Department of Pediatrics, University of New Mexico School of Medicine, Albuquerque, 87131, USA.
Am J Community Psychol. 2010 Dec;46(3-4):386-94. doi: 10.1007/s10464-010-9347-4.
American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15-24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed.
美洲印第安人/阿拉斯加原住民青年代表着许多民族和部落的力量和持续生存。然而，他们目前面临着许多健康差距和挑战，包括美国 15-24 岁人群中自杀率最高。我们对美洲印第安人/阿拉斯加原住民青年心理健康文献的综合回顾强调了导致行为健康差距的七个焦点原因：(1) 暴力和创伤暴露以及创伤性丧失的高发率，(2) 过去和现在的压迫、种族主义和歧视，(3) 护理系统资金不足，(4) 忽视在服务提供、政策和资金方面的有效本土实践，(5) 过度依赖循证实践，(6) 护理系统和提供者的文化能力不足，(7) 护理障碍。提出了七项政策建议，这些建议认识到超越对西方护理模式的独家依赖的重要性，并寻求促进个人、家庭、社区、行为健康护理服务系统和社会结构的转变，这些建议得到了支持和讨论。
