Treatment implications of comorbid psychopathology in American Indians and Alaska Natives.

This paper discusses treatment implications of comorbid psychopathology in the context of American Indian and Alaska Native (AI/AN) cultures and in the context of the Indian Health Service's Mental Health and Alcohol and Substance Abuse Program Branches. Treatment of comorbidity in this population is a particularly difficult problem due to numerous barriers to treatment and a poorly defined treatment system. As in other clinical populations, these patients are high utilizers of the limited treatment services available, but may not receive the type of treatment they need. After describing the extent of comorbidity in this population, the authors present an historical perspective of mental illness that provides an Indian's view of where the system is today in treating these problems. The authors also discuss Western and traditional treatment implications for comorbidity among adults and adolescents. The authors suggest directions for future research in this area.