title: Obstacles for rural American Indians seeking alcohol, drug, or mental health treatment.
abstract: The purpose of this study was to identify factors associated with 4 clusters of obstacles (self-reliance, privacy issues, quality of care, and communication and trust) to mental health and substance abuse treatment in 3 treatment sectors for residents of 3 reservations in the United States. Participants (N=3,084) disclosed whether they had sought treatment for emotional, drug, or alcohol problems in the past year and, if so, whether they had faced obstacles in obtaining care from Indian Health Services, tribal services, and other public or private systems. Correlates of these obstacles included negative social support, instrumental social support, utility of counselors, utility of family doctors, treatment sector, treatment type, diagnosis of an anxiety disorder, and tribe.
authors.affiliation: University of New Mexico, Albuquerque, NM87131, USA.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Duran
authors.forename: John
authors.initials: J
authors.lastname: Oetzel
authors.forename: Julie
authors.initials: J
authors.lastname: Lucero
authors.forename: Yizhou
authors.initials: Y
authors.lastname: Jiang
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Novins
authors.forename: Spero
authors.initials: S
authors.lastname: Manson
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000208:ethnology / Q000628:therapy; D035841:Behavioral Research; D003156:Community Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000208:ethnology* / Q000628:therapy; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011593:Psychology, Social; D012044:Regression Analysis; D019035:Rural Health Services / Q000191:economics / Q000706:statistics & numerical data*; D012944:Social Support; D012962:Sociology, Medical; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy; D014481:United States; D016549:United States Indian Health Service