Introduction
One of the most disturbing aspects of life as a Native American is the fact that this population suffers from historical trauma—the trauma of having lost their land, their way of life, and essentially their freedom to self-determination when the American colonies began to assert themselves and push the Natives off their land. The Cherokee were expelled from the East, for instance, by the Indian Removal Act in the 19th century, and countless more were slaughtered in brutal territorial wars of conquest as the US expanded westward. Historical trauma is a real struggle for this invisible minority (Brown-Rice). It has led to a deterioration of mental health among Native Americans, who in turn now suffer from alcoholism, substance abuse and a lack of access to adequate mental health care (Hartmann and Gone). Compared to other ethnicities and racial groups, Native Americans experience higher lifetime substance abuse rates. There are many factors that contribute to this statistic: historical trauma, violence, unemployment and low levels of attained education—but at the end of the day it is evident that Native Americans have been marginalized, historically speaking, for centuries—and such marginalization denies them equal opportunity and boxes them into a way of life that is psychologically dehumanizing (“Substance Abuse Statistics for Native Americans”). Famous Native American novelist Sherman Alexie writes about what it is like to be an alcoholic Native American in his novel Flight. He also describes what it is like to be, basically, an orphan—which is what many indigenous people feel themselves to be in white American where Uncle Sam is the symbol of patriotism. There is literally no representation of Native American greatness in the mainstream consciousness. It should not be surprising, therefore, to find that this invisible population suffers from alcoholism and poor mental health more than any other population.

Understanding the Native American Experience

Before analyzing the alcoholism and mental health of the Native American population, it is helpful to understand this population just from a humanistic point of view. Few authors have penetrated the Native American psyche like Sherman Alexie. And of course he is a Native American, so his perspective is vital for understanding what it is like to be of this population. In Flight, Alexie describes the life of a Native American boy who has lost a mother to cancer and whose father is lost in a haze of alcoholism. The boy bounces from one foster home to another, but all the Native American fathers he meets are abusive and violent drunks. There is some self-destructive impulse in Native American men, as though they are continually heaving themselves upon their own spears and daggers in despair at having lost their way of life two centuries ago.

There is also the fact of racism, and Alexie describes this in very bitter detail in The Absolutely True Diary of a Part-Time Indian: “Our white dentist believed that Indians only felt half as much pain as white people did, so he only gave us half the Novocain” (2). It is an off-hand comment meant as a joke, but it does get to the heart of the matter for Native Americans. They have been mistreated as a population and that pain they have experienced is real. It is part of their historical trauma and part of the reason so many of them seek to self-medicate. It is also why so many of them need mental health services. Yet the issue remains: they are a population that is marginalized; access to adequate mental health care is not available to them. Because no one is there to treat them, they treat themselves—with alcohol—which only makes matters worse.

Native Americans carry a great deal of baggage in terms of historical trauma. That baggage has never been dealt with in a meaningful manner. The foremost authority on this matter is Alexie: his novels explore the underlying reality of the most invisible population. Yet Alexie is an author who is often marginalized and even canceled in some parts of the US. He is seen as provocative and worthy of being banned in schools because he brings up matters that some take as offensive—not understanding that Alexie is merely reflecting the truth of the situation. If the truth of what the Native American population has endured for centuries is not confronted, their situation will never improve. Mainstream America has driven them out of view and now even still refuses to give them any consideration.

Alcoholism

Alcoholism is a significant contributor to mental health problems, such as depression and suicide. Native Americans are highly susceptible to these problems, as the Centers for Disease Control and Prevention note: “Death records show that American Indian and Alaska Native (AI/AN) death rates for both men and women combined were nearly 50 percent greater than rates among non-Hispanic whites during...…is often spent on alcohol or substances that are abused, it is unlikely that the Internet is a readily available option. That means even if the technology is available for telehealth-based therapy, the likelihood of it being used as an access point remains low.

That leaves individual care providers establishing themselves in Native American communities to increase health literacy and provide mental health care where it is needed. Social workers can play a part in bringing about change in a system that has neglected this community. Social workers are on the front lines and they can be activists in their own right by advocating for invisible populations like the Native American community. Their advocacy can be important in bringing to light issues that the federal government can address. But even here the government works so slowly and so inconsistently that it is difficult to see this as a hopeful option.

What is really needed for this population is more cultural acceptance and less marginalization. There is no way for the US to make up for past crimes committed against this population—but it can start to change things for the better by providing a way for this population to be more integrated into American communities. Cultural stereotypes have to be abandoned and bias and prejudice also have to be set aside. Far from being banned in schools, the works of Alexie should be read and celebrated: his is a voice that is crucial, honest and sensitive. He writes with humor and understanding and sensitivity, and people can learn a great deal about this population and their experiences by exploring his works. Understanding is the key to change.

Conclusion

The Native American population is an invisible population that has been marginalized by mainstream American society for centuries. It should, therefore, not be surprising to find that this population, to whom interconnectedness means so much, suffers so greatly from mental health issues, such as depression, suicide and alcoholism. Their family structures have deteriorated, they live in poverty—more so than almost any other population in the US—and there is little to no access to mental health care for this population. This is a group that is in need of help—but help is slow to come because there is so little understand in mainstream America about what it is like to be a Native American in today’s world.

Works Cited

Alexie, Sherman. The Absolutely True Diary…