Reference no: EM133524732

Case: Native Elder Wisdom, healthcare, mental health, and substance use. Particularly, this forum focuses on the health and wellbeing of this vulnerable population. Early on, we read and discussed that American Indian/Alaskan Natives (AIAN) make up (1.3%) of the total US population with AIAN elders presenting just (0.7%) of the population. Keeping this in mind, let's look at the most recent reports submitted by federal government organizations.

The US Department of Health and Human Services (DHHS), as reported by the Indian Health Services (IHS), indicates that the life expectancy of American Indian and Alaskan Natives is 5.5% less than the total population, which is alarming. Moreover, in comparison with all other races in the US, the mortality disparity rates for American Indian and Alaskan Natives (AIAN) accidents are reported as (93.7%), alcohol (50.0%), chronic liver disease (42.9%), and suicide (20.4%). Further still, SAMHSA (2015) reports a 70% likelihood of native youth being reported for emotional disturbances and major depressive disorders than their counterparts. The overall serious mental health issues reflect (6.3%) higher than the national average for Whites (4.5%) with Blacks and Hispanics signifying (2.9%). Alcohol use disorders, according to SAMHSA (2017) are at 9.7% for AIAN between 18 -44 years of age.

These statistics are distressing yet have raised a flag of awareness that has been missing for much too long. For example, the disturbing data has enlightened some researchers and social work professionals (Pearson, Parker, Fisher, & Moreno, 2014) that culturally specific interventions, treatment modalities, and prevention measures with Indigenous people and communities are critical for the health and wellbeing particularly for children, youth, and adolescents. The past is an ongoing painful present-day reality.

The historical experiences of grief and trauma are realisms for all Native American/First Nations people regardless of tribal territory and federal recognition, private lands, and state recognition (or the lack thereof). Social injustices exist nationally and internationally; time, place or native affiliation holds no partiality in reference to inequalities and imbalances. Although intergenerational trauma is inherent among native people, research is on the horizon for further study on the depth of inherited resilience (Pember, 2016). The resilience concept, as coined by Ore', Teufel-Shone, & Chico-Jarillo (2016) echoes the circular perspective, which is woven with internal and external meaning of families, communities, culture, environment, and spirituality. This discussion forum brings attention to Indigenous/Native American and Alaskan Native youth and adolescents.

Keep in mind the meaning and importance of self-identity in the Indigenous approach toward health and well being.

Reflect on the previous readings and discussion of Indigenous Populations' practices of the four sacred directions and the medicine wheel. Also in your reflection, revisit the seven stages of life and storytelling and further, Indigenous Peoples typically have a distinct characteristic of intuition.

This forum provides an opportunity to discuss and apply your understanding of traditional Indigenous practices (circular models) through the social work perspective. Perhaps you remember the content discussed in the Breadth of Life Theory article on Maslow's Hierarchy of Needs.

The Medicine Wheel provides in-depth coverage of how healing is viewed from the indigenous (circular perspective). Think of circular approaches and the important elements necessary for balance and harmony. Further, be cognizant that the practice of storytelling, is another example of circular view and is known as narrative theory. Storytelling is considered a qualitative approach. Qualitive approaches/interventions are comparable to quantitative interventions which are measurable by collection of empirical data based on linear theory such as cognitive behavior theory. It's important to match and apply both linear and circular approaches in our social work delivery. The knowledge you've obtained thus far in this course will assist in the development and application of critical thinking and the delivery of a successful discussion post.

Social Work Practice: Review the following case scenario carefully.

Case Scenario
Imagine being in a social work office/setting. Your agency provides mental health-substance use services with youth and adolescents. The agency sits in a rural community consisting of a diverse population, which services have been given. However, services have never been provided to Indigenous populations. Everything is running smoothly; it's a calm day, which is allowing you, your co-workers, and supervisors time to engage in "chats". Everyone's office doors are open. There are no clients today. It's Friday.

Suddenly, a Native American teenager (18), walks into the door of the agency. In silence, he/she looks at everyone. The teen is quiet, reserved, and nervous. Everyone in the office is looking. After a brief moment, the client walks over to you and directly asks you for help. The teenager vaguely expresses issues with substance use and depression.

Initially, you may wonder "Why did he/she choose me and not someone else"? and "What could be the problem"? Afterwards, you realize, out of all the workers in the agency, "there must be a reason this person chose to communicate with me". Then, as your thoughts continue, you remember that no one else in the agency has any knowledge on social work practice with Indigenous Peoples or understanding in the application of cultural competency.

Question 1. "What were your initial thoughts when you read this scenario"? to recognize any automatic (unconscious) biases you may have. Proceed into inquiry on

Question 2. "How does the seven generation principle apply to this case"? Share with each other the concept and importance of elder wisdom and its applicability in this case.

Now, that you've broken the ice and your critical thoughts are flowing, continue in your group to address the following questions as well.

Question 3. What would you do upon first meeting this client?

Question 4. In what way would you learn the reason for the youth's visit to the agency?

Question 5. Share if/or how you would inform the youth of your knowledge of Indigenous Peoples.

Question 6. Now suppose you've learned this youth suffers from substance misuse (alcohol) and is considering another suicide attempt.

Question 7. How would you begin to build and maintain a relationship with the client?

Question 8. From a social work approach, how you would work with Indigenous Native American youth and adolescents (clients) who are at risk of or have experiences of suicide and substance use/abuse.

Question 9. Who would you involve in this case? State the reasoning behind your suggestions.

Question 10. Share some suggestions that would incorporate some traditional Indigenous cultural practices (potential circular interventions) through your social work delivery with this client.

Question 11. How would you know your suggestions of intervention or prevention are working?

Question  12. Summarize your case study assessment.