title: Help seeking for substance use problems in two American Indian reservation populations.
abstract: OBJECTIVE
  This study examined the extent and types of help seeking (biomedical, traditional, and 12-step groups) for substance use problems in two American Indian reservation populations by using data from the American Indian Service Utilization, Psychiatric Epidemiology, Risk, and Protective Factors Project (AI-SUPERPFP). This study also sought to understand the correlates of such help seeking, including measures of need, demographic characteristics, spirituality, and ethnic identity.
  
  
  METHODS
  AI-SUPERPFP, completed between 1997 and 2000, was a cross-sectional probability sample survey. Altogether 2,825 tribal members, aged 18 to 54 years, representing two tribal groups living on or near their home reservations, were randomly sampled from the tribal rolls. Response rates averaged 75.3 percent. The primary outcome measure was help seeking in the past year for substance use problems, which was further divided into help seeking from biomedical services, traditional healing sources, and 12-step programs.
  
  
  RESULTS
  Help-seeking rates were high, with 13 percent of the population and 38 percent of those with diagnoses of substance use disorders in the past year having sought services for alcohol or drug problems in the preceding 12 months. Correlates of help seeking included variables related to need for services (substance use disorders, tobacco use, and mental and physical health problems), marital status, and spirituality. Slightly more than half of service users sought help from formal biomedical providers; use of traditional healing and 12-step programs was also common. Need and spirituality variables best differentiated among the users of the three modalities.
  
  
  CONCLUSIONS
  Help seeking for alcohol and drug problems was common in these communities, with traditional healing and 12-step resources as essential components of the local service ecologies.
authors.affiliation: American Indian Program, University of Colorado at Denver and Health Sciences Center, F800, P.O. Box 6508, Aurora, Colorado 80045-0508, USA. jan.beals@uchsc.edu
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Novins
authors.forename: Paul
authors.initials: P
authors.lastname: Spicer
authors.forename: Nancy R
authors.initials: NR
authors.lastname: Whitesell
authors.forename: Christina M
authors.initials: CM
authors.lastname: Mitchell
authors.forename: Spero M
authors.initials: SM
authors.lastname: Manson
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D015205:Northwestern United States; D010342:Patient Acceptance of Health Care; D015206:Southwestern United States; D019966:Substance-Related Disorders