Third, the legacy of violence against indigenous peoples is appalling. One need look no further than the slaughter of American Indians and the African slave trade to get a sense of the forces to which indigenous peoples have been subjected. But while the mass killings are generally no longer the rule, they do continue. As stated at the outset, it seems reasonable to expect that the mental health of indigenous peoples has suffered as a consequence of the social and historical forces to which they have been subjected. Nevertheless, the lack of empirical data and the inherent difficulties of conducting cross-cultural psychiatry mean that any discussion of this topic must be considered impressionistic and preliminary.
Several trends are obvious, however.
High rates of suicide have been reported for American Indians and Alaska Natives, Australian Aborigines, the people of Micronesia, and the Northern Minorities of Siberia. Even more widespread are problems of alcohol and substance abuse. Epidemiological research among several groups of indigenous peoples in North America have shown that they suffer from high rates of depression, although it must be noted that we have very little sense of intratribal variations. That being stated, however, I would maintain that it is not THE most critical step. Above all else, we must place mental health problems within the contexts by which they are shaped.