Joseph P. Gone AB '92 PhD

Introduction

My name is Joseph Gone. I am a clinical community psychologist by training. I am an enrolled member of the Aaniiih-Gros Ventre tribal nation of Montana on the Fort Belknap reservation. I was born and reared in Montana, left and went to three different colleges over five years, spent some time enlisted in the Army in between, and graduated from Harvard in 1992 in Psychology. I worked for my tribe for a bit, then went to get a doctorate in Psychology from the University of Illinois in 2001 and have been in academia ever since. First, I was at the University of Chicago for two years, then at the University of Michigan for 16 years prior to coming here to Harvard in 2018, where I have now been for nearly four years. I am a psychologist by training, but really I’m an interdisciplinary social scientist. I’m appointed in both the Anthropology department in the Faculty of Arts and Sciences and in the Global Health and Social Medicine department in the Faculty of Medicine at HMS. I am also a research psychologist, which is to say that my career is dedicated to producing knowledge at the intersection of culture, coloniality, and mental health in American Indian and other Indigenous communities. That takes me into the realm of rethinking, reconceiving, and reimagining what mental health services might look like for our populations, particularly by attending to issues like Indigenous traditional knowledge, Indigenous healing, and those sorts of practices.

What do you view as the greatest obstacle against the expansion of community-based mental health services, whether that be pertaining to your specific work in American Indian communities or generally regarding the U.S. healthcare system?

I think there are a number of obstacles. One of those is that mental health problems are often thought of as secondary within biomedical treatment. While many mental health treatments that we have are helpful to people, they don’t necessarily provide a complete cure. Mental health problems with actual diagnoses afflict around half of the national population, and yet only a third of those people actually get formal help for their mental health challenges, and only a small subset of them get the very best quality care available. Additionally, the more prevalent challenges are the hardest to treat. Addiction is one such example; people grapple with it, but there’s no pill that’s going to resolve addiction. Any time there’s no simple solution like an inoculation, a surgery, or a pill, it’s less motivating for the powers that be to allocate resources to invest enough and truly combat this challenge.

As mentioned previously, I work in Indigenous American Indian communities, and the biggest challenge for us is that our services are really underfunded. There is a history of making treaties between tribal nations and the United States in which we surrendered lands in exchange for promises. Healthcare services are understood to be part of what’s called the ‘trust responsibility’ of the United States to take care of the health of American Indian people. There is a branch of the U.S. public health service, known as the federal Indian Health Service (IHS), which is responsible for the delivery of healthcare services across “Indian Country,” as we say [to refer to] reservations and tribal nations. However, it has never been funded very well, so it’s very inadequate for meeting all of our healthcare needs. For example, while funds from the Indian Health Service can include hiring physicians, social workers, and nurses to deliver care, it does not typically include specialists. In fact, in the area of the country I’m from, the service area for the IHS encompasses all of Montana and Wyoming, where only one psychiatrist consults with all of the different reservations on mental health concerns. As such, being really deeply under-resourced is one of our chief dilemmas in Indian country.

While conducting research with these communities, what is that experience like for you, especially knowing that stigmas might exist about mental health or similarly prevalent issues?

Stigma plays a huge role, but the stigma [in question] is not quite the same as in mainstream contexts. American Indian people often feel that they have been researched to death over long decades. Researchers arrive, gather information, go back to their University, start moving forward in their career, and never share what they learned with the community. So, many tribal nations now operate their own research review boards. To do research in a tribal community, you must now pass their tribal research review process, which is often more comprehensive than what an Institutional Review Board (IRB) does. Research review boards in Indian Country have many other concerns besides just protecting human subjects’ rights like an IRB. They’re also concerned about how this research will benefit the community, what the findings make us look like in the broader media, and how we can protect endangered traditional knowledge.

Once you make it through that hurdle, there are concerns about the sensitivity around mental health. This is in part due to the fact that Indian societies— if I had to distill down what it means to be Indian— are about being part of a large kinship network where family reputation matters a lot. There’s a kind of vying for power and status, which certainly happens in all human societies, but having mental health conditions can mark a family as being less robust in a way that might accrue to reputational damage. Having said that, every extended family I know of in Indian country has people who are contending with addiction, depression, trauma, violence, suicide, and the after-effects of that. We have been subject to colonial oppression and powers that, for centuries, have plundered our resources, dispossessed us of our lands, and sought to Christianize us. Any society in the world that undergoes a kind of collapse— whether it’s in the face of war or people trying to campaign against your way of life— would end up with these kinds of problems. [The current crisis] is not surprising at a human level, but it is very difficult to figure out how to best harness resources, scarce as they are, to address and overcome suicide, addiction, and traumatic stress.

One of the problems with standard–especially psychosocial–therapies is that these are grounded in Western European orientations. Those don’t map very well onto some of our reservation and urban Indian populations. There’s a real need to rethink what is therapeutic. How can we tap into Indigenous traditional therapeutic approaches? How do we find approaches that fit better for people who maintain Indigenous orientations and perspectives? My career has been dedicated to sorting through that set of thorny problems of how to accommodate alternative perspectives with the services we offer.

You mentioned that you have a background of education in psychology and anthropology. What led you specifically to these two fields?

When I was deciding on getting a graduate degree, I was deciding between Clinical-Community Psychology, Cultural Anthropology, and Psychiatry. At some point in making that decision, I had an epiphany — I was excited about rethinking important, taken-for-granted ideas in conceptual terms, but also wanted to be really useful to communities that I care about. Social Anthropology might have too many ideas with too few applications, and Psychiatry might have too many applications and too few ideas. Psychology, particularly Clinical Psychology, allows for knowledge production within an arts and sciences framework— ideas— but also learning of clinical tools, techniques, and approaches to be helpful to people, which is the application side. Clinical-Community Psychology on its own is not particularly sophisticated in terms of how it considers  culture, cultural differences and practices. So I became a card carrying member of the American Anthropological Association and the American Psychological Association as a student; I understood that there were things to learn from both of these disciplines and to put together in useful ways.

Medical anthropology has a set of approaches that looks different from the kind of research that psychologists do. Psychologists tend to [perform] variable analysis with findings that are more scientific. Medical anthropology doesn’t use statistics as much and is a lot more case-study based— whether it’s a patient or a community case study.  Most of my research involves case examples and tries to unpack them by asking, “Okay, what does this say? What do we learn? What are the challenges that arise? What can we do to think through this in a way that would be more sophisticated in terms of ‘culture,’ but also in terms of providing better services?”

The blend of medical anthropology and clinical psychology has been really important for my career, but it has also meant that it’s been hard for me to fit into how academia is organized at times. My first job in Chicago for two years was in an interdisciplinary social science unit called the Committee on Human Development. That was perfect! I was colleagues with sociologists, anthropologists, and biologists who were thinking together about these issues. At my next job at Michigan for 16 years, I was jointly appointed in Psychology— in the Clinical Science area— and in American Studies, where the Native American Studies Program was. Instead of an interdisciplinary fusion, it was more multidisciplinary, a foot in here and a foot in there. They involved different ways of thinking and producing knowledge, but it was really fertile in terms of my putting them together and benefiting from two ways of thinking and writing.

How have those two disciplines, medical anthropology and clinical psychology, contributed to the work you do, especially at Harvard?

Harvard continues that kind of multidisciplinary approach I described through the combination of Anthropology— I’d never been in an Anthropology department before, so that’s exciting and certainly an adventure— and the Medical School’s Global Health and Social Medicine department, where our Chair, the late Paul Farmer whose loss we grieve immensely, led a fantastic collection of folks who are doing really cool, socially conscious medicine. I had never been at a medical school before, so that’s an adventure as well; again, I have two feet in different fields that overlap. The nice thing about being at Harvard is I am not alone in having this kind of appointment. I’m following in the trail of Arthur Kleinman and Byron Good, so I get to see how folks have developed and established this for around 40 years already. 

I’m also the Faculty Director of the Harvard University Native American Program. We work hard to try to identify and recruit and, importantly, retain Native American and Indigenous students who come to Harvard, especially at the College. My first college was  a private religious college in Oklahoma where I went for one year, got disillusioned, and joined the Army. Then, I came to Harvard from the Military Academy at West Point, so I have had different college experiences. I remember that, as an undergraduate at Harvard, especially if you’re coming from an untraditional background— you’re not from prep school or a wealthy family, your parents don’t send the family helicopter to get you for spring break, that kind of thing— Harvard can be a bit overwhelming with the concentration of wealth and privilege that some students enjoy. If you don’t come from that, it can sometimes feel intimidating. [I tell students] that the Harvard admissions office so carefully curates who the entering class is going to be: All of you belong at Harvard. There are different ways that people belong here. You have to figure out exactly how you belong, but rest assured that you do. I want to support students during that time of transition.

Who has been the most influential mentor in your life or in your career so far?

I’ve been so fortunate in my life to have a series of mentors without whom my career would not have come together in the way it has. For example, as mentioned, I was in the Army for a couple years and enlisted overseas in the U.S. Second Armored Cavalry Regiment. I met a lot of officers there who were quite inspiring and one thing they all had in common was going to West Point as educational preparation for military service. I applied and, at the last minute, received an appointment at the United States Military Academy at West Point and transferred out of the Army a year early to become a cadet and prepare for military officer status. I spent two years and three summers there being pushed to all my limits; it involved very heavy pre-professional training, so ideas and intellectual inquiry were a bit muted compared to all the other demands on your time to train as an officer.

I realized at one point there that I wanted to transfer and, as part of an extracurricular activity, visited Harvard one time. Just feeling the excitement of entering Harvard Yard intellectually was really striking to me. I confided to a couple of mentors who were colonels in the Army and assistants to the generals at West Point; I told them, “Look, I think I really want to go to Harvard.” I had no idea what they would think. They’re there to help us grow into military officers, so I’m sure it must have been disappointing to hear. In the end, I was able to transfer to Harvard as a junior, which is really difficult because there aren’t very many slots available. I later found out that when these two colonels were in Boston on military business, they walked into the Harvard admissions office, met with a staff member, and said, “You’ve got to admit this guy who we have supported as he applied to transfer here.” I didn’t know that at the time, but that’s an example of what mentors can do for you. Who knows if I would have gotten in without that kind of endorsement.

In graduate school, mentorship was really important for me. I was lucky to have four faculty members whom I think of as my close mentors, but my primary mentor was a community psychologist named Julian Rappaport. At Chicago, Rick Shweder, who’s a well known cultural psychologist was really influential to me. Of course, Arthur, Byron, and Mary-Jo Good here at Harvard have helped me out most recently. 

The way I’ve made it in this world, in my career at least, has been so unusual and so distinctive that there’s no one I could look to who’s done exactly this. Without mentors, I’m sure I would not have succeeded because there’s no template for what I’ve done.

If you have any insights or advice that you could offer to students looking to do the kind of work that you’re doing or to follow along in a similar path, what words of advice would you have to share?

Julian, my graduate school mentor, told me that he believed my vision of rethinking mental health services for American Indian people was worthy of pursuing and something I could do well. Given that, he really encouraged me to fully pursue my vision, downplaying the notion that I had to fit into existing disciplinary frameworks for how to conduct this sort of work— so much so that when I was looking for a job as a faculty member, I was very surprised by how conservative many departments of Psychology are around what counts as “appropriate” knowledge. When I first showed up at the University of Michigan on the tenure track in Psychology and Native Studies, I convened a group of potential mentors to guide me on how to get tenure at the University of Michigan, which is a six to eight year process where you have to “publish or perish” and all that. I spent 45 minutes going through what I was about, the questions I wanted to ask, the communities I wanted to work with, the kinds of studies I wanted to do. After I finished, one of them spoke up and said, “Well that’s all well and good, but I think you should shelf all that for another eight years. You need a different approach or you’re at risk for not getting tenure here. That’s all slow and messy and you won’t have enough of a record.” I had to really grapple with that feedback in my very first year on the tenure track there.

Then I remembered that Julian’s view was, “Why would you even want to get tenure at a place that wouldn’t value what it is you’re trying to accomplish? Yeah, you might not get tenure, but if you do good work somewhere, people will evaluate that and you’ll find another job.” I decided, “Well, maybe I won’t get tenure at the University of Michigan, but I’m going to write and publish what I care about. If they don’t value it, that’s okay, but I personally have to be proud of the quality of that work.” When I was up for evaluation, I got the feedback from my committee, who had canvassed a bunch of faculty all over the country to find out what they thought of my portfolio. It was uniformly positive so I was tenured and was able to move forward. I took a big risk, but with encouragement and guidance, it all paid off.

I believe that’s what your readers, especially if they are Harvard alumni and students, need to be thinking about. There are these well worn pathways that many people have tried, but if you feel limited by those, you have the potential to blaze a new trail just by virtue of coming through Harvard, so go do something new and exciting. It can be scary and not particularly predictable, but stick to your guns and do what matters to you. I am convinced that it will typically work out.

Joseph P.Gone, AB PhD

AB Psychology | 1992

Professor (FAS/HMS), Faculty Director of Harvard University Native American Program (HUNAP)

Compiled and interviewed by Christine Lee

Edited by Felicia Ho