|Eleanor Yurkovich (standing)
is the lead investigator for the three-year project.
Assisting her is Izetta Lattergrass, a UND graduate
and member of the Three Affiliated Tribes.
Chuck Kimmerle/University Relations)
the dimensions of treating mental illness of American
Mental illness has as significant an impact within
the American Indian community as on the population
at large. The reservation environment, however, poses
special challenges — and opportunities —
Researchers at the UND College of Nursing have completed
the second phase of a project focusing on mental health
issues of rural reservation-dwelling American Indians
with chronic mental illness. The principal investigator
is Eleanor Yurkovich, associate professor of nursing.
A three-year, $80,000 Otto Bremer Foundation grant
is funding the study titled, “A Needs Assessment
Focused on Defining Health and Health-Seeking Behaviors
of Native American Indians Experiencing Severe and
Persistent Mental Illness.”
In Phase I of this project, the researchers interviewed
mental health care providers. This information underscored
a major shortcoming in that only acute health care
services exist on the reservations, without long-term
treatment programs for chronic mental health problems.
In Phase II, the researchers interviewed American
Indians experiencing chronic mental illness about
their definitions of health, their health-seeking
behaviors, and the treatments that work for them.
The setting of the study was four reservations in
Northern Plains states that include five Indian Health
Service Human Service Centers.
Phase III will involve taking these findings back
to health care providers, tribal councils, and other
involved parties. The researchers will work with them
on defining the next steps needed to improve mental
health care and expand services, including soliciting
Whether among American Indians or the population at
large, there are obstacles in treating persons experiencing
Individuals often use denial until a health crisis
forces them to access acute care resources. Mental
health patients sometimes hide their illness by self-medicating
their symptoms through chemical use/abuse. Culturally
related stigma and lack of understanding can interfere
with the ability of patients to receive support from
significant others. Trauma, depression, intergenerational/historical
grief, anxiety/panic disorders, and schizophrenia
Yurkovich noted that improvements are needed to the
existing reservation health care system in terms of
funding, staff, and infrastructure. More treatment
opportunities can draw upon the profound resilience
of American Indians themselves.
Both Phases I and II revealed that wellness in the
community can be built through community centers,
or “psychosocial clubs,” for peer support
and sheltered work opportunities for “meaningful
doing” that establish purpose and enhance self-esteem.
A dream exists among health professionals, Yurkovich
observed, to develop programs that integrate American
Indian ceremonies and traditions more visibly into
treatment plans. The goal is to enhance patients’
mental health by reinforcing a sense of belonging
and connection to their culture.
The researchers emphasize the importance of treating
the person with mental problems on the reservation
where there is cultural responsiveness, a framework
of tribal beliefs and customs, the opportunity to
access Native healers, and a holistic approach.
“We’re trying to get the information summarized
and sent back to tribal people so they can take it
to Senate hearings and try to get more funding for
the services needed,” Yurkovich said.
Her fellow researchers at UND are all enrolled American
Indians. Co-principal investigator Donna Grandbois,
clinical instructor and a psychiatric nurse, holds
two UND degrees and is working on her doctorate. She
is an enrolled member of the Turtle Mountain Band
of Chippewa. Izetta Lattergrass holds a B.A. in psychology
from UND and is a member of the Three Affiliated Tribes.
Sara Roy, a member of the White Earth Band of Chippewa,
holds a B.S. in nursing from UND.
Yurkovich came to UND six years ago from Montana State
University. She holds a master’s degree in nursing
from Loyola University in Chicago and a doctorate
from Montana State.