ABSTRACT
As early as the Community Mental Health Movement of the 1960s, psychologists have recognized that conventional mental health services have failed to reach a significant segment of the American population who might truly benefit from appropriate support and assistance while experiencing profound psychological distress (Albee, 1968). Although this observation continues to characterize service delivery with regard to many troubled persons in today’s society, it would be difficult to identify a more underserved group of people than this country’s small population of American Indians and Alaskan Natives (Nelson, McCoy, Stetter, & Vanderwagen, 1992). The cultural, political, and economic isolation of Native Americans from adequate mental health services is even more remarkable when one considers that the federal government is legally and morally obligated to provide such services, given the unique political status of tribal groups in their historic government-to-government relationship with the United States (LaFromboise, 1988; Pevar, 1992). This chapter reviews the principal challenges confronting mental health researchers, professionals, and policymakers as they seek to most effectively address the mental health needs of American Indians before suggesting alternatives to conventional mental health service delivery. It is the firm conviction that Native American people deserve fully accessible, culturally appropriate, and demonstrably effective mental health services during times of psychological distress that motivates this chapter’s commitment to re-envisioning mental health service delivery in American-Indian communities.
