The Indian Health Services (IHS) TeleBehavioral Health Center of Excellence (TBHCE) offered a series of webinars that provide insights into caring for people, including American Indians, with SMI.
Rates of psychotic illness in American Indians are similar to the national average. Risk factors are also common include genetic as well as substance abuse and adverse childhood events among others. Thus, some American Indians may have greater risk depending on their environment. Bullying is more common in American Indian populations and a risk factor for mental illness, substance abuse, and suicide.
The overall presentation, diagnosis, and medication treatments for schizophrenia are largely the same. Approaches like CBT, motivational interviewing, and other commonly used therapeutic techniques are useful for American Indians just like any other populations. The same applies to trauma-informed care. Of course, cultural factors, like with any patient, must be accounted for. For example, on the Navajo reservation there are many elders who do not speak English or it is their second language. Taking into account each person’s cultural and spiritual activities is thus critical in caring for American Indians.
Like in the general population, comorbidity with mental illness is common in American Indians. The same treatments for comorbid conditions are useful. For example, substance abuse, support groups like Alcoholics Anonymous, Narcotics Anonymous, Wellbriety, etc are useful as are medication treatment options too.
For more details, you can listen and watch the full IHS presentations below.