Models for successful interactions of psychiatrists with indigenous patients and communities
Introduction Conventional psychiatric services are not always acceptable to indigenous communities and people. Objectives To present successful models of interactions of psychiatrists with indigenous patients and communities based upon our work with five communities in Maine. Methods We review...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821008610/type/journal_article |
| _version_ | 1797616279294574592 |
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| author | L. Mehl-Madrona B. Mainguy |
| author_facet | L. Mehl-Madrona B. Mainguy |
| author_sort | L. Mehl-Madrona |
| collection | DOAJ |
| description |
Introduction
Conventional psychiatric services are not always acceptable to indigenous communities and people.
Objectives
To present successful models of interactions of psychiatrists with indigenous patients and communities based upon our work with five communities in Maine.
Methods
We reviewed the strategies that worked for community interaction from our project for supporting indigenous communities to implement medication-assisted treatment and we reviewed the literature to see what other strategies are reported successful.
Results
Psychiatrists working in these communities may need to share more personal details than to what they are usually accustomed to be accepted. They may need to acknowledge local culture and spirituality and work with traditional knowledge holders to create collaborative healing approaches. As part of this, a narrative approach appeared to work best in which the psychiatrist worked within the stories and beliefs of the community which required taking the time in dialogue to learn those stories and beliefs. Specifically, we address the challenges of flying into northern, rural, and remote communities, of academic physicians consulting to tribal-based opiate treatment programs, of modifying usual counseling techniques such as motivational interviewing to an indigenous population, and of the changes made in practice styles when taking into account the critiques made by indigenous people about medicine in general and psychiatry in particular.
Conclusions
We propose that participatory action-based approaches can improve service delivery to indigenous people. Indigenous cultures share a collectivist mindset in which the needs of the group supersede the needs of individuals, a reliance upon stories, and commitment to a biopsychosocial and spiritual approach.
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| first_indexed | 2024-03-11T07:38:52Z |
| format | Article |
| id | doaj.art-31be51973d874386a3058ba117837225 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:52Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-31be51973d874386a3058ba1178372252023-11-17T05:08:55ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S321S32110.1192/j.eurpsy.2021.861Models for successful interactions of psychiatrists with indigenous patients and communitiesL. Mehl-Madrona0B. Mainguy1Medical Arts And Humanities Program, University of Maine, Orono, United States of AmericaEducation Division, Coyote Institute - Canada, Ottawa, Canada Introduction Conventional psychiatric services are not always acceptable to indigenous communities and people. Objectives To present successful models of interactions of psychiatrists with indigenous patients and communities based upon our work with five communities in Maine. Methods We reviewed the strategies that worked for community interaction from our project for supporting indigenous communities to implement medication-assisted treatment and we reviewed the literature to see what other strategies are reported successful. Results Psychiatrists working in these communities may need to share more personal details than to what they are usually accustomed to be accepted. They may need to acknowledge local culture and spirituality and work with traditional knowledge holders to create collaborative healing approaches. As part of this, a narrative approach appeared to work best in which the psychiatrist worked within the stories and beliefs of the community which required taking the time in dialogue to learn those stories and beliefs. Specifically, we address the challenges of flying into northern, rural, and remote communities, of academic physicians consulting to tribal-based opiate treatment programs, of modifying usual counseling techniques such as motivational interviewing to an indigenous population, and of the changes made in practice styles when taking into account the critiques made by indigenous people about medicine in general and psychiatry in particular. Conclusions We propose that participatory action-based approaches can improve service delivery to indigenous people. Indigenous cultures share a collectivist mindset in which the needs of the group supersede the needs of individuals, a reliance upon stories, and commitment to a biopsychosocial and spiritual approach. https://www.cambridge.org/core/product/identifier/S0924933821008610/type/journal_articleParticipatory action researchOCAP Principlestwo-eyed seeingIndigenous communities |
| spellingShingle | L. Mehl-Madrona B. Mainguy Models for successful interactions of psychiatrists with indigenous patients and communities European Psychiatry Participatory action research OCAP Principles two-eyed seeing Indigenous communities |
| title | Models for successful interactions of psychiatrists with indigenous patients and communities |
| title_full | Models for successful interactions of psychiatrists with indigenous patients and communities |
| title_fullStr | Models for successful interactions of psychiatrists with indigenous patients and communities |
| title_full_unstemmed | Models for successful interactions of psychiatrists with indigenous patients and communities |
| title_short | Models for successful interactions of psychiatrists with indigenous patients and communities |
| title_sort | models for successful interactions of psychiatrists with indigenous patients and communities |
| topic | Participatory action research OCAP Principles two-eyed seeing Indigenous communities |
| url | https://www.cambridge.org/core/product/identifier/S0924933821008610/type/journal_article |
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