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Rural Health Information Hub

Mental Health Program Considerations for American Indian/Alaska Native and Tribal Populations

American Indian and Alaska Native (AI/AN) persons and tribal communities are more likely to report experiencing mental health challenges than the general population but face several barriers to accessing mental health support. For example, AI/AN individuals living in rural, isolated communities often experience limited access to mental healthcare. Other barriers may include unemployment, lack of adequate health insurance coverage, and language and culture.

Rural planners implementing mental health programs must recognize and account for cultural differences in health-related values and beliefs. The understanding of mental illness, its development, and treatment can be unique to different racial and ethnic groups, including AI/AN populations. For example, due to historical medical mistrust, some AI/AN individuals may prefer traditional healing and tribal remedies to address mental health issues over Western-based treatments or interventions.

Rural mental health programs should consider the effects of historical trauma on mental health. Integrating trauma-informed care (TIC) can improve the uptake of mental health services among AI/AN populations. The Indian Health Service offers several web-based trainings and resources on TIC. Rural mental health programs may also consider developing culturally competent trainings for mental healthcare providers to enhance their knowledge of native and indigenous cultures and values. For more information on cultural competency workforce trainings, see Provider Trainings to Improve Health Literacy in our Rural Health Literacy Toolkit.

Resources to Learn More

Cultural Elements of Native Mental Health with a Focus on Rural Issues
Provides an overview of mental healthcare challenges among rural Native American communities.
Organization(s): National American Indian and Alaska Native Mental Health Technology Transfer Center Network
Date: 3/2022

Increasing Culturally Responsive Care and Mental Health Equity with Indigenous Community Mental Health Workers
Examines how indigenous community mental health workers could work along with indigenous mental health professionals to improve mental health outcomes among American Indian and Alaska populations.
Author(s): O'Keefe, V., Cwik, M., Haroz, E., & Barlow, A.
Citation: Psychological Services, 18(1), 84-92
Date: 2/2021

Mental Health Resources
Offers an annotated selection of mental health resources by topic to promote mental wellness in American Indian and Alaska Native communities.
Organization(s): Tribal Training and Technical Assistance Center, Substance Abuse and Mental Health Services Administration