotional problems associated with abusive experiences. Content analysis of the interviews revealed common themes in violence discourse including loss of identity and control, the normalization of violence, and revictimization. Substance use, family dysfunction, and difficulty in interpersonal relationships were also associated with abuse experiences. When the sample was stratified for history of physical and/or sexual abuse, the analyses indicated that social, psychological and behavioural problems were amplified among those with histories of abuse. Rates of recent and lifetime psychological distress were highest among those who had been both physically and sexually abused. In addition, females were more likely to have been physically and sexually abused (males 25.6% versus females 48.4%, p < 0.001). Family dysfunction was a key indicator of psychological problems among abuse victims. In particular, a family history of psychological problems was strongly associated with physical/sexual abuse. While rates of family history of drug or alcohol problems are high for abused and non-abused individuals alike, those who had experienced physical abuse or physical/sexual abuse rated higher for a current substance abuse problem. It is suggested that issues such as family functioning and the intergenerational transmission of violent behavior and substance abuse be pursued in future mental health research among urban Aboriginal peoples.