Mental and Behavioral Health in American Indians/Alaska Natives

In 2022, suicide was the second leading cause of death for non-Hispanic American Indians/Alaska Natives ages 10–34.1
In 2018, American Indians/Alaska Natives experienced the feeling that everything is an effort, all or most of the time, 2.75 times more than the total population.2
In 2022, the overall death rate from suicide for American Indians/Alaska Natives was 91% higher than the total population.3
In 2022, the death rate for suicide among adolescent American Indian/Alaska Natives, ages 15–19, was 2.74 times higher than the total population.4
Despite higher occurrences of poor mental health, American Indians/Alaska Natives receive less mental health treatment compared to the total population.5

Visit the Indian Health Service for resources about mental health and healing among American Indians/Alaska Natives.

For more information and resources on mental health, visit the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Looking for curated searches on mental health within minority and tribal populations, including American Indians/Alaska Native populations, in the United States and its territories? Check out the OMH Knowledge Center Topic Guides.

Mental health status

Serious psychological distress in the past year among persons ages 18 years and over, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
15.9	13.9	1.14

Source: Substance Abuse and Mental Health Services Administration (SAMHSA), 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.88B. For the definition of “serious psychological distress,” see Appendix A.

Feelings of sadness, hopelessness, worthlessness, or that everything is an effort, all or most of the time, among persons ages 18 and over, percentage, 2018
	American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Sadness	9.2	3.0	3.07
Hopelessness	5.4	2.3	2.35
Worthlessness	9.2	2.3	4.00
Everything is an effort	20.1	7.3	2.75

Source: Centers for Disease Control and Prevention (CDC), 2021. Summary Health Statistics: National Health Interview Survey: 2018. Table A-7c. For the explanation of response categories see footnote 1 to Table A-7c.

Major depressive episode in the past year among persons ages 18 and over, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
8.4	8.2	1.02

Source: SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.41B. For the definition of “major depressive episode,” see Appendix A.

Any mental illness in the past year among persons ages 18 and over, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
25.9	23.4	1.11

Source: SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.7B. For the definition of “any mental illness,” see Appendix A.

Death rates

Age-adjusted death rates for suicide by sex, race, and Hispanic origin, 2022
	Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Male	39.6	23.0	1.72
Female	14.6	5.9	2.47
Total	27.1	14.2	1.91

Source: CDC, 2025. Deaths: Final Data for 2022. National Vital Statistics Report, Vol. 74, No. 4. Table 11.

Suicide rates by age, race, and Hispanic origin, 2019: Males
	Non-Hispanic American Indian/Alaska Native Males	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
15–24 years	54.8	22.0	2.49
25–44 years	59.1	28.0	2.11
45–64 years	23.2	29.9	0.78
65 years and over	16.3	31.7	0.51
All ages, age adjusted	33.0	22.4	1.47

Source: CDC, 2023. Health, United States, 2020–2021. Table SuicMort.

Suicide rates by age, race, and Hispanic origin, 2019: Females
	Non-Hispanic American Indian/Alaska Native Females	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
15–24 years	24.9	5.5	4.53
25–44 years	19.3	7.4	2.61
45–64 years	10.1	9.6	1.05
65 years and over	Not Reported	5.2	Not Reported
All ages, age adjusted	12.1	6.0	2.02

Source: CDC, 2023. Health, United States, 2020–2021. Table SuicMort.

Adolescents

Death rates for suicide: ages 15–19, 2022
	Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Male	33.7	13.9	2.42
Female	18.1	4.7	3.85
Both Sexes	26.0	9.5	2.74

Source: CDC. National Center for Injury Prevention and Control. Web Based Injury Statistics Query and Reporting System (WISQARS). National Violent Death Reporting System. Violent Deaths Report.

Students in grades 9–12 who seriously considered attempting suicide in the past 12 months, percentage, 2023
	Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Male	22.6	14.1	1.60
Female	27.1	27.1	1.00
Total	24.5	20.4	1.20

Source: CDC, 2024. High School Youth Risk Behavior Survey Data. High School Students Who Seriously Considered Attempting Suicide, 2023.

Students in grades 9–12 who attempted suicide in the past 12 months, percentage, 2023
	Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Male	8.3	6.4	1.30
Female	15.4	12.6	1.22
Total	11.5	9.5	1.21

Source: CDC, 2024. High School Youth Risk Behavior Survey Data. High School Students Who Actually Attempted Suicide, 2023.

Access to healthcare

Adults ages 18 and over who received mental health treatment in the past year, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
19.1	22.9	0.83

Source: SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.21B.

Adults ages 18 and over who received mental health treatment through prescription medication, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
12.4	16.7	0.74

Source: SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.25B.

Adults ages 18 and over with a major depressive episode in the past year who received treatment for depression, percentage, 2024
Non-Hispanic American Indian/Alaska Native	Total Population	Non-Hispanic American Indian/Alaska Native / Total Population Ratio
Not Reported	64.4	Not Reported

Source: SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. Table 6.43B. For the definition of “major depressive episode,” see Appendix A.

1 CDC. National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). [Accessed 08/28/2025]. (Back to top)

2 CDC, 2021. Summary Health Statistics: National Health Interview Survey: 2018. Table A-7c. (Back to top)

3 CDC, 2024. Deaths: Final Data for 2021. National Vital Statistics Report, Vol. 73, No. 8. Table 10. (Back to top)

4 CDC. National Center for Injury Prevention and Control. Web Based Injury Statistics Query and Reporting System (WISQARS). National Violent Death Reporting System. Violent Deaths Report. (Back to top)

5 SAMHSA, 2025. Results from the 2024 National Survey on Drug Use and Health: Mental Health Detailed Tables. (Back to top)

Date Last Reviewed: September 2025