Skip to main content

Psychology of Older American Indians and Alaska Natives: Strengths and Challenges to Maintaining Mental Health

  • Chapter
  • First Online:
Handbook of Race and Development in Mental Health

Abstract

This chapter presents information on mental health issues among older American Indian and Alaska Native adults, focusing on sociohistorical factors, environmental factors, and barriers to help-seeking as major challenges to the maintenance of mental health in this group. We also describe several strengths that contribute to resilience among Native elders, including support systems, ethnic and cultural identity, and spirituality. We provide recommendations for capitalizing upon these strengths in order to address the challenges faced by Native elders, including the importance of engaging community networks in the research process and incorporating Native cultural elements into biomedical mental health care. The chapter concludes with recommendations for future research, including the need to develop culturally relevant instrumentation and methods specific to this population.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ackerson, L. M., Dick, R. W., Manson, S. M., & Baron, A. E. (1990). Depression among American Indian adolescents: Psychometric characteristics of the inventory to diagnose depression. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 601–607.

    Article  PubMed  Google Scholar 

  • Administration on Aging. (2000). Facts and figures: Statistics on minority aging in the U.S. http://www.aoa.gov/prof/statistics/minority_aging/facts_minority_aging.asp#PopulationbyRace. Accessed November 16, 2007.

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychological Association. (2005). Briefing sheet on Indian health service mental health/alcohol and substance abuse programs. http://www.apa.org/ppo/funding/ihsbriefingsheet.html. Accessed June 1, 2006.

  • Attico, N. B. (1997). The elder female: A preventative care plan and health watch. The IHS Primary Care Provider, 22(5), 80–87.

    Google Scholar 

  • Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2005). Health Characteristics of the American Indian and Alaska Native Adult Population: United States, 1999–2003. Rockville: U.S. Department of Health and Human Services, National Center for Health Statistics.

    Google Scholar 

  • Barney, D. D. (1994). Use of mental health services by American Indian and Alaska Native elders. American Indian & Alaska Native Mental Health Research, 5(3), 1–14.

    Article  Google Scholar 

  • Beals, J., Manson, S. M., Mitchell, C. M., Spicer, P., & the AI-SUPERPFP Team. (2003). Cultural specificity and comparison in psychiatric epidemiology: Walking the tightrope in American Indian research. Culture, Medicine and Psychiatry, 27, 259–289.

    Article  PubMed  Google Scholar 

  • Beals, J., Manson, S. M., Whitesell, N. R., Spicer, P., Novins, D. K., Mitchell, C. M., et al. (2005). Prevalence of DSM-IV disorders and attendant help-seeking in two American Indian reservation populations. Archives of General Psychiatry, 62, 99–108.

    Article  PubMed  Google Scholar 

  • Beals, J., Novins, D. K., Spicer, P., Whitesell, N. R., Mitchell, C. M., Manson, S. M., & the American Indian Service Utilization, Psychiatric Epidemiology, Risk, and Protective Factors Project Team. (2006). Help seeking for substance use problems in two American Indian reservation populations. Psychiatric Services, 57(4), 512–520.

    Article  PubMed  Google Scholar 

  • Buchwald, D. S., Tomita, S., Ashton, S., Furman, R., & Manson, S. M. (2000). Physical abuse of urban Native Americans. Journal of General Internal Medicine, 15, 562–564.

    Article  PubMed  Google Scholar 

  • Bureau of Indian Affairs. (2005). Indian entities recognized and eligible to receive services from the United States Bureau of Indian Affairs. Federal Register, 70(226), 71194–71198.

    Google Scholar 

  • Chapleski, E. E., Lamphere, J. K., Kaczynski, R., Lichtenberg, P. A., & Dwyer, J. W. (1997). Structure of a depression measure among American Indian elders: Confirmatory factor analysis of the CES-D Scale. Research on Aging, 19, 462–485.

    Article  Google Scholar 

  • Curyto, K. J., Chapleski, E. E., & Lichtenberg, P. A. (1999). Prediction of the presence and stability of depression in the Great Lakes Native American elders. Journal of Mental Health and Aging, 5, 323–340.

    Google Scholar 

  • Curyto, K. J., Chapleski, E. E., Lichtenberg, P. A., Hodges, E., Kaczynski, R., & Sobect, J. (1998). Prevalence and prediction of depression in American Indian Elderly. Clinical Gerontologist, 18, 19–37.

    Article  Google Scholar 

  • DeNavas-Walt, C., Proctor, B. D., & Lee, C. H., U.S. Census Bureau. (2005). Income, poverty, and health insurance coverage in the United States: 2004. http://www.ncuih.org/about/index.html. Accessed December 13, 2006.

  • Dixon, M., & Joseph-Fox, Y. (2001). Federal and state policy to strengthen Indian health. In M. Dixon & Y. Roubideaux (Eds.), Promises to keep: Public health policy for American Indians and Alaska natives in the 21st century (pp. 275–295). Washington, DC: United Book.

    Google Scholar 

  • Dixon, M., & Roubideaux, Y. (Eds.). (2001). Promises to keep: Public health policy for American Indians and Alaska Natives in the 21st century. Washington, DC: United Book.

    Google Scholar 

  • Garroutte, E. M., Kunovich, R. M., Buchwald, D., & Goldberg, J. (2006). Medical communication in older American Indians: Variations by ethnic identity. The Journal of Applied Gerontology, 25(10), 27S–43S.

    Google Scholar 

  • Goldwasser, H. D., & Badger, L. W. (1989). Utility of the psychiatric screen among the Navajo of Chinle: A fourth-year clerkship experience. American Indian & Alaska Native Mental Health Research, 3, 6–15.

    Article  Google Scholar 

  • Gone, J. P. (2004). Mental health services for Native Americans in the 21st Century United States. Professional Psychology: Research and Practice, 35(1), 10–18.

    Article  Google Scholar 

  • Gone, J. P. (2008). So I can be like a white man: The cultural psychology of space and place in American Indian mental health. Culture and Psychology, 14(3), 369–399.

    Article  Google Scholar 

  • Gone, J. P., & Alcàntara, C. (2005). Practice makes perfect? Identifying effective psychological treatments for mental health problems in Indian country. In E. H. Hawkins & R. D. Walker (Eds.), Best practices in behavioral health services for American Indians and Alaska Natives. Portland: One Sky National Resources Center for American Indian and Alaska Native Substance Abuse Prevention and Treatment Services.

    Google Scholar 

  • Hahn, R. A. (1995). Sickness and healing: An anthropological perspective. New Haven: Yale University Press.

    Google Scholar 

  • Hendrix, L. R. (2003). Intercultural collaboration: An approach to long term care for urban American Indians. Care Management Journals, 4(1), 46–52.

    Article  PubMed  Google Scholar 

  • Howard, J. H. (1955). Pan-Indian culture of Oklahoma. The Scientific Monthly (November), 215–220.

    Google Scholar 

  • Indian Health Service. (2002). American Indian and Alaska Native roundtable on long term care: Final report 2002. http://www.ihs.gov/PublicInfo/PublicAffairs/PressReleases/Press_Release2002/Final_LTC_Report_ALL.pdf. Accessed January 10, 2007.

  • Jackson, D. D., & Chapleski, E. E. (2000). Not traditional, not assimilated: Elderly American Indians and the notion of ‘cohort’. Journal of Cross-Cultural Gerontology, 15, 229–259.

    Article  PubMed  Google Scholar 

  • Jenkins, J., Kleinman, A., & Good, B. (1990). Cross-cultural studies of depression. In J. Becker & A. Kleinman (Eds.), Advances in Mood Disorders (pp. 67–99). New York: Erlbaum.

    Google Scholar 

  • Jervis, L. L., & Manson, S. M. (1999). Native elder component - Major themes and emerging questions. In Redefining Retirement: Research directions for successful aging among America’s diverse seniors (pp. 17–22). Washington, DC: SPRY Foundation.

    Google Scholar 

  • Jervis, L. L., & Manson, S. M. (2006). Native American elders. In R. Schulz (Ed.), Encyclopedia of Aging: Springer Publishing Company.

    Google Scholar 

  • Jervis, L. L., & Manson, S. M. (2007). Cognitive impairment, psychiatric disorders, and problematic behaviors in a tribal nursing home. Journal of Aging and Health, 19(2), 260–274.

    Article  PubMed  Google Scholar 

  • Jervis, L. L., Beals, J., Croy, C. D., Klein, S. A., Manson, S. M., & The AI-SUPERPFP Team. (2006). Historical consciousness among two American Indian tribes. American Behavioral Scientist, 50(4), 526–549.

    Article  Google Scholar 

  • Jervis, L. L., Beals, J., Fickenscher, A., & Arciniegas, D. B. (2007a). Performance on the Mini-Mental State Examination and Mattis Dementia Rating scale among older American Indians. Journal of Neuropsychiatry and Clinical Neuroscience, 19(2), 173–178.

    Article  Google Scholar 

  • Jervis, L. L., Jackson, M. Y., & Manson, S. M. (2002). Need for, availability of, and barriers to the provision of long-term care services for older American Indians. Journal of Cross-Cultural Gerontology, 17, 295–311.

    Article  PubMed  Google Scholar 

  • Jervis, L. L., Shore, J., Hutt, E., & Manson, S. (2007b). Suboptimal pharmacotherapy in a tribal nursing home. Journal of the American Medical Directors Association, 8, 1–7.

    Article  Google Scholar 

  • John, R., Kerby, D. S., & Hennessy, C. H. (2003). Patterns and impact of comorbidity and multimorbidity among community-resident American Indian elders. The Gerontologist, 43(5), 649–660.

    Article  PubMed  Google Scholar 

  • Johnson, J. L., & Cameron, M. C. (2001). Barriers to providing effective mental health services to American Indians. Mental Health Services Research, 3(4), 215–223.

    Article  PubMed  Google Scholar 

  • Johnson, D. L., & Johnson, C. A. (1965). Totally discouraged: A depression syndrome of the Dakota Sioux. Transcultural Psychiatric Research, 1, 141–143.

    Google Scholar 

  • Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.

    Google Scholar 

  • Kramer, J. B. (1991). Urban American Indian aging. Journal of Cross-Cultural Gerontology, 6(2), 205–217.

    Article  Google Scholar 

  • Lewis, T. H. (1990). The medicine men: Oglala Sioux ceremony and healing. Lincoln: University of Nebraska Press.

    Google Scholar 

  • Manson, S. M. (1986). Recent advances in American Indian mental health research: Implications for clinical research and training. In N. I. o. M. Health (Ed.), Mental Health Research and Practice in Minority Communities: Development of Culturally Sensitive Training Programs

    Google Scholar 

  • Manson, S. M. (1992). Long-term care of older American Indians: Challenges in the development of institutional services. In C. Barresi & D. E. Stull (Eds.), Ethnicity and long-term care (pp. 130–143). New York: Springer.

    Google Scholar 

  • Manson, S. M. (1994). Culture and depression: Discovering variations in the experience of illness. In W. J. Lonner & R. S. Malpass (Eds.), Psychology and culture (pp. 285–290). Needham: Allyn and Bacon.

    Google Scholar 

  • Manson, S. M. (1995a). Culture and major depression: Current challenges in the diagnosis of mood disorders. Psychiatric Clinics of North America, 18(3), 487–501.

    Google Scholar 

  • Manson, S. M. (1995b). Mental health status and needs of the American Indian and Alaska Native elderly. In P. D. (Ed.), Handbook on ethnicity, aging and mental health. Westport, CT: Greenwood Press.

    Google Scholar 

  • Manson, S. M. (1997). Ethnographic methods, cultural context, and mental illness: Bridging different ways of knowing and experience. Ethos, 25(2), 249–258.

    Article  Google Scholar 

  • Manson, S. (2000). Mental Health Services for American Indians and Alaska Natives: Need, use, and barriers to effective care. Canadian Journal of Psychiatry, 45(7), 617–626.

    Google Scholar 

  • Manson, S. M., Ackerson, L. M., Dick, R. W., Baron, A. E., & Fleming, C. M. (1990). Depressive symptoms among American Indian adolescents: Psychometric characteristics of the the Center for Epidemiological Studies Depression Scale (CES-D). Psychological Assessment, 2, 231–237.

    Article  Google Scholar 

  • Manson, S. M., Shore, J. H., & Bloom, J. D. (1985). The depressive experience in American Indian communities:  A challenge for psychiatric theory and diagnosis. In A. Kleinman & B. Good (Eds.), Culture and depression (pp. 331–368). Berkeley: University of California Press.

    Google Scholar 

  • Meisenhelder, J. B., & Chandler, E. N. (2000). Faith, prayer, and health outcomes in elderly Native Americans. Clinical Nursing Research, 9(2), 191–203.

    Article  PubMed  Google Scholar 

  • Moberg, D. O. (1997). Religion and aging. In K. F. Ferraro (Ed.), Gerontology perspectives and issues, second edition (2nd ed., pp. 193–220). New York: Springer.

    Google Scholar 

  • Morgan, W. L., Hooper, E.Y., & Saari, J. F. (1997). Earthstar project, Inc. The IHS Primary Care Provider, 22(5), 75.

    Google Scholar 

  • Moss, M. P., Roubideaux, Y. D., Jacobsen, C., Buchwald, D., & Manson, S. (2004). Functional disability and associated factors among older Zuni Indians. Journal of Cross Cultural Gerontology, 19, 1–12.

    Article  PubMed  Google Scholar 

  • National Council of Urban Indian Health. (2007). Administration proposes elimination of urban Indian health program again. http://www.ncuih.org/. Accessed February 13, 2007.

  • National Council of Urban Indian Health. (unknown). http://www.ncuih.org. Accessed Dec. 13, 2006. National Indian Council on Aging. (2004). Preventing and responding to abuse of elders in Indian country. http://www.elderabusecenter.org/pdf/whatnew/abuseindian040707.pdf. Accessed December 13, 2006.

  • National Indian Health Board. (2006). Testimony of the national Indian health board presented to the Senate committee on Indian affairs by Kathy Kitcheyan chairwoman–San Carols Apache Tribe and board member national Indian health board on the President’s fiscal year 2007 (FY07) budget for American Indian and Alaska Native health programs. http://www.nihb.org/docs/budget_fy07_testimony_nihb.pdf. Accessed Oct. 10, 2006.

  • Neligh, G., & Scully, J. (1990). Differential diagnosis of major mental disorders among American Indian elderly (No. DHHS publication no. HRS-P-DV-90). Washington, DC: US Government Printing Office.

    Google Scholar 

  • Nelson, S. H., McCoy, G.F., Stetter, M., & Vanderwagen, W.C. (1992). An overview of mental health services for American Indians and Alaska Natives in the 1990s. Hospital and Community Psychiatry, 43(3), 257–262.

    PubMed  Google Scholar 

  • O’Nell, T. (1996). Disciplined hearts: History, identity, and depression in an American Indian community. Berkeley: University of California.

    Google Scholar 

  • Pickering, K. A. (2000). Lakota culture, world economy. Lincoln: University of Nebraska Press.

    Google Scholar 

  • Rhoades, D. A. (2006). National health data and older American Indians and Alaska Natives. Journal of Applied Gerontology, 25(1 Suppl), 9S–26S.

    Article  Google Scholar 

  • Rhoades, E. R., Marshall, M., Attneave, C., Echohawk, M., Bjork, J., & Beiser, M. (1980). Impact of mental disorders upon elderly American Indians as reflected in visits to ambulatory care facilities.

    Google Scholar 

  • Rodenhauser, P. (1994). Cultural barriers to mental health care delivery in Alaska. The Journal of Mental Health Administration, 21(1), 60–70.

    Article  Google Scholar 

  • Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4), 433–440.

    Article  PubMed  Google Scholar 

  • Salois, E. M., Holkup, P. A., Tripp-Reimer, T., & Weinert, C. (2006). Research as spiritual covenant. Western Journal of Nursing Research, 28(5), 505–524.

    Article  PubMed  Google Scholar 

  • Schweder, R., & Bourne, E. (1984). Does the concept of the person vary cross-culturally? In R. Schweder & R. LeVine (Eds.), Culture theory: Essays on mind, self, and emotion (pp. 158–199). Cambridge: Cambridge University Press.

    Google Scholar 

  • Simić, A. (1993). Aging and ethnic identity: A refutation of the double-jeopardy theory. Journal of Case Management, 2(1), 9–13.

    PubMed  Google Scholar 

  • Simmons, R. C., & Hughes, C. C. (1985). The culture-bound syndromes. Boston: D. Reidel.

    Book  Google Scholar 

  • Somervell, P. D., Beals, J., Kinzie, J. D., Leung, P., Boehnlein, J., Matsunga, D., et al. (1993). Use of the CES-D in an American Indian village. Culture, Medicine and Psychiatry, 16, 503–517.

    Google Scholar 

  • Somervell, P. D., Manson, S.M., & Shore, J. H. (1995). Mental illness among American Indians and Alaska Natives. In I. Al-Issa (Ed.), Handbook of culture and mental illness: An international perspective Madison: International Universities Press, Inc.

    Google Scholar 

  • Storck, M., Csordas, T. J., & Strauss, M. (2000). Depressive illness and Navajo healing. Medical Anthropology Quarterly, 14(4), 571–597.

    Article  PubMed  Google Scholar 

  • Terminsen, J., & Ryan, J. (1970). Health and disease in a British Columbian community. Canadian Psychiatric Association Journal, 15, 121–127.

    Google Scholar 

  • Trimble, J. E., Manson, S. M., Dinges, N. G., & Medicine, B. (1984). American Indian concepts of mental health: Reflections and directions. In P. B. Pedersen, N. Sartorius, & A. J. Marsella (Eds.), Mental health services: The Cross-cultural context (pp. 199–220). Beverly Hills: Sage.

    Google Scholar 

  • U.S. Census Bureau. (2000). American Indian and Alaska Native areas geographic program for census 2000: Notice. Federal Register, 65(121), 39062–39069.

    Google Scholar 

  • U.S. Census Bureau. (2002). The American Indian and Alaska Native population: 2000. Census 2000 Brief. Washington, DC: U.S. Department of Commerce, U.S. Census Bureau.

    Google Scholar 

  • U.S. Census Bureau. (2005). American Indian, Alaska Native tables from the statistical abstract of the United States 2004–2005. http://www.census.gov/statab/www/sa04aian.pdf. Accessed 16 November 16, 2007.

  • U.S. Department of Commerce, & U.S. Census Bureau. (2006). We the people: American Indians and Alaska Natives in the United States. Washington, DC.

    Google Scholar 

  • U.S. Department of Health and Human Services. (2005). Current population reports–65+ in the United States: 2005. http://www.census.gov/prod/2006pubs/p23-209.pdf. Accessed November 26, 2007.

  • Weibel-Orlando, J. (1988). Indians, ethnicity as a resource and aging:  You can go home again. Journal of Cross-Cultural Gerontology, 3, 323–348.

    Article  Google Scholar 

  • Weibel-Orlando, J. (1989). Elders and elderlies: Well-being in Indian old age. American Indian Culture and Research Journal, 13(3 & 4), 149–170.

    Google Scholar 

  • Whitbeck, L. B., Adams, G. W., Hoyt, D. R., & Chen, X. (2004). Conceptualizing and measuring historical trauma among American Indian people. American Journal of Community Psychology, 33(3/4), 119–130.

    Article  PubMed  Google Scholar 

  • Yellow Horse Brave Heart, M., & DeBruyn, L. M. (1998). The American Indian holocaust: Healing historical unresolved grief. American Indian and Alaska Native Mental Health Research, 8(2), 60–82.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah Poff Roman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Roman, S., Jervis, L.L., Manson, S.M. (2012). Psychology of Older American Indians and Alaska Natives: Strengths and Challenges to Maintaining Mental Health. In: Chang, E., Downey, C. (eds) Handbook of Race and Development in Mental Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0424-8_8

Download citation

Publish with us

Policies and ethics