Perspectives of Child and Adolescent Psychiatrists on the Influence of School Connectedness on American Indian Youths

Shawn Clark

Arizona State University, Tempe, USA.

DOI: 10.4236/jss.2022.1011010                

Abstract

This article presents findings captured during a study with four Non-Indigenous child and adolescent psychiatrists treating American Indian youths at a child and adolescent psychiatry hospital located in a rural northwestern state. The author used a qualitative design to develop a deeper understanding of how the psychiatrists conceptualize the relationships between the components of school connectedness and American Indian youths. The study resulted in categorizing 53 descriptors of protective factors and 31 descriptors of risk factors associated with elements of school connectedness identified as 1) Cultural Connectedness, 2) Community, 3) Caregivers, 4) Teachers, and 5) Peers. The descriptors are illustrated through richly detailed comments from the participants.

Keywords

American Indian, School Connectedness, Ethnic Racial Identity

1. Introduction

American Indian (AI) adolescents are understudied (Quijada Cerecer, 2013)and seldom represented in educational spheres (Covarrubias & Fryberg, 2015; Serafini et al., 2017). They experience worse mental health outcomes than non-Native adolescents (Uink et al., 2022), and their rates of death by suicide peak during adolescence (Wexler et al., 2015). School connectedness is a protective factor against suicide for AI adolescents (Fullerton et al., 2019; Marraccini & Brier, 2017; Mohatt et al., 2011; Pharris et al., 1997). Moreover, scholars allege that a weaker sense of school connectedness for AI youths is associated with increased episodes of depression (Serafini et al., 2017).

The youth mental health crisis experienced by AI communities (Ersan & Rodriguez, 2021) and the near silence in the literature on the positive associations between school connectedness and AIs (Hussain et al., 2018) make this study critically important. This research complements and broadens the knowledge base about school connectedness by adding the perspectives of child and adolescent psychiatrists on the elements of school connectedness and including cultural connectedness as an element of school connectedness. This manuscript centers on one research question: How do child and adolescent psychiatrists perceive the components of school connectedness influencing AI youths?

Developmental psychologists underscore the significance of schools for nurturing social and emotional growth (Schachner, 2019). Schools are especially significant during adolescence (Allen et al., 2021a) when youths begin separating from their parents and searching for other connections (Eccles & Roeser, 2011; Oldfield et al., 2016). It is also when their social and ethnic identities begin to form (Hoffman et al., 2021; Newman, 2005). The process of identity formation is more arduous for AI youths as they stand at the crossroads between childhood and adulthood and must navigate between their traditional culture and that of the dominant culture (Bang et al., 2019; Brayboy & Lomawaima, 2018; Prete, 2021; Yasui et al., 2015). An AI youth explained the difficulty of straddling two cultures, stating, “Some Native youth are trapped between cultures” (Clausen et al., 2021: p. 34).

For AI youths to successfully navigate between these two cultural worlds, they must “code switch” (p. 38), a skill Brayboy & Castagno (2009) argue is dependent on their cultural traditions being ingrained throughout the schoolhouse. A Native Elder (as cited in Clark, 2022) expressed the difficulty young people have balancing two cultures, stating, “School can be difficult for our children as they balance the expectations between the Western world and traditional ways” (p. 168). The balancing act between cultures nurtures acculturation stress (Snowshoe et al., 2017) that contributes to adverse mental health issues and increased suicide rates (LaFromboise et al., 2010; LaFromboise & Malik, 2016).

1.1. Acculturation Impact

AI adolescents face elevated occurrences of mental health discord (Hunter et al., 2022; Ross, 2016; Serafini et al., 2017). Suicide is one of the leading causes of death for AI adolescents between 10 - 24 (Leavitt et al., 2018; O’Keefe et al., 2014; Taylor et al., 2014; Wexler et al., 2015) and twice as many AI adolescents between 15 - 19 commit suicide than non-Native youths (Hunter et al., 2022). AIs have the highest death rate by suicide of all ethnic groups (Burrage et al., 2016; Taylor et al., 2014; Wexler et al., 2015) and they have a suicide completion rate 3.5 times higher than the general public (Bolton et al., 2013; LaFromboise & Malik, 2016). Scholars suggest that 40% of all suicides on Indian reservations were completed by adolescents (Taylor et al., 2014). Montana is third in the nation for death by suicide (Montana DPPHS, 2022), and it is the second leading cause of death for ages 10 - 44 (AFSP, 2022). AIs in Montana have the highest rate of death by suicide (28.16 per 100,000) compared to an overall statewide suicide rate of 21.70 per 100,000 deaths (Montana DPPHS, 2016).

Montana youths participate in the Montana Youth Risk Behavior Survey (YRBS), administered annually by the Centers for Disease Control (CDC). The survey measures six health-risk areas that contribute to death and disability. A study examining seven years of Montana YRBS data revealed that AI youths were more apt to experience suicidal ideation and attempt suicide than White children in Montana (Manzo et al., 2015). The 2021 Montana YRBS indicates that 49% of AI youths report feelings of sadness or hopelessness for two weeks or more; 26.70% report considering suicide, 20.70% report they had made a suicide plan, and 17.60% report attempting suicide (MOPI, 2021).

1.2. What Is School Connectedness?

Scholars suggest that school connectedness relates to the degree youths perceive their teachers and peers value their learning and identity (Crespo et al., 2013; Foster et al., 2017; Oldfield et al., 2018) and how supported they feel in the school community (Goodenow, 1993; Joyce & Early, 2014). A commonly accepted definition of school connectedness was offered by Blum and Libbey (2004) and further explained by Waters and Cross (2010) as “the belief by students, that adults in the school community care about students’ learning and about them as individuals” (p. 165). Other scholars describe school connectedness as “the extent to which students feel personally accepted, respected, included, and supported by others in the school social environment” (Goodenow & Grady, 1993: p. 60). Scholars suggest that school connectedness is also comprised of their affinity and sense of belonging with their classmates (Karcher et al., 2006), and includes families, and the broader community (Lester et al., 2013). Ladd et al. (2017) suggest that schoolchildren have an emotional engagement with school, explained as their feelings about their peers and teachers. Research indicates that emotionally supportive connections between teachers and students nurture school connectedness (Theron et al., 2022).

Scholars investigating connectedness with Alaska Native (AN) adolescents suggest that belonging refers to the interconnected well-being of the person with their family, community, and habitat (Mohatt et al., 2011). Other scholars used an AI personhood model (Ruedas-Gracia et al., 2020) as a holistic framework to highlight the interconnectivity between “language, sacred history, ceremonial cycle, and land” (Tachine et al., 2017: p. 789) to study school connectedness with Native American college students (Tachine et al., 2017).

1.3. Why Does School Connectedness Matter?

Supportive relationships with caregivers, educators, and other adults can significantly reduce suicide among AI youths (Fullerton et al., 2019). School connectedness links to improved healthier mental health (Eugene, 2021; Oldfield et al., 2016), emotional well-being (Allen et al., 2021b; Eugene et al., 2021; Kidger et al., 2012), reduced suicidal ideation (Eugene, 2021; Marraccini & Brier, 2017), and is a barrier to adolescent depression (Wilson, Asbridge, & Langille, 2018; Elmelid et al., 2015; Eugene et al., 2021; Joyce & Early, 2014; Millings et al., 2012; Shochet et al., 2006; Shochet et al., 2008; Wilson et al., 2018). Scholars assert that schoolchildren experiencing strong school connectedness are more adept at overcoming adverse outcomes of bullying (Foster et al., 2017), encounter fewer violent episodes (Bearinger et al., 2005; Steiner et al., 2019), and use fewer drugs and alcohol (CDC, 2018; Serafini et al., 2017). Other scholars note that youths experiencing dilapidated school connectedness demonstrate a higher willingness to participate in risky behaviors (Prado et al., 2009; Rink et al., 2007; Wilson et al., 2018), have lower academic achievement, and are at an increased risk of dropping out of school (Bond et al., 2007).

1.4. American Indian Schooling Context

AI children were forced into boarding schools (Kirmayer et al., 2014; Ross, 2016) to control their social, academic, cultural, and physical development (Brayboy & Lomawaima, 2018; Reyhner & Eder, 2017). The architects of boarding schools punished AI children for speaking their traditional languages (Kimmerer, 2013; Running Bear et al., 2018) and denied them opportunities to participate in their cultural or spiritual practices (Clark & Wylie, 2021). Many AI children went years without visiting their homelands or their families (Adams, 2020; Reyhner, 2018), were physically and sexually abused (Charbonneau-Dahlen et al., 2016; Running Bear et al., 2018), and many died (Adams, 2020; Fear-Segal & Rose, 2016). The experiences at boarding schools contributed to a genocide (Moffitt & Rogers, 2022; Running Bear et al., 2018; Wolfe, 2006). A Native Elder explained genocide this way, “When we talk about genocide, the definition is to extinguish the culture through the children” (Clark & Wylie, 2021: p. 336).

Scholars note that several generations of AI descendants may have transferred the trauma they inherited at boarding schools to their kinship (Brave Heart & DeBruyn, 1998; Deloria et al., 2018; Evans-Campbell, 2008; Running Bear et al., 2018). One scholar alleges that “mental illness, depression, and PTSD can be genetically transmitted to secondary and subsequent generations” (Sotero, 2006: p. 99). Other research suggests intergenerational trauma might transfer through epigenetic mechanisms described as “a set of potentially heritable changes in the genome that can be induced by environmental events” (Yehuda & Lehrner, 2018: p. 246).

The transfer of intergenerational trauma for AIs is related to historical trauma (Brave Heart et al., 2011; Mohatt et al., 2014; Sotero, 2006; Wexler & Gone, 2012) or the Soul Wound (Duran & Duran, 1995). Historical trauma is the collective experiences shared by generations of AIs (Brave Heart et al., 2011; Mohatt et al., 2014) who faced intentional acts of colonization (Brayboy, 2005; Crawford, 2014; Gone, 2013; Kirmayer et al., 2014). Scholars indicate that the shared cultural-related historical trauma experienced by AIs may contribute to higher suicide rates (Running Bear et al., 2018; Wexler, 2006). Complicating the healing process is the belief that descendants of boarding school survivors must conceal their mental health struggles because they think their pain pales compared to their caregivers’ suffering associated with historical trauma (Hussain et al., 2018).

Scholars claim that AI schoolchildren are experiencing contemporary elements of historical trauma with the loss of their Elders to COVID-19 (O’Keefe et al., 2021; Tsethlikai et al., 2020). AI Elders are the keepers of sacred knowledge (Robbins et al., 2006) and possess the right to transfer cultural knowledge (Clark & Wylie, 2021). Cultural knowledge is critical to helping youths develop cultural resiliency (Burnette & Figley, 2017; Heavy Runner & Marshall, 2003) to triumph over adversity (Tsethlikai et al., 2020). Cultural resiliency is the belief that all cultures have positive attributes that contribute to individuals overcoming hardships (Strand & Peacock, 2003).

Current colonization efforts are reflected in teacher training programs that are ill-prepared to “recruit, nurture, and retain Indigenous educators in schools” (Anthony-Stevens et al., 2022: p. 91), resulting in AIs making up less than 1% of schoolteachers across America (Anthony-Stevens et al., 2022; Covarrubias & Fryberg, 2015). The lack of AI teachers harms AI youths by limiting access to culturally normative role models (Locke, 2018; Martinez, 2014) which reduces their opportunities for developing positive self-esteem or a healthy cultural identity (Brave Heart, 1999; Locke, 2018).

The limited number of culturally competent teachers serving AI youths (Bang et al., 2019; Lee, 2015) forces them to acculturate to a Euro-Western learning model that suppresses their cultural identity (Brayboy & Lomawaima, 2018; Fryberg et al., 2013; Gone, 2013). The suppression of their cultural identity contributes to cultural discontinuity (Cholewa & West-Olatunji, 2008; Lovelace & Wheeler, 2006). The collective impact of AI children experiencing cultural discontinuity is an early achievement gap (Brayboy, 2005; Dalla & Kennedy, 2014), contributing to AIs having the lowest academic attainment levels of any group (Aud et al., 2010; Brayboy et al., 2015; Chow-Garcia et al., 2022). Scholars report an association between AI caregivers’ educational attainment level and school connectedness for their children (Ruedas-Gracia et al., 2020). The dearth of educational attainment is a factor in AIs experiencing inequalities in work opportunities, elevated poverty rates, and intergenerational mental and physical health difficulties (Aud et al., 2010; Gentry & Fugate, 2012; Gone & Trimble, 2012).

Scholars avow children benefit educationally, and their identity, values, and sense of self are influenced by interacting (Gehlbach et al., 2016) with self-relevant role models (Covarrubias & Fryberg, 2015). Self-relevant role models are people believed to have similar defining traits like ethnicity, gender, or socioeconomic status deemed vital to the individual the role model motivates (Bandura, 1986; Blanton et al., 2000). Literature notes that self-relevant role models impact children as early as preschool (García Coll & Ferrer, 2021). Researchers assert that AI youths expressed a more profound sense of school connectedness when exposed to self-relevant role models (Covarrubias & Fryberg, 2015). Likewise, García Coll et al. (1996) report that lower levels of rapport occurred between White teachers and their AI students when the teachers failed to use an AI rhythm and speech pattern during instruction. In contrast, scholars wrote that AI students attending a school consisting primarily of their tribal members reported a low sense of school connectedness (Ruedas-Gracia et al., 2020). Other scholars suggest that physical proximity to other people may contribute more to connectedness than having similar defining traits (Baumeister & Leary, 1995).

1.5. Theoretical Orientation

The current article was viewed through the analytical lens of the American Indian Post-Colonial Psychology Theory (Duran & Duran, 1995). The American Indian Post-Colonial Psychology Theory uses an American Indian political, cultural, and historical context to connect with Western psychological ideas (Robbins et al., 2006). The theory highlights the lived experiences of AIs (Duran & Duran, 1995) through the lens of historical trauma (Hartmann et al., 2019; Mohatt et al., 2014; Sotero, 2006). The theory critiques historical and actionable viewpoints that AIs have adopted mainly by being subjected to American schooling environments (Duran & Duran, 1995).

2. Methods

2.1. Setting

This study was conducted at an acute and residential child and adolescent psychiatric hospital in a northwestern state, serving over 4000 young people. The hospital began as a home for orphaned and abandoned children in 1896, was the first facility to treat children with polio, offer genetic services, and have a chemical dependency unit dedicated to adolescents. The hospital is accredited by the Joint Commission, which is recognized worldwide as the leader in health care accreditation.

2.2. Participants

I identified a purposeful rather than a random sample of child and adolescent psychiatrists (CP) working at a child and adolescent psychiatry hospital. I began my recruitment by meeting with the hospital CEO and Chief Medical Director. Following their approval, an email was sent to each of the psychiatrists working at the hospital. Ultimately, I interviewed four (n = 4) psychiatrists, one male and three females using a semi-structured interview guide attached as Appendix A. The psychiatrists’ years of service at the hospital ranged from 7 - 18 years (a = 13.25, SD = 3.96). All were board certified in psychiatry and completed a child and adolescent psychiatry fellowship. The duration of each interview ranged between 45 - 120 minutes (a = 80, SD = 28.06). With permission, the discussions were recorded and later transcribed verbatim.

2.3. Analytic Methods and Results

The method of data analysis centered on an approach described by Briggs (1986), in which each interview is considered on its own terms to understand what a participant meant by the answers they gave during an interview, rather than decontextualizing answers from their original context. I used a grounded theory approach to compare the interview data (Glaser & Strauss, 1967). In this approach, I read through each transcript a minimum of five times and used In Vivo Coding (Saldaña, 2013) to place descriptors of risk factors and protective factors associated with self-esteem into predetermined categories associated with school connectedness. I report detailed descriptions of protective factors and risk factors associated with elements of school connectedness within subsequent paragraphs. The elements of school connectedness were operationalized to include cultural connectedness, the broader community, caregivers, teachers, and peers. Materials and analysis code for this study are not available. The results are illustrated in Table 1. An example of In Vivo Coding follows:

Table 1. Descriptors of school connectedness elements as risk or protective factors for self-esteem.

School Connectedness Elements.

2.4. Cultural Connectedness

Research describes culture as a vibrant guidepost that shapes and helps people make meaning of worldviews and replicates itself as an identifiable community (Wexler & Gone, 2012). Cultural connectedness is an understanding and association with facets of one’s culture (Henson et al., 2016; Snowshoe et al., 2017). Ruedas-Gracia et al. (2020) suggest that school and cultural connectedness are interrelated. Scholars indicate that cultural connectedness combined with guidance from AI Elders might protect AI youths against suicide (Doria et al., 2021). Snowshoe et al. (2017) avow a positive connection between culture and AI youths’ mental health. A strong sense of cultural identity is a protective factor for adverse mental health outcomes (Brougham & Haar, 2013; Houkamau & Sibley, 2011; Williams et al., 2018), improved self-esteem, increased healthiness, and lesser frequencies of binge drinking (Gone, 2013; Saewyc et al., 2013; Snowshoe et al., 2017). Moreover, scholars reported that AI youths can overcome mental health struggles by developing belongingness to their tribal culture and connecting with tribal spirituality (Pharris et al., 1997). The CPs were asked: How does an adolescent’s understanding of their cultural identity influence their self-esteem?

CP 1:

The sense of self and self-identity comes out of people’s individual traditions. I think our traditions get affirmed because we’re in the majority, where I think as a minority your traditions don’t get affirmed to the same degree, and if you don’t have your traditions affirmed by the people that you interact with all the time, then I think they feel negated in that regard. I think without our culture being understood and affirmed; we are going to have difficulty affirming ourselves coming out of that culture…that’s why I feel like it’s our job as Europeans who are working with kids from different cultures to try to understand them, really work hard at understanding them better…

CP 2:

Kids who have a strong connection to their culture would help with their self-esteem because…your developmental task as an adolescent is kind of figuring out…who do I want to be when I grow up…what kind of person do I want to be. If you’re starting that journey with a stable cultural identity and a strong connection to a greater culture, I feel like that’s going to be…a grounding force for you as opposed to if you don’t have a strong cultural identity… The whole cultural trauma of what we white people put the Native Americans through, and, …the implications that has for them culturally, so, you know, I think the people that are in that particular system and culture, just have multi-dimensional and multi-generational trauma histories…

CP 3:

Some people have a lot stronger cultural identity than others. Some people are very proud of their cultural identity, some people are ashamed of their cultural identity. I think in general if it had a positive identification with a cultural identity that they perceived to be positive, then it would be good for their self-esteem, but if they identified negatively with their culture or they perceived their culture to be negative, it would probably be negative for their self-esteem…

CP 4:

Well, I think it’s always important to feel part of a family, part of a community, part of a culture, and it creates a sense of connectedness and pride, and I think safety. And I think when you can see pride in multi-generations and feel, you know, I’m part of that, then it improves their self-esteem…

2.5. Community Connectedness

Community connectedness relates to how youth perceive the level of care, support, and assistance by adults in the community (Bernat & Resnick, 2009). A growing collection of research indicates that in addition to parents and peers, adolescent development is also affected by non-parental adults (Gehlbach et al., 2012) who have become crucial in their lives (DuBois & Karcher, 2005; Zimmerman et al., 2002) by strengthening their resiliency (Ahrens et al., 2011). Connections to non-parental adults are protective against depression (Barney, 2001), suicidal ideation (Pharris et al., 1997), and suicide attempts for AI youths (Borowsky et al., 1999). Scholars suggest that AI youths frequently bond with several extended family members (Swanson et al., 2022), including aunts, uncles, grandparents, and cousins (Bang et al., 2019; Prete, 2021; Swanson et al., 2022). Other scholars note that connections to non-parental adults protects adolescents against alcohol, tobacco, and drug use (Baldwin et al., 2011). The CPs were asked: How do perceived or actual community social supports influence an adolescent’s self-esteem?

CP 1:

Other things that kids are involved in through sports teams, or choirs, or any kind of sense of connectedness with other teens…not only are kids feeling connected with each other, but they also feel connected with their friends’ parents…

CP 2:

Outside social supports or perceived social supports can also have a large impact on self-esteem. Some of them may be involved in community groups…so it could be sports teams, it could be scouting groups, it could be faith communities, it could be, you know, other kind of clubs or activities that kids are attracted to…

CP 3:

I think whenever there is fear and discord people become frightened, disillusioned, they feel hopeless about them having any impact in the world, and they feel very vulnerable, and that’s how I think it affects their self-esteem…what comes to mind is Columbine, because that was a societal, you know, event… And I think the sense of vulnerability…you feel like when you do things right you’ll be safe, and when it feels like there’s nothing you can do, you can’t even go to school and be safe, it does affect your sense of being able to take care of yourself…it frightens people…

CP 4:

There can be other important self-object relationships, grandparents, aunts, uncles, teachers, who can change the course for children and replace what may be missing in the home…

2.6. Caregiver Connectedness

Caregiver connectedness relates to how youth perceive affection, genuine concern, and respect demonstrated by caregivers (Foster et al., 2017). Academic literature notes that positive relationships between a parent and child are a protective factor against substance abuse (Brockie et al., 2021), violence (Farrell et al., 2010), internalizing disorders (Day & Padilla-Walker, 2009), depression and anxiety (Eugene, 2021), suicidal ideation (Pharris et al., 1997), and suicide attempts (Borowsky et al., 2001; Brockie et al., 2021; Foster et al., 2017; Pharris et al., 1997). The CPs were asked: To what extent do parents or caregivers influence an adolescent’s self-esteem?

CP 1:

Parents influence their kids to grow up to be confident and competent…I think that sense of self-esteem and sense of self is all interrelated to that connectedness through those relationships…children that…feel affirmed in their relationships with their caregivers… So, if as a parent you’re always second guessing yourself, you feel inferior, you lose your temper, and you handle situations in a way that causes scar tissue, then you’re going to raise kids that have scar tissue and feel inferior…if somebody has a lot of scar tissue, and they haven’t worked through the scar tissue, then they disseminate it to other people…it becomes generational.

CP 2:

Kids are…really impacted by their parents, and I feel like parents often don’t appreciate how much they still have an impact on their kids… Even though they may be telling them like go away, leave me alone, I don’t want to talk to you, they really do want to talk to you, and it really is important, and I think parents can have, like if they are intentional, and they try to really listen to their kids and talk to their kids, they can have a really positive impact. Self-esteem is correlated with having had a solid early upbringing and having that unconditional love from parents… When people feel like they are worthy and lovable and are valued, there tends to be less depression and worthlessness leading to suicidal thoughts… On the other hand, kids who’ve been abused by their parents are going be at very high risk for not having healthy self-esteem and not having healthy self-worth…

CP 3:

I think parents can be very helpful in combating negative experiences or negative information that has been received through the environment or through social media, but we also see cases where the parent is one of the primary negative influences…the parent is one of the reasons the patient identifies that they have low self-esteem…

CP 4:

I think parents play a part, from a very early age. They say that empathy is learned within the first year of life…are the children the focus of their care and attention? Or are other things distracting them that affects how children feel about themselves? … A lot of kid’s sense of self-worth or self-esteem is dependent upon how they’re brought up. I could go on and on about how parents impact children’s self-esteem, but it’s huge…

2.7. Teacher Connectedness

Supportive teacher-student relationships are ingrained with a sense of belonging, kindness, and encouragement (Hamre & Pianta, 2001). Schoolchildren who have caring and hopeful relations with educators use them as a foundation for examining the schoolhouses’ academic and social aspects, confronting rigorous educational offerings, and developing self-awareness, self-control, and vital interpersonal skills (Krasnof, 2016). Children who have a positive connection with their teachers may feel supported (Birch & Ladd, 1997) contributing to fewer episodes of suicidal ideation or suicide attempts (Wyman et al., 2019). Positive teacher-student relationships influence academic self-esteem (Ryan et al., 1994) and benefit students attending schools in high poverty areas (Murray & Malmgren, 2005). The CPs were asked: What influence do school personnel have on an adolescent’s self-esteem?

CP 1:

I think it’s huge… They have a tremendous impact and influence on kids… particularly in elementary school, you spend more time with your teacher in the daytime than you do with your parents…kids who feel affirmed by their teachers, are kids who go on to…have successful relationships…not only can they be really positive in kids’ lives, but they can also be extremely detrimental…I have…great memories of teachers, and then I have a few that weren’t so great, right, that really kind of hindered me in terms of, you know, creating self-doubt…

CP 2:

I think teachers and administrators can have a big impact. You know, I think if you talk to kids who have done well in the face of adversity, they often will cite…some important person outside of their family, whether it was a coach or a teacher, or, an administrator that took a personal interest in them or connected with them, and really, there’s a lot of research that even just having that one connection, that one really positive person in your life, can make a big difference in the kind of overall outcome that a kid has…

CP 3:

There are…children who form strong relationships with school staff and the school staff have a strong influence on their self-esteem…We have definitely seen school staff be advocates for children in bullying situations working directly with children on self-esteem issues…

CP 4:

When a child goes through their development, they are separating and individuating from their parents…the biggest move is usually around middle school, which is a tough time for kids to begin with, and they need positive role models to be able to appropriately move further away and develop away from their parents, and I think teachers can provide a tremendous amount of support and stimulation, curiosity, and positive reflection that could help change a kid’s life…

2.8. Peer Connectedness

Peer connectedness relates to how youths perceive the degree of support, authentic kindness, and belief in their schoolmates (Bernat & Resnick, 2009). Adolescents who experience positive peer relationships tend to have healthier self-esteem, experience positive psychosocial adjustment (Savin-Williams & Berndt, 1990), and are more likely to avoid violence and delinquency (Pardini et al., 2012). Adolescents who struggle to form positive connections with peers experience elevated symptoms of loneliness (De Luca et al., 2022; Rejaän et al., 2022), contributing to depression and suicidality (Prinstein et al., 2000). Past research suggests that adolescents’ peer experiences link to mental health outcomes, educational consequences, addictive behaviors, and mortality decades later (Allen et al., 2014; Almquist & Östberg, 2013; Menting et al., 2016; Modin et al., 2011). The CPs were asked: To what extent do an adolescent’s peers influence their self-esteem?

CP 1:

If your friendship group is about a group that always feels ostracized, feels inferior, then you’re going take on those characteristics…it’s an interesting social experiment on a psychiatric milieu to watch how kids gravitate to certain kids. Typically, the kids that are having the most difficulties are attaching to the kids that are having the most difficulties…

CP 2:

In typical adolescent development, you’re pulling away from your parents, your peer group is the most powerful group…peers have probably the biggest impact on self-esteem for adolescents… I think there use to be more of like when you’re at school you’re influenced more by your peers and when you were at home you’re influenced more by your family, but again, that’s where social media has really blurred those lines, because now kids are constantly communicating with peers…the influence doesn’t stop when they walk out of the school doors…

CP 3:

I think peer relationships make a huge difference… They’re rough on each other…it’s important to get your kids in with kids who can just be a kid, rather than being focused on attaining the values of older children.

CP 4:

An adolescent’s peers have a large influence on self-esteem… Adolescent patients are typically trying to form a sense of identity and trying to figure out where they fit in society… Peers can have a large role either in helping someone feel accepted and having a higher self-esteem or in delivering negative messages and lowering self-esteem…

3. Discussion

This study fills a void in the academic literature concerning school connectedness by presenting the perspectives of child and adolescent psychiatrists on the elements of school connectedness. The results support prior research findings on school connectedness and embed cultural identity as a core component of school connectedness. I operationalized the elements of school connectedness to include cultural connectedness, the broader community, caregivers, teachers, and peers.

School closures tied to COVID-19 mandates highlight the valuable social support that schools (Campione-Barr et al., 2021) provide youths for building caring communities (O’Keefe et al., 2021; Leach Sankofa, 2022). Schools can offer a community of caring (Hussain et al., 2018), contributing significantly to providing hope, creating a sense of belonging (Clausen et al., 2021; Ersan & Rodriguez, 2021; Hussain et al., 2018), and nurturing an academic identity (Martinez, 2014). An academic identity is when an individual sees a reflection of their personal and cultural identities embedded in the educational environment (Martinez, 2014).

Martinez (2014) notes that AI students can successfully navigate a dominant culture if they view a positive association between their cultural and academic identities. Regrettably, a publication by the National Congress of American Indians uncovered that 87% of state history standards in schools across America make little reference to AI history after 1900, and 27 states abandoned teaching their youths about AI altogether (NCAI, 2019). Research indicates that when AI students have strong academic and cultural identities, they’re more likely to overcome difficult situations (Alberta, 2001).

A healthy connection to school personnel and classmates positively impacts youths’ self-esteem (Hughes & Kwok, 2007; Hughes et al., 1999). Self-esteem is critical during adolescence by helping them develop a positive sense of self (Orth et al., 2012). In youths, a positive sense of self leads to better future relationships and job satisfaction, career status, emotional regulation, and physical health (Orth et al., 2012). Scholars note that success in life and school links to an individual’s identity and how they and other people perceive them (Verhoeven et al., 2019). Identity is not just a product of having a positive self-concept but is related to discovering your place in the world through humility and strength (Reyhner, 2006).

Scholars allege that marginalized youths yearn to see their cultural identities embedded throughout the school (Carjuzaa & Ruff, 2010) and are mindful of their collective voices being absent from school discussions or having their experiences or beliefs affirmed (Solórzano et al., 2000). Failing to recognize the influence that culture has on forming identity can contribute to young people feeling invisible because the school community fails to validate their identity (Clausen et al., 2021). Research reports that AI youths are more successful in school when less assimilated into the dominant culture (Reyhner, 2010). Other research says that students thrive academically when teachers deliver quality instruction plaited with cultural competencies (Suarta et al., 2022). Scholars indicate that having pride in one’s culture and identifying with traditional cultural elements enhances students’ school attitude and academic success (LaFromboise et al., 2006; Whitbeck et al., 2001). Authors argue that community experiences braided with culturally-centered learning empower (Carjuzaa, 2012; Gay, 2013) AI children (Carjuzaa, 2012; McCarty, 2012).

AI schoolchildren flourish in caring settings that produce a positive mental image, pride in ethnic difference, and a feeling of belonging among pupils (Strayhorn, 2012). A strong sense of belongingness is associated with a strong ethnic identity and connection with an individual’s ethnic group over time (Saylor & Aries, 1999). Ethnic identity comes from a person’s feeling of connection to an ethnic group (Newman, 2005; Phinney, 1990). A positive view of ethnic identity contributes to healthy psychological well-being (Galliher et al., 2011; Phinney & Chaviara, 1992) and links with positive self-esteem for AI adolescents (Yasui et al., 2015).

AI parents and their children struggle to develop a healthy ethnic identity because they receive conflicting messages about their way of knowing (Battiste, 2013; Brayboy & Lomawaima, 2018; Castagno et al., 2022). The lack of legitimacy about Indigenous Knowledge (IK) (Brayboy & Maughan, 2009; Castagno et al., 2022) contributes to AIs experiencing cultural socialization based on a Euro-Western worldview (Brayboy & Lomawaima, 2018). Cultural socialization is how parents and children convey messages about the importance of their ethnicity and race (Bakth et al., 2022; Byrd & Legette, 2022; Syed et al., 2018).

Umaña-Taylor et al. (2014) assert that concepts of ethnicity and race are discrete, and the United States has a long history of dividing and categorizing according to race, making it essential to acknowledge that these racially motivated divisions influence identity formation. Academic literature notes that Identity formation is the main task of adolescence (Erikson, 1968) and for youths of color is made more arduous by the added task of blending ethnic and racial identity into one’s sense of self (Umaña-Taylor et al., 2014). To describe this process, Umaña-Taylor et al. (2014) operationalized Ethnic Racial Identity (ERI) to explain (Williams et al., 2020) how one defines their sense of self in relation to their cultural heritage and racial context.

Research notes that a positive view of one’s ERI is linked to a robust sense of self and well-being in AI adolescents (Byrd & Legette, 2022; Hoffman et al., 2021). Scholars wrote that ERI development might contribute to AI adolescents’ positive attitudes towards school (Bakth et al., 2022). Clark (2022) learned in a study with AI youths that ERI exploration contributes significantly to increasing cultural connectedness. Other scholars allege that a person’s ERI is central to self-identity because it nurtures a sense of belongingness to a group’s “cultural values, kinship, and beliefs” (Woo et al., 2019: p. 2), deemed essential by AI parents for identity formation (Clausen et al., 2021).

Limitations

This study’s findings must be understood considering specific limitations. First, only four psychiatrists were interviewed from a single child and adolescent psychiatric hospital. Second, none of the psychiatrists were AI, and as a result, an AI worldview is absent from their perspectives and conclusions.

Notes

For the current article, the terms American Indian, Native, and Indigenous were used interchangeably, “relating to people who trace their ancestral origins to the indigenous cultures and peoples of the Americas” (Strayhorn et al., 2016: p. 67).

Study Approval and Declaration

The author would like to offer a special thank you to the Arizona State University Institutional Review Board.

Appendix A

Data Collection Instrument

Semi-Structured Interview Protocol

OVERVIEW & CONFIDENTIALITY: Thanks again for agreeing to participate in this interview. As previously mentioned, I would like to record and transcribe this conversation to have an accurate account of your perspectives. I will assign a pseudonym on each transcript instead of your name in the study. I am interested in your views on the relationships between elements of school connectedness and self-esteem developed for American Indian adolescents. Please remember that all of these questions are about American Indian adolescents. The aspects of school connectedness were operationalized to include cultural identity, the broader community, caregivers, teachers, and peers. Do you have any questions before we start?

Introduction

1) Please tell me your name.

2) Please describe your professional training.

3) Please tell me the number of years you have worked in the field of child psychiatry.

Self-esteem development

1) How do you perceive self-esteem development?

2) How is self-esteem developed during adolescence?

3) How are adolescents’ self-esteem and suicidal ideation related?

4) How does an adolescent’s understanding of their cultural identity influence their self-esteem?

5) How do societal issues faced by adolescents influence their self-esteem?

6) To what extent do traumatic experiences such as face to face bullying or cyberbullying influence an adolescent’s self-esteem?

7) To what extent do parents or caregivers influence an adolescent’s self-esteem?

8) To what extent do an adolescent’s peers influence their self-esteem?

9) How do perceived or actual community social supports influence an adolescent’s self-esteem?

10) What influence do school personnel have on an adolescent’s self-esteem?

Conflicts of Interest

The authors declare no conflicts of interest regarding the publication of this paper.

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