Plain Language Summary: Considerations for Improving Services for Native American/American Indian Individuals with Disabilities and Mental Health Concerns

Note About Use of Terms: We will use the acronym NA/AI for Native American/American Indian. These terms are used to refer to the Indigenous people (original cultures in North America prior to colonization) of the United States. Individuals may have their own preference of how to refer to their culture. For example, someone might prefer a more specific description like Alaska Native. Our recommendation is to use the term an individual prefers.

Many service providers are not familiar with Native perspectives on disabilities. Although NA/AI people are said to have the highest rate of disability of any racial/ethnic group. However, this higher identified percentage can be because of many reasons. For example, NA/AI are at-risk for having many factors affecting health. These include poverty and limited access to healthcare. Also, NA/AI adults report experiencing serious psychological distress more often than the general population. Being aware of cultural beliefs and values is important for professionals looking to provide the best service and support they can.

A study found four important factors on how disabilities are viewed by NA/AI people. This study was done by hearing directly from NA/AI people on this topic.

Disabilities are subjective. Many NA/AI people agreed having a disability means someone needs more help completing tasks. However, people also agreed that disabilities are subjective. This means that people can decide if they think something is a disability. Some examples of disabilities given were disabilities that affect walking, hearing, seeing, talking, and learning. Illnesses that require a lot of help were given as examples too, like cancer and diabetes. However, there are mixed views on whether mental health concerns are a disability.

Disabilities affect a person’s sense of belonging. Many Native communities treat people with disabilities the same as people without disabilities. Individuals with disabilities are seen as “knowledge keepers” and are important in their communities. However, not everyone views disability the same. Some people with disabilities may be separated from others, which affects their sense of belonging. This can happen in school or at work, and among peers, family, and in other relationships.

Action is needed. NA/AI people felt providers could learn more about how Native people view disability and build relationships with NA/AI communities. This could improve care and providers’ cultural competence.

Individuals with disabilities face barriers to accessing services. People with disabilities can face transportation barriers, long waits and distances for services, and lack of internet access. Other common problems discussed were the process of getting a diagnosis, and not knowing how to begin access services. This means that NA/AI peoples might be experiencing one barrier after another when trying to access services.

Some suggestions for professionals and service providers that NA/AI people agreed on are:

1. Build trust in Native communities by getting to know people and learning how to support NA/AI people. If someone shows that they can be trusted and are unbiased, then NA/AI families can feel more comfortable and willing to let someone in to help their child.
2. Learn more about NA/AI culture. This can help professionals communicate and work better with their clients. It can also build rapport with individuals and families.
3. Include NA/AI values and interests into professional support and work with individuals and families.
4. Improve education about what services are available and how they can access them.

You can learn more by reading the full Considerations for Improving Services for Native American/American Indian Individuals with Disabilities and Mental Health Concerns fact sheet and recommended resources shared in it.