Effects of cultural factors on mental health care for American Indians living in New York State

The literature suggests that American Indians need a unique mental health approach based on different cultural norms. Yet research supporting the existence of cultural differences among American Indian mental health clients is rare. The hypothesis of this study was that American Indian and White, non-Hispanic mental health care recipients have differences in demographic characteristics, services received, and attitudes which may necessitate an alternative therapeutic approach for American Indians. Research methods were an analysis of a secondary data base and a field study using a questionnaire. Preliminary analysis identified a difference in rate of mental health services received between all American Indian residents (rate of 1/100 population) and White, non-Hispanic residents (11/100 population) of upstate New York. The study found that thirty-eight American Indian subjects were more likely to have an alcohol problem or to report a religion other than Christian or Jewish, and less likely to have been treated over one year ago or to have completed high school than thirty-eight White, non-Hispanic recipients of services matched by age, gender and program. On an attitudinal questionnaire, fourteen American Indian clients differed from twenty-six White clients regarding the importance to good or poor mental health of the following: has visions, sees things others do not, guides life according to spirits, views things differently at different times, is bored, attempts to improve self, and communicates directly and honestly. There were differences in response between eleven federally enrolled members of the Seneca Nation and three other American Indians. The results indicate the importance of assessing degree of acculturation in social work practice and of the synthesis of the client\u27s belief system with the therapeutic process. Policy implications are that the awareness of cultural differences and the extent of difficulties in care related to these must be clarified so that American Indians can help design their own mental health care. Future research needs to replicate these findings with other American Indian groups and to identify successful treatment approaches based on different cultural characteristics and beliefs