Promoting healing and restoring trust: policy recommendations for improving behavioral health care for American Indian/Alaska Native adolescents.
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.
Goodkind
Jessica R
JR
Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, 87131, USA. JGoodkind@salud.unm.edu
Ross-Toledo
Kimberly
K
John
Susie
S
Hall
Janie Lee
JL
Ross
Lucille
L
Freeland
Lance
L
Coletta
Ernest
E
Becenti-Fundark
Twila
T
Poola
Charlene
C
Begay-Roanhorse
Regina
R
Lee
Christopher
C
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