Title

Mental health disparities, historical realities, and sociocultural barriers of american indians and alaska natives: A focus on suicide prevalence and prevention

Document Type

Article

Publication Title

Indigenous Peoples: Perspectives, Cultural Roles and Health Care Disparities

Abstract

American Indians and Alaska Natives (AI/AN) have experienced profound sociopolitical and economic hardship, characterized by a history of colonialism and racial oppression. These experiences have resulted in higher prevalence rates across a broad range of mental health difficulties, including depression, posttraumatic stress disorder (PTSD), anxiety, substance use disorders, and suicide, as compared to the general U.S. population (Beals et al., 2005; IHS, 2015). In this chapter, we provide a conceptual overview of the current state of the problem. We begin byproviding a framework for understanding these mental health disparities, including discussion regarding interpretations (material vs. psychosocial) designed to enhance our understanding of this phenomena, followed by a description of latent, pathway, cumulative and latent effects of disparities across the lifespan. We then review current research, including comparisons of lifetime prevalence rates for a variety of mental health consequences across AI/AN communities. In order to enhance our understanding of these disparities, we focus on suicidality, which represents one of the greatest discrepancies experienced among AI/AN individuals, and the leading cause of death due to mental health difficulties. Next, we critically examine risk and protective factors known to impact suicidality and other mental health disparities across AI/AN communities. This is followed by a discussion of the complex relationship between risk and protective factors, which provides a foundation for our recommendations. Finally, we conclude with an examination of indigenous epistemologies and cultural competence to prevention and early intervention that promote social justice within these communities.

First Page

133

Last Page

172

Publication Date

1-1-2016

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