Poor disaster preparedness, a lack of resources for rebuilding, and a legacy of "collective grief" make disaster recovery especially difficult for American Indians.

That was the message delivered by Marilyn Shigetani, M.A., M.P.H., to attendees at a session on the cultural aspects of disaster mental health at APA’s 2003 Institute on Psychiatric Services in Boston in October.

Shigetani, an American Indian, is a Federal Emergency Management Agency (FEMA) liaison to Region IX, which encompasses California, Hawaii, and the U.S. Pacific islands.

When a levee broke near the small town of Wakpala, S.D., in 1997, there were no sirens and no emergency broadcasting system to warn members of the Standing Rock Sioux tribe to evacuate ahead of the impending flood, Shigetani said. Instead, a town crier of sorts walked through the reservation telling people to evacuate.

"In Indian country, there are no shelters in place when disaster strikes," she said, "so evacuating an entire community becomes problematic."

Tribal government officials guided the displaced families to a village that was miles away. When they returned, 27 families discovered that the flood had destroyed their homes.

Disaster struck again two years later. In 1999 tornadoes tore through southwestern South Dakota, causing significant damage to the Pine Ridge Indian Reservation. This time, as many as 200 Sioux families lost their homes, Shigetani said.

The Pine Ridge reservation depended on money from FEMA to rebuild, she added, because "there were no funds set aside for disaster recovery." A shortage of funds is only one of many obstacles to disaster recovery for American Indians, she said.

The numerous tribulations of American Indians over the past couple of centuries make recovery from disasters such as floods and tornadoes in the present seem like an uphill battle.

"We have collective grief of many treaties broken and many sad memories. We lack trust in outsiders and even other Indians. We are a race that has been separated, and we feel disempowered. Then we further victimize ourselves—we don’t need floods or tornadoes to feel like victims," Shigetani said.

In addition, admitting the need for mental health services is especially problematic for American Indians, such as members of the Standing Rock Sioux tribe. "By seeking help for the white man’s understanding of mental health problems," she said, tribal members would believe this "shows a weakness in the community. . . .What we have done is fail each other by not meeting the needs of our people."

Shigetani dispensed the following advice to attendees about assisting American Indians in disaster recovery: One must first seek an invitation from the tribal government before one can help, she said. Introductions are important, too. Many times, she observed, people introduce themselves by stating their names and the agency they represent.

"Now you are an institution—not a person—coming to help," she observed. "We’ve had some experiences with institutions, and there are some issues there. . . . To us, it’s not who you represent that is important, but who you are."

In addition, American Indians want to know how committed outsiders are to helping them cope with disaster. "How long are you going to be around?" Shigetani asked. "Are you going to assist us through the transition to recovery, or are you going to spend a couple of weeks and then get out of town?"

She advised attendees that they should be "committed for the long haul," or at least work with staff from local mental health or disaster-relief organizations or both to ensure that their efforts are carried out. ▪