CHAPTER 4

Mental Health Care for American Indians and Alaska Natives

Introduction

American Indians and Alaska Natives (Indians, Eskimos, and Aleuts) were self-governing people who thrived in North America long before Western Europeans came to the continent and Russians to the land that is now Alaska. American Indians and Alaska Natives occupy a special place in the history of our Nation; their very existence stands as a testament to the resilience of their collective and individual spirit. This chapter first reviews history and the current social con-texts in which American Indians and Alaska Natives live and then presents what is known about their mental health needs and the extent to which those needs are met by the mental health care system.

The U.S. Census Bureau estimates that 4.1 million American Indians and Alaska Natives lived in the United States in 2000¹. This represented less than 1.5 percent of the total U.S. population (U.S. Census Bureau, 2001). However, between 1960 and 2000, the recorded population of this minority group increased by over 250 per-cent, largely due to better data collection by the Census Bureau, an increasing number of individuals who identify themselves as American Indians or Alaska Natives, and an increase in the birth rate of this population. Alaska Natives comprise approximately 4 percent of the combined population of American Indians and Alaska Natives (Population Reference Bureau, 2000). But numbers alone tell little of this population, for it is the social and political history of Native people² and their relation-ship to the U.S. Government that define their distinctive place in American life.

¹ This figure includes people identifying themselves as Hispanic and/or multiracial members of this group. Those identifying solely as American Indian or Alaska Native comprise just less than 1 percent of the U.S. population.

² In 1977, the National Congress of American Indians and the National Tribal Chairmen's Association issued a joint resolution indicating that in the absence of specific tribal designations, the preferred reference to people indigenous to North America is American Indian and/or Alaska Native. A variety of other referents are apparent in the professional literature, including Native Americans, First Americans, and Natives. In keeping with the 1977 resolution, this report adopts American Indian and/or Alaska Native except in limited instances where, editorially, Native people or Native American is used as a general term to refer to both American Indians and Alaska Natives.