Early intervention in eating disorders with Indigenous youth: a qualitative exploration of clinician-perceived barriers and facilitators in Northwestern Ontario

Objective: The purpose of this program evaluation was 1) to report the demographic and clinical characteristics of Indigenous youth aged 15–24 with eating disorders (EDs) in Northwestern Ontario, Canada, and 2) to determine clinician-perceived facilitators and barriers to providing appropriate ED early intervention to Indigenous youth. Methods: A multimethod approach was used, collecting demographic and clinical data from 26 intake records at St. Joseph’s Care Group in Thunder Bay, Ontario. Seven clinicians participated in semi-structured interviews to discuss barriers and facilitators to early intervention for EDs. Results: Patients were primarily female (80.8%), in high school (61.5%), and diagnosed with anorexia nervosa (53.8%). Clinicians identified barriers included limited access, lack of evidence for culturally appropriate interventions, and other youth-specific challenges (other mental health diagnoses, food insecurity, and human rights concerns). Facilitators included practice-based evidence (cultural experiences and practices, flexible approach to the delivery of interventions, awareness of biases, virtual services, and continuity of services), partnership with communities, knowledge translation, and systemic supports. Conclusion: Recommendations for ED early intervention for Indigenous youth in Northwestern Ontario: increased funding and research, partnerships with communities, specialized intervention guidelines, training and education for community members and clinicians, peer networks, and development of community resources.