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Rural American Indian and Alaska Native veterans' telemental health: A model of culturally centered care.
Psychol Serv. 2017 Aug; 14(3):270-278
Publication Type
Journal Article
Cynthia W Goss
W J Buck Richardson
Nancy Dailey
Byron Bair
Herbert Nagamoto
Spero M Manson
Jay H Shore
Author Affiliation
Veterans Rural Health Resource Center.
Psychol Serv. 2017 Aug; 14(3):270-278
Publication Type
Journal Article
Alaska Natives
Culturally Competent Care
Health Services Accessibility
Health services needs and demand
Indians, North American
Mental health services
Models, Theoretical
Rural Population
Stress Disorders, Post-Traumatic - psychology - therapy
United States
United States Department of Veterans Affairs
Veterans - psychology
Veterans Health
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans. Administrative and, to some extent, clinical considerations of these clinics have been reviewed previously. This paper describes a model of care, evolved over a 14-year period, that weaves together evidence-based Western treatment, traditional Native healing, and rural Native communities into 4 main components: mental health care, technology, care coordination, and cultural facilitation. We delineate improvements to care made by addressing barriers such as system transference, provider-patient trust, and videoconferencing. Similarly, the discussion notes ways that the care model leverages strengths within Native communities, such as social cohesion and spirituality. Future steps include selection of appropriate performance indicators for systematic evaluation. The identification of key constructs of this care model will facilitate comparisons with other models of care in underserved populations with chronic and complex health conditions, and eventually advance the state of care for our warriors. (PsycINFO Database Record
PubMed ID
28805411 View in PubMed
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