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Indigenous Peoples

HomeTopicsIndigenous Peoples

Calling for Truth & Reconciliation

There are an estimated 370 million Indigenous peoples living around the world who have distinct cultures, languages, traditions, and ways of life. We believe that it is important to celebrate Indigenous heritage while also acknowledging the historic and ongoing oppression of Indigenous people.

Many Indigenous peoples have been historically marginalized, subject to violence, and displaced from their ancestral homelands, with significant consequences. Disparities in health and well-being are prominent, with Indigenous adults more likely to experience poverty, reduced life expectancy, and higher rates of mental health concerns and metabolic disease.

In working for change, it is critical that Indigenous leaders are centered in these efforts at all stages, ensuring that measures are appropriate and meaningful. The Global Alliance emphasizes transitional justice, truth and reconciliation, and empowerment and self-determination of Indigenous peoples in our work. Starting with widespread acknowledgment and discussion of the historic displacement and oppression of Indigenous peoples, we believe global communities must take a holistic response to address the social, economic, and legal/political harm caused by ongoing colonization of Indigenous lands and peoples. Actions should not only seek reconciliation and peace but also focus on sustainable transformation that empowers Indigenous communities to achieve well-being.

Our Commitment

From 2007–2009 the Global Alliance supported the National Multicultural Conference and Summit. At the 2007 meeting in Seattle, Washington, we presented a symposium: “The Forgotten Race: American Indians in Today’s World.”

Through our organizational awards, we are committed to recognizing the efforts and contributions of Indigenous people to research, policy, and practice. Select award winners include:

2019 Vera Paster Award Recipient

Jill Fish, PhD

Creator of OrigiNatives, a digital storytelling platform for Native communities

Check out Jill’s TED Talk on honoring Indigenous cultures and histories.

Research on Indigenous Peoples in AJO

Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents


Substance use (SU) among adolescents is a critical public health concern that increases the risk for negative outcomes. Although Asian American (AA) adolescents tend to report low rates of SU, Native Hawaiian and Pacific Islander (NH/PI) adolescents often report significantly higher rates of use. Yet, NH/PI youth are seldom studied as a separate group. Consequently, little is known about the factors involved in SU among NH/PI adolescents and how to prevent it. This prospective study investigated the effect of ecological risk and protective factors at the individual, family, and school levels on SU for NH/PI adolescents. This prospective study utilized longitudinal data from 120 NH/PI adolescents who were7 part of an SU prevention program. Information was collected at two time points—Time 1 and Time 2 (32 weeks later)—and included adolescents’ SU behaviors and individual, family, and school factors. The parents of these adolescents also provided data; all information was self-report. Positive academic attitudes at Time 1 were negatively associated with alcohol and other drug (e.g., marijuana) use at Time 2. Specifically, NH/PI adolescents who had more positive attitudes toward their school, peers, and teachers reported less alcohol and other SU. Prevention efforts may be most effective for NH/PI adolescents if addressed within the school context. This may include programs implemented in schools, utilizing teachers as role models, and/or promoting prosocial peer relationships to support positive behaviors. Additional implications are discussed.

PHuang, C. Y., Nishioka, S. A., Zane, N. W., & Uchigakiuchi, P. (2021). Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents. American Journal of Orthopsychiatry. Advance online publication.

Hazardous drinking, alcohol use disorders, and need for treatment among Pacific Islander young adults


Pacific Islander (PI) young adults are suspected to bear heavy risk for hazardous drinking, alcohol use disorders (AUD), and alcohol-related harms. Yet, PIs remain among the most understudied racial groups in the United States—creating a lack of empirical data documenting their alcohol use problems and treatment needs. The present study presents the first known data on PI young adults’ hazardous drinking, possible AUDs, alcohol-related harms, and treatment needs. Survey data were collected from 156 community-dwelling PI young adults (40% women, age 18–30 years) in 2 large PI communities: Los Angeles County and Northwest Arkansas. We screened participants for alcohol, cigarette, and marijuana use, hazardous drinking, possible AUD, alcohol-related harms, and past-year need for mental health and substance use disorder (SUD) treatment. Logistic regressions examined whether experiencing possible AUD and alcohol-related harms were associated with past-year need for treatment. PI young adults reported 78% lifetime rate of alcohol use with 56% screening positive for hazardous drinking, 49% for any possible AUD, and 40% experiencing significant alcohol-related harm (e.g., health, finances). Yet, just 25% of participants reported past-year need for SUD treatment. Although having possible AUD was not associated with perceived SUD treatment need, experiencing any alcohol-related harm associated with 4.7–13.2 times greater adjusted odds for needing treatment. Therefore, despite having low self-perceived treatment need, PI young adults experience excessive burden of hazardous drinking and alcohol-related harms. Given the profound negative social and health effects of AUDs, culturally grounded interventions should be designed to reduce PI young adults’ elevated rates of hazardous drinking and alcohol-related harms.

Subica, A. M., Guerrero, E., Aitaoto, N., Moss, H. B., Iwamoto, D., & Wu, L.-T. (2020). Hazardous drinking, alcohol use disorders, and need for treatment among Pacific Islander young adults. American Journal of Orthopsychiatry, 90(5), 557–566.

Psychometric evaluation of depression measures with Northern Plains Indians


Numerous psychometric measurements are used to assess for mental health problems in Native American and Alaskan Native (AI/AN) populations; however, few studies have been carried out to assess their validity and reliability within these populations. This study was designed to assess the validity and reliability of numerous measures among the Northern Plains Indians. This article is a partial report, focused on the psychometric measures directed at detecting depression, namely the Beck Depression Inventory (BDI) II, the Center for Epidemiologic Studies Depression (CES-D) Scale, the Tri-Ethnic Depression Scale (TEDS), the Beck Hopelessness Scale (BHS), the Beck Anxiety Inventory (BAI), and the Symptom Checklist-90-Revised (SCL-90–R). Results revealed moderate to strong correlation across all measures, alpha coefficients that exceeded published alphas for the general population, and overall indicated their validity and reliability of these measures, and a 2-factor solution for the BDI-II. While there were limitations to the study, analysis of the results supports the use of each measure with the Northern Plains Indians (NPI) subpopulation, that the NPI subpopulation scored similar to the general population.

Gray, J. S., Brionez, J., Petros, T., & Gonzaga, K. T. (2019). Psychometric evaluation of depression measures with Northern Plains Indians. American Journal of Orthopsychiatry, 89(4), 534–541.

Assessment of anxiety among Northern Plains Indians


This study is an examination of the reliability and validity of the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) in a sample of NPIs (N = 529). Validity was assessed by comparing BAI scores among 3 different diagnostic categories in a clinical sample (anxiety disorder, mood disorder, and comorbid anxiety/mood disorder diagnostic groups) and a community sample of participants with no self-reported mental health diagnoses. The BAI was also compared with depression, quality of life, and anxiety measures to assess validity. Support toward the validity of the BAI was demonstrated through high correlations with similar measures of anxiety, as well as higher scores among the clinical samples compared to the control sample. The BAI also demonstrated strong internal consistency (α = .95). An exploratory factor analysis indicated the presence of 3 factors: (a) fear, (b) cardiorespiratory, and (c) body instability symptoms. The BAI was unable to accurately differentiate between mood disorder and anxiety disorder groups. Results of this study indicate that the BAI may be a useful instrument in the assessment of anxiety with NPIs; however, the BAI is potentially unsuited to differentiating between mood disorders and anxiety disorders with this population.

Gray, J. S., McCullagh, J. A., & Petros, T. (2016). Assessment of anxiety among Northern Plains Indians. American Journal of Orthopsychiatry, 86(2), 186–193.

What are the policy issues related to the mental health of Native Americans?


The range of severity of social problems across the 564 federally recognized tribes of American Indians and Alaska Natives vary substantially, and Pine Ridge reservation faces more severe challenges than most. Nonetheless, Pine Ridge is certainly not unique in its struggles with attempted suicides, crushing poverty and disease, and lack of prospects for employment. Native American youth 15–24 years old are committing suicide at a rate more than 3 times the national average for their age group, according to the surgeon general. In fact, suicide has become the second leading cause of death for those ages 10–34. In the Great Plains, the suicide rate among Indian youth is 10 times the national average. The reservations on which many live are among the poorest places in the country, and the tribes experience all the consequences that come with poverty. Native American people have a rate of depression that is twice the national average, alcoholism that is 5.5 times the national rate, and heart disease that is twice the national average. To understand the daunting health-related statistics, one must look to history.

McLeigh, J. D. (2010). What are the policy issues related to the mental health of Native Americans?[Editorial]. American Journal of Orthopsychiatry, 80(2), 177–182.

Disparities in drug use and disorder: Comparison of two American Indian reservation communities and a national sample


Population-based samples provided estimates of drug use and disorder in two American Indian populations. Comparison to a national sample revealed tribal-national, intertribal, and intratribal gender and age differences. Findings suggest that disparities in drug use and disorder are complex, characterized by important variations across diverse American Indian tribal cultures.

Rumbaugh Whitesell, N., Beals, J., Mitchell, C. M., Spicer, P., Novins, D. K., Manson, S. M., & AI-SUPERPFP Team. (2007). Disparities in drug use and disorder: Comparison of two American Indian reservation communities and a national sample. American Journal of Orthopsychiatry, 77(1), 131–141.

Trauma and posttraumatic stress disorder symptomatology: Patterns among American Indian adolescents in substance abuse treatment


In this study the authors examined the prevalence and correlates of posttraumatic stress disorder (PTSD) and trauma symptomatology among a sample of 89 American Indian adolescents in a residential substance abuse treatment program. These youths reported an average of 4.1 lifetime traumas, with threat of injury and witnessing injury being most common; molestation, rape, and sexual attack were least common. Approximately 10% of participants met the Diagnostic and Statistical Manual IV Text Revision (DSM-IV-TR) criteria for full PTSD, and about 14% met the criteria for subthreshold PTSD. Molestation (including rape and sexual attack), experiencing 6 or more traumas, and a diagnosis of abuse of or dependence on stimulants were significantly associated with PTSD. Findings indicated that trauma was a pervasive phenomenon among this population, with sexual traumas being particularly stigmatizing, resulting in high rates of posttraumatic symptomatology, specifically PTSD.

Deters, P. B., Novins, D. K., Fickenscher, A., & Beals, J. (2006). Trauma and posttraumatic stress disorder symptomatology: Patterns among American Indian adolescents in substance abuse treatment. American Journal of Orthopsychiatry, 76(3), 335–345.

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