National American Indian and Alaska Native Heritage
Commentary by Daniel Dickerson, D.O.
The Native American population is diverse, consisting of 562 federally-recognized tribes. Although diverse in nature, the collective spirit and identity of American Indians, Alaska Natives, and Native Hawaiians (A.I./A.N./N.H.) continues to be evident. This is seen throughout the many cultural celebrations and activities occurring this month across the United States in urban areas, American Indian reservations, Alaska Native villages, and Native Hawaiian communities.
In order to maintain and enhance the strengths of the Native American community, addressing the mental health care needs of A.I./A.N./N.H. is important. Various mental health and substance abuse issues adversely impact our Native American communities. Depression, youth suicide, methamphetamine and alcohol abuse, childhood psychiatric disorders, and access to care issues in both rural and urban areas are some of these important issues. Many of these issues stem from previous injustices our Native American communities have experienced throughout U.S. history including forced relocations and cultural assimilation, numerous broken treaties, and other social, economic, and political injustices. These “historical traumas” continue to affect our communities in significant ways resulting in a complex array of ongoing intergenerational trauma in addition to significant contemporary issues including high unemployment rates, poverty, and limited access to psychiatric and substance abuse treatement.
The majority of A.I./A.N./N.H. now reside in urban areas (67%). These individuals, however, continue to identify strongly with their Native American traditions and identity. As an Alaska Native addiction psychiatrist serving the Native American Los Angeles county community at the United American Indian Involvement (UAII), I continually see urban Native Americans who possess a strong identity of their cultural pride and identity. Many have lived the majority of their lives in the urban setting, while others moved to the urban area from their home reservations. In the urban setting, I see significant issues related to intergenerational trauma, substance abuse, homelessness, depression and other mental illnesses. However, our clients often express their frustration with not being able to find culturally-relevant care in the complex matrix of the urban environment. The need for increased funding of mental health and substance abuse programs, research, and community outreach in urban areas throughout the United States is significant and necessary for the Native American community to reach a level of social equality. Optimization of mental health and substance abuse services has the potential to enhance and revitalize the peace and harmony highly valued in our Native American communities.
The APA Office of Minority and National Affairs, the Council on Minority Mental Health and Health Disparities, and the APA Committee of American Indian, Alaska Native, and Native Hawaiian Psychiatrists are dedicated towards addressing the mental health and substance abuse treatment needs of the Native American community. For further information, with regards to A.I./A.N./N.H. mental health, contact the APA Office of Minority and National Affairs at 703-907-7300.
Daniel Dickerson, D.O., chair of the
APA Committee of 
