American Indian youth: Who southwestern urban and reservation youth turn to for help with mental health or addictions

We illustrate the addictions and mental health service use of American Indian adolescents. Interviews concerning mental health need and service configurations with 401 Southwestern American Indian (AI) youth used questions from the Diagnostic Interview Schedule (DIS) and the Service Assessment for Children and Adolescents (SACA). Seventy-nine percent had mental health or addiction problems, with half meeting criteria for at least one diagnosis. One in 4 youth met criteria for drug dependence/abuse or conduct disorder, 1 in 5 for depression, and 1 in 8 for alcohol dependence/abuse. Most youth were helped by a combination of providers. Youth meeting more diagnostic criteria were increasingly likely to use service configurations with adults, nonspecialist professionals, and specialists, respectively. Regardless of disorder, youth were least likely to use configurations with traditional healers or specialists and there was little difference in rates of use between the two. The lack of services from specialist providers was potentially offset by use of an extensive range of informal adults, nonspecialist professionals, and peers. Since informal helpers, peers, and nonspecialist providers, but not specialists, are providing the bulk of services they must be given support and skills so they can function effectively.