The People Who Give More: Health and Mental Health Among the Contemporary Puyallup Indian Tribal Community
George M. Guilmet and David L. Whited )
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American Indian and Alaska Native Mental Health Research
The Journal of the National Center Monograph Series Centersfor American Indian andAlaska Native
American Indian and Alaska Native Mental Health Research Copyright:
Volume 2, Monograph 2, Winter 1989 ColoradoSchoolofPublic Health/University ofColorado Anschutz Medical Campus
Published by the National Center
University of Colorado Health Sciences Center Department of Psychiatry 4200 East Ninth Avenue, Campus Box C249 Denver, Colorado 80262
ISSN 0893-5394 EDITOR-IN-CHIEF Spero M. Manson, Ph.D.
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American Indian and Alaska Native Mental Health Research
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ISSN 0893-5394 @1989 The Center for American Indian and Alaska Native Mental Health Research Denver,Colorado All Rights Reserved American Indian and Alaska Native Mental Health Research Copyright: Centers for American Indian and Alaska Native Health Colorado School of Public Health/University of Colorado Anschutz Medical Campus (www.ucdenver.edu/caianh)
The People Who Give More: Health and Mental Health Among the Contemporary Puyallup Indian Tribal Community
George M. Guilmet and David L. Whited
American Indian and Alaska Native Mental Health Research Volume 2, Monograph 2, Winter 1989 )
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Introduction 9
Centersfor American Indian andAlaska Native Acknowledgments 13 American Indian and Alaska Native Mental Health Research Copyright:
Authors' Statement 17 ColoradoSchoolofPublic Health/University ofColorado Anschutz Medical Campus
Chapter One The Historical Context
Ethnohistory of the Puyallup Mental Health Care System 19 Broader Medical Context 25 Impact of Western Medicine 27
Chapter Two The Contemporary Situation
The Puyallup Tribal Community 33 The Mental Health Care System 36 Chapter Three Health Care and Health Care Seeking Strategies
Introduction 41 Research Methods 41 Results 43 Discussion 49 Conclusions 54
Chapter Four Mental Health in a General Health Care System
The Problem 57 Mental Health Care within a Primary Health Care Clinical Facility 57 Coordination of Primary Care with Basic Mental Health Services 61 ) Conclusions 65
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Chapter Five Cultural Lessons for Clinical Mental Health Practice Centersfor American Indian andAlaska Native Introduction 68 American Indian and Alaska Native Mental Health Research Cultural Maps 69 Copyright: Family Structure 70 Ritual and Ceremonialism 73 ColoradoSchoolofPublic Health/University ofColorado Anschutz Medical Campus Values and Value Conflict 76 Educational Conflict 79 Sense of Time and Self 81 Communication Styles 84 Prejudice or Pride 88 Barriers to Services in the Non-Indian Community 90 Cultural Sensitivity 91
Chapter Six Contemporary Health Care Crisis
The Current Health Care Situation 95 Legal and Historical Basis for Indian Health Services 97 The Puyallup Tribal Position Summarized 98 Chapter Six (continued) Contemporary Health Care Crisis
The Medicine Creek Treaty and Medical Care: A Federal Responsibility 99 Puyallup Response to Proposed Eligibility Criteria 101 Puyallup Response to Contract Care Payment Limitation on Reimbursements to Medicare Rates 105 The Perspective of Anthropology 106 Should Any Tribe Support the Quarter Blood IHS Criteria? 108 The Duties of the Trustee no
Chapter Seven
Incontinence and Biomedicine )
Introduction www.ucdenver.edu/caianh
113 ( Health Definitions 113 Historic Examples 116 Conclusions 125 Centersfor American Indian andAlaska Native
American Indian and Alaska Native Mental Health Research Authors' Notes 127 Copyright: ColoradoSchoolofPublic Health/University ofColorado Anschutz Medical Campus References 131
About the Authors 141