Overview

American Indians and Alaska Natives (AI/AN) make up approximately 1.5% of the U.S population. This means that about 4.1 million Americans identify themselves as having American Indian or Alaskan Native heritage, making them the smallest minority group in the country. Of these 4.1 million individuals 33% of them lack health insurance and about 57% of AI/AN rely only on the Indian Health Services (IHS) for care.

Mental Health

Unfortunately research on mental health among AI/ANs is limited due to the small size of population and large variation between individuals identifying as AI/AN. The limited existing research suggests that AI/AN youths and adults suffer a disproportionate burden of mental health disorders and problems

  • American Indians and Alaskan Natives experience psychological distress 1.5 times more than the general population
  • The most significant mental health concerns currently are high prevalence of depression, substance use disorders, suicide, anxiety, and PTSD
    • AI/ANs experience PTSD more than twice as often as the general population
    • Suicide is the second leading cause of death among 10-34 year old AI/AN, however the suicide rate among AI/AN over 75 is only one-third of the suicide rate of the general population
  • This is some variation in how American indians and Alaskan Natives experience mental health
    • Suicide rates among Alaskan Natives are twice the national average
    • Alaskan Natives experience five times more alcohol-related deaths than any other group
    • Native American use and abuse alcohol and other drugs at younger ages, and at higher rates than all other ethnic groups

Mental Health Status, Services, and Disparities

There are a wide range of different beliefs among American Indian and Alaskan Native people about illness, healing, and health. Their beliefs and theories about mental illness and how it develops may not align with standard diagnostic categories and criteria.

American Indians who meet the criteria for depression, anxiety or substance abuse are significantly more likely to seek help from Traditional/Spiritual Healers than from specialists or other medical sources

  • Traditional health systems focus on balancing the mind, body, and spirit within a community context
  • Their focus is not on single parts of the body but rather treating the individual as a whole
  • Only 11-13% of AI/AN seek out professional mental health care when dealing with behavior/emotional mental health problems
  • Some research has found that an above average amount to Native American do seek out mental health services for alcohol and substance use

Protective Factors

Although American Indians and Alaskan Natives have a long history of oppression and mental illness there are many built in protective factors within their community that may help to combat the progression of mental health problems.

These protective factors include:

  • Strong identification with culture
  • Strong connection with family and community
  • Connection with the past
  • The wisdom and guidance of elders within the community

Because of the strong community connections and group identification within the American Indian and Alaskan Native communities there is an abundance of community support for individuals dealing with mental health problems

Barriers to Care

Although the Native American and Alaskan Native communities have built in support systems they still experience barriers to care and challenges to their health and wellbeing that interfere with access to treatment and the willingness to pursue treatment even where it is offered.

Some of the challenges to health and well-being that Native American and Alaskan Natives face are:

  • A long history of alcohol misuse and abuse within the community and culture.
  • Strong, and resilient cultures make it harder to accept change.
  • There are often clashes between  AI/AN and non-AI/AN views of mental health causes and treatment.
  • There is a history of communal trauma and oppression.
  • A lack of awareness about mental health issues and services and strong stigma associated with mental illness.
  • There is continual pressure to assimilate to the “American” way of life and abandon the traditions of the AI/AN culture to fit in.

Along with challenges to health and well-being Native Americans and Alaskan Natives also face many barriers that limit their ability to access care.

These access to care issues include:

  • Lack of education.
  • Rates of poverty and unemployment that are over twice the national average.
  • Lack of health insurance.
  • Limited availability of appropriate services.
  • Historical and cultural mistrust of health care provider.
  • Lack of accurate data and research on the American Indian and Alaskan Native population.
  • Lack of intervention strategies that integrate traditional/holistic approaches and biomedical health care.

How Can We Fix This?

Now that we know that there are many issues with the mental health care of American Indians and Alaskan Natives what can we do to ensure this population gets access to the care they need and deserve?

  • Increase awareness of mental health and its connection to chronic diseases
  • Conducts stigma awareness training with members of the community
  • Educate providers about unique mental health issues in the American Indian and Alaskan Native population
  • Advocate for policies that promote social justice, equity, and equality
  • Create and provide comprehensive, affordable, health coverage for everyone
  • Shift the focus of mental health care to prevention and early intervention
  • Better integrate  traditional healing and spiritual practices with modern biomedical health care
  • Develop a  more person-centered care philosophy and respect of the importance of family and community
  • Health care providers treating American Indians and Alaskan Natives should familiarize themselves with the belief system and traditional treatment for mental illness used in the community to better integrate care
  1. Mental Health Disparities: American Indians and Alaskan Natives [Fact sheet]. (2014). Retrieved July 12, 2015, from American Psychiatric Association website: http://www.psychiatry.org/american-indians-alaska-natives
  2. Barcus, C. (2003). Chapter 5: Recommendations for the treatment of American Indian populations. Psychological Treatment of Ethnic Minority Populations, 24-28.
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  10. American Indians - Alaskan Natives.Retrieved July 12, 2015, from American Psychiatric Association website: http://www.psychiatry.org/american-indians-alaska-natives
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