The COVID-19 pandemic and the Black Lives Matter movement have raised consciousness about the country’s persistent health inequities, but one group is often overlooked in efforts to reduce these disparities: American Indian and Alaska Native people. Data reveal troubling realities about the long-standing and escalating mental health conditions affecting the 3.7 million people in this population.
Alcohol-induced deaths were highest among American Indian and Alaska Native people at 172 per 100,000, followed by Latinx people at 26.6, Whites at 25.8, and Blacks at 18.4, according to national data from 2016. These deaths could be caused by alcoholic liver disease, mental and behavioral disorders due to alcohol use, degeneration of the nervous system, or other conditions related to alcohol consumption (Spillane, S. et al., JAMA Network Open, Vol. 3. No. 2, 2020). The largest escalations in suicide rates from 1999 to 2017 occurred in American Indian and Alaska Native women and men, with increases of 139% and 71%, respectively. By comparison, the increases for White women and men were 68% and 40%, and even less for other racial and ethnic groups (Curtin, S. C., & Hedegaard, H., Health E-Stats, 2019).
COVID-19 also disproportionately affected tribal communities. They experienced the largest drop in life expectancy of any racial and ethnic group in the United States during the pandemic.
Although these health disparities may seem intractable, Native American psychologists suggest that progress has been slow in part because the mental health profession needs to embrace a new paradigm to better serve American Indian and Alaska Native people. “The traditional understanding of mental health issues and the models for treating them are still rooted in a Western perspective,” said Art Blume, PhD, a clinical psychology professor at Washington State University who is Cherokee and Choctaw. “In psychology, we focus on treating the individual and promoting autonomy as a marker for health and well-being, but this is not necessarily the worldview of Indigenous people.” Traditionally, many tribes have viewed the world as an interdependent system in which the cosmos, the natural environment, and the community are connected to wellness, Blume added.
Rather than adapting empirically validated treatments from mainstream psychology, Blume is among a cadre of psychologists who are calling for the development of innovative treatment approaches based on American Indian and Alaska Native values and worldviews. As a start, practitioners and researchers must embrace cultural humility and a willingness to learn how the history of subjugation, oppression, and dispossession has affected tribal communities, said Harvard University’s Joseph Gone, PhD, a professor of anthropology and of global health and social medicine who is also past-president of the Society of Indian Psychologists. “Our way of life was considered hopelessly backwards and savage, and we were expected to become farmers and ranchers and learn reading, writing, and arithmetic,” said Gone, who is a member of the Aaniiih-Gros Ventre Tribal Nation of Montana. “The deep damage from the loss of identity contributed to postcolonial disorders such as suicide, trauma, and addiction.”
Read more at APA.org.
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