The shortage of Native American mental health doctors is a professional and personal issue Mary Owen.
“I myself have struggled with depression since high school,” said Owen, a Duluth Native American physician and associate dean of Indigenous health at the University of Minnesota School of Medicine.
Owen, a member of the Tlingit Nation, grew up in Juneau, Alaska, where “the Natives were at the bottom of the sneak arrangement,” she recalls, and the racism she faced so often made her feel like a second-class citizen.
She has dedicated much of her career to increasing the number of Native American healthcare professionals of all kinds. Owen said she always struggles to find authentic healers — for her patients at Duluth and for her sake.
“I would definitely be able to connect more with the color consultant, just our shared history of trauma and marginalization in this country. But I couldn’t even find that,” she said.
“And then, someone can relate to my experiences as an Aboriginal woman, as a woman not always visible in this country, [I’ve also] I couldn’t find that.”
While exact numbers are difficult to obtain, there are likely only 200 to 300 Native American psychologists in the entire country, out of several million residents.
“American Indians are the most disadvantaged and underrepresented when it comes to psychologists relative to the potential population ratio,” said Doug MacDonald, professor of clinical psychology at the University of North Dakota and a member of the Oglala Lakota and Northern Cheyenne tribes.
At the same time, there is a file big need Mental health services in indigenous communities. According to government estimates, nearly 20 percent of Native American adults suffer from mental illness. The suicide rate for Native teens is more than double the suicide rate for white youth. Indigenous peoples experience serious psychological distress at more than twice the rate of the general population.
“It comes down to the date we tested and we can’t sort of disconnect it,” he explained. John GonzalezProfessor of Psychology at Bemidji State University and a member of the White Earth Nation.
“We have generations and generations of people who have experienced trauma and continue to experience various forms of trauma, and then continue to struggle to live in poverty.”
While he stresses that not every Indigenous person will experience negative outcomes because of it, “there is enough of it in our society where there hasn’t been much healing,” he said. “This is what should happen.”
culturally appropriate care
For healing to occur in Native American communities, experts stress the importance of providing culturally appropriate mental health care.
To help explain why, MacDonald tells a story he remembers from high school, when a fellow non-Aboriginal was trying to help a young Aboriginal client. He remembers watching him when the girl showed up for her third session, and he immediately noticed her recent haircut.
“They sit down and my colleague looks at her and says, ‘Oh, what did you do with your hair? You had such beautiful hair. “The young aboriginal agent burst into tears, got up, left, and never came back.”
MacDonald explains that some Aboriginal people cut their hair when they are in mourning. In this case, it was later found out that the client’s mother had died.
He said, “It was unintentional, what my colleague did, she cared about, she was trying to be helpful. But it was a huge mistake.”
For the past 30 years, MacDonald has worked to try to reduce the number of those cultural “fatal errors.”
When he received his Ph.D. in 1992, he estimated that there were only 100 Native American psychologists.
In response, he started a program at the University of North Dakota called Indians in psychology PhD educationand focused on training more Native American psychologists, and increasing the cultural competence of non-Native service providers.
The program was written into the federal Indian Health Care Improvement Act, which also provides funding for similar programs at the University of Montana and Oklahoma State University.
Progress since then has been steady, but slow. In the past 30 years, the program at UND has graduated about 30 indigenous psychologists. this More than any universitybut at this rate, MacDonald acknowledges that the program “will not be able to meet the need that exists there in India in our reservations and in urban Indian centres.”
But some of these graduates are sowing the seeds to grow more mental health professionals to serve indigenous communities.
Gonzalez is one of them. He started a program at Bemidji State University last year aimed at promoting Native American undergraduates studying psychology.
“We meet with them every two weeks. It’s basically just a time for them to get together as Indigenous students, to share what’s going on in their lives, to talk about what’s going on in class, what’s going on at home and the things they struggle with,” Gonzalez said.
There were six students in the beginning Indigenous students in psychology training cohort. One of them has already gone to high school. The program is now offering scholarships to up to ten Native American students majoring in psychology, through a recent scholarship from the Blandin Foundation.
“Most of these students would like to go home,” Gonzalez said. “They want to go back and provide services in the community.”
Jessica Journo One of the first Indians to graduate in the University of North Dakota’s psychology program, he is now clinical director at the American Indian Family Center in St. Paul, which offers a range of services from the old Indian Health Service clinic on the east side of town.
When she started more than 20 years ago, Gorno realized that the mental health approach she learned in school did not work for her clients, who often dealt with complex historical trauma.
Bits and pieces have worked, but “nothing quite helps people get to the point of recovery,” she said.
Now, she said, the center helps people take advantage of the resilience and healing that already exists within Aboriginal people by focusing on traditions, values and ceremonies. “Because we notice that people are begging for this,” Gorno said. “And they benefit from this.”
Two years ago, Journo and others successfully lobbied the state legislature to create a program specifically aimed at financing Traditional healing of tribal societies.
Two million in annual funding now helps ten tribal nations and five urban American Indian organizations across the state integrate traditional healing practices into treatments for mental health and substance abuse disorders.
This process begins the first time people enter the American Indian Family CenterGorno explains. Suppliers will visit customers, serve food, and try to build a relationship. They don’t just do a diagnostic evaluation. They also ask about spirituality and cultural identity.
“That’s an important part of mental health,” she said. “So when we get to that, we start talking about it, and we give them that space.”
If clients are interested, providers will connect them with seniors in the community, including Richard Wright, who works as a spiritual assistant at the Indian Health Board in Minneapolis.
“One of my first questions is, ‘Where are you from?’ For me, it’s a diagnostic feature. “It helps me develop a series of questions to determine if it’s conventional.”
Wright is 73 years old, and speaks slowly and gently. His office is filled with tobacco, sweet grass and sage – the traditional medicines he shares with clients. Being able to return to his traditions as an Ojibwe, he said, allows him to “share some of the practices we use in order to heal people”.
Wright leads circles of healing and celebrations in society, which can have profound effects on people.
“People have come to me at these healing ceremonies and talk about feeling suicidal, and that this helped them survive another day,” Gorno said. “He’s hitting very close to home. He’s talking to them.”
She said that people often need traditional ceremonies to step back as they work through what they learn in therapy.
“I feel that traditions and values speak to the Indians within them, and that opens them up to being open to the process,” Gorno said.
This story is part of the Call to Mind, American Public Media, and MPR initiative to promote new conversations about mental health. Catch up on MPR with Angela Davis for a discussion with a local therapist at 9 a.m. Tuesday, October 18. You can also hear an hour-long special call on Find Color Providers Wednesday, October 19th at 9am