This post about mental health issues related to American Indians and Alaskan Natives was precipitated by the 20/20 special called Hidden America: Children of the Plains which was hosted by Diane Sawyer (see here). During the program, Sawyer explored the multitude of issues that children of the Oglala Lakota Sioux tribal nation living on the Pine Ridge Reservation in South Dakota face including extreme poverty and alcoholism. According to some estimates, unemployment on the Pine Ridge Reservation ranges from 83-85% and can be higher during the winter months when it is difficult to travel. As a result, the median income on the Reservation is $2,600 to $3,500 per year and approximately 97% of the population lives below federal poverty lines. The nearest town that could potentially offer employment for those with the ability to travel is Rapid City, South Dakota, which is 120 miles away from the Reservation. Likely due to the lack of opportunity, many on the Pine Ridge Reservation either turn to alcohol or become severely depressed and/or suicidal. On this Reservation alone, alcoholism affects 8 out of 10 families; the death rate from alcohol-related problems is 300% higher than the remaining population. Rampant medical problems among the population including high rates of diabetes, heart disease, and cancer in addition to substance abuse and poor nutrition have resulted in a life expectancy of 48 years for men and 52 years for women (compared to 77.5 years for the US population as a whole).
Because of the serious social and economic difficulties they face, Native American populations like the Oglala Lakota Sioux are more susceptible to mental illnesses. Here are some facts regarding mental health and Native American communities gathered from the National Alliance on Mental Illness (NAMI).
- Approximately 26% of American Indians/Alaska Natives live in poverty compared to 13% of the general population and 10% of Caucasian Americans.
- The American Indian and Alaska Native populations report higher rates of frequent distress than the general population.
- Alcohol abuse is a problem for a substantial portion of the American Indian adult population, but widely varies among different tribes.
- A study of Alaska Natives in a community health center found that substance abuse was the reason that 85% of men and 65% of women seek mental health treatment.
- Native Alaskan males have had one of the highest documented suicide rates in the world. Suicide rates are particularly high among Native American males ages 15 - 24 who account for 64% of all suicides by American Indian/Alaska Native individuals.
- The words "depressed" and "anxious" are absent from some American Indian and Native Alaskan languages. Culturally different expressions of illness ("ghost sickness" or "heartbreak syndrome") do not easily correspond to Western psychiatric diagnosis criteria.
- In a Northern Plains study, 61% of children had experienced a traumatic event.
- Compared to the general population, American Indians and Alaska Natives tend to under-utilize mental health services, have a higher therapy dropout rates and are less likely to respond to treatment. This may derive from the fact that individuals tend to have negative opinions of non-Indian health providers and that traditional healing is used by a majority of Native Americans.
- Mental health services are available for the American Indian/Alaska Native communities, such as the services provided by the Indian Health Service (IHS), but they are in need of improvement. Currently only 7% of IHS' s budget is allocated for mental or behavioral health and substance abuse treatment services combined.
Gone, J.P. (2004). Mental health services for Native Americans in the 21st century United States. American Psychological Association, Vol. 35, No.1, 10-18.
National Alliance on Mental Health: American Indian and Alaska Native Communities Mental Health Fact Sheet http://www.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=79888
Schwartz, S.M (2006). The arrogance of ignorance: hidden away, out of sight, out of mind. Regarding life, conditions and hope on the Oglala Lakota (Sioux) Reservation of SD. http://www.nativevillage.org/Messages%20from%20the%20People/the%20arrogance%20of%20ignorance.htm