Defining health and unhealthiness: Perceptions held by Native American Indians with persistent mental illness1

Abstract

Discrepancies in definitions of health exist. These discrepancies, if not acknowledged, create major communication gaps between health-care professionals and their clients, which interferes with the provision of culturally responsive care. The purpose of this study was to understand how Native American Indians experiencing persistent mental illness (PMI) define/describe being healthy and being unhealthy. Grounded theory design was used in conducting data gathering (semistructured interviews) and analysis (constant comparative) because the study focuses on generating social/psychological phenomena or process. Forty-four audiotaped interviews were conducted and transcribed. Symbolic interactionism is this study's framework. During data analysis, health emerged as being in balance/equilibrium, having a sense of harmony, and not being out of control of spiritual, cognitive, emotional, and physical domains. Furthermore, as this study reflects, the modified Circle of Wellness model emerges as a better fit for Native American Indians with PMI than the traditional Medicine Wheel because it more effectively presents the social nature/needs and the centrality of spiritualism of this population. Clearly, deficits in healthy social environments and relationships affect the ability of a Native American Indian with PMI to maintain health. To provide culturally competent care, professionals and native healers need to work the integration of spirituality into treatment processes, and advocate the creation and maintenance of healthy environments for improved social opportunities. 1The opinions expressed in this manuscript are those of the authors and do not necessarily reflect the views of Indian Health Services. The following presentation was reviewed and approved by four Tribal Councils and five Service Unit Directors in either a passive understood agreement manner or by a signature of agreement.