Am Indian Alsk Native Ment Health Res. 2023;30(2):22-54. doi: 10.5820/aian.3002.2023.22.
Native adolescents experiencing mental health challenges, including substance misuse, often prefer to seek support from their peers and other informal sources, which may be due to lack of access to, and cultural fit with, professional behavioral health services. xaʔtus (First Face) for Mental Health is a Tribal community-based intervention designed to strengthen networks of informal mental health support and open pathways to more formal support. We sought insights from key informants to optimize the planning, promotion, and delivery of First Face trainings to seven Tribal communities in the Northwest United States. We conducted three focus groups with (1) teens completing a residential chemical dependency program at the Healing Lodge of the Seven Nations (n = 10), (2) clinical staff representing the Healing Lodge's Behavioral Health Department (n = 9), and (3) community members representing educators and social service professionals at five of the Tribal nations that support the Healing Lodge (n = 6). Discussion generated planning, promotion, and training recommendations. Planning recommendations focused on showing respect for trainees' time by holding the training during convenient times and factoring in trainees' commitments to work and family, integrating the training into high school science or health education classes, and taking steps to protect trainees' physical safety in the age of COVID while avoiding "Zoom fatigue." Promotion recommendations highlighted community members' possible reluctance to become a First Face due to fear about the responsibilities associated with taking on this role and the need to emphasize the personal relevance of First Face training. In terms of training delivery, participants emphasized the importance of including engaging, interactive activities; instructing future First Faces in self-care; and acknowledging the impact of traumatic contemporary experiences on mental health, while at the same time preventing heated and distressing political debates. We describe our response to participants' recommendations and the rationale for those responses.
土着青少年在经历心理健康挑战时，包括药物滥用，他们通常更愿意从同龄人或其他非正式渠道寻求支持，这可能是因为他们无法获得专业行为健康服务，或者这些服务与他们的文化背景不匹配。xaʔtus (第一面孔)心理健康项目是一个部落社区为基础的干预项目，旨在加强非正式心理健康支持网络，并为更多正式支持开辟途径。我们从主要信息提供者那里获得了见解，以优化在美国西北部的七个部落社区中进行第一面孔培训的规划、推广和交付。我们进行了三次焦点小组讨论，参与者包括：(1)在七个民族治疗中心完成住院化学依赖项目的青少年（n=10）；(2)代表治疗中心行为健康部门的临床工作人员（n=9）；(3)代表五个支持治疗中心的部落社区的教育工作者和社会服务专业人员（n=6）。讨论产生了规划、推广和培训建议。规划建议侧重于通过在方便的时间举办培训来尊重学员的时间，并考虑到学员的工作和家庭承诺，将培训纳入高中科学或健康教育课程，以及在 COVID 时代采取措施保护学员的身体安全，同时避免“Zoom 疲劳”。推广建议强调了社区成员可能不愿意成为第一面孔的原因，即担心承担这一角色所带来的责任，以及需要强调第一面孔培训的个人相关性。就培训交付而言，参与者强调了包含引人入胜、互动性强的活动的重要性；教导未来的第一面孔如何自我照顾；以及承认创伤性当代经历对心理健康的影响，同时防止激烈和令人痛苦的政治辩论。我们描述了我们对参与者建议的回应以及这些回应的理由。
