Characterizing Trauma and its Impact in the Yurok Tribe

ABSTRACT Approximately 16-24% of American Indian/Alaska Native (AI/AN) people exhibit post-traumatic stress disorder (PTSD). Left unresolved, trauma is believed to contribute to marked health disparities, including higher rates of community and interpersonal violence, suicide, and child and substance abuse in Native communities. The Yurok tribe, residing in Humboldt and Del Norte County, California, has endured genocide, enslavement, dislocation, and various forms of physical, mental, and social oppression, which have been shown to manifest in high rates of historical and interpersonal trauma and contribute to marked health disparities. Importantly, rates of suicide and drug overdose deaths are higher in Humboldt County than national rates. Further compounding these disparities is the rural location, absence of trauma-focused treatment, and shortage of mental healthcare providers. Narrative Exposure Therapy (NET) is a community-driven, evidence-based form of trauma therapy that can be performed with peer and lay counselors. Our program of research seeks to adapt and implement NET with Yurok lay counselors. However, prior to adaptation and implementation, community data on trauma and its effect is necessary. Aim 1: Characterize trauma (type, severity, and frequency of symptoms) and assess the relationship between trauma, harmful behaviors, and cultural engagement. Aim 2: Conduct in-person qualitative semi-structured interviews with Yurok tribal members to contextualize findings from Aim 1 and obtain an in-depth understanding of the relationship between trauma, cultural engagement, and harmful behaviors. The proposed study aligns with the National Institute of Nursing Research’s (NINR) interest in health disparities and the research lens, Population and Community Health. The results will be the first to document and characterize trauma and its effect in this community as well as identify cultural frameworks that promote resilience and healing. The results will inform the next steps of our program of research by providing essential information to adapt and implement a NET intervention within the Yurok tribe. Successful implementation of NET will address barriers to mental healthcare access for this community and will be the first step towards restorative justice for the Yurok.