Depression is very common. In Canada, more than 1 in 10 people will experience major depression in their lifetime, with even higher rates among Indigenous Peoples. While there are many effective treatments, antidepressants are the main publicly funded option for moderate to severe major depressive disorder (MDD) in BC. However, many people struggle to find a treatment that both relieves symptoms and avoids side effects. For over half of those with MDD, the first prescribed medication is not effective, which can lead to treatment discontinuation, poorer long-term outcomes and higher overall costs. 

An individual’s genetic makeup can influence how well medications work and whether they cause side effects. Pharmacogenomic (PGx) testing uses genetic information to guide medication selection and dosing. Although PGx testing for antidepressants is not currently publicly covered in Canada, it is gaining attention from policymakers in BC. Yet, studies have not explored the views of Indigenous Peoples in Canada on PGx testing. 

Given the history of colonization and harms in healthcare and genetic research, it is essential to explore ethical issues and Indigenous perspectives on mental healthcare and PGx testing. Without this, there is a risk of furthering harm, deepening mistrust and widening health inequities, as well as missing the opportunity to identify safeguards and culturally appropriate approaches. 

To address this, the project will hold interviews with key partners and community discussions with Indigenous Peoples across BC. This work will generate recommendations for implementing PGx and identifying priorities for Indigenous-led PGx projects. The project will also co-produce resources to raise awareness and understanding.