Background: American Indian/Alaskan Native (AI/AN) individuals were 3.5 times more likely to be hospitalized from the virus compared to other race/ethic groups (CDC, 2021). Despite being disproportionately impacted by COVID-19, the experiences of the AI/AN population during the pandemic have not been documented. There are approximately 93,123 individuals in Massachusetts (MA) that identify as AI/AN (U.S. Census, 2020). This study examined the impact of COVID-19 on the behavioral health of the MA AI/AN population.

Methods: A web-based survey was completed by 452 AI/ANs. A focus group with members of the AN/AI/AN (n=10) community was conducted to provide insights into the survey results. Individuals were recruited through the Institute of New England Native American Studies research team’s Community Advisory Board.

Results: Forty-two percent of sample were between 45-64 years of age, female (77.2%), and identified as AN/AN in combination with another race (85%). Almost half of AI/AN participants had 15 or more days of poor mental health in the past month with rates highest among younger individuals. Forty-four percent reported that their substance use was a lot or somewhat more than pre-pandemic. Focus group findings indicated that the pandemic exacerbated (1) behavioral health challenges; (2) isolation from others and from AI/AN organizations; (3) telehealth was helpful to some; but (4) 30% had limited broadband access. Conclusion & Implications: The AI/AN community in MA has experienced devastating behavioral health outcomes during the pandemic. Urgent action is needed to address with crisis. Funding for risk-reducing programs and culturally specific treatment interventions are needed.