American Indian Psychiatric and Social Problems

Abstract

This paper is an overview of the past 15 years of research on American Indian psychiatric and social problems. Since the development of the first mental health program in the Indian Health Service (IHS) in 1967, there has been a significant increase in published articles on this topic. The number of relevant citations has doubled each decade, rising from 48 in the 1930s to 759 in the 1970s (Kelso and Attneave 1981). More important, in the past decade we have witnessed greater participation by American Indian scholars who have contributed significantly to the field with papers which put increased emphasis on indigenous syndromes, the relevance of service programmes, and the need for appropriate tribal sanction for research. The focus of recent investigations is shifting from anecdote and description to data-based studies covering many aspects of American Indian behaviour, including patterns of mental health and illness, socio-cultural determinants of behaviour, and developmental stages. In this paper we have included major contributions from all these areas.The paper is organized in ten sections. We first review the development of new Indian programmes and consider their impact on subsequent field studies and publications on Indian mental health.We then discuss emerging trends in mental health service utilization patterns, psychiatric epidemiology, and the renewed emphasis on understanding indigenous forms of illness and adjustment. Other sections consider depression and suicide, substance abuse and alcoholism, social pathologies, Indian children, prevention, and research approaches. Because of the importance of the subpopulation of Indian children, relevant studies concerning them are summarized separately. EMERGING NETWORKIn the mid 1960s, Bergman, Mindell, and Bloom were appointed as area mental health directors for the IHS on the Navajo and Oglala at University of Texas Libraries on June 6, 2015 tps.sagepub.com Downloaded from

Indigenous suicide in Australia, New Zealand, Canada and the United States

“…Increasing youth suicide rates have been documented with rates increasing for males aged 15–25 years, from 4.1 to 12.1 per 100 000 between 1958 and 1982 35 . However, intergroup differences are considerable 18 with rates up to the 1970s varying from 8 to 120 per 100 000 36,37 . Similar caveats are suggested in a recent review, which pointed to a three‐fold increase among adolescents and young adults to levels some two to three times higher than for the nation as a whole, with males constituting approximately two‐thirds of all suicides between 15 and 34 between 1979 and 1992 11 .…”

Factorial structure of the Center for Epidemiologic Studies—Depression Scale among American Indian college students.

“…Comparisons of the factor structure across gender demonstrated that the differences were due largely to 1 item: cry. The implications of this work in the context of studies with other populations are discussed.Depression is among the most frequently acknowledged psychopathologies in American Indian communities, second only to suicide and alcoholism (Shore & Manson, 1983). Its occurrence has been linked to a variety of circumstances, including frequent interpersonal conflict (Ross & Davis, 1986), prolonged, unresolved grief (Jilek-All, Jilek, & Flynn, 1978), chronic familial instability (Resnik & Dizmang, 1971), unemployment (Travis, 1984, and rapid culture change (Kraus & Huffier, 1979).…”

Suicidal ideation among American Indian youth

“…Indian youth, especially during adolescence (Berlin, 1986;Blum, Harmon, Harris, Bergeisen, & Resnick, 1992;Shore & Manson, 1983). In two studies of high school students, a greater proportion of American Indian adolescents met diagnostic criteria for clinical depression than did non-Native adolescents (cited in U.S. Congress, Office of Technology Assessment, 1990).…”