Lianne Tomfohr-Madsen

This thesis explores the lived experiences of six Indigenous students at the University of British Columbia who have accessed campus-based recovery support services for substance use. The study investigates the systemic, institutional, and cultural barriers that shape access to recovery, as well as the factors that support Indigenous students’ engagement and success in these programs. Guided by Indigenous Storywork methodology and framed within an Indigenous Culturally Responsive Theoretical (ICRT) framework, this research centers Indigenous voices and stories as sources of knowledge, resistance, and renewal. Through one-to-one Storywork interviews, participants described recovery as relational, non-linear, and deeply connected to land, ceremony, and community. Findings highlight the need for Indigenous-specific recovery spaces, Elder-led supports, and land-based healing in post-secondary settings.

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Background: Perinatal mental health challenges are common, yet research largely overlooks 2SLGBTQIA+ pregnant populations. Due to systemic discrimination and social exclusion, 2SLGBTQIA+ populations have elevated rates of mental health challenges, adverse birth and child health outcomes, and barriers to perinatal care. Gender diverse and sexual minority pregnant people also have intersecting identities, such as ethnicity, which has a well-established association with perinatal mental health outcomes. The current study investigated the intersecting impacts of sexual minority status and ethnicity on perinatal mental health.Methods: Using data collected from the Pregnancy During the COVID-19 Pandemic cohort, linear regression analyses were conducted to assess differences across sexual orientation in symptoms of depression and anxiety while controlling for covariates. The intersecting impact of sexual minority status and ethnicity on perinatal mental health was also examined. Social support was considered as a protective factor in secondary analyses.Results: Results indicated that sexual minority status was directly associated with increased symptoms of depression and anxiety during pregnancy beyond other known correlates. Models that included ethnicity better explained the variance in perinatal wellbeing, with significant main effects of sexual minority status and ethnicity on depressive symptoms. Interactions between sexual minority status and perceived social support did not significantly predict symptoms of depression or anxiety in adjusted models, but there was a significant main effect of perceived social support on symptoms of depression and anxiety.Discussion: Findings inform understanding of perinatal mental health for diverse sexual minority individuals, including resilience factors and targets for future intervention.

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