Within the context of the U.S. occupation of Hawai'i, State-sponsored and Hawaiian-led health initiatives cannot be reduced to a binary of "colonial/unhealthy" versus "Hawaiian/healthy." Instead, they operate within overlapping and often conflicting paradigms structured by what we term the Ideology of Occupation. This ideology obscures a central reality: kaumaha-the deep, collective malaise affecting the Hawaiian psyche ( )-is the result of a disruption in the k & umacr;'auhau (genealogy) of Hawaiian public health, in which sovereign systems of care were replaced by a bureaucratic apparatus detached from Hawaiian life. Although culturally grounded interventions provide meaningful therapeutic value, the prevailing culture-as-health paradigm remains embedded within the status quo of occupation. As such, it functions as a co-opted form of palliative care that manages the symptoms of a political source of suffering. Drawing on Laenui's phases of Decolonization and grounded in Sai's legal framework of Belligerent Occupation, we reframe healing through the conceptual paradigm of health sovereignty, defined as the authority of a people to determine the knowledge systems, institutions, and political conditions that shape health and well-being. We argue that the health of the Hawaiian nation cannot be realized within an occupied system of care. Meaningful healing requires the restoration of the Hawaiian Kingdom's lawful authority and the reestablishment of self-determined health systems rooted in Hawaiian knowledge, institutions, and jurisdiction.
While numerous studies have found that children affected by war and forced displacement are at increased risk for common mental health problems, research also indicates that experiences of emotional distress and the way it is expressed and understood vary by cultural group and context. In this study, we used previously developed rapid qualitative assessment methods to examine local perceptions of mental health and emotional distress among recently arrived children (7-17 years old) from Afghanistan who were living in the Boston area. We conducted 100 free listing interviews and 40 key informant interviews. The rapid assessment approach worked well as a method for understanding the problems of newcomer communities. Our analysis identified four culturally relevant mental health and emotional distress problems in the Dari and Pashto languages: tashwish (Dari and Pashto, worry and stress); jighar khoon (Dari, deep sorrow) / ghamjan (Pashto, deep sorrow); bi adab (Dari, going astray and mannerless) / bi-adabha (Pashto, going astray and mannerless) and dek shodan (Dari, missing) / yaadidal (Pashto, missing). While some of the findings resemble Western constructs of anxiety, depression, and conduct-related problems, they also highlight grief and adjustment experiences that may be specific to uprooting from home and culturally relevant terms and indicators useful for further assessing mental health and emotional distress in Afghan children and adolescents and areas of focus for culturally appropriate care and support.
Addressing clients’ faith-based practices (FBPs) is indispensable in psychotherapy, especially in a religiously diverse country like India. This can be particularly challenging in contexts where psychotherapy is highly stigmatized and FBPs are culturally accepted. A review of the literature highlighted a gap in research on how psychotherapists negotiate FBPs in the Indian context. This pilot qualitative study aims to address this gap by exploring the experiences of Indian psychotherapists in navigating FBPs as mental health service providers. Semi-structured interviews were conducted with 10 Indian psychotherapists. Thematic analysis of the transcribed data generated three major themes and eight subthemes. The findings indicate that FBPs play a nuanced role in clients’ mental health care, especially when clinical services like psychotherapy are stigma-laden and difficult to access. However, it is often challenging for psychotherapists to discern the adaptive and maladaptive aspects of FBPs for the client's welfare. Additionally, systemic factors shape clinician interactions with FBPs in psychotherapy practice. This study highlights the dual role of FBPs in supporting and hindering psychotherapy and provides insights into the interplay of culture, faith, and mental health. However, all participants revealed that religious and spiritual competence training programs were unavailable in India. Although psychotherapists learn these skills through experience, their ability to effectively engage these competencies is limited by social barriers like stigma. The findings of this study underscore the importance of these competencies and provide insights into contextualizing such training programs.
In a diversity intervention context, the practitioner may have biases and stereotypes related to their own cultural background that will influence their approach. Developing cultural self-awareness could help reduce the manifestation of these biases and stereotypes. However, it is likely to be one of the least researched aspects of intercultural competence. This scoping study was conducted to provide an overview of how cultural self-awareness is addressed across disciplines related to interventions in diverse contexts. The methodology used followed that of the Joanna Briggs Institute. The different steps of the scoping review are the following: keyword selection and translation in the different selected databases; a first sorting of the selected studies according to the defined criteria, based only on the title and the abstract; a second sorting by reading the entire study; data extraction and finally, analysis of the results. In total, 25 studies were included. The results showed that it is indeed possible to develop cultural self-awareness through workshops that promote interaction among participants, whether they are students or professionals already in the workforce. However, this focus of the research is relatively new and underexplored in the literature.
Indigenous youth's strength and resilience play a vital role in their well-being and mental health. Protective factors, closely linked to resilience, spanning individual, family, and community levels reinforce positive mental health outcomes. The purpose of the current scoping review was to summarize the available literature that describes resilience and/or protective factors promoting mental health and well-being among Indigenous youth in Canada. As a secondary objective, this review investigated community involvement reported in the identified sources. JBI scoping review methodology was followed, and the search of PubMed, EMBASE, CINHAL, PsycINFO, ERIC, and Scopus commenced in August 2021, and was updated in February 2023. A targeted Google search was also conducted to identify eligible gray literature. A total of 61 papers were included in the data extraction. The types of sources identified were observational (n = 22), participatory action research (n = 11), mixed/multi-methods (n = 10), qualitative (n = 9), case study (n = 4), quasi-experimental (n = 1), experimental (n = 1), and other designs such as quality improvement and program evaluation (n = 3). In addition, only a handful of included studies reported use of an Indigenous-specific approach, such as Two-Eyed seeing. Protective and resilience factors were identified across various levels such as individual (n = 52), interpersonal (n = 37), and wider environmental beyond social systems (n = 37) levels. Forty studies described community involvement, which included non-specified community members, like friends or citizens (n = 21), youth (n = 19), Indigenous community members such as leaders and workers (n = 14), and Elders (n = 11). These groups were engaged to varying degrees, functioning either as equal collaborators, consultants, or, in some instances, as decision-makers.
