Mental Health and Substance Abuse Services Preferences among American Indian People of the Northern Midwest

Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE 68588-0324, USA.
Community Mental Health Journal (Impact Factor: 1.03). 01/2007; 42(6):521-35. DOI: 10.1007/s10597-006-9054-7
Source: PubMed


This study examines factors that influence preferences between traditional cultural and western mental health and substance use associated care among American Indians from the northern Midwest. Personal interviews were conducted with 865 parents/caretakers of tribally enrolled youth concerning their preferences for traditional/cultural and formal healthcare for mental health or substance abuse problems. Adults strongly preferred traditional informal services to formal medical services. In addition, formal services on reservation were preferred to off reservation services. To better serve the mental health and substance abuse treatment needs of American Indians, traditional informal services should be incorporated into the current medical model.

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Available from: Dan R Hoyt, Oct 05, 2015
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    • "From sweat lodges [1,2] to traditional teachings [3,4], these regionally diverse interventions are commonly located within the context of Indigenous treatment programs and integrated into existing treatment practices [5]. They are led by individuals who are sanctioned and recognized by traditional teachers, community members, and spiritual beings to facilitate cultural activities [6,7]. For example, in Canada, the 56 National Native Alcohol and Drug Abuse Programs and nine Youth Solvent Addiction Program treatment centres emphasize that Indigenous traditional culture is vital for client healing and wellness [8]. "
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    ABSTRACT: Background Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.
    Substance Abuse Treatment Prevention and Policy 09/2014; 9(1):34. DOI:10.1186/1747-597X-9-34 · 1.16 Impact Factor
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    • "The extent to which treatment programs can facilitate connections with cultural educators or traditional healers would be extremely valuable in reaching AI/AN populations. A clinical implication would be to query where people would most want to seek help such as family and friends, traditional healers, specialty substance abuse treatment agencies, mental health agencies, and primary care settings (Beals, Novins, Spicer, et al., 2006; Walls et al., 2006). "
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    ABSTRACT: The majority of people with alcohol use disorders do not seek formal treatment. Research on barriers to help-seeking have only recently focused on ethnic minority populations. The present study investigated the extent to which an adult American Indian (AI) sample experienced similar and/or unique barriers to help-seeking as have been reported in the literature. Using both qualitative and quantitative methods, 56 (54% male) AIs with lifetime alcohol dependence completed a semistructured face-to-face interview and a self-administered written survey. Interviews were tape recorded, transcribed, and coded for four major themes: personal barriers, pragmatic barriers, concerns about seeking help, and social network barriers. Quantitative data provided percentage endorsing each survey item and strength of each barrier, which were categorized according to the four major themes. In previous research, most barriers questionnaires have not queried for cultural concerns or how the specific type of help may be a mismatch from the client's perspective. Given the rapidly changing racial/ethnic demography in the United States, further research addressing cultural and spiritual concerns as well as more common barriers is indicated. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
    Cultural Diversity and Ethnic Minority Psychology 09/2012; 18(4):352-62. DOI:10.1037/a0029757 · 1.36 Impact Factor
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    • "Culture-based interpretations of AI SUDs treatment failure are supported by the literature. For example, in one study, AIs with a variety of psychiatric problems expressed preferences for " traditional " informal services instead of formal medical services (Walls et al. 2006), and in another study were as likely or more likely to consult traditional healers for help in comparison to actual behavioral health professionals (Beals et al. 2005). Although the reasons for AI reluctance to participate in counseling have not been well studied, one plausible explanation is the " western " cultural assumptions that undergird modern counseling. "
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    ABSTRACT: Contemporary tribal commitments to traditional cultural reclamation and revitalization find continued expression by recent generational cohorts of American Indians who, when it comes to matters of recovery, healing, and wellness in the context of substance abuse, routinely assert that "our culture is our treatment." And yet, empirical investigations of this culture-as-treatment hypothesis--namely, that a (post)colonial return to indigenous cultural orientations and practices is sufficient for effecting abstinence and recovery from substance use disorders for many American Indians--have yet to appear in the scientific literature. Preliminary activities of a research partnership dedicated to the empirical exploration of this hypothesis for reducing Native American substance use disorders are summarized. Specifically, collaboration between a university-based research psychologist and a reservation-based substance abuse treatment program staff has thus far resulted in a detailed blueprint for a radically alternative, culturally-grounded intervention developed for reservation residents. This proposed alternative intervention--a seasonal cultural immersion camp designed to approximate the day-to-day experiences of prereservation ancestors--was designed for eventual implementation and evaluation with adult clients referred for residential treatment on the Blackfeet Indian reservation. It is anticipated that the proposed intervention will eventually afford empirical evaluation of the culture-as-treatment hypothesis.
    Journal of psychoactive drugs 10/2011; 43(4):291-6. DOI:10.1080/02791072.2011.628915 · 1.10 Impact Factor
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