A humble guest: a phenomenological exploration of success and competence in rural Alaskan mental health care

Abstract

Objective: Rural communities in Alaska face a long list of mental health disparities that are exacerbated by the other challenging factors inherent within the rural context. Rural Alaskan mental health care providers are faced with the tremendous task of providing clinically and culturally competent care to underserved and marginalized populations, with limited personal and professional resources, all while balancing the needs of the community, their own personal boundaries, and the pressure of remaining accountable to the larger system of professional ethics and guidelines. The aim of this study was to explore, identify, and understand from the perspective of rural Alaskan providers what it means to be successful and competent mental health care providers in rural Alaska. The ultimate goal of this study was to develop a deeper understanding of what being successful and competent means from the perspective of providers who have been successful in rural Alaskan practice. Methods: This study utilized an exploratory qualitative methodology grounded in the interpretive/constructivist paradigm. Semi-structured interviews were used to explore the perspectives of 12 mental health providers who have practiced successfully and competently with rural Alaskan patients. Furthermore, a phenomenological-hermeneutic approach was applied in order to work collaboratively with participants to reach a deeper understanding of mental health care success and competence in a rural Alaskan context. Results: Ten contextual themes and 27 subthemes emerged from the interviews that illuminate the experience of success and competence as experienced by rural Alaskan mental health care providers. The implications of this study serve to deepen the current understanding of what it means to practice in rural Alaska with communities and Indigenous people. Furthermore, the findings provide a culture and context specific understanding of success and competence that will help current providers, employers, and communities to better serve rural Alaskan people. The findings contribute to the literature by promoting a salient perspective of practice that is within a context of mental health that is generally disregarded, overlooked, and rarely considered.