“We Never was Happy Living Like a Whiteman” : Mental Health Disparities and the Postcolonial Predicament in American Indian Communities

In the context of increasing attention to disparities in health status between U.S. ethnoracial groups, this article examines the dilemma of divergent cultural practices for redressing disparities in mental health status in American Indian communities. Drawing upon an ethnographic interview with a tribal elder from a northern Plains Indian reservation, a prototypical discourse of distress is presented and analyzed as one exemplar of the divergence between the culture of the clinic and the culture of the community. Situated in the context of continuing power asymmetries between tribal nations and the U.S. federal government, the implications of this cultural divergence for the efforts of mental health professionals, practitioners, and policymakers are identified as a predicament that only the conventions and commitments of a robust community psychology have the potential to resolve.