We present three community case studies for how community development and cultural enhancement affected mental health as an epiphenomenon.

An initiative was undertaken in 3 Northern Canadian aboriginal communities to enhance spiritual and cultural fluency and to provide opportunities to healthy interaction among community members. We began each process with a narrative investigation of the community by eliciting stories about perceived problems in the community. We collected further narratives at the end of the intervention about how it had affected people personally. We reviewed the narratives for commonalities and themes using modified grounded theory and dimensional analysis. We measured numbers of patients presenting to behavioral health services with mental health diagnoses, number of people sent to hospital for mental health treatment, and number of suicide attempts. We collected quality of life data using the My Medical Outcome Profile 2.

Community development and cultural enhancement efforts reduced all of the variables we were tracking. Follow-up interviews revealed common themes of people becoming more present-centered, feeling higher quality in their relationships; feeling more connected to god, creator, nature, or higher power; feeling more peaceful; feeling more accepting of death and change; and having a greater sense of meaning and purpose. As an interesting side effect, people began to eat more traditional diets and to be more active.

Creating opportunities for community interaction and shared community projects and enhancing interactions with spiritual elders resulted in improvement in indices of mental health in three indigenous communities in Northern Canada.

The authors have not supplied their declaration of competing interest.