Alcohol use disorder (AUD) is a significant problem for communities throughout the country. For American Indians (AI), the rates of AUD are startlingly high—yet few seek treatment for their dependency. Numerous studies have been conducted on treatment barriers among people with AUD, but few have focused on barriers for AIs, and those that have relied on reservation-dwelling samples. To extend the insight into treatment barriers for AIs, Kamilla L. Venner of the Department of Psychology at the University of New Mexico recently led a study focusing on treatment barriers among a nonreservation sample of American Indians.
The participants were 56 AIs with a history of AUD. All of the participants were interviewed and then completed surveys asking them about barriers to seeking treatment. The participants revealed four prominent areas in which they perceived the most barriers: personally, socially, pragmatically, and general concerns related to help seeking. More than half of the participants cited personal barriers such as stigma surrounding help seeking. Specifically, they believed they would be perceived as weak if they were not able to overcome their alcohol dependency on their own. The participants reported financial restrictions as a major pragmatic barrier to treatment, whether inpatient or outpatient. They also raised concerns about the cultural disparities between treatment professionals and themselves. They were unsure if the clinicians would be sensitive to their cultural and ethnic differences and felt as if most people in treatment were “Anglos.” This supported their contention that they were not “one of them.”
Finally, social barriers existed, including lack of family or community support. In sum, the results demonstrate that AIs may avoid help seeking for AUD as a result of many factors. Although the participants volunteered and were not selected at random, and time of sobriety varied greatly, the overall findings warrant further exploration into ways to decrease perceived treatment barriers among this segment of the population. “Community and family interventions to decrease the stigma of substance abuse problems and increase the perception that treatments and traditional healing are effective would be a worthy endeavor,” Venner said.
Venner, K. L., Greenfield, B. L., Vicuña, B., Muñoz, R., Bhatt, S., O’Keefe, V. (2012). ‘I’m not one of them’: Barriers to help-seeking among American Indians with alcohol dependence. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. doi: 10.1037/a0029757
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