Best Practice Highlights for Working with Native American Patients
Source: American Psychiatric Association
Resource Type: Website or Webpage Article
Focus Population: BIPOC (Black, Indigenous, and People of Color), Behavioral Health Leaders, People who have experienced Trauma
Topics: Behavioral Health Organizational Guidance Docs, Culturally Specific Strengths and Resilience, Experience of Racism, Discrimination, and Oppression, Mental Health Treatment, Recovery from Mental Health or Substance Use Disorders, Trauma-informed
There are 3 million indigenous people in the United States, belonging to more than five hundred federally recognized nations. It’s important to remember that today Indigenous peoples mostly live in urban centers, rather than reservations, and are a heterogeneous group, representing hundreds of nations each with their own cultural practices and history. There are several significant periods in US History that exemplify the genocidal policies of the United States upon the American Indian. Indigenous Peoples have personal, and family histories of forced relocation. Examples include the Navajo Long Walk of 1864, a 300 mile forced march of 8,000 Navajos to a military concentration camp in southern New Mexico; and the Cherokee “Trail of Tears” in 1838, a forced march of Cherokee women and children from their homelands in Georgia and Alabama to Oklahoma. Subsequently, beginning with The General Allotment Act of 1887 and continuing through the 1960s, forced assimilation and land appropriations led to the termination of more than 100 Indigenous nations and the widespread seizure of Indigenous lands. The United States eventually created federally recognized reservations, in Canada these were called Reserves, many not on the indigenous sacred homelands.
This history of trauma has resulted in intergenerational trauma. Children being forcibly removed from their homes to be raised in boarding schools still impact how parents raise their children. Indigenous peoples experience higher rates of substance use and related disorders, PTSD, and suicide, all of which are directly associated with this intergenerational trauma on Indigenous peoples. As one staggering example, Indigenous peoples are 526% more likely to die from alcohol use than are non-indigenous people.
In addition to mental health, other health disparities also continue to be an issue. Death rates from preventable diseases such as diabetes and infant mortality rates are significantly higher. Willingness to access care is also an issue. Many Indigenous people feel stereotyped, ignored, and disrespected by non-Indigenous providers. Many programs serving Indigenous people are often not culturally relevant or sensitive to the significant trauma within Indigenous communities.