Native Americans and brief spiritual assessment: Examining and operationalizing the Joint Commissions assessment framework

At the turn of the century, the Joint Commission— the nation's largest health care accrediting organization— began requiring spiritual assessments in hospitals and many other mental health settings frequented by Native Americans. Despite high levels of service use, culturally unique forms of spirituality, and a history of oppression in mainstream settings, no research has explored how to best implement this new requirement with Native Americans. Accordingly, this mixed-method study asked recognized experts in Native American culture (N = 50) to identify the degree of cultural consistency, strengths, and limitations of the new assessment framework and a culturally valid question protocol to operationalize the requirements. The results indicate that the framework is moderately consistent with Native American culture, and a number of practice-oriented suggestions and tools are offered to implement the requirements in a culturally valid manner.