California is one of the most culturally diverse Indigenous regions in North America, home to over 100 federally recognized tribes—such as the Yurok, Hupa, Karuk, Miwok, Yokuts, Ohlone, Tongva, Cahuilla, Luiseño, Kumeyaay, Mojave, and Quechan—as well as many unrecognized and transnational Indigenous communities. Due to thousands of years of migration and interconnection, California is also home to large populations of Indigenous peoples from Mesoamerica and beyond, including Mixtec, Zapotec, Triqui, Purépecha, Nahua, Maya, Totonac, and Huichol communities. It is important to distinguish between legal identity, which is based on federal tribal recognition and confers sovereignty and access to resources, and cultural or ancestral identity, which is rooted in lineage, language, and community belonging. Although the Office of Management and Budget defines an American Indian or Alaska Native as “a person having origins in any of the original peoples of North and South America (including Central America) who maintains tribal affiliation or community attachment,” many Indigenous individuals exist outside U.S. systems of recognition and remain invisible in formal systems of care despite strong cultural identities.
Understanding Indigenous identity today requires acknowledging the profound disruptions caused by colonization, including what scholars describe as “The Great Dying,” where entire populations, lineages, languages, and ways of life were disrupted or erased. representing not only lives lost but entire lineages erased. What was taken was not only life, but memory, connection, and continuity. Borders further severed longstanding interconnections across the Americas, contributing to what can be understood as ancestral amnesia: a forced disconnection from identity created through assimilation, criminalization of culture, and imposed racial hierarchies that associated Indigeneity with inferiority.
From a trauma-informed perspective, this can show up in ways that feel deeply personal: a sense of not fully knowing where you come from, feelings of shame or confusion about identity, or a quiet grief for something that feels missing but hard to name. Dr. Frantz Fanon described how oppression can become internalized, shaping how we see ourselves and our worth. But this is not the full story. Yet, despite these forces, Indigenous communities have persisted through intentional acts of resistance, including preserving language, maintaining ceremonies, practicing cultural syncretism, and sustaining oral traditions. Today, there is a powerful resurgence through language revitalization, cultural reclamation, and renewed identity affirmation. Some are reconnecting, while others have maintained continuous traditions, fulfilling an intergenerational promise to preserve knowledge for future generations.
For mental health professionals, it is essential to recognize that Indigenous identity is often misinterpreted, and presenting concerns—such as disconnection, shame, or lack of belonging—may reflect cultural loss and historical trauma rather than individual pathology. Mental health is not just about managing symptoms—it can also be a pathway back to self, to ancestry, and to community. If you have ever felt disconnected, unsure, or curious about your roots, that experience is valid—and it may be an invitation. Healing can include remembering, exploring, and reconnecting, as well as community belonging and collective approaches to restoration. Indigenous teachings remind us of xochiyaoyotl, the “beautiful war”— the ongoing internal and collective struggle against oppression and despair through healing, resistance, and growth. Unlike models that ask us to heal alone, this path reminds us that healing happens in relationship—with others, with community, and with those who came before us.
You are not alone in this process. Your story, your questions, and your search for belonging are part of something larger. Despite everything that has been endured, Indigenous peoples are still here—carrying resilience, wisdom, and continuity. And wherever you are in your journey, there is space to reconnect, to heal, and to remember.
Indigenous-focused Mental Health
Indigenous communities have their own ways of understanding wellness, distress, and healing—ways that are deeply connected to culture, history, spirituality, and community. Because of this, standard Western mental health diagnoses don’t always fully capture Indigenous experiences, especially when it comes to the long-lasting effects of colonization, forced assimilation, and loss of land and identity.
What many people experience today—such as depression, anxiety, substance use, or even thoughts of suicide—can be connected to historical and intergenerational trauma. This is sometimes described as a “soul wound” or a deep cultural injury that has been passed down over time. These experiences may not fit neatly into labels like PTSD or other diagnoses, and when providers don’t understand the cultural context, people can be misunderstood or misdiagnosed.
For example, trauma responses like distrust, emotional distance, or hypervigilance may be mistaken for personality disorders or depression, when they are actually rooted in lived and historical trauma. Similarly, spiritual experiences or cultural practices might be incorrectly labeled as mental illness if they are not understood within their cultural meaning.
Indigenous-Focused Mental Health (IFMH) seeks to address a wide range of mental health needs and conditions by incorporating themes such as intergenerational trauma, the trauma of racism and post-colonization, cultural erasure, and intergenerational resilience. It also integrates ancestral healing practices into modern psychotherapeutic treatment.
How does trauma become stored in the body and nervous system? How do Eurocentric standards of beauty and ideals of thinness contribute to eating disorders? What role do intergenerational and transgenerational trauma play in mood disorders such as depression? What is the impact on self-esteem and identity when segments of society send messages that one does not belong, or that one’s ancestors did not deserve to exist? How has structural racism shaped the field of mental health and influenced attitudes toward Indigenous peoples? How does the concept of food apartheid relate to social determinants of health and mental health outcomes, particularly when entire communities have been historically targeted by systemic, race-based, and economic inequities in food access—highlighting that unequal access to healthy food is a deliberate, human-made system rather than a natural “food desert”?
Because of this, it is essential that mental health care for Indigenous communities be culturally informed, respectful, and grounded in listening. Healing is not just about symptoms—it is about understanding a person’s story, their connection to community, and the impact of history on their life.
If you or someone you know has felt misunderstood, disconnected, or impacted by these experiences, seeking support can be a powerful step. The right kind of care will honor your identity, your culture, and your story. You deserve to be seen fully—not just through a diagnosis, but as a whole person with strength, resilience, and a history that matters.