Mental health in the Sámi population and the importance of cultural affiliation: cross-sectional analyses at two time points in mid and Northern Norway.

Mental health disparities have been reported among Indigenous populations worldwide. It remains unclear how different dimensions of Sámi affiliation, such as heritage, identity, and language are related to mental health outcomes. We aimed to examine mental health in the Sámi population according to different forms of Sámi affiliation (heritage, identity, and language affiliation). Furthermore, we examined changes in mental health from 2004 to 2012. Data were derived from two cross-sectional population-based studies conducted in 2004 and 2012. Both surveys included information on Sámi heritage, Sámi identity, linguistic background, and mental health assessed by the Hopkins Symptom Checklist-10 (HSCL-10). Slightly higher levels of psychological distress were observed in most Sámi groups compared to the non-Sámi population, with the exception of Sámi-speaking women. Differences over time were generally small, although men with Sámi heritage showed a modest increase in distress. In adjusted analyses, Sámi affiliation remained associated with psychological distress after controlling for age, education, and household income. Psychological distress was slightly higher in the Sámi population compared to the non-Sámi population, although differences were modest. Sámi affiliation appears to be associated with psychological distress beyond socioeconomic factors, potentially reflecting a complex interplay of social, cultural, and historical influences.