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Published Online: 6 September 2022

An Integrative Review of Barriers and Facilitators Associated With Mental Health Help Seeking Among Indigenous Populations

Abstract

Objective:

Indigenous populations, compared with majority populations, have a reduced likelihood of receiving professional help for mental health, contributing to health disparities. To increase use of and access to mental health services for Indigenous people, specific factors that affect service use need to be examined. An integrative review was undertaken of the barriers to and facilitators of help seeking and service use for Indigenous populations in Canada, the United States, Australia, and the Pacific Islands.

Methods:

Five databases—PsycINFO, PubMed, Web of Science, Social Services Abstracts, and Bibliography of Native North Americans—and gray literature were searched to identify original studies with data specific to Indigenous people. A qualitative analysis of common themes among the studies was conducted, along with a quality appraisal of included articles. Of the 1,010 records identified, the final synthesis included 41 articles.

Results:

Six main themes emerged: informal supports, which were often used as a first choice for help seeking compared with formal services; structural obstacles and supports; stigma and shame; self-reliance and uncertainty about services; cultural factors and mistrust of mainstream services; and the need for outreach and information regarding mental illness and services.

Conclusions:

Policy implications include needed structural changes to decrease mistrust of mainstream systems and services and increased funding and resource availability. Along with technology-facilitated treatment, programs for Indigenous people, families, and communities that enhance education and foster positive relationships can serve as a first step toward Indigenous people becoming comfortable with the idea of talking about mental health and with seeking treatment.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 272 - 281
PubMed: 36065579

History

Received: 18 August 2021
Revision received: 31 January 2022
Revision received: 30 April 2022
Accepted: 27 May 2022
Published online: 6 September 2022
Published in print: March 01, 2023

Keywords

  1. Utilization patterns and review
  2. Stigma/discrimination
  3. Mental health systems/hospitals
  4. Cultural competence
  5. American Indians/Native Americans
  6. Indigenous health

Authors

Details

Christiana J. Goetz, M.A. [email protected]
Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada.
Christopher J. Mushquash, Ph.D.
Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada.
K. Amanda Maranzan, Ph.D.
Department of Psychology, Lakehead University, Thunder Bay, Ontario, Canada.

Notes

Send correspondence to Ms. Goetz ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Funding Information

This work was partially supported by the Canada Research Chairs Program and the Canada Foundation for Innovation.

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