Title: What Is Mental Health and Wellness? Perspectives from Native American Youth
Description: The purpose of this participatory research was to gain the perspective from the youth of a plains tribe Native American community about their concept of mental health and wellness, and to discover how youth participants related these ideas and narratives to their life processes and experiences. This study also investigated the methodological use of participatory photo-elicitation for talking about mental health and using grounded research theory to explore what types of themes and testimony are most common. This participatory research was done in partnership with an American Indian-operated health promotion and disease prevention program that is tackling inequity in mental health youth outcomes. Forty-one children ages 9 to 17 participated in this qualitative study. Semi-structured one-one-one interviews using the participatory photo-elicitation method generated conversation and formed the basis of the raw data. Grounded theory was employed in both data collection and analysis. A “zig-zag” pattern of data collection defined basic subgroups of children by age, allowing for a saturation of themes.

The five major themes that emerged were: strategies for mental health, ecology and mental health, identity and mental health, social support/loss of social support and mental health, and, ambivalent feelings/thoughts about mental health. Categories within themes held across the three age groups and overlapping themes held theoretical importance. Photo-creation followed by photo-elicitation resulted in a rich relay of diverse testimony including literal translation, metaphor, analogy, shadowed data, and personally recounted lived experiences, often shared via expository dialogue. The saturation of themes showed fidelity to developmental groupings. Identity, particularly Native identity overlapped with themes of strategy and ecology. This study heightens awareness that most older children in this sample identified loss of a loved one as part of their lived experience of mental health. A majority of children spoke of mental health and wellness strategies that included finding balance, healing, seeking social support and inhabiting at least one positive ecology.

Finally, many children related their concept of mental health to their natural surroundings and the sky. Some children used visual and verbal metaphors such as the medicine wheel, a Native quilt, the undulation of a landscape, and the tipi to help describe their concept of mental health and wellness.