/
Native American Adolescents: Native American Adolescents:

Native American Adolescents: - PowerPoint Presentation

sherrill-nordquist
sherrill-nordquist . @sherrill-nordquist
Follow
433 views
Uploaded On 2017-07-12

Native American Adolescents: - PPT Presentation

A Systematic Review of Indigenous Pathways to Resilience Sheena Brown PhD MPH Mel and Enid Zuckerman College of Public Health University of Arizona Tucson AZ Background The experts talk ID: 569301

health mental american native mental health native american youth family aian community services factors amp adolescents protective illness indian resilience focus 1993

Share:

Link:

Embed:

Download Presentation from below link

Download Presentation The PPT/PDF document "Native American Adolescents:" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

Native American Adolescents: A Systematic Review of Indigenous Pathways to Resilience

Sheena Brown PhD MPH

Mel and Enid Zuckerman College of Public Health

University of Arizona, Tucson AZSlide2

Background“The experts talk about our community in terms of statistics and numbers. They don’t realize that these statistics

are

our friends, cousins, and brothers. They [the experts] don’t know that they might have had

a

brilliant future or who they were before bad things happened to them. They just have them

as

a statistic.

Jaron

Kie

(17),

Laguna youth group Albuquerque, New

Mexico

www.apha.org

“This

is my concern, that mental health … is bad, you have horrible statistics

but

no information about why it is so horrible. So, if you treat the symptom of

alcoholism

and not have it in the context of historical trauma, you are to miss

what

really the whole family is suffering from. What the whole generation is

suffering

from. So, this is my big concern that historical trauma doesn’t really

get

assessed as a diagnosis, it doesn’t get

treated.”

Native

American Community

Leader

UCDavis

CRHD, 2009 Slide3

American Indians and Alaska Natives (AIAN) are frequently among the most highly vulnerable populations including those who are homeless, incarcerated, and victims of traumaAIAN youth

75%

of deaths AIAN youth (12-20yrs): intentional injury, homicide, suicide*

79%

of youth in the Federal prison system are AIAN** 50% national high school graduation rateLiterature Review: Mental health issues of AIAN adolescents; programs, program needs, inequalities, risk and protective factors Explore the concept of resilience as a protective factor *SAMHSA**Bureau of Justice Statistics, 2004

BackgroundSlide4

MethodsDatabases searched: Pubmed, EBSCO, Web of ScienceTo

be included the article had to:

B

e written in English

Be peer-reviewed and published before May 1 2014 Identify AIAN adolescentsSpecify mental health focusIdentify social and environmental factors Search terms: Native American, American Indian, Alaska Native, Adolescent mental health, Adolescent and family mental health Slide5

Results – Literature

R

eview

Peer reviewed articles

(n=28)Number of journal articles identified

in database search (n=772)

Titles and abstracts with epidemiological, clinical and non-definitive

age focus

excluded

(n=710)

Number of articles reviewed by primary categories (n=62)

Mental Health Services (n=10)

n

=6

Mental Health Inequities (n=10)

n=3

Mental Health Needs (n=

8

)

n

=6

Risk Factors

(n=10)

n

=7

Articles excluded as Other

( n=18 )

Articles excluded, policy and/or off-topic focus

( n=16 )

Protective Factors (n=6) n=6

N=44Slide6

Mental Health ServicesServices predominantly community based and federally fundedProgram protocols originated from non-native communities

Medicalization of mental health issues

Pharmaceutical

influence on mental health diagnoses

Insufficient staff numbersPolitical, economic, institutional forces interpreted as MH issues ObstaclesSelf-relianceQuality of careCommunication / trustSlide7

Mental Health InequitiesAIAN adolescents suffer from disproportionately high rates of certain mental disorders and suicide

Substance abuse

Disruptive behavior disorder

Suicide

IncarcerationEffective mental health services remain in short supplyLack of Native cliniciansDistrust of non-Native cliniciansFunding Slide8

Mental Health Needs“The year 1992 was declared the "Year of the American Indian.” As we begin the new year, I am certain that all Americans want to continue to observe the respect that Native Americans deserve, by doing our best to raise Indian health status to the highest level possible by the year

2000”

Inouye 1993

Negligible mental

health services available to AIAN youth1 provider: 23,000 youth (Inouye 1993)Providers not always equipped to respondLack of facilities for youthSlide9

Risk FactorsIntergenerational traumaAlienation from family / lack of family cohesionLack of meaning and purpose, hopelessnessExposure to violence

Grief and loss

Poverty

Unemployment

Abuse Stigma Protective FactorsCommunity & family supportFamily connectionSupportive peer networksMeaning & purpose, hope

Culture & Ceremony

Traditional healing

Spirituality

Ethnic identity optimism, self-esteemSlide10

Recommendations Mental Health ServicesThe role of cultural, religious, and often social values and beliefs

are

poorly

understood

and accepted, by the general populationEvaluation of the role of traditional healers working with adolescentsRe-evaluate requirements for certification of lay-MH counselorsThe traditional holistic approach is different to non-Native MHS Slide11

Recommendations Mental Health InequitiesTailor or

augment

existing mental

health treatments

and services or…Reimagine MH approaches with local communitiesFamily involvement – key protective factorFunding: evidence vs innovationSlide12

Recommendations Mental health needsFamily is a key protective factorYouth involvement, Family involvement, Community involvementMental health services incorporated into education system

Program focus on values of individual communitiesSlide13

ResilienceThe ability to rise above adversityAll communities have strengths – deficit based programs negatively define, label and blame individuals

Community resilience; moving beyond labels

Risk and protective factors are context & environment dependentSlide14

Who Decides What Is And What Is Not Mental Illness?“Mental illnesses without aberrant symptomatology may not be viewed as illness at all” (Keltner

1993)

Prior

to European contact, there was no concept of mental illness

per se.Among various AIAN people, mental illness is viewed as: (a) a form of supernatural possession (b) an imbalance and disharmony with the inner and outer natural forces in the world (c) the expression of a special gift

Source:

Grandbois 2005Slide15

Worldview Differences that Impact Mental Health CareAmerican Indian/Alaska Native Majority culture• Relational, circular • Linear, point A to B

• Mind, body, spirit/One

• Psyche

is the focus

• Mystical/acceptance • Scientific/verification• Ceremonials/rituals • Psychotherapy• Tribal connectedness • Individualism• Spirituality & balance • Organized religions• Cooperation/sharing • Competition/winning• Patience/respectful • Assertive/forceful• Present oriented • Future oriented• Herbs, plants, nature • PsychopharmacologySource: Grandbois, 2005 (Table 2).

Who decides what

is,

and is not mental

illness?Slide16

ConclusionsNative initiated programsCulturally appropriate evaluationsIncrease tribal access to core Federal funding sources

Economic needs of youth

must

be addressed

Youth need to have important roles in the communityNeed meaning & a sense of autonomy in their livesEducation system – does it currently serve the needs of youth?Program focus on family cohesion and community strengthsReduce emphasis on defining the problemMuch information is not in the peer-reviewed literatureSlide17

Contact Information:

Dr. Sheena Brown

sheenab@email.arizona.edu

This

work was supported by the Center for American Indian Resilience (CAIR) a NIH-NIMHD P20 Exploratory Center of Excellence (1P20MD006872) awarded to Northern Arizona University with subcontracts to University of Arizona and

Diné

College

Photograph by

Sebastião

SalgadoSlide18

References Grandbois, D. M. 2005. Stigma of mental illness among American Indian and Alaska Native Nations: Historical and Contemporary perspectives. Issues in Mental Health Nursing, 26:1001–1024.

Inouye DK. 1993. Our future is in jeopardy: The mental health of Native American adolescents. J.

Health

Care

Poor &Underserved. 4: 6-8Keltner BR. 1993. Native American Children and Adolescents: Cultural Distinctiveness and Mental Health Needs. JCPN 6(4): 18-23U.S. Congress, Office of Technology Assessment. Indian adolescent mental health. OTA-H-446. Washington, DC: U.S. Government Printing Office, 1990.