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In the last decade, the United States has increasingly focused on the reduction and elimination of health disparities in racial and ethnic minority groups.1 Somewhat neglected in these efforts have been mental health disparities for American Indians.2 American Indians remain in a precarious position as an underserved community with limited culturally competent resources to address their mental health and substance-abuse needs.3 The lack of resources continues to prevail despite emerging data that indicate that American Indians’ disparities in mental health and behavioral health occur at alarming rates, which calls for the need for interventions and attention for public mental health, medical, and educational resources.4  As a diverse and heterogeneous population, American Indians consist of approximately 2.5 million members with more than 560 federally recognized tribes and nations.5 They reside in widely separated rural areas in 279 state and federal reservations and in urban locations. American Indians make up approximately 1.5 percent of the total US population with the majority living in the western states of California, Arizona, Oklahoma, Texas, and New Mexico.6 Although many remain linked to reservations, blending traditional and Western healing, nationwide about two-thirds of the American Indian population are classified as urban, with Los Angeles as the largest urbanized American Indian population in the United States.7  Attention to the public mental health needs of urban American Indians is important because of the historical lack of health resources to ensure that this community will thrive emotionally and recover from its history of trauma.8 Specifically, it has been noted that cultural competency in the health care settings will help to reduce, if not eliminate, health disparities.9 As we strive to meet the goals of Healthy People 2020, it becomes clear that attention must be devoted to the broader goal of creating and sustaining culturally competent mental and behavioral health services for both tribal and urban American Indians.

Expanding the Circle: Decreasing American Indian Mental Health Disparities through Culturally Competent Teaching about American Indian Mental Health