The 130th Annual Meeting of APHA

Abstract #42494

Catherine Woodstock Striley, MSW, PhD¹, Arlene Rubin Stiffman, PhD², Eddie Brown, DSW², Gordon Limb, PhD², and Emily Ostmann, BS². (1) Psychiatry, Washington University, Campus Box 8134, 40 N. Kingshighway, St. Louis, MO 63108, 314-286-2268, strileyc@gwbmail.wustl.edu, (2) Social Work, Washington University, Campus Box 1196, 1 Brookings Drive, St. Louis, MO 63130

American Indian youth symptoms have often been defined and treated at the individual level. The history of oppression and genocide against American Indian communities has left a legacy of unemployment, poverty, and broken social networks as well as unique strengths. This paper explores the predictive power of the life context of youth, including the negative quality of the school environment, the number of traumatic events lived through, and the number of family issues (with addictions, including gambling, and mental health) on youths' mental health and substance use.

The American Indian Multisector Help Inquiry (NIDA-funded) interviewed 403 urban and reservation American Indian adolescents in the southwest part of the country, assessing both mental health and substance use symptoms. Total symptoms were summed. Negative school environment summed the degree of fighting, drugs dealing and other negative behaviors in the school attended. Family issues, including whether family members suffered from mental health and substance problems, were unemployed, and were suicidal were summed.

Traumatic events (mean of 2.05, sd=1.87), negative school (mean of 3.58, sd=2.7) and family issues (mean of 1.86, sd=1.61) in multivariate analysis explained 39% of the variance in total symptoms (mean of 17.48, sd=17.37) (F=69.87, p.<0001). Symptom counts increase by 3.54 (p.<.0001) for every trauma experienced. Each family problem drives an increase of 2.59 (p.<.0001) symptoms. Negative school environment increases symptoms .74 (p.<.001) for every one point change.

Practice and policy must address the context in which youth symptoms arise and are maintained.

Learning Objectives: At the conclusion of this session, participants will be able to

• Articulate the power of youth life context in predicting youth mental health and substance use symptoms;
• Explain the relative importance of experiencing traumatic events in subsequent mental health;
• List at least one practice and policy implication derived from understanding the importance of life context for American Indian youth.

Keywords: Native Americans, Child and Adolescent Mental Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.