Diagnosable Mental Disorders Among American Indians and Alaska Natives in the United States: A Scoping Review

Abstract

Objective: American Indian/Alaska Native (AI/AN) communities experience critical health inequities in the United States. In American mental health research, these inequities are defined by disorders classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Therefore, it is vital to the pursuit of health equity to understand howdiagnosable mental health disorders among AI/AN people have been characterized and understood.We conducted a scoping review to address the question: What havewe learned from existing research concerning diagnosable mental disorders among AI/ANs in the United States? Method: A literature search was conducted on February 16, 2024, in PsycINFO, PubMed, Embase, andWeb of Science. Results: The final corpus was composed of 152 peer-reviewed articles that were published between 1973 and 2024 and addressed a wide variety of research questions. The corpus was reviewed for disorder focus, sampling and methodology, diagnostic approach, and reoccurring project and investigator groups. Substance use disorders were the most frequently studied, followed by depression. Symptom screeners were the most commonly used diagnostic approach (37% of corpus studies). Trends in sampling strategies and populations studied are also reported. Discussion: Based on these findings, we discuss insights for future research and the limitations of the DSM as a taxonomy that has never been cross-culturally validated for AI/AN populations and may conflict with AI/AN conceptions of health, distress, and desirable intervention.