Since the earliest days of the republic, Native Americans have stepped up to defend the United States at higher rates than any other ethnic group.

From General Washington’s inclusion of Tuscarora and Oneida warriors at Valley Forge, through the world wars and Vietnam to today’s conflicts in the Middle East, Native Americans continue to answer their cultural calling to serve.

Traditionally, these soldiers were welcomed home with healing ceremonies that helped reintegrate them with the tribe and wider society. Compassionate medicine men, and women, used time-honored practices to mend the emotional, spiritual, and physical trauma of war.

“Unfortunately, the U.S. government banned Native religious ceremonies for many years, which subsequently limited their use in modern PTSD treatment programs,” says Greg Urquhart, Washington State University counseling psychology doctoral student. Urquhart is a veteran of Operation Iraqi Freedom and descendant of the Eastern band of Cherokee. As a cavalry scout, he developed mild symptoms similar to PTSD which, with sweat lodge and other traditional practices, have since resolved.

Urquhart says Native veterans are often reluctant to seek PTSD treatment because western therapies typically don’t represent their cultural worldview or religious beliefs. Those who do attempt treatment frequently become frustrated and leave the program.

“The traditional Native view of health and spirituality is intertwined,” he explains. “Spirit, mind, and body are all one—you can’t parcel one out from the other—so spirituality is a huge component of healing and one not often included in western medicine, although there have been a few studies on the positive effects of prayer.”

In an effort to give Native veterans a voice in shaping PTSD treatment options, Urquhart designed the largest pan-tribal veteran study ever conducted in the United States. His survey, which began in 2014, represents feedback from more than 200 tribes including 716 individuals from every branch of the military.

The comprehensive study examines veterans’ attitudes, perceptions, and beliefs about PTSD and its treatment, including the use of equine and other animal-assisted therapy.

The clearest takeaway, says Urquhart, is that a majority of survey respondents reported dissatisfaction with standard PTSD therapy.

Many said they would prefer programs to incorporate traditional healing elements such as smudging or the sweat lodge ceremony along with western behavioral and cognitive therapies.

Another common request was that treatment programs be staffed by veterans, who can better understand their military experiences as well as their Native background. Other participants expressed the need to tackle issues associated with PTSD such as drug and alcohol abuse, social difficulties, isolation, and lack of friends.

According to the survey, the biggest barriers to seeking treatment are practical concerns like location and cost of services. One respondent wrote that he had walked for two days to keep an appointment with the Veterans Affairs.

Urquhart says some Native veterans fear that disclosing a PTSD diagnosis will result in being seen as weak or “letting down the tribe.” Instead, his findings show that most veterans view those with PTSD the same or more favorably than before.

“Historically, there are very few studies directly related to Native veterans and PTSD and most of them have been based on old datasets created in the Vietnam era,” he says. “I’m hoping researchers will take my information, create friendly relationships with tribal governments, and build on it.”

Though still a student, Urquhart has become a national advocate who often consults with professionals and presents research to groups like the Congress of American Indians and the American Psychological Association. He says the tide is slowly changing as VA hospitals and treatment centers expand their programs to include traditional practices like talking circles, vision quests, drumming, gourd dances, and more.


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