Examining Major Depressive Disorder in Native American Communities to Advance Culturally Competent Care Strategies
Objective: To better understand Native American patients’ experiences and perceptions of depression and treatment.
Methods: Educational sessions hosted by three Tribal Health Centers brought Indigenous patients and providers together to discuss depression care. Surveys assessed patient perspectives regarding major depressive disorder (MDD).
Results: American Indian or Alaskan Native patients (Nf44) predominantly identified as female (70%) with a mean age of 49 (range: 22-78). Sixteen percent reported experiencing depression symptoms for greater than 10 years, 14% for 6-9 years, 16% for 3-5 years, 11% for 1-2 years, and 43% for less than 1 year. The majority of patients indicated no (66%) or uncertain (16%) anti-depressant use. Only 45% felt they had an understanding of depression (Likert 4/5) and its symptoms. Among patients’ biggest concerns about taking anti-depressives were worries about side effects (55%), long-term use (23%), and safety (16%). While 48% felt confident (Likert 4/5) in voicing their needs and preferences, patients identified their top barriers in communicating as not being sure which symptoms are important (32%) and not wishing to complain (16%). Moreover, 32% said not knowing their medication options made it difficult to be involved in care decisions. Patients shared that providers could better support them by asking about their symptoms and experiences with depression (57%) and listening to their concerns (57%).
Conclusions: These data provide insight into the barriers to care and educational needs of Native Americans with depression. The results highlight opportunities for clinicians to enhance culturally competent, patient-centered MDD care among Native Americans.
