HUNAP Director Discusses How to Improve Indigenous Mental Health Care at HSPH Lecture

Director of the Harvard University Native American Program, Joseph P. Gone ’92, discussed how to improve mental health care for Indigenous populations at an online lecture hosted by the Harvard School of Public Health on Tuesday.

The event was part of the Yerby Diversity Lecture in Public Health series, which brings minority academics to HSPH.

“The problems of Indian Country are not going to be solved by more or better mental health services, more or better counseling or clinical activity,” Gone said. “Our problems are much, much deeper and much more expansive than that.”

Gone described a framework he developed called “Alter-Native Psy-ence,” which he said aims to recast “mainstream psychiatric and mental health professional discourse.”

Alter-Native Psy-ence addresses four domains — distress, well being, treatment, and evaluation.

“When it comes to this Alter-Native Psy-ence — when it comes to distress — it’s not mental disorders, but historical trauma,” Gone said.

“When it comes to wellbeing, we’re not talking about neoliberal individualism, but instead relational selfhood,” he said. “When it comes to treatment, we’re not talking about empirically supported interventions, but rather reclaimed healing practices.”

“In terms of evaluation, it’s not scientific studies, but Indigenous ways of knowing,” Gone added.

Gone explained the challenges of implementing traditional mental health treatment models for Indigenous people, which he said he first learned of during a research project at the Fort Belknap Indian Reservation in Montana.

He said he traveled to the reservation to engage in “open-ended and discovery-oriented inquiry,” instead of using traditional evidence-based practice to gauge the relationship between culture, drinking, and depression. Gone is a member of the Aaniiih-Gros Ventre tribal nation, whose people reside on the Fort Belknap Reservation.

After interviewing policymakers and service providers across Fort Belknap, Gone said he honed in on an interview with Traveling Thunder, a tribal member. Gone said he focused on Traveling Thunder because of the “explanatory model” he used to understand Indigenous mental health challenges.

According to Gone, Traveling Thunder described four historical eras in his explanatory model: pre-colonial existence, colonial contact and alienation of Indigenous custom, post-colonial loss and psychological unrest, and post-colonial revitalization. Traveling Thunder’s account was historical instead of biological or psychological, Gone said.

“He deliberately and clearly identified colonization as the original cause of Indigenous distress,” Gone said. “In doing so, he emphasized systemic factors over interpersonal factors.”

Gone said that when he asked Traveling Thunder if he would bring a loved one to the Indian Health Service — an agency within the U.S. Department of Health and Human Services — he responded that the agency’s mental health services were a “cross-cultural encounter for many Indigenous people” and acted as “a kind of conversion effort.”

“I guess a lot of people want to end up looking good to the white man — then, it’d be a good thing to do,” Gone recalled Traveling Thunder telling him. “Go to the white psychiatrists in the Indian Health Service and say, ‘Well, go ahead and rid me of my history, my past, and brainwash me forever, so I can be like a white man.’”

“I guess that’d be a choice each individual will have to make,” he added.