Rebecca M. B. White, MPH, School of Health Management & Policy, Arizona State University, Box 4506, Tempe, AZ 85287-4506, 480-965-3533, rebecca.white@asu.edu, Sheila S. Tann, RN, ND, College of Nursing, Arizona State University, P.O. Box 872602, Tempe, AZ 85287-2602, and Sharon Cini, Arizona Urban Indian Community Partners Health Group, PO Box 25047, Phoenix, AZ 85002.

BACKGROUND: Few studies have focused on Urban American Indians’ mental health needs. This population is heterogeneous, hard to reach, and often located far away from medical homes. In response to this need a mental health assessment for Urban Indians (UIs) in the greater Phoenix area was conducted using a well-known assessment framework. Integrating national, state, and local data with data from 17 stakeholder in-depth interviews, three windshield surveys, and a clinic questionnaire (n=55), we identified service barriers, service gaps, and discrepancies between symptom reporting and disease recognition in this community. FINDINGS: Within the secondary data, UIs reported spending a week or more in the last 30 days feeling sad, blue or depressed (10%); and/or feeling worried, tense, or anxious (24%). Within the primary data, a conflict arose between UI’s perceptions of mental health and mental illness and the service system’s approaches to prevention and treatment. In a classic work, Pepper (1942) presented four worldviews: formistic, mechanistic, organismic, and contextualism. Perceptions of mental health are dependent upon the community’s worldview. While more mechanistic views shape and define clinical mental disorders and diagnoses in the U.S., organismic perspectives shaped respondents’ perceptions of mental health. Consistent with this conflict, respondents expressed a need for an approach to mental health that is holistic in nature. The findings demonstrate that understanding a populations’ perspective of mental illness is a decidedly fundamental step in developing appropriate prevention and care systems. Recommendations are made for treatment/prevention systems that are consistent with UI’s perceptions of mental illness.

Learning Objectives: