OCD in Native Americans

There are about 4 million Native Americans (including American Indians and Alaska Natives) in the US (1.4% of the population), either alone or in combination with one or more other races. [1] It is estimated that OCD affects around 6.5% of Native Americans, which is a much higher rate than the impact of OCD on the general population. [2] In spite of this, there has been very little research done about OCD in Native American populations. This section will discuss some general information about mental health in Native American communities, which are likely still applicable when talking about OCD specifically.

Views on mental health

Among Native American cultures, the concept of mental illness has different meanings and is interpreted in various ways — cultural and spiritual beliefs greatly influence the outlook on mental illness. Furthermore, these vary widely by tribe, each having a unique culture, heritage, and beliefs. For example, Native Americans can view mental health conditions as:

  • Spirit/supernatural possession [3]
  • An imbalance of natural forces, inner and outer [4]
  • A special gift [5]
  • A hopeless state [6]
  • The terminal phase of another illness [7]
  • Abnormal behaviors of an individual who required punishment [8]
  • A physical ailment resulting from “soul loss” [9]

Views on mental health treatment

The spiritual beliefs of many Native American communities impact not only how they see mental health, but also how they approach treatment.

  • Attributing the symptoms of OCD, for example, to supernatural forces leads to sufferers seeking help from their tribe’s healers. Full trust is placed on these healers to remove the negative forces and heal the individual of their OCD symptoms.
  • This is a different approach to the Westernized treatment of cognitive behavioral therapy (CBT), which tends to be collaborative in nature. [10] Native American sufferers are thus not likely to be completely treated by CBT or other Westernized treatments.

Stigma and shame

The stigma attached to having a mental illness is often a large deterrent against seeking services for Native Americans. The more separation an individual and/or their family has from their tribe’s traditional belief system, the more stigma about mental illness they will have. [11] This means that connection to traditional belief systems may be protective for Native Americans, and might help to reduce some of the stigma associated with mental illness.

On the other hand, the more an individual is assimilated into Western culture, the more likely it is that they will accept the Westernized diagnosis and treatment process. [12] [13] This issue is complicated by the fact that Native American tribes are highly diverse, and different tribes may have varying levels of acculturation.

Some tribal groups attach very little stigma to mental illness because they do not make distinctions from physical illnesses. Conversely, other tribal groups attach high levels of stigma to psychiatric disorders, but accept the Western diagnoses and treatments. [14]

 

Resources

 

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Sources:

  • [1] U.S. Census Bureau. (2007). The American Community—American Indians and Alaska Natives: 2004. American Community Survey Reports. U.S. Department of Commerce. Retrieved from http://www.census.gov/prod/2007pubs/acs-07.pdf
  • [2] Duran, B., Sanders, M., Skipper, B., Waitzkin, H., Malcoe, L., Paine, S., & Yager, J. (2004). Prevalence and correlates of mental disorders among Native American women in primary care. American Journal of Public Health, 94, 71-77.
  • [3] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [4] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [5] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [6] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [7] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [8] Thompson, V. L. (1996). Perceived experiences of racism as stressful life events. Community Mental Health Journal, 32, 223–233.
  • [9] Walker, R. D., & Ladue, R. A. (1986). An integrative approach to American Indian mental health. In C. B. Wilkinson, (Ed.), Ethnic psychiatry (pp. 146–194). New York: Plenum.
  • [10] Jilek-Aall, L. (1976). The western psychiatrist and his nonwestern clientele. Canadian Psychiatric Association Journal, 27(6), 353-359.
  • [11] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.
  • [12] Hooper, K. (1991). Some old questions for the new cross-cultural psychiatry. Medical Anthropology, 5, 229–330.
  • [13] Kleinman, A. (1996). How is culture important for DSM-IV? In J. E. Mezzich, A. Kleinman, H. Fabrega, & D. L Parron (Eds.), Culture & psychiatric diagnosis: A DSM-IV Perspective (pp. 17–18). Washington, DC: American Psychiatric Press.
  • [14] Thompson, J.W., Walker, R. D., & Silk-Walker, P. (1993). Psychiatric care of American Indians and Alaska Natives. In A. C. Gaw (Ed.), Culture, ethnicity and mental illness (pp. 189–243). Washington, DC: American Psychiatric Press.