title: Indian boarding school experience, substance use, and mental health among urban two-spirit American Indian/Alaska natives.
abstract: BACKGROUND
  Systematic efforts of assimilation removed many Native children from their tribal communities and placed in non-Indian-run residential schools.
  
  
  OBJECTIVE
  To explore substance use and mental health concerns among a community-based sample of 447 urban two-spirit American Indian/Alaska Native adults who had attended boarding school as children and/or who were raised by someone who attended boarding school.
  
  
  METHODS
  Eighty-two respondents who had attended Indian boarding school as children were compared to respondents with no history of boarding school with respect to mental health and substance use.
  
  
  RESULTS
  Former boarding school attendees reported higher rates of current illicit drug use and living with alcohol use disorder, and were significantly more likely to have attempted suicide and experienced suicidal thoughts in their lifetime compared to non-attendees. About 39% of the sample had been raised by someone who attended boarding school. People raised by boarding school attendees were significantly more likely to have a general anxiety disorder, experience posttraumatic stress disorder symptoms, and have suicidal thoughts in their lifetime compared to others.
authors.affiliation: Indigenous Wellness Research Institute, University of Washington , Seattle, WA 98105, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Evans-Campbell
authors.forename: Karina L
authors.initials: KL
authors.lastname: Walters
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Pearson
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Campbell
mesh_terms: D000069:Acculturation; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000208:ethnology; D001008:Anxiety Disorders / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D004930:Inuit / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000208:ethnology; D008875:Middle Aged; D012574:Schools; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000208:ethnology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014505:Urban Population