Beliefs about Health and
Mental Health
Traditional Native American Perspective
University of Oklahoma
School of Social Work
Master’s Advanced Curriculum Project
Dr. Lisa Byers (Cherokee)
Supported by:
Social Work Relevance
 Health beliefs determine the meaning of illness and
service preference
 Knowledge of Native American traditional concepts
of wellness and illness
 Compare to Western conceptualizations of illness
 Provide knowledge of traditional healing
 Impart elements of respect for traditional healing
 Assessment of health through explanatory models
Origin of Illness Across Cultures
Prior to beginning PowerPoint have students
engage in the ‘Origins of Illness’ In Class Activity
Traditional Concept of Wellness1
Holistic
Medicine Wheel
Spiritual
• All must be in
balance to have
health or wellness
Physical
Emotional, Mental,
Physical, and Spiritual
Realms of Self,
Others, and the
Environment
Emotional
• Encompasses
Mental
Medicine Wheel:
Concept of Health Remains Significant2
The Medicine Wheel concept
from Native American culture
provides a model for whom we
are as individuals: We have an
intellectual self, a spiritual self,
an emotional self, and a physical
self. Strength and balance in all
quadrants of the Medicine Wheel
can produce a strong, positive
sense of well-being, whereas
imbalance in one or more
quadrants can cause symptoms
of illness. Addressing issues of
imbalance can potentially
diminish your patient’s
symptoms and enrich their
quality of life.
- Louis T. Montour, MD, CM; CCFP; ABFP Presented at
the Fifth Annual Meeting of the Native Physician Association
in Canada, Ottawa, Ontario, August 23-25, 1996.
Big Horn Medicine Wheel
Wyoming
Traditional Concept of Illness1
 Illness is the result of imbalance
• Within the self systems, the family, tribe, or
the world
• An individual may not be living up to their
roles or obligations to their self or to the group
• Bad medicine
 Symptoms
• A symptom can occur in any of the realms
(emotional, mental, physical, spiritual)
Traditional Healing1
Goal-Holistic Treatment
 Restore balance across all realms within the
individual and within relationships
Potential Participants
 Individual, her/his family, and/or clan
 Individuals that are deemed important to
healing process by the person or healer
http://xnet.kp.org/permanentejournal/winter00pj/wheel.html
Traditional Stories of Illness
Origins of Disease and Medicine
A Cherokee example:
Story tells of how birds, fish, insects,
animals, and humans lived in harmony
until the humans overcrowded the
animals and created weapons to kill
them. The was retaliation from the
birds, fish, insects, and animals in the
form of disease. The plant world
responded by offering their leaves,
roots, bark to make medicine to save
the Cherokees.
Traditional Healing
Discussion with Client
 American Indian and Alaska Natives may be
reluctant to discuss traditional medicine
• Protective in past traditional spirituality and
healing was considered illegal
• Current era of exploitation of Native American
spirituality and healing
Traditional Healing
Sources
o Medicine people are known within the tribe or area
o Medicine people do not advertise in a commercial manner
o A client may ask for funds to travel back to see their
traditional healer-your agency will need to determine if
such travel is fundable
o If an individual is new to the area and cannot utilize the
healer that they have used in the past, here are some
options:
• Contact local Native American social workers or Native
American based social service agencies
• Access individuals who will know the way to access a
healer and the protocol
“Sometimes a Broken Bone is
Just a Broken Bone”
• Native Americans will not attach every
injury with spiritual significance
• They know that if they break a bone they
need to go to the emergency room or a
physician
• Later they may reflect on whether there
was a meaning behind the event, if they
were distracted by a worry that may have
lead to carelessness or not.
Social Work Implications
 Listen to person’s story about their symptoms
& illness.
 Follow Up Questions:
 What do you believe caused this illness?
 Who have you seen in the past to help with
this kind of illness?
 Was it whom you preferred to see?
 Was it helpful? What made it helpful or not
helpful?
 Who would you like to see now?
Assessment Questions
from Kleinman4
Explanatory Model
• What do you think caused this?
• Why do you think it started when it
did?
• What do you think your illness does
to you?
• How does it work?
• How severe is your illness?
• Will it have a short or long course?
• What kind of treatment do you think
you should receive? What are the
most important results you hope to
receive from this treatment?
• What are the main problems your
illness has caused for you?
• What do you fear most about your
illness?
TO STUDENTS:
How would you adapt
the Explanatory Model
questions for a Native
American elder?
References
Barlow, A., & Walkup, J.T. (1998). Developing mental health
services for Native American children. Child and Adolescent
Psychiatric Clinics of North America: The Child Psychiatrist in
the Community, 7(3), 555-577.
Montour, L.T. (2000, Winter) The medicine wheel: Understanding
“problem” patients in primary care. The Permanente Journal ,
4(1), 34-39.
Cherokee Nation (no date). The origins of disease and medicine.
Retrieved August 10, 2008 from
http://www.cherokee.org/Culture/Default.aspx?section=culture
&culture=literature&cat=PdWeE5zX1DE
Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness,
and care: Clinical lessons from anthropologic and cross-cultural
research. Annals of Internal Medicine, 88, 251-58