At best, mainstream mental health services are often ineffective with Native American clients, and, at worst, they are a vehicle for Western colonization. As such, the authors explore the notion of abandoning the Western therapeutic project and rebuilding the helping process on the basis of indigenous knowledge foundations. To this end, they discuss a Native perspective on wellness that emphasizes balance among the interconnected areas of spirit, body, mind, and context or environment. From this perspective, mental health is a product of balance and harmony among these four areas. The authors conclude with a discussion of the practice implications of this relationally based perspective in which practitioners target interventions toward improving balance and harmony.

This study details ethnic disparities that exist between American Indian/Alaska Native (AI/AN) youth and White, African American, and Hispanic/Latino youth based on secondary data analysis of Youth Risk Behavior Surveillance Survey from surveys conducted in 2003, 2005, and 2007. Items were selected for secondary analysis based on their relevance to one of five categories including (a) Violence or delinquent behaviors, (b) substance use, (c) sexual behaviors, (d) experience of victimization, and (f) suicide-related behaviors. The analyses suggest that pervasive levels of disproportionality exist between AI/AN youth and youth of other race/ethnicities on an array of risk items. These differences are most profound between the AI/AN and White youth populations, but also exist in numerous areas between the AI/AN and both African American and Hispanic/Latino youth. The findings highlight elevated levels of victimization, drug use, and suicidal behaviors among AI/AN youth. These data must be filtered through the realities of growing up in Indian Country, and must include positive factors not identified in the Youth Risk Behavior Surveillance Survey. Future research should focus not only on disparities, but on culturally appropriate interventions that have been successfully used to address the unique trauma experienced by youth living in AI/AN communities.

This article reports findings from three qualitative studies exploring supports for positive transitions of American Indian/Alaska Native (AI/AN) youth to adulthood. Community-based participatory methods were employed through a research partnership involving a culturally based community agency, the Native American Youth and Family Center (NAYA), the National Indian Child Welfare Association, and Portland State University. Studies utilized a Relational Worldview (RWV) framework, where well-being is understood as a balance among the domains of mind, body, spirit, and context. Collectively, findings demonstrate that NAYA employs culturally grounded interventions to overcome the traumatic histories and current oppressive conditions affecting low-income urban AI/AN youth with mental health challenges and to support their well-being and transition to adulthood. In addition, addressing the mental health and well-being of AI/AN youth in culturally appropriate ways involves consideration of all RWV domains. Recommendations for behavioral health practice are to connect AI/AN youth to culturally specific services whenever possible, utilize cultural consultants, and implement holistic and positive approaches to mental health.

This article is based on the author's address at the National Multicultural Conference and Summit III in Los Angeles, California, in January 2003. The author focuses on culture as a resource--a resource for theories that can inform one's understanding of human behavior; a resource for healing, self-help, and positive emotions; a resource for clinical practice; and a resource for mental health and wellness. The author uses a healing story from native culture to describe the essence of his relational worldview and to reframe the professional thinking about culture as one of the greatest assets for healing and mental wellness rather than as a problem to solve.

The development of Indian child welfare programs since the passage of the 1978 Indian Child Welfare Act has been increasingly influenced by Indian tradition, role models, and natural helping systems. An important dual role—providing services and maintaining cultural integrity—is postulated for these programs.