Behavioral Health at Tribal Colleges and Universities: A Scoping Review

Background: Research activities throughout American college campuses are enormous and well-funded. The scientific knowledge generated from those efforts have greatly improved the health status of college students and empirically informed health-related interventions. What is unknown is the level and quality of research activities occurring on Tribal Colleges and Universities (TCUs). Given the historical fact that American Indian and Alaska Native (AI/AN) populations suffer disproportionately from various health and wellness conditions, TCUs are ideal systems to build the scientific knowledge needed to address these public health conditions. Along with AI/AN young adults having a 2.5x higher suicide rates, highest smoking rate of any other ethnic group, and experience PTSD at triple the rate of the general population, these underserved communities also face dim academic outcome trajectories, with only 14% of the AI/AN population holding a bachelor’s degree or higher. This work seeks to understand what is presently known about TCU-based research actives that stand to benefit this population similarly as their peers attending non-TCUs.

Methods: We used a scoping review method to determine the body of literature in order to identify and map the available evidence. Research criteria were developed and set to capture published, peer-review literature in the Ebsco database. Our results yielded a total of 90 articles published in peer-reviewed journals within the last 10 years, excluding dissertations and grey literature. The vast majority of the articles were excluded from the study based upon search criteria. As a result, 7 articles remained that met inclusion criteria; these results are similar to previous work examining mental health and substance use within AI/AN communities. Note: all criteria and methods will be made available if accepted.

Results: Seven articles met the inclusion criteria related to TCUs. Three were policy and design-related and the remaining four discussed results relating to alcohol and tobacco use. Only two articles of the seven referenced programs or interventions. Overall, there were no randomized controlled trials or experimental designs utilized.

Conclusion: Our scoping review revealed several large gaps in scientific literature throughout the TCU systems making up 32 locations with nearly 17,000 students. There is an overall lack of scientific research activities happening throughout this system, particularly in the examination of general mental health prevalence, illicit substances, and prevention or intervention focused studies. Additionally, no relevant literature was identified pertaining to public mental health efforts on campus such as community services or stigma reduction work at TCUs. Researchers and practitioners alike are presently ill-equipped to address behavioral health needs of Native TCU students; without concerted effort towards addressing these gaps, these historically underserved communities will continue to suffer.