Healing From Within: Identifying and Understanding the Intersecting Barriers to Help-seeking After Experiences of Violence for Wisconsin American Indian Women Through Survivor-led Research

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ABSTRACT Indigenous women experience gender-based violence (GBV) at disproportionately high rates, contributing to devastating impacts to health and wellbeing including substance misuse and mental health disorders. Our understanding of the complex, intersecting health needs of Indigenous women who experience co-occurring substance misuse, mental health,and GBV on reservation-based and urban areas in the Midwest is limited. Additionally, the services available toaddress these issues are siloed and ineffective in meeting the needs of Indigenous women. To address this urgent gap, we propose a pilot study that uses a mixed-methods and community engaged approach to identify and understand barriers to help-seeking among Indigenous women with co-occurring mental health and/or substance use disorders after experiences of gender-based violence, and to understand how resiliency and cultural identity may help to motivate help-seeking among Indigenous women survivors of GBV in the localcontext of Wisconsin. This proposed pilot study is the first of its kind in Wisconsin by being Indigenous led, andthrough the formation of academic community partnerships between universities, 3 of Wisconsin’s 11 federally recognized tribes, Indigenous-led organizations, and tribal community leaders across the State. First, a community advisory team comprised of GBV survivors, providers, elders, and other stakeholders will be assembled and meet to ensure that all aspects of the study are culturally safe and meets the needs of the collaborating communities. We will conduct a survey and individual interviews with 90-100 Indigenous women to better understand their experiences, barriers to help-seeking, and resiliency factors that motivate help-seeking after experiences with GBV. Women will be recruited from community-based partner agencies, tribal health clinics, Indigenous led organizations, and tribal community leaders in order to capture women seeking help as well as women who have not sought help. Our proposed community engaged study is in line with the priorities of the Native American Research Center for Health (NARCH) initiative because it aims to address the health disparities related to GBV while promoting wellness in Indigenous populations by allowing communities to select, control and prioritize health-related research and research career enhancement opportunities, and establishes trust between academic institutions and tribal communities. Our pilot study data will generate baseline data andknowledge to advance our understanding of the complex needs of Indigenous women after experiences of GBV and reduce barriers to needed services and allow for the meaningful dissemination of findings in a way that reduces health disparities and promotes health equity. This pilot study proposal also helps to build a foundationupon which to carry out larger community based participatory studies that can be used to generate actionable recommendations to improve identification and comprehensive treatment of substance misuse, GBV, and otherhealthcare and safety concerns among Indigenous women.