Urban Indian psychiatric patients in community care.

This study examines characteristics and problems of, and services received by Indian psychiatric patients in an urban community care setting in Canada. A census of patients of a community mental health service showed 25 Canadian Indian patients out of 2,652 patients in care, or 0.9%; whereas Canadian Indians are estimated to comprise somewhere between 1.6% and 4.8% of the general population. A comparison group of 100 Anglo Canadian patients was matched fourto-one with the group of 25 Canadian Indian patients in terms of sex, age, educational level, and employment status to render the groups sociodemographically comparable. The Canadian Indian and Anglo groups are compared in terms of related socioeconomic factors, accommodations and transiency, selected clinical characteristics, social networks and social support, prior psychiatric service utilization, and psychiatric services currently received. In 1966 less than 16% of registered Canadian Indians was living off-reserve. By 1980 this figure rose to nearly 30%, and some 80% of off-reserve Canadian Indians now live in cities. Further, of the more than 100,000 off-reserve Canadian Indians in 1978, more than one-quarter lived in the province of British Columbia. Numbers are readily available for registered Indians only; no one knows in total how many persons of Indian descent live in Canada's urban centers. Indian Affairs figures for 1980 give estimates for the city of Vancouver, British Columbia ranging between 6,500 and 20,000, or, from 1.6% to 4.8% of the general Vancouver population (Frideres, 1983). Little is known about the utilization by Canadian Indians of urban community mental health services. Fritz & D'Arcy (1982) and Rhoades et al. (1980) find that Canadian Indians under-utilize these services in relation to their numbers in the population, and find an over-representation of substance abuse problems among those who seek treatment. The purpose of this study was to look at characteristics and problems of, as well as patterns of service utilization among, Canadian Indian psychiatric patients in community care. The hope was that such analyses can offer a guide to the ways in which services can be made more accessible and acceptable to a major group of potential recipients of service. The study was conducted at the Community Mental Health Teams of the Greater Vancouver Mental Health Service Society (GVMHSS). Operating under a mandate to care for the seriously and chronically mentally ill, the GVMHSS maintains an active caseload of around 3,100 patients, more than half of whom carry diagnoses involving psychotic conditions. Eight multidiscipliAMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 1(2), OCTOBER, 1987, PP. 16-31. 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)