Rural american indians' perspectives of obstacles in the mental health treatment process in three treatment sectors.

This study sought to identify obstacles associated with alcohol, drug, and mental (ADM) health care utilization in three treatment sectors for residents on three reservations in the United States. Participants (N 224) disclosed that they had sought treatment for ADM problems in the past year and identified obstacles they faced during this process. Four obstacles were identified: (a) self-reliance, (b) privacy issues, (c) quality of care, and (d) communication/trust. A vast majority (71%) of participants reported at least one of these obstacles during treatment, and 61% faced two or more obstacles. There were no differences in the type or number of obstacles by treatment sector. Privacy and communication/trust obstacles were more likely to occur in emotional treatment compared to alcohol/drug treatment.