title: Promoting healing and restoring trust: policy recommendations for improving behavioral health care for American Indian/Alaska Native adolescents.
abstract: American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15-24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed.
authors.affiliation: Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, 87131, USA. JGoodkind@salud.unm.edu
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Goodkind
authors.forename: Kimberly
authors.initials: K
authors.lastname: Ross-Toledo
authors.forename: Susie
authors.initials: S
authors.lastname: John
authors.forename: Janie Lee
authors.initials: JL
authors.lastname: Hall
authors.forename: Lucille
authors.initials: L
authors.lastname: Ross
authors.forename: Lance
authors.initials: L
authors.lastname: Freeland
authors.forename: Ernest
authors.initials: E
authors.lastname: Coletta
authors.forename: Twila
authors.initials: T
authors.lastname: Becenti-Fundark
authors.forename: Charlene
authors.initials: C
authors.lastname: Poola
authors.forename: Regina
authors.initials: R
authors.lastname: Begay-Roanhorse
authors.forename: Christopher
authors.initials: C
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D019317:Evidence-Based Medicine; D006801:Humans; D007198:Indians, North American; D008605:Mental Health Services / Q000458:organization & administration*; D011050:Policy Making; D011787:Quality of Health Care; D035502:Trust; D014481:United States