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.

Download full-text


Available from: Dan R Hoyt,
    • "Centuries of subjugation, dispossession, and other colonial tactics have given rise to contemporary Natives sensitivities surrounding the validity and appeal of long-subjugated Indigenous cultural practices vis-a-vis frequently imposed Euro-American ideals and institutions. In the context of ongoing inequality, discrimination , and marginalization, many Native community members today in both the US and Canada continue to express interest in—and even preference for—markedly Indigenous supports and services (Beals et al. 2005a, b; Walls et al. 2006). Despite the call by many within diverse Native communities for adoption and promotion of Indigenous practices within mental health services—and as different as biomedical and Indigenous approaches may be—the results of this analysis demonstrate that integrating Indigenous and biomedical healing practices may be particularly advantageous for addressing the unique health disparities that affect these communities. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This article reports insights from a 4-day Gathering of Native American Healers at the University of Michigan in October of 2010. This event convened 18 traditional healers, clinically trained service providers, and cross-cultural mental health researchers for a structured group dialogue to advance professional knowledge about the integration of Indigenous healing practices and conventional mental health treatments in community-based mental health services for Native Americans. Our thematic analysis of transcripts from five Roundtable sessions afforded several key insights and understandings pertaining to the integration of Indigenous healing and conventional mental health services. First, with reference to traditional healing, the importance of a rampant relationality, various personal qualities, Indigenous spirituality, and maintenance of traditional life and culture were accentuated by Roundtable participants. Second, for traditional healers to practice effectively, Roundtable participants posited that these individuals must maintain personal wellness, cultivate profound knowledge of healing practices, recognize the intrinsic healing potential within all human beings, and work for the community rather than themselves. In speaking to the possibilities and challenges of collaboration between Indigenous and conventional biomedical therapeutic approaches, Roundtable participants recommended the implementation of cultural programming, the observance of mutuality and respect, the importance of clear and honest communication, and the need for awareness of cultural differences as unique challenges that must be collaboratively overcome.
    American Journal of Community Psychology 09/2015; DOI:10.1007/s10464-015-9747-6 · 1.74 Impact Factor
  • Source
    • "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]. "
    [Show abstract] [Hide abstract]
    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
  • Source
    • "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). "
    [Show abstract] [Hide abstract]
    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
Show more