Alcohol Screening and Brief Intervention as Standard Practice: Working with the American Indian/Native Alaskan Populations

Alcohol use and the resulting problems associated with high-risk drinking in the American Indian/Native Alaskan (AI/NA) population are well-documented, as alcohol misuse has taken an incredible toll on many AI/NA communities. Presently, both overall health issues and alcohol use occur disproportionately within this population. This article provides an updated overview of the impact of alcohol use in the United States and within AI/NA communities specifically. It also provides recommendations for an alcohol-related screening and brief intervention instrument that social workers can begin using in their practice and can be utilized within the AI/NA community.     

Factors predicting placement of urban American Indian/Alaskan Natives into out-of-home care

American Indian/Alaskan Native children have disproportionately been placed into out-of-home care compared to White children in the child welfare system. What were the factors that child protective services (CPS) workers considered when deciding to remove a child from the home? Utilizing data from the National Survey of Child and Adolescent Well-Being, this study examined out-of-home care factors for 2215 urban American Indian/Alaskan Native (AI/AN) and White children. In the urban sample, children from White families were younger and were more likely to be investigated for lack of supervision, while AI/AN families were investigated for physical neglect. In the placement regression models, urban AI/AN children came from homes where caregivers had greater alcohol, drug and mental health problems. Decisions by CPS workers to place AI/AN children may have been influenced by racial bias. A CPS system that acknowledges culture and race may reduce overrepresentation in placement. Efforts to work with AI/AN families prior to a child's removal may prove to be beneficial and less expensive.     

Disability Through a Native American Lens: Examining Influences of Culture and Colonization

Disability is a socially constructed identity. What constitutes a disability and what it means to be a person with a disability can vary across cultures. This article explores meanings of disability within Native American cultures, including how ideas about wellness, balance, roles, and responsibilities influence perceptions of disabilities. This is followed by a review of disability prevalence, discussion of services, and explorations of possible reasons for the disproportionate impact of disabilities in Native American populations. The article concludes with an examination of how the colonial context frames both attitudes about and services for Native Americans with disabilities.     

Urban American Indian/Alaskan Natives compared to non-Indians in out-of-home care

Historically, American Indian/Alaskan Native (AI/AN) children have been disproportionately represented in the foster care system. In this study, nationally representative child welfare data from October 1999 was used to compare urban AI/AN children to non-Indian children placed into out-of-home care. Compared to non-Indian children, urban AI/AN children were older, were more often male, came from poorer homes, and were more frequently placed into group homes/ residential placements. Urban AI/AN caregivers had a greater prevalence of alcohol abuse and mental health problems compared with non-Indian caregivers.     

Re-examining child welfare's response to ICWA: Collaborating with community-based agencies to reduce disparities for American Indian/Alaska Native children

Many state and county child protection systems (CPS) are attempting to reduce the documented disproportionality in out of home placement rates for American Indian/Alaska Native children. This article presents a case example of collaboration between Colorado CPS and an urban American Indian family services agency that was intended to impact this disproportionality. The Denver Indian Family Resource Center created and evaluated a family preservation model that includes both direct services to Native families and CPS-level systemic interventions designed to reduce out-of-home placement. Direct services addressed family stressors and caregiver substance abuse and mental health issues, and incorporated Native cultural values. Systemic interventions focused on collaborative partnerships and provided CPS with practical ways to comply with the Indian Child Welfare Act. Agency data showed an increase in the number of children remaining at home or with extended family. Statewide data showed a decrease in the disparity ratio for placement of Native children compared to White children.     

The Influence of Parent Expectations and Parent-Child Relationships on Mental Health in Asian American and White American Families

Previous studies have suggested that Asian parents’ high academic expectations can lead to negative mental health outcomes among Asian American youth. We explore this hypothesis by analyzing data collected in an affluent, suburban high school with a large Asian American population. We examine the relationships between parent expectations, students’ relationships with their parents, and mental health outcomes among Asian American (predominantly Indian American and Chinese American) and white youth. We find that the quality of parent-child relationships is associated with mental health outcomes and that the association between parent expectations and mental health outcomes is insignificant after controlling for these relationships. We discuss significant differences by race and gender. The findings presented expand our understanding of the influence of Asian parents. They suggest that focusing on improving parent-child relationships, as opposed to altering parents’ expectations, might lead to improved mental health outcomes for Asian American youth, particularly for those in affluent communities.     

Mental Health Care for American Indians in Prison

Abstract

Based on an earlier finding that as many Native Americans in upstate New York received mental health care in prison as outside of prison during a 10-month period, this study was designed to investigate if prisons had become an alternative treatment option for Native Americans with a mental illness in New York State. The study was not able to answer this question due to the limited number of cases and to outside constraints. However, it is possible from the results to provide a picture of mental health needs and attitudes among Native American inmates which is surprising and instructive for those who provide psychiatric care to American Indians, either within or outside of prison walls. A noteworthy finding was the importance placed by these inmates on the use of culturally appropriate ceremonies to assist in their rehabilitation. Low rates of serious mental illness among the American Indian sample highlight the need for further study in this area.     

Impediments to Academic Performance of Bisexual College Students

Abstract

Objective: To investigate health-related impediments to academic success for bisexual college students. Participants: Respondents to the Fall 2011 American College Health Association–National College Health Assessment II (ACHA-NCHA II) survey who self-identified as bisexual, heterosexual, gay, or lesbian. Methods: Secondary analyses of the ACHA-NCHA II data were conducted to compare the experiences of bisexual students with both each other (bisexual men and bisexual women) and those of their nonbisexual counterparts (heterosexual and gay/lesbian students). Results: Bisexual college students are a large and distinct sexual minority group. On all measures with the exception of discrimination, bisexual college students reported the strongest threats to academic success of all sexual orientations. Conclusions: Given the unique impediments for bisexual students, college health professionals should consider specifically addressing needs for bisexual students, bisexual women in particular.     

College Health Professionals and Academic Librarians: Collaboration for Student Health

College health professionals must find new ways of educating students on finding and evaluating consumer health information, specifically in the online environment. Librarians are trained as information professionals; however, librarians at general academic libraries are not taking a lead role in providing consumer health information. Objective: The authors' purpose in this research was to determine the health information resource needs of college and university students and provide a model for collaboration between college health professionals and academic librarians. Participants and Methods: The authors compared data from a national survey on college health (N = 54,111) with their own results from a survey of general academic librarians (N = 17) to create recommendations for synching students' reported health information needs with librarians' resources. Results: Although the Internet was students' second most-often consulted health information source, they ranked the believability of online health information above only television. In the librarian survey, although 12 respondents indicated that health information provision is a library's responsibility, the majority (n = 11) believed their library's consumer health outreach to be passive. Conclusions: The authors offer recommendations for partnerships between college healthcare professionals and academic librarians to better provide this information to students.     

Perceptions of Academic Achievement and Educational Opportunities Among Black and African American Youth

Research focusing on disparities in academic achievement among Black, African American, and other youth has largely examined differences in quantitative risk and protective factors associated with levels of achievement. Few interpretive studies of academic achievement by race or ethnicity have considered how the context of young people’s lives impact their perceptions of academic performance. Furthermore, the lived experiences of Black and African American youth have rarely been considered. This study examined perceptions of academic achievement among a sample of Black and African American elementary and middle school students living in four public housing neighborhoods in a Western US city. Twenty-five Black and African American youth participated in the study. Fourteen youth were in grades 4 and 5, and 11 youth were in grades 6, 7, or 8. Sixty-four percent of participants (n?=?16) were male and 36% (n?=?9) were female. Four themes emerged regarding participants’ perceptions of academic achievement: (1) (in)equity and the internalization of messages; (2) teachers as gatekeepers; (3) family and community factors promoting and inhibiting academic success; and (4) cultural considerations—language, stereotypes, and difference. Implications for improving academic outcomes and reducing the achievement gap among Black, African American, and other students are noted.     

The Impact of Work and Volunteer Hours on the Health of Undergraduate Students

Abstract

Objective: To examine the impact of work and volunteer hours on 4 health issues among undergraduate college students. Participants: Full-time undergraduate students (N = 70,068) enrolled at 129 institutions who participated in the Spring 2011 American College Health Association–National College Health Assessment II survey. Methods: Multiple linear regression and binary logistic regression were used to examine work and volunteer hour impact on depression, feelings of being overwhelmed, sleep, and physical activity. Results: The impact of work and volunteer hours was inconsistent among the health outcomes. Increased work hours tended to negatively affect sleep and increase feelings of being overwhelmed. Students who volunteered were more likely to meet physical activity guidelines, and those who volunteered 1 to 9 hours per week reported less depression. Conclusions: College health professionals should consider integrating discussion of students' employment and volunteering and their intersection with health outcomes into clinical visits, programming, and other services.     

Complex Intersections: Reproductive Justice and Native American Women

This article presents an overview of reproductive justice as a theoretical and activist paradigm developed in response to reproductive oppression in the United States, and focuses on the reproductive justice needs of Native American women, as well as the responses developed by Native American women and their allies to these needs. I make explicit the links between reproductive justice, environmental justice and human rights for Native American communities, and articulate the ways in which reproductive healthcare for Native American women as it is provided by the Indian Health Service (IHS) acts as a fulcrum for these links. Ultimately, the failure of the IHS to meet the reproductive healthcare needs of Native American women reflects the failure of the federal government to meet its obligations to Tribal nations; further, these failures produce structures of reproductive oppression in Native communities which scholars and activists seek to redress utilizing the rubric of women’s reproductive health.     

Culturally Responsive Teaching in an Oglala Lakota Classroom

In response to the widening academic achievement gap between Native American students and other students in the United States, a culturally responsive approach was used in a Native American social studies class with positive results. Eighth-grade Oglala Lakota students in an American History classroom experienced a unit infused with lessons that highlighted Native American culture, history, and values. Students' knowledge, skills, and culture were used as frames of reference for the teacher, enabling students to personally engage with the content and making learning more meaningful. By incorporating culturally responsive teaching practices into the social studies curriculum, teachers not only give students the opportunity to come face to face with multiple perspectives but students are able to come face to face with their own ancestors, bringing history home, and bringing it to life.     

Alaskan villagers' views on problem drinking: "those who forget"

Statewide statistics suggest that problems relating to alcohol abuse represent a major public health problem for Native Alaskans but very little is known about alcohol use on a community level, due to deficient reporting mechanisms and a lack of relevant research. The research reported here was designed to begin to fill this stated need. Alcohol use patterns, the extent of drinking, and associated problems as perceived by residents of two Alaskan Eskimo villages are documented. The structure and effects of alcohol programs in the villages, which represent local attempts to manage alcohol, are also examined. The research demonstrates that it cannot be assumed that all Native Alaskan communities have the same scale of drinking and consequent problems. Differential response to alcohol programs, which have essentially the same structure, is demonstrated and related to the recent development of contrasting levels of community organization in the two villages, which share a common cultural tradition. The utility of a comparative case study approach in examining alcohol problems in Native American communities and the need for expanded research for informed alcohol program planning and implementation are emphasized.     

American College Health Association-National College Health Assessment Spring 2008 Reference Group Data Report (Abridged): The American College Health Association

Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, and impediments to academic performance. Participants: The spring 2008 reference group includes ACHA-NCHA data from 80,121 students at 106 institutions of higher education. Methods: Officials at participating institutions administered the ACHA-NCHA to all students, randomly selected students, or students in randomly selected classrooms. ACHA collected data between January and May 2008. Results: Results from the spring 2008 reference group (N = 80,121) are presented. Conclusions: These data expand the understanding of the health needs and capacities of college students.     

Ethnic pride, biculturalism, and drug use norms of urban American Indian adolescents

This study examines how strength of ethnic identity, multiethnic identity, and other indicators of biculturalism relate to the drug use norms of urban American Indian middle school students. The article distinguishes categories of norms that may affect drug use. Regression analysis of self-reports by 434 American Indian seventh graders attending middle schools in a large southwestern U.S. city indicated that students who had a more intense sense of ethnic pride adhered more strongly to certain antidrug norms than those who did not. Whereas American Indian students with better grades in school held consistently stronger antidrug norms, there were few differences by gender, socioeconomic status, or age. These results have implications in social work practice for better understanding and strengthening the protective aspects of American Indian culture in drug prevention efforts.     

American College Health Association-National College Health Assessment Spring 2007 Reference Group Data Report (Abridged)

Objective: Assessing and understanding the health needs and capacities of college students is paramount to creating healthy campus communities. The American College Health Association-National College Health Assessment (ACHA-NCHA) is a survey that ACHA developed in 1998 to assist institutions of higher education in achieving this goal. The ACHA-NCHA contains approximately 300 questions assessing student health status and health problems, risk and protective behaviors, and impediments to academic performance. Participants: The spring 2007 reference group includes ACHA-NCHA data from 71, 860 students at 107 institutions of higher education. Methods: Officials at participating institutions administered the ACHA-NCHA to all students, to randomly selected students, or to students in randomly selected classrooms. ACHA collected data between January and May 2007. Results: Results from the spring 2007 reference group (N= 71, 860) are presented. Conclusions: These data expand the understanding of the health needs and capacities of college students.     

Associations Between Past Bullying Experiences and Psychosocial and Academic Functioning Among College Students

Abstract. Objectives: This study examined whether childhood bullying victimization was associated with psychosocial and academic functioning at college. Participants: The sample consisted of 413 first-year students from a large northeastern university. Methods: Students completed an online survey in February 2012 that included items assessing past bullying involvement, current psychosocial and academic functioning, and victimization experiences since arriving at college. Results: Regression analyses indicated that reports of past bullying and other peer victimization were associated with lower mental health functioning and perceptions of physical and mental health, but were not associated with perceptions of social life at college, overall college experience, or academic performance. Conclusions: Childhood bullying victimization is associated with poorer mental and physical health among first-year college students. Colleges should consider assessing histories of bullying victimization, along with other past victimization exposures, in their service provision to students.     

Disability Services and College Students with Psychiatric Disabilities

Abstract

Weiner (1999) has suggested that the process of accepting a disability and its associated limitations is often protracted for students with psychiatric disabilities, thus leaving many students unable to fully participate in services or in the design of academic accommodations. This research examines the relationship between psychiatric disability identity and use of academic accommodation services for 57 undergraduates with psychiatric impairments who are experiencing problems in their academic functioning. Willingness to utilize services was related to students' identification as having a psychiatric disability. Social work interventions are needed to support students in accepting psychiatric disabilities while concurrently crafting necessary accommodations.     

A Survey of Wellness/Healthy Lifestyling on College and University Campuses

Abstract

Mental health providers at university counseling and health centers should be alert to the possibility that college students with previously unrecognized attention deficit hyperactivity disorder (ADHD) may present for initial evaluation at their centers. This study was a systematic chart review of 42 students at an Upper Midwest university who were diagnosed with ADHD during calendar year 1993. Diagnoses were made by the treating psychiatrist, who reviewed records for presenting problems; recent associated problems; previous evaluations as a child, adolescent, or adult; and associated problems in childhood. Presenting problems included ADHD symptoms, mood symptoms, nonspecific learning disability, and academic underachievement. Associated problems were depressive disorders, anxiety disorders, drug and alcohol abuse or both, dependency, legal problems, learning disabilities, and eating disorders. Thirty-three percent had been evaluated for academic or behavior problems as children, and 36% had sought previous psychological care for non-ADHD symptoms as adults. Thirty-one percent were presenting at the university health center for their first evaluation. Childhood histories showed educational underachievement, learning disabilities, and behavior problems.