Healing Mental Health

Bringing more Native Americans into mental health professions.

By Melanie Lenart

Sisseton Wahpeton College is now offering a four-year behavioral sciences degree, the first of its kind at a tribal college. Photo courtesy of Sisseton Wahpeton College.

So many aspects of the Indigenous experience in the United States are challenging for non-Natives to comprehend. To non-Natives, the seizure of Indigenous homelands might seem like the distant past. Yet descendants of the American Indians who survived continue to carry evidence of the trauma from colonization, including attempted genocide, in their genes, according to recent research.  

More recently, many Indigenous people attended brutal boarding schools, or had parents and other ancestors who were forced to attend these off-reservation systems. Many boarding schools started with a mission to “kill the Indian, save the man,” punishing students for using their language or practicing their spirituality. Hundreds of graves at the boarding schools help convey the inhumane conditions. At a minimum, these schools disrupted the cultural and language education of entire generations.

“We made it through all of that, but not without some scars and some baggage that we’re still struggling to come to terms with,” said Justin Douglas McDonald, a professor of psychology at the University of North Dakota and member of the Oglala Lakota Nation. Tragedies continue today, with loved ones lost to the pandemic or to the killing or kidnapping of women and children by perpetrators who know the federal legal system in charge will rarely bother to prosecute violence occurring on reservations.

For all of these reasons and more, there’s a dire need for psychologists—particularly American Indian psychologists—who can understand what their clients are going through and work with them in the context of their culture. McDonald has made it his life mission to bring more American Indians into the field.

“The year I graduated in 1992, we barely topped 100,” McDonald said. “And not just what was there at the time, but 100 ever.” Since that time, McDonald has been directing the university’s Indians into Psychology Doctoral Education program, known as INPSYDE. Since the program launched in 1992, the university has awarded 75 American Indians graduate degrees in clinical psychology, with 30 of them doctorates. 

This program and sister programs at Oklahoma State University and the University of Montana have helped push the tally of American Indians holding doctorate degrees in psychology above 200. “It’s heartening. It makes me able to sleep better at night,” McDonald said. “But they need help, they need support. Because it’s really easy for them to get burned out. They can’t clone themselves five times and be available 24/7 and that’s what the need is like. It honestly is.”

The Indians into Psychology Doctoral Education program at the University of North Dakota caters to Native Ph.D. students in clinical psychology, with the goal of serving indigenous communities. Pictured here is Justin Douglas “Doug” McDonald, who leads INSPYDE, and INPSYDE student Elizabeth Luger, who recently defended her Ph.D. dissertation. Photo by Mike Hess/UND Today.

Another program goal aims to increase the competence of non-Indians who wish to work with Indian Health Services or other groups serving reservations. As it stands, many members of tribal nations resist using the mental health services offered by the agency because they mistrust the western approach typically offered by people unfamiliar with their culture.

Cankdeska Cikana Community College, a tribally controlled college in North Dakota, has a partnership with McDonald to provide telemedicine services for its employees, students and Head Start families, according to college President Cynthia Lindquist. As she explained by email, the college is also working on programs “to fill the pipeline with tribal members to obtain credentials to staff these roles/positions much needed for our community.”

Other tribal colleges also are providing mental health services to students and communities, and are working to develop programs to prepare tribal members for mental health professions. The most ambitious academic program to date is a new four-year degree in behavioral science launched in the fall by Sisseton Wahpeton Community College in South Dakota.

Scott Morgan, the college’s director of Institutional Research & Programs, put a lot of emphasis on developing a program to suit the needs of the tribal nations served by Sisseton Wahpeton College. In looking through the job descriptions posted by them, he realized that half or more of the job categories would benefit from an education in behavioral science. Not only that, but the program would help prepare students for continuing into a graduate degree in psychology, which is typically required for counseling work.

The college accepted its first students in the two-year program in 2016 and the program enrollment expanded so quickly that he and other administrators decided to seek accreditation for a four-year program.

The Higher Learning Commission approved their submission in 2021—just in time for them to submit a National Science Foundation proposal to help support the program. In 2022, the NSF’s Tribal College and Universities Program provided $2.5 million in funding for a five-year project to get the bachelor’s of science degree up and running.

Students are enthusiastic about the offering. Of the college’s 170 students registered for the fall semester, 10 of them were pursuing the bachelor’s degree in behavioral science. Students can focus on criminal justice, sociology or psychology.

“The way people think of behavioral health, they’re thinking of psychologists usually, or psychiatrists. But there’s a lot of lower-level positions too, and broader positions, in my mind,” Morgan said. For instance, graduates of the bachelor’s program could take jobs in child protection services or working with victims of domestic violence, among other things.

Scott Morgan, Sisseton Wahpeton College’s director of Institutional Research & Programs

While the psychology emphasis would be most suitable for someone who plans to pursue a graduate degree in counseling or psychology, graduates from any of the behavioral science focus areas could provide helpful services to their communities, said Morgan, who holds a master’s degree from Capella University in public safety with an emphasis in criminal justice.

For instance, understanding how people operate and think might give a program graduate with the criminal justice emphasis a better idea on how to help keep troubled youth out of jail, and even help integrate them back into the community—especially if they grew up on the same tribal nation.

“That’s mental health in my mind too,” he added.

The University of North Dakota’s Indians into Psychology doctoral program would welcome candidates with a bachelor’s degree in psychology or a related field, McDonald said, including behavioral science. Still, he said incoming students from any college might have some deficiencies if their coursework didn’t include statistics, assessment and psychopathology.

McDonald suggested students in any program could email him if they have questions about their coursework. He also provides mentoring services through the Society of Indian Psychologists. Applications to the INPSYDE program are due by January 1.

The high suicide rates on tribal lands were an issue of concern for both Morgan and McDonald, who said that suicide rates tend to run about four to eight times higher in Indian communities than non-Hispanic white communities.

“The best way to have an impact on suicide prevention is to have more competent practitioners out in the field and in the communities themselves to be effective,” he said.

Unfortunately, even a person with a Ph.D. in clinical psychology does not have the authority to write prescriptions for medications. The right medication can make a difference when it comes to depression and anxiety, debilitating conditions that can sometimes lead to suicidal thoughts or actions.

The American Psychology Association has been supporting a movement to provide “prescription privileges” to licensed psychologists who receive an additional year or two of training. Several states, including New Mexico, Louisiana, Illinois, Iowa and Idaho, already have programs in place that give trained psychologists the right to prescribe medications for depression and anxiety instead of having to refer patients to distant, and more expensive, psychiatrists.

“It’s a really good deal in Indian Country because trying to find a psychiatrist is virtually impossible,” McDonald noted.

Still, the INPSYDE program supports a “broadening circle” of psychologists, with graduates serving as the president of the Montana Psychological Association, a member of the North Dakota Psychology Board of Examiners, and a chair of psychology at Minnesota’s Bemidji State University.

“It’s not hard for our graduates to find work, that’s for sure,” McDonald said.

Morgan, too, said jobs abound for graduates of Sisseton Wahpeton Community College’s behavioral science degrees. In fact, it has been a challenge to keep students in the associate degree program because some employers are eager to hire them after they’ve taken just a few classes in the subject. 

Despite the job security, McDonald presumably would sleep even better if the demand for American Indian Psychologists declined. In fact, many people would rest easier if the supply of Indigenous practitioners could meet the demand.

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Melanie Lenart is a regular contributor to Native Science Report. The grant supporting Native Science Report goes through Sisseton Wahpeton Community College.

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RESOURCES

Society of Indian Psychologists Mentoring Program

https://www.nativepsychs.org/sip-mentorship-program

Email address for Dr. Justin Douglas McDonald: justin.mcdonald@und.edu

University of North Dakota INSPYDE program: https://arts-sciences.und.edu/academics/psychology/inpsyde

Oklahoma State University:  https://aiip.okstate.edu

University of Montana: www.umt.edu/inpsych

Indian Health Service: http://info.ihs.gov

The Suicide Prevention Lifeline is available by phone at 1-800-273-8255.

For more information about how trauma affects genes, a field known as “epigenetics,” see these resources:

https://amber-ic.org/wp-content/uploads/2017/01/ICMN-All-About-Generations-Trauma.pdf

https://archive.discoversociety.org/2016/10/04/the-promise-of-indigenous-epigenetics/

Society of American Indian Psychologists position paper on Missing and Murdered Indigenous Women and Girls in the United States:

https://www.nativepsychs.org/_files/ugd/6c5978_b9372d10baeb49e6a7c1560df9ff5e2d.pdf

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