It is easy to be overwhelmed with the remarkably complex circumstances when considering American Indian and Alaska Native (AI/AN) communities across the United States and the mental health issues and needs of these tribes and/or individuals. Each tribe has a specific history, traditions, customs, and culture, and knowing something of these will help build an understanding of how mental health problems develop and how they are expressed. In addition to learning about a patient’s tribe, gathering a personal history takes time and effort. Issues of poverty, violence, survival, family morbidity and mortality, alcoholism and drug problems, suicide, racism, and historical trauma are often a part of their story.
It might be tempting to start a problem list and then formulate a treatment plan, as has been done so many times before in Western medicine, but what are the issues in need of treatment? What are the odds of a treatment plan resolving the problems? What is the patient’s home environment? It is important to take time to think about the AI/AN communities and why chronic illnesses beset their lives. A historical review sheds light on the causes of behavioral health issues and other chronic medical problems.
Although vast improvements have been made over the past 20 years, including as part of federal agency efforts, AI/AN people still have a high prevalence of behavioral health problems and limited access to care relative to the overall US population.
Read more at PsychiatricTimes.com.
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