Morbidity from mental health concerns are similarly elevated and help to elucidate a more nuanced and complicated picture. National Center for Health Statistics showed that premature deaths among AI/ANs was highest and increased each year from 1999 to 2014, primarily due to consequences of mental health and substance use disorders such as liver disease and cirrhosis, suicide, and injuries. AI/ANs face some of the greatest challenges to their health, mental health and well-being of any ethnic or racial group in the United States. In spite of sovereign nation status, tribal communities still reside within a federal system that has historically undermined their self-determination (Gone & Trimble, 2012) and are challenged by difficult structural and social conditions that differ from the general experiences of others in the United States. American Indian (AI)/Alaska Native (AN) communities represent strength and resilience within a history of attempted genocide, cultural assault, and ongoing systemic oppression. To learn more about Peer Support Canada (PSC), visit or email
Comparisons to other systematic reviews
Lastly, Twitter—the microblogging platform—has been discussed as a venue for Indigenous perspectives to be shared, and for communities to lead social innovation and enhance social and emotional well-being . Noted health-related applications of social media are health promotion and social marketing campaigns for behavior change. In a literature review on social media use among Indigenous young people, Rice et al. 39•• describe several drivers of use.
Indigenous individuals or groups with decision-making responsibilities at the study design level
- Spatial proximity methods examine the minimum travel distance or time needed to access the nearest health service from residential locations , the average travel distance or time to all or selected health services, or the quantity of health services that can be reached within a specified distance that patients can accept .
- Federal grants have supported recruiting and retaining AI/AN doctoral psychology students, including the Indians into Psychology Doctoral Education program at the Universities of North Dakota and Montana, American Indians into Psychology at Oklahoma State University, and Alaska Natives into Psychology at the University of Alaska (Trimble & Clearing-Sky, 2009).
- The solutions for addressing mental health issues for Indigenous Australians requires a ‘best of both worlds’ approach, including clinical and specialised, culturally informed areas of practice (Calma et al. 2017).
- Other noted benefits included the social and emotional well-being benefits of receiving care in one’s own community, reduced feelings of alienation, and the facilitation of family attendance during care 13••.
- The references used in the 45 articles included in the full-text screening were also reviewed, resulting in six additional studies being included in the final set and subsequently analysed.
For the second step, all participants were invited to share, discuss, and explore their proposed directions. As the first step, participants were invited to silently reflect and generate responses on provided cue cards following the facilitators’ posing of the question. It is an effective way to enable people who might otherwise be excluded from decision-making to contribute . NGT is an approach to group dialogue and decision-making that places weight on all participants having an equal opportunity to express a view. Participants were divided into four roundtable groups, lasting an average of 60 min and ranging from thirteen to fourteen participants, to explore each question with a discussion facilitator who resided in the region. Scholars have concluded that the validity and effectiveness of the NGT is reflected in the level of expertise of the participants .
Institutional Review Board Statement
One possible reason for these gaps could be a lack of standardised accessible data at a fine resolution that helps capturing details of mental health service providers and users, impedances of the accessing process (e.g., travel cost), and relevant locational information . This adjustment can better accommodate the service density difference between rural and urban areas for Indigenous people, aiding in measuring accessibility and preventing bias in distributional inequality . There are also government-funded programs such as the Mental Health Services in Rural and Remote Areas program in Australia which could be preferred in mental health service selection of Indigenous people.
For example, while overall rates of suicide and suicidal ideation for Aboriginal youth are higher than in the general population of Canada,13,14 Chandler and Lalonde15 found wide variations in rates of completed suicide in a study of 80 First Nations bands in British Columbia (BC). Children were often removed from their communities; isolated from their families, ways of living and language; and expected to take on a completely foreign demeanor in an atmosphere of strict regimentation. I do not think as a matter of fact, that the country ought to continuously protect a class of people who are able to stand alone… Our objective is to continue until there is not a single Indian in Canada that has not been absorbed into the body politic and there is no Indian question, and no Indian Department, that is the whole object of this Bill.4 The locations of these communities were decided by government and commercial interests with the main purpose of freeing more desirable land for the use of European settlers. The creation of Indian reserves aimed to confine Aboriginal people to small settlements while appropriating their lands. By 500–1000 CE, First Nations peoples had established trade routes across what is now Canada, while the Inuit, descendants of the Thule in Alaska, migrated across the Arctic starting from around 1000 CE.
Indigenous mental health is not a peripheral issue – it is central to the survival, dignity, and resurgence of Indigenous Peoples. As stated in the UNPFII’s 2023 report, Indigenous Determinants of Health in the 2030 Agenda for Sustainable Development (Condo, F. McGlade, H. Roth, G., 2023), makes clear that mental health is not a siloed concern – it is deeply Suicide and young Black men awareness interdependent with every other domain of life. Conventional systems continue to treat mental health and addiction as isolated problems, focusing on symptoms or behaviors rather than the broader, structural roots.