Project Leader:  Dr. Annie Belcourt | University of Montana

Abstract

Developing effective mental health interventions for American Indian communities in Montana is a critical public health need. The state of Montana has the highest suicide rate in the Nation and Native Americans in Montana have the highest suicide rate in the state. Prior research within AI/AN communities has revealed that PTSD and trauma exposure are significant problems in the region. The goal of this 6-month study is to engage in full partnership with the Blackfeet Community College, regional mental health providers, and cultural leaders (expert panel) to thoroughly review two evidence-based trauma-focused interventions (EBIs) to identify adaptability (i.e. cultural fit) and feasibility (i.e., appropriate delivery methods).

In addition, we will analyze local epidemiological data, to inform the development of a mental health intervention program for AI/AN residing in or around the Blackfeet reservation. The therapies of focus are two promising evidence based interventions: narrative exposure therapy (NET) and cognitive processing therapy (CPT). Both of these therapies have been extensively assessed within other populations, but not American Indian communities in Montana. Following the review, community members will select one EBP that will be adapted and piloted in a future pilot study. Review of these two EBIs will identify therapeutic-delivery needs and develop strategies to address trauma-related mental health concerns. Study data will benefit tribal and rural communities and the mental health treatment field for AI/ANs in Montana. If successful, findings from this developmental study will facilitate a community and academic partnership to expand treatment capacity and enhance mental health among AI/AN youth living in a rural tribal community.

Study Aims

  1. Work with the Blackfeet community to review and identify at least one trauma-focus EBI to be adapted. Aim 1 will be achieved through three 2-day community meeting with 10 school counselors, health providers, and cultural advisors to review two trauma-focused EBI’s and select at least one trauma focused evidence based program to adapt. The expert panel members will review each EBI and identify cultural appropriateness, assess initial acceptability and feasibility, and identify conceptual changes that will be reflective of Blackfeet culture, values, and beliefs.
  2. Conduct a secondary analysis of the Blackfeet Tribal College epidemiological study (BTC) collected data from 212 young AI/AN adults to identify mental health risk and protective factor and health service access, utilization and barriers. The BTC epidemiological study provides assessment measures on suicide risk, PSTD, depression, generalized anxiety, substance use, adult and childhood trauma, support system and psychological wellbeing. These data will be obtained to provide preliminary data and inform program development.
  3. Prepare for the AI/AN CTRP pilot award and submit an application in 2017. This aim will be achieved through writing the application, submitting it for tribal approval, obtaining a tribal resolution and collaboration letters, a signed data sharing agreement, draft research protocol guidelines, and BNIRB approval.

This project will use community-based participatory methods to engage the community, promote intervention development and adaptation for PTSD treatment. This will provide essential information to improve cross-cultural intervention incorporating traditional forms of knowledge.