Recognizing that there has been a lack of systematic teaching about the unique mental health experiences of urban American Indians, this article examines data from national studies and specific case studies to illustrate some issues regarding the mental health of American Indians in urban areas. Some studies have reported that when American Indians are included in mental health studies they were significantly more likely than others to report experiencing "serious psychological distress" and feelings of helplessness compared to all other ethnic groups surveyed. The primary source for information on Diagnostic and Statistical Manual (DSM)-diagnosed disorders in the American Indian population is derived from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP). The study found that diagnoses of alcohol dependence, post-traumatic stress disorder (PTSD), and depression were the most prevalent DSM-III diagnoses. (Contains 2 tables and 58 notes.)