American Indian youths experience a variety of conditions related to mental health functioning. These include alcohol and drug abuse, depression, anxiety, suicide, and dual axis diagnosis (Flynn, Clark, Aragon, Stanzell, & Evans-Campbell, 1998). This is compounded when one adds the pressures of growing up in an urban environment in which the struggle to define oneself as an Indian person is difficult, especially if one is of mixed heritage. In large part, it appears that many of these issues stem from greater social, economic, and sociocultural problems within the community, including the intergenerational trauma that impacts all Native people.