American Indian and Alaska Native Mental Health Research最新文献

Family relationships are an important source of emotional and instrumental support. In American Indian (AI) communities, families often provide support for women during childbirth and childrearing. The present study sought to gain insight into the influence of family during the pregnancy, childbirth, and childrearing experiences of AI women from a Gulf Coast tribe. A qualitative descriptive research design was used, and 31 interviews were conducted with women from the tribe. The average age of participants was 51.17, and the majority of women had 2 to 3 children. Data was analyzed using a content analysis approach. Themes that emerged include: Influence of Childhood on Participant's Families and Parenting Styles, Significance of Family Emotional Closeness, Significance of Family Physical Closeness, Importance of Taking Care of Family Members, Importance of Family in Childbirth, and Generational Shifts in Caregiving. Results of the study may influence health interventions for this community, and results should encourage health care providers to consider positive implications of including family and community supports in care.

The diverse American Indian and Alaska Native (AI/AN) population suffers health inequities perpetuated by colonialism and post-colonialism. The urban AI/AN population is steadily increasing in part because of federal policies relocating AI/AN away from tribal lands. However, studies of AI/AN urban communities are rare, and efforts to understand and ameliorate health inequities in AI/AN communities typically emphasize deficits rather than capacities. Resilience is an important resource in this context but mainstream, rather than community-derived definitions of resilience, predominate. The present study used multi-investigator consensus analysis in a qualitative study to identify urban American Indian (AI) derived concepts and construct a definition of resilience. The study included 25 AI adults in four focus groups in three urban locales in the southwestern United States. Four resilience themes emerged: 1) AIs built strength through toughness and wisdom; 2) the value of traditional 'lifeways' (i.e., elements of traditional culture that help people navigate their journey through life); 3) the importance of giving and receiving help; and 4) the interconnectedness of Native lifeways, family relationships, and tribal and urban communities. Themes overlap with extant resilience conceptualizations but also provide unique insights into structure and function of urban AI resilience in the Southwest United States.

Elder tribal members are important cultural and spiritual leaders and experts among many American Indian and Alaska Native (AI/AN) cultures. AI/AN Elders play a key role in the maintenance and transmission of traditional cultural knowledge and practices and are highly valued members of AI/AN communities. AI/AN populations face disparities in healthcare outcomes, and the healthcare needs of AI/AN Elders remain an understudied area of research, particularly among tribes in the South and for tribes who do not have federal recognition. Qualitative data was collected through semi-structured interviews among 31 women, all of whom are members of a state-recognized Tribe in the Southern United States. While the interview questions were specific to their own reproductive healthcare experiences, repeated concerns were voiced by the women regarding the health of the Elders in their community. Key findings captured several concerns/barriers regarding Elders' healthcare experiences including: (a) Language and communication barriers between Elders and healthcare workers; (b) Prior negative experiences with Western medicine; (c) Lasting impacts of educational discrimination; (d) Concerns over self-invalidation; (e) Transportation barriers; and (f) Need for community programs. Issues related to these barriers have resulted in a concern that Elders are not receiving the full benefit of and access to Western healthcare systems. The purpose of this analysis was to highlight the concerns voiced by women tribal members on the health and wellbeing of Elders in their community. Opportunities related to the importance of prioritizing and improving AI/AN Elders' healthcare experiences and access are also described.

Indigenous communities suffer from the highest rates of mental health disparities of any ethnic group in the United States, as well as experience significant amounts of historical and contemporary trauma including violence, racism, and childhood abuse. Unfortunately, the mental health workforce is unprepared to effectively work with this population due to the influence of stereotypes, bias, and lack of training. A 90-minute training for mental health agency employees using decolonizing methods was delivered to improve knowledge of and empathy for Indigenous patient populations (N = 166). Results indicated that the training increased participants' Indigenous knowledge and beliefs across demographic variables and may increase aspects of empathy including awareness. This training was feasible for a wide variety of mental health employees and resulted in increased learning about Indigenous people, which is a critical starting point for mental health professionals working with this population. Suggestions are offered to train mental health providers to deliver culturally responsive care to Indigenous clients and families and for decolonizing mental health professions.

Although over 70% of American Indians and Alaska Natives (AI/ANs) reside in urban areas, our knowledge of urban AI/AN adults receiving mental health treatment is limited. This study compares primary psychiatric diagnoses, commercialized tobacco use, and homelessness between AI/AN and non-AI/AN adults receiving services in an urban public mental health agency serving primarily AI/AN people in southern California. Depressive disorders were the most common psychiatric diagnoses for both groups. However, AI/AN adult clients demonstrated significantly less anxiety disorders and significantly more homelessness. Schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, and commercialized tobacco use were higher among AI/AN adults compared to non-AI/AN adults. Results from this study offer data needed to further understand important public health issues that exist among AI/AN adults receiving mental health services in urban areas. We provide suggestions to enhance integrated and culturally appropriate treatment approaches and homelessness initiatives for this under-resourced, yet resilient population.

Historic loss and historic loss-associated symptoms were examined in a cross-section of 60 American Indian and Alaska Native students attending a Native American serving college that is also a former Indian boarding school. To measure awareness of current events regarding finding unmarked graves at boarding schools, authors developed and used the Truth and Reconciliation Scale. Levels of self-compassion were assessed in participants to determine if there was a correlation between negative feelings towards oneself and psychological risk factors brought forth as a result of how aware students were of current events surrounding former Indian boarding schools. Self-compassion was predicted to act as a protective factor and a positive coping mechanism for those most impacted by historic loss and intergenerational trauma. Participants reported thinking about, and being psychologically impacted by, historic loss. Psychological impacts were stronger in participants who were more aware of current reconciliation efforts and those who had higher levels of negative thoughts towards themselves. This suggests the possibility that current events, such as the finding of unmarked graves at former Indian boarding schools, might be increasing trauma responses in current students. Working to reduce negative thoughts about self and increase self-compassion may help buffer the negative impacts of the current truth and reconciliation work. Researchers and practitioners are encouraged to engage in more research and practice exploring the potential benefits of self-compassion for those adversely affected by historic loss, thus improving the likelihood of cultural revitalization from a broad perspective.

Despite their recent high-profile removal by a handful of professional sports teams, Native-themed mascots continue to be a mainstay of professional, college, and youth athletics. To determine the extent of the literature on the health impacts on American Indians and Alaska Natives (AI/ANs) as a result of Native-themed mascots, we conducted a scoping review of primary research articles, utilizing the National Institute on Minority Health and Health Disparities (NIMHD) research framework as a guide to define health impacts broadly to include impacts on determinants of health and health disparities. Three databases were utilized, MEDLINE/PubMed, PsycINFO, and JSTOR, to identify the peer-reviewed literature for a twenty-year period that studied the health impacts of Native-themed mascots. We found 26 articles and books in the peer-reviewed literature and additional gray literature during the time period of 1999-2019. To better identify the relationship between Native-themed mascots and health impacts, we reviewed the articles by their focus on three groups: AI/ANs generally, AI/AN youth, and those that studied all races/ethnicities. The majority of research included in this review illustrates overall negative impacts of Native-themed mascots on health and its determinants that influence health and health disparities. Public health efforts should include review and replacement of harmful Native-themed mascots in professional and academic sports to avoid negative health impacts on AI/AN adults and youth.

Culturally grounded after-school programs (ASPs) aim to promote health and well-being among Indigenous youth. Native Spirit is a 10-session ASP that focuses on local cultural values and activities facilitated by local cultural practitioners. This pilot study used a single group, pretest-posttest design (N = 18) with Indigenous adolescents in grades 7-12 and conducted participant interviews (N = 11) to assess the impact of the program on cultural identity, self-esteem, and resilience. There were immediate post-program increases in mean strength in cultural identity (p = 0.002), resilience (p = 0.161), and self-esteem (p = 0.268). Themes related to benefits of program participation included curiosity and commitment to cultural identity, increases in self-esteem, and ability to build resilience. This study provides new insights on the relationship between cultural engagement and adolescent health.

The COVID-19 pandemic has disproportionately impacted American Indian and Alaska Native (AI/AN) communities. Tribes, tribal organizations, AI/AN youth and community-serving programs, and tribal health organizations have responded and adapted programs and services in response to the COVID-19 pandemic. This paper explores how COVID-19 impacted Native PRIDE, an American Indian non-profit organization, and the tribal communities involved in the Intergenerational Connections Project (ICP). Native PRIDE utilized a mixed-method Indigenous Evaluation Framework (IEF) to reflect on COVID-19 impacts. Qualitative data collected during the COVID-19 pandemic and quantitative data from an online survey helped Native PRIDE explore impacts and recommendations for future programming. With a focus on context and relationship, this paper explores what was felt, observed, and known by program participants and Native PRIDE staff in the delivery of ICP during the COVID-19 pandemic. Results from this evaluation are a reminder of the importance of strengthening cultural resilience by providing access and opportunities for AI/AN youth, elders, and adults.