Alaska Native Mental Health Research Articles

Perspectives of American Indian/Alaska Native Mental Health Practitioners on Psychological Distress, Social Support, and Wellness

Objective: This quantitative research study employed a correlational design to determine if there is an association between social support, psychological distress, and wellness among American Indian and Alaska Native mental health practitioners (AI/ANMHPs). Methods: A quantitative correlational approach examined to what extent a relationship exists between social support, psychological distress, and wellness among mental health practitioners who are Native American. The variable of psychological distress was measured by the Outcome Questionnaire 45 (OQ-45.2), the variable of social support was measured by the Multidimensional Scale of Social Support (MSPSS), the variable and the variable of wellness was measured using the Five Factor Wellness Inventory (5F-WEL). Results: The sample comprised 95 AI/ANMHPs in the United States. A Spearman’s rank-order correlation was used to explore the relationship between social support and psychological distress (RQ1) and social support and wellness (RQ2) among AI/ANMHPs. The results of the study indicate a statistically significant negative correlation between social support and psychological distress (rs= -0.386, p < .001) and a statistically significant positive correlation between social support and wellness (rs = 0.439, p < .001). Conclusions: The current study found two statistically significant correlations. Social support was statistically significantly negatively correlated with psychological distress, and social support was statistically significantly positively correlated with overall wellness. These findings suggest that as the NAMHPs perceive more social support, their psychological distress decreases; so, NAMHPs need more culturally responsive support if they want to manage distress.

The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults: Guideline V. Assessment of Cultural Factors.

(Excerpted from "The American Psychiatric Association Practice Guidelines for the Psychiatric Evaluation of Adults, Third Edition." Copyright © 2016, American Psychiatric Association. Reprinted with permission.).

The Collaborative Research Center for American Indian Health's Partnership River of Life: Special Issue Introduction.

In 2012, the National Institutes of Health funded the Collaborative Research Center for American Indian Health (CRCAIH) to work toward two broad goals: 1) to build tribal research infrastructure, and 2) to increase research on social determinants of health in American Indian communities. As the introduction to this special issue of American Indian and Alaska Native Mental Health Research, we highlight results from the Partnership River of Life evaluation tool in order to provide broader context for the other manuscripts presented here. Insights were gained during the Partnership River of Life group discussion and evaluation process of combining the groups' rivers to create one representation of the CRCAIH partnership. Detailed results underscore insights for similar transdisciplinary groups.

We Will be Known Forever by the Tracks we Leave: Rising up to Meet the Reproductive Health Needs of American Indian and Alaska Native Youth

Many U.S. adolescents of all races/ethnicities engage in multiple behaviors that increase their risk for poor reproductive health outcomes (Eaton, 20101; Everett Jones, Anderson, Lowry, & Conner, 2011; Ramisetty-Mikler & Ebama, 2011; Rutman, Park, Castor, Taualii, & Forquera, 2008). American Indian and Alaska Native (AI/AN) youth are disproportionately affected by poor reproductive health outcomes, including high rates of sexually transmitted diseases (STDs) and teen pregnancy. Peer-reviewed literature on AI/AN reproductive health issues is sparse and often not generalizable to all AI/AN because of small and geographically specific study populations. In the limited studies that have been conducted, some have shown high rates of STDs and teen pregnancy among AI/AN adolescents may result from a lack of familial support, a history of sexual and physical abuse, and early sexual debut (Palacios & Kennedy, 2010); alcohol and substance use and low and inconsistent condom use (Kaufman, 2006); and multiple sex partners (Marsiglia, Nieri, & Stiffman, 2006). The Journal of American Indian and Alaska Native Mental Health Research disseminated the call for submissions for this special issue through its extensive formal and informal networks. The journal received 11 submissions; 9 of those are included in this special issue of the journal and 2 will appear in a later issue. No submission was rejected. Authors were instructed to attain necessary approvals prior to submission. Every author was assigned a mentor to help polish and finalize the manuscripts; the articles were reviewed by two external reviewers with expertise in the manuscripts’ subject areas. We hope that this special journal issue on sexual risk behaviors and assets among AI/AN youth will lead to increased attention and efforts to meet the health care needs of Native youth and that the tracks that we leave will lead to the elimination of health disparities. STD rates among AI/AN youth are among the highest in the country. In 2009, non-Hispanic AI/ANs had the second highest rates of STDs in the U.S.; compared to non-Hispanic White (NHW) youth, they were 4.5 times as likely to be diagnosed with chlamydia, more than three times as likely to be diagnosed with gonorrhea, and twice as likely to be diagnosed with primary or secondary

American Indian and Alaska Native Mental Health: Diverse Perspectives on Enduring Disparities

As descendants of the indigenous peoples of the United States, American Indians and Alaska Natives (AI/ANs) have experienced a resurgence in population and prospects since the beginning of the twentieth century. Today, tribally affiliated individuals number over two million, distributed across 565 federally recognized tribal communities and countless metropolitan and nonreservation rural areas. Although relatively little evidence is available, the existing data suggest that AI/AN adults and youth suffer a disproportionate burden of mental health problems compared with other Americans. Specifically, clear disparities have emerged for AI/AN substance abuse, posttraumatic stress, violence, and suicide. The rapid expansion of mental health services to AI/AN communities has, however, frequently preceded careful consideration of a variety of questions about critical components of such care, such as the service delivery structure itself, clinical treatment processes, and preventive and rehabilitative program evaluation. As a consequence, the mental health needs of these communities have easily outpaced and overwhelmed the federally funded agency designed to serve these populations, with the Indian Health Service remaining chronically understaffed and underfunded such that elimination of AI/AN mental health disparities is only a distant dream. Although research published during the past decade has substantially improved knowledge about AI/AN mental health problems, far fewer investigations have explored treatment efficacy and outcomes among these culturally diverse peoples. In addition to routine calls for greater clinical and research resources, however, AI/AN community members themselves are increasingly advocating for culturally alternative approaches and opportunities to address their mental health needs on their own terms.

Addressing psychosocial issues and problems of co-morbidity for Native American clients with substance abuse problems: a conference proceedings.

This proceedings consists of five papers presented at a conference titled: Psychosocial Issues and Problems of Co-Morbidity for Native American Clients with Substance Abuse Problems. The conference was held June 2-4, 1999, in Albuquerque New Mexico, and was hosted by the Native American Research and Training Center (NARTC) and the National Center for American Indian and Alaska Native Mental Health Research.

The Zuni Life Skills Development Curriculum: A Collaborative Approach to Curriculum Development

IThis article describes the development, implementation, and pilot evaluation of a skills-based suicide prevention curriculum for the Zuni Pueblo. The Zuni Life Skills Development curriculum takes a skills training approach to reduce the risk factors for suicide among Zuni adolescents. This article presents some background information about skills training and its applicability to Indian cultures and suicide prevention. The process by which curriculum development was initiated and maintained is described, with an emphasis on the collaborative efforts between the Zuni community and Stanford researchers and the challenges faced by each to develop a culturally sensitive, effective curriculum. Results of the process and outcome evaluation of a pilot test are described in detail as background for the reasoning behind modifications made in a revised curriculum and evaluation design that met the needs and concerns of the community, school, and researchers. An overview of additional efforts in the community to develop a more comprehensive approach for suicide prevention that moves beyond a curriculum-only intervention is presented. (Abstract Adapted from Source: American Indian and Alaska Native Mental Health Research, 1994. Copyright © 1994 by the National Center for American Indian and Alaska Native Mental Health Research) For more information on the American Indian Life Skills Development Curriculum, see VioPro 2942. Late Adolescence Early Adolescence Senior High School Student Native American Juvenile Native American Suicide School Based Suicide Prevention Juvenile Suicide Juvenile Development Youth Development Social Skills Development Prosocial Skills Curriculum Prevention Program Program Evaluation Program Effectiveness New Mexico 10-04

Special Section: Training Practicing Anthropologists

No more than 60 American Indians and Alaska Natives currently hold doctoral degrees in the fields of anthropology, psychiatry, psychology, social work, and sociology. Only a few of these persons actually work in positions where they can directly impact American Indian and Alaska Native mental health programs. Moreover, lacking graduate level trained Indian professionals, many of these programs—as within the Indian Health Service, for example—have become almost solely dependent upon an Indian paraprofessional workforce. Communities and service agencies alike, however, prefer more trained Indian and Native psychologists, psychiatrists, social workers, medical sociologists, and medical anthropologists.