Challenges to Evidence-Based Practice in American Indian and Indigenous Community Mental Health-View Presentation

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Video Summary

In the video, the speaker discusses challenges to evidence-based practice in American Indian and indigenous community mental health. They emphasize the high prevalence of trauma, substance abuse, and suicide in indigenous communities. They highlight the underfunding and lack of resources for mental health services in these communities. The speaker contrasts evidence-based practice, which focuses on standardized and scientifically supported treatments, with indigenous healing practices, which prioritize cultural, spiritual, and relational approaches. They provide an example of a Lakota medicine man suggesting a fishing ritual to a depressed cancer patient. The speaker also discusses differences in cultural worldviews and psychological mindedness between Western mental health approaches and indigenous healing practices. They conclude by proposing the concept of an alternative science that recognizes the historical and cultural contingency of knowledge-making in mental health.<br /><br />In terms of an alternative indigenous approach to mental health, the speaker advocates for decolonizing psychiatry. They highlight four key domains: distress, well-being, treatment, and evaluation. The alternative science focuses on historical trauma rather than DSM disorders. They reject neoliberal individualism and emphasize relational selfhood, where individuals have connections to their community and responsibilities to non-human relatives. Treatment involves reclaiming traditional healing practices, such as prayer and ceremony. Evaluation is based on indigenous ways of knowing rather than scientific outcome studies. The speaker argues that evidence-based practice may not resonate with indigenous communities and emphasizes the importance of consulting with community members to determine what works best. The alternative science challenges traditional Western approaches to mental health, calling for a more culturally informed and community-driven approach.

Keywords

evidence-based practice

indigenous community

mental health

trauma

substance abuse

suicide

underfunding

indigenous healing practices

cultural worldview

decolonizing psychiatry

relational selfhood

community-driven approach