Today, perhaps more than ever, we see an incredible proliferation of non-Western healing methodologies in the collective American socio-economic context. Many, including myself, might reference many of these attempts to prescribe healing pathways that are foreign to the “American body politic” as appropriation. Though, beyond this, and even more perplexing, if not ironic, is the fact that health systems are based on evidence-based practices – and it is not until a practice is appropriated into our positivist Western culture, that it is widely accepted, typically by way of publication in peer-reviewed journals. What we don’t know, however, will not kill us, it may make us stronger as a collective. Certainly, in my mind, this is the case of culture and healing for co-occurring disorders among American Indian and Alaska Native youth.

Despite not engaging in clinical trials, practice-based evidence and culturally appropriate services are oft cited as the critical tool and metric to which these debilitating co-occurring presentations require for any relief. In this case, traditional practices, cultural and tribal customs are understood to be the arbiter of health and healing in AI/AN communities. Unfortunately, however, the main actors (i.e., Indian Health Service) and federal regulations, as well as the movement of Evidence-based practice serves to only stifle the efforts of tribal and Indigenous communities to serve their communities, according to tradition and origin of their original teachings.

Right now, AI/AN communities are in the midst of a mental health crisis. Not only are AI/AN among the poorest, least educated and youngest of other U.S. races, they also suffer from disproportionate rates of substance misuse/abuse, suicide, depression, unintentional injury, domestic/interpersonal violence, etc.


Such circumstances within AI/AN communities are the result of generations of oppression steeped in a history of discrimination and genocide. The fate of young AI/AN people are in the hands of culture and tradition that breathe in embers, once a spirited fire that warmed each of the 567+ “Federally Recognized” nations. Many understand the co-occurring illnesses to be symptoms of colonization. Without acknowledging the sovereignty of our First Americans to practice their beliefs and own their healing, at any cost to American Society, the children may continue to be lost.

For this reason, it is important to allow space and rights for Indigenous people to practice customs, according to their traditional teachings in federal spaces, especially those spaces that are dedicated, by treaty and law, to the healing and wellness of AIAN people.



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