Dialogue 2008

In the wake of European settler-colonialism, the indigenous peoples of North America still contend with the social and psychological sequelae of cultural devastation, forced assimilation, social marginality, enduring discrimination, and material poverty within their respective nation-states. In response to this contemporary legacy of conquest and colonization, a cottage industry devoted to the surveillance and management of the ‘‘mental health’’ problems of Native Americans proliferates in the United States and Canada without abatement. The attention of clinically concerned researchers, practitioners, and policy makers to an indigenous ‘‘patient’’ or ‘‘client’’ base, however, invites critical analysis of the cultural politics of mental health in these contexts. More specifically, the possibility that conventional clinical approaches harbor the ideological danger of implicit Western cultural proselytization has been underappreciated. In this special section of Ethos, three investigators engage the provocative cultural politics of mental health discourse and practice in three diverse Native American communities. Each provides a critical analysis of mental health discourse and practice in their respective research settings, collectively comprising an analytical and political subversion of the potentially totalizing effects of authorized, universalist mental health policy and practice. [mental health, American Indians, psychiatric anthropology, cross-cultural counseling, postcolonialism] Interviewer: Under what circumstances would you take your grandkids, say, into Behavioral Health or Mental Health at [the Indian Health Service clinic]? Native Respondent: I would say that’s kind of like taboo. You know, we don’t do that. We never did do that. . . . I guess it’s like a war, but they’re not using bullets anymore. . . . [Sigh] Like ethnic cleansing, I guess you could say. They want to wipe us out. Wipe the Indian reservations out so they could join the melting pot of the modern White society. And therefore the Indian problem will be gone forever. . . . But they’re using a more shrewder way than the old style of bullets. [Gone in press b:14] At the outset of the 21st century, indigenous communities in North America continue to pursue autonomy and self-determination in the aftermath of centuries of European colonization. The sweeping transformations of Native life and livelihood that resulted from European invasion of the New World have included rampant disease, dislocation, demoralization, and disintegration for indigenous communities, even as many of this continent’s 310 ETHOS ETHOS, Vol. 36, Issue 3, pp. 310–315, ISSN 0091-2131 online ISSN 1548-1352. & 2008 by the American Anthropological Association. All rights reserved. DOI: 10.1111/j.1548-1352.2008.00016.x. First Peoples have met these challenges with creativity, fortitude, resilience, and humor. Nevertheless, alarming numbers of Native Americans still contend with the social and psychological sequelae of marginality, poverty, tragedy, and discrimination within their respective nation-states (Kirmayer et al. 2000; U.S. Department of Health and Human Services 2001). Arising from this historical conjuncture is a cottage industry devoted to the surveillance and management of the ‘‘mental health’’ problems of North America’s indigenous peoples. The attention of clinically concerned researchers, practitioners, and policy makers to an indigenous ‘‘patient’’ or ‘‘client’’ base, however, invites critical analysis of the cultural politics of mental health in Native North America (O’Nell 1989; Waldram 2004). Such politics emerge at the confluence of culture, power, and postcoloniality. Although authoritative definitions of culture remain elusive (Borofsky et al. 2001), shared patterns of activity, interpretation, and interaction persist in most Native North American communities. In regard to cultural processes and practices, Native American societiesFlike most human communitiesFrepresent historically distinctive constituencies whose public, patterned, and intergenerationally reproduced semiotic conventions are both durable and dynamic. Moreover, the cultural processes and practices of these societies differ markedly from those of Europe and the West. In the historical wake of the colonial encounter, however, the nation-states of North America came to dominate many indigenous lives thoroughly and ruthlessly (Stannard 1992). Whether through military conquest, religious repression, reservation captivity, forced assimilation, or resource theft, the exercise of power to contain, to control, or to represent demonstrated Euro–North American cultural dominance over most Native lives (Washburn 1988). Thus, the vast majority of the indigenous communities of North America remain heirs to a shattering European colonialism that waged both material and ideological war on the cultural practices of these societies. Finally, despite a postcolonial shift away from the ideologies of extermination, incorporation, and appropriation, Native communities today remain at the margins of their respective settler societies in terms of opportunity and access to educational, economic, political, and cultural resources (Jaimes 1992). Such marginality serves as the backdrop for the (sometimes-frantic) communal pursuit of viable postcolonial sources of coherence, connectedness, and continuity for grounding personal and collective meaning-making (Gone 1999, 2006a; Gone et al. 1999). Indigenous efforts in this regard have frequently yielded a self-conscious, community-based discourse about ‘‘culture’’ that expresses a commitment to the preservation and revitalization of traditional practices that diverge in important respects from their ‘‘Western’’ counterparts. Not surprisingly, scholarly and community considerations of culture, power, and postcoloniality reveal that indigenous and dominant society cultural differences do not in reality intersect and engage on ‘‘equal footing,’’ but are, instead, subject to negotiation in ideologMENTAL HEALTH IN NATIVE NORTH AMERICA 311