Cancer-related depression among Southwest American Indian survivors: a qualitative study Rey Paolo Ernesto J. Roca III, Wendie Robbins, Felicia Schanche Hodge Volume 2, Issue 3 + +...

https://www.academia.edu/journals/academia-global-and-public-health/articles?source=journal-top-nav Introduction: Depression is common among cancer survivors and may disrupt sleep, appetite, and daily functioning. American Indian and Alaska Native populations experience disproportionate cancer incidence and mortality for several cancers, including cervical, liver, and stomach cancer. These disparities are shaped by well-documented structural barriers, including limited access to quality care and a shortage of culturally responsive mental health services in American Indian and Alaska Native (AI/AN) communities. Limited research has examined how Indigenous cancer survivors understand and respond to depression within the context of cancer survivorship. Materials and methods: This study reports findings from the qualitative focus group phase of a multi-phase research project examining cancer symptom management among American Indian cancer survivors in the United States Southwest. Thirteen focus groups were conducted with adult American Indian cancer survivors across urban and reservation settings. Four groups addressed experiences with depression. Audio-recorded sessions were transcribed and analyzed using thematic analysis. Results: Results revealed four central themes shaping the experience of depression among participants: denial of depressive symptoms, framing depression as weakness, fear of medications and treatment, and growing awareness and recognition of depression as a condition warranting attention. Quantitative baseline data showed limited participation in counseling or support groups, consistent with documented structural barriers to culturally responsive behavioral health services in AI/AN communities. Conclusions: Among participants in this study, depression is shaped by cultural meanings, stigma, structural barriers to culturally responsive care, and overlapping cancer-related symptoms. While many of these patterns—such as stigma, silence, and treatment hesitancy—are also documented in non-AI/AN populations, this study did not include a comparison group, and findings should not be interpreted as uniquely AI/AN. Culturally responsive depression screening and survivorship care models that integrate mental health support may improve recognition, treatment engagement, and quality of life among Indigenous cancer survivors. Keywords: cancer survivorship; depression; American Indian; Indigenous health; cultural beliefs; mental health https://www.academia.edu/3071-0324/2/3/10.20935/AcadPHealth8402