The PICO question addressed, in this case, is whether the Native American tribal members who live in the rural and reserved areas receive mental health care and services which are culturally appropriate. Research indicates that mental health issues such as depression are rampant among Native Americans. The mental issues are associated with the lives that these people live, where they struggle financially and lack of recognition by the American government. Over time, the United States government has been involved in the lives of the Native Americans by coming up with programs that will improve their lives. Health consultation programs are among the initiatives. The programs are meant to improve the health status of the Indians and ensuring that they have easy access to medical services, even for those living in reserved and rural areas.
Mental health issues face different age groups in the Native American Community. The middle school students are faced with depression due to the struggles of trying to fit in the school. The students also have the pressure of performing academically so that they can improve their family status. Provisions of intervention through cognitive-behavioral treatment have helped in improvising the mental status of students. A study conducted by Listug-Lunde, Vogeltanz-Holm, & Collins (2013) shows that the Indian participants of Adolescent Coping with Depression (CWD-A) course had reduced depressive symptoms after three months follow-up. A clinical relevant but nonsignificant reduction in anxiety symptoms of the participants was noted. The rural native grandparents are required to take care of their grandchildren as the parents work, and that resulted in depression (Letiecq, Bailey, & Kurtz, 2008). Intervention approaches for addressing depression helped to address the issue by assisting the grandparents in coping with being the primary caregivers. Social workers are supposed to understand the Native Americans to assist them, but they are faced with various practice implications.
Delegate your assignment to our experts and they will do the rest.
Practical Implications
Partnering with Employers to Address Workplace Depression
Mental health issues have different implications among Native Americans. Mental health issues such as depression and anxiety affect the quality of life of the patients, and it worsens their general health. The social workers are faced with various issues in the provision of mental health services. The first implication is the social workers partnering with employers to address depression issues. The social workers have to convince the Native Americans to trust them despite the differences in cultural beliefs. The Indians may not be willing to address the issues facing them such as in work, absenteeism, with increased sickness, due to poor health and physical conditions such as heart disease, ulcers, headache, sleeping disorder, high blood pressure and low resistance to infections.
The patients may not be willing to talk about work performance and how it is affected by mental health problems. It causes an increase the error rates, reducing productivity and output, increasing the number of accidents, making poor decision and deterioration in planning and work control. There are among the factors which lead to an employee being fired from work. The relationships at work worsen, due to the foul attitude shown to the clients, increased disciplinary problems and tension and disagreements with workmates. A change in staff attitude and behavior is noted, such as poor time management, high turnover, and lack of motivation. The social worker should address this issue from the perspective of struggling to get employed and how losing the job will affect the entire family. The social workers may work with hiring organizations to provide employment as well as seek coping mechanisms in the place of work. A coping mechanism will also be sought to enable the Native American parents to deal with their issues without forgetting the family responsibilities.
Creating Trust with Native Families
Mental health issues have large effects on family relationships, and social workers have to learn how to handle such a family. When the burden of providing for the family is left to the mothers, for instance, she will get stressed, and it will affect the entire family. The Native Americans are economically disadvantaged, which means that even the wages the employed get are low. Therefore, it would be wise to ensure that each family member is aware of the duty they play to ease the burden on the provider. Married couples, especially among the Indians, are expected to take care of their parents. Since they are working, the parents are expected to provide care for their grandchildren, and that makes them stressed. The children, when sent to school, are faced with the pressure of performing so that they can improve their economic situation in the future. The high expectations result in anxiety, and that affect their academic performance Lunde, Vogeltanz-Holm, & Collins (2013). A social worker should come up with ways in which the entire family can cope with the problems they are facing. In that way, the burden will not be laid on a single person, leaving them to be stressed to the point of affecting their health. When the issues are shared, then the chances of one person being depressed will be reduced. Creating trust will make the family open up about their issues, and that will help determine best intervention methods.
Learning the Culture of the Native Americans
The cost of practice is very high, considering that the Native Americans are economically-disadvantaged. The cost of mental health care is high in the United States. The Native Americans are already marginalized, which means they have issues in accessing high health care services. In addition, when the services are available, they are not culturally appropriate as most providers are not aware of the cultural requirements of the Indians. Native Americans are already having economic issues. Adding the cost of treating mental health issues, which are normally expensive, would drain families of their available money. It would affect the family and financial issues faced with children unable to receive a good quality education. The American government had been getting involved by providing healthcare programs which will help the Indians to access medical attention (Kinzie, Shore, & Pattison, 1972). A social worker in such a case should first learn how Indian culture relates to their mental requirements. In that way, when providing intervention methods, they will be related to cultural believes of these people, thus helping in coping with their conditions. The social workers should thus learn the culture of the Native Americans.
Discussion
The practice implication that can be implemented in my organization is working with companies and organizations to help address the mental issues facing the Native Americans. There are high unemployment levels among the Native Americans, with most families struggling to make ends meet. The children are put under pressure to perform well in school so that their lives can be improved in the future. The grandparents are required to take care of the young ones since they are not working, while the parents become the providers. The grandparents are faced with stress as they are already old, and providing primary care is not easy (Letiecq, Bailey, & Kurtz, 2008). All these issues at home affect the parents most and that, in turn, has implications on their performance at work, due to fear of failing the family.
When the workers are performing poorly, it has large effects on the organizations as they do not get satisfactory results. Therefore, it would be the interest of the company to work with social work in coming up with various intervention approaches to address mental health cases. When the Native Americans are stressed at home, they will bring the stress at work, which lowers their productivity. To avoid it, the company can work with social workers to design the best intervention and motivation strategies. To ensure that the intervention methods are effective, it is essential for social workers to learn about the Native Americans culture (Kinzie, Shore, & Pattison, 1972). The culture has a specific belief about the mental condition, and such factors should be incorporated in the practice for the employees to get the best help. Combining the efforts of the employers and the social workers will address the issue of the high cost of treating mental conditions.
There are different intervention strategies that can be used. Accommodation of nursing mothers, for instance, will reduce the worry associated with infants being left for an entire day without feeding. A company can establish day care where the working mothers bring their children to work and check on them regularly. That will make the employee concentrate on their work and improve productivity. It will also be an advantage to the grandparents who are required to provide primary care for the young ones when the parents are at work. Therapy is the other intervention method. The social workers will be providing therapy sessions to the workers, and the companies should make the sessions mandatory. In that way, the workers will have a safe place where they can talk about the issues they are facing at home and work. The social worker, in turn, will provide coping methods both at work and at home, thus reducing stress. Medical benefits are the other approach that can be applied. It will enable the employees with mental issues to seek high-quality mental services, and that will improve their overall performance at work and home.
To measure the outcome of the practice method, twenty working Native Americans should be included. Ten of them should pass through the indicated intervention methods, while ten should be hired without the organization. The study design should be observing the work performance, such as their output, how they interact with colleagues and clients, motivation, and commitment to work. The employees in companies working with social workers will show better-coping methods with stress and depression with improved performance.
References
Kinzie, J., Shore, D., & Pattison, J. (1972). Anatomy of psychiatric consultation to rural Indians. Community Mental Health Journal, 8(3), 196-207. https://link-springer-com.du.idm.oclc.org/content/pdf/10.1007%2FBF01435082.pdf
Letiecq, B. L., Bailey, S. J., & Kurtz, M. A. (2008). Depression Among Rural Native American and European American Grandparents Rearing Their Grandchildren. Journal of Family Issues, 29(3), 334–356. https://doi-org.du.idm.oclc.org/10.1177/0192513X07308393
Listug-Lunde, L., Vogeltanz-Holm, N., & Collins, J. (2013). A Cognitive-Behavioral Treatment for Depression in Rural American Indian Middle School Students. American Indian & Alaska Native Mental Health Research: The Journal of the National Center, 20(1), 16–34. https://doi-org.du.idm.oclc.org/10.5820/aian.2001.2013.16
