Medical and psychological effects of the threat of compulsory relocation for an American Indian tribe.

The psychological and medical impact of the threat of compulsory relocation on an American Indian reservation community due to the proposed construction of a dam were assessed using the Langner 22-Item Screening Scale, Rotter Internal-External Control Scale, and aggregate medical facility utilization statistics. Participants' feelings about compulsory relocation as well as their estimation of its potential effects were assessed through a number of specific questions employing a Liken-type rating scale. The same data were collected from another culturally similar reservation community. An ancillary study calibrated the Langner scale for the population under study. As opposed to the comparison group, the people threatened with relocation experienced significantly more severe psychological distress and made significantly more use of medical services. The community perceived the effects of the dam to be as distressing as the death of loved ones. Certain variables significantly discriminated successful adjustment in the face of this distress. Much of the research on relocation has occurred within the past 20 years and has generally demonstrated that relocation, whether voluntary or compulsory, functions as a significant stressor and disrupts social support networks (Bodley, 1982; Coelho & Ahmed, 1980; Finsterbusch, 1980; Kantor, 1969; Kiste, 1974; Scudder, 1973, 1979). Compared to voluntary relocation, effects of compulsory relocation have been reported as significantly more negative in terms of the subsequent social support disruption and psychological distress (Butler, McAllister, & Kaiser, 1973; Scudder, 1973; Steinglass, De-Nour, & Shye, 1985). The poor, elderly, long-time residents, minority groups, and community-oriented cultural groups have been defined as high-risk populations in which the psychological effects of compulsory relocation are particularly negative in terms of psychological adjustment and social networks (Finsterbusch, 1980; Scudder, 1973, 1979; Watson, 1980). Additional effects of compulsory relocation include increased morbidity and mortality rates (Finsterbusch, 1980; Fried, 1963; Kowalski, 1978; Scudder, 1973, 1979; Thomas, 1979; Watson, 1980) and increased utilization of medical facilities (Scudder, 1979; Topper &Johnson, 1980). Following involuntary relocation, rural tribal communities have experienced cultural identity crises, resistance to innovation, and increased dependency upon the national government responsible for the relocation (Colson, 1971; Kiste, 1972; Scudder, 1973, 1979). AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH VOLUME 2(1), pp. 3-19 American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) 4 MICHAEL J. O'SULLIVAN AND PAUL J. HANDAL Instead of presenting a consistently bleak picture, previous studies of psychological distress following involuntary relocation have differed in their conclusions regarding the level of distress populations experience (Heller, 1982; Steinglass et al., 1985). Relocations having more profound and enduring effects seem to be those that affect entire communities and are human-made rather than natural occurrences (Steinglass et al., 1985). Even the threat of such relocations has been associated with severe levels of psychological distress and dysfunction (Steinglass et al., 1985; Topper & Johnson, 1980). Since 1968, the American Indian Yavapai community at Fort McDowell, near Phoenix, Arizona, had been threatened with compulsory relocation due to the proposed construction of the Orme Dam. This threat intensified in September of 1968 when the United States Congress passed, and President Johnson signed into law, authorization for the proposed dam and for the relocation of the Yavapai community from the Fort McDowell Reservation. The members of a culturally similar American Indian community (hereafter referred to as the Comparison Reservation) had experienced no such threat of relocation. Most studies investigating the psychological impact of compulsory relocation both for communities and individuals have by necessity examined the parameters of coping and adjustment after the relocation has occurred (Steinglass et al., 1985). The present study was designed to assess the psychological and medical impact of the threat of relocation upon the Fort McDowell community as a function of the source of that threat: the dam. The psychological effects were estimated by the Langner 22-Item Screening Scale (Langner, 1962), and aggregate community medical data were used to estimate the medical effects. An ancillary study calibrated the Langner scale for the populations under study. In addition, the community's feelings about the dam, their estimation of its potential effects if it were constructed, and their locus of control orientation were assessed. It was hypothesized that both the Langner scale and the aggregate medical statistics would reveal more psychological distress at Fort McDowell than in the other culturally similar reservation community. It was further hypothesized that the Fort McDowell community would estimate the effects of the dam's construction as more severe and would have a more external locus of control orientation than would the comparison group. American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh) INDIAN COMPULSORY RELOCATION 5