Obstacles for rural American Indians seeking alcohol, drug, or mental health treatment

Bonnie Duran, John Oetzel, Julie Lucero, Yizhou Jiang, Douglas K. Novins, Spero Manson, Janette Beals, Cecelia K.Big Crow, Dedra Buchwald, Buck Chambers, Michelle L. Christensen, Denise A. Dillard, Karen DuBray, Paula A. Espinoza, Candace M. Fleming, Ann Wilson Frederick, Joseph Gone, Diana Gurley, Lori L. Jerwis, Shirlene M. JimCarol E. Kaufman, Ellen M. Keane, Suzell A. Klein, Denise Lee, Monica C. McNulty, Denise L. Middlebrook, Laurie A. Moore, Christina M. Mitchell, Tilda A. Nez, Ilena M. Norton, Theresa O'Neill, Heather D. Orton, Paul Spicer, Carlette J. Randall, Angela Sam, James H. Shore, Sylvia G. Simpson, Lorette L. Yazzie

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


The purpose of this study was to identify factors associated with 4 clusters of obstacles (self-reliance, privacy issues, quality of care, and communication and trust) to mental health and substance abuse treatment in 3 treatment sectors for residents of 3 reservations in the United States. Participants (N = 3,084) disclosed whether they had sought treatment for emotional, drug, or alcohol problems in the past year and, if so, whether they had faced obstacles in obtaining care from Indian Health Services, tribal services, and other public or private systems. Correlates of these obstacles included negative social support, instrumental social support, utility of counselors, utility of family doctors, treatment sector, treatment type, diagnosis of an anxiety disorder, and tribe.

Original languageEnglish (US)
Pages (from-to)819-829
Number of pages11
JournalJournal of Consulting and Clinical Psychology
Issue number5
StatePublished - Oct 2005


  • American Indians
  • Mental health services
  • Obstacles to care

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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