The well-being of American Indian and other Indigenous communities has long been compromised by ruthless processes of European colonial dispossession and subjugation. As a result, contemporary Indigenous communities contend with sometimes overwhelming degrees of demoralization, distress, and disability. The concept of Indigenous historical trauma has arisen during the past thirty years as an alternative mental health discourse that critically contests prevailing categories of psychological disability, psychiatric distress, and mental disorders (including addiction, trauma, and suicide). Indigenous adoption and promotion of historical trauma affords an explanatory account for community mental health inequities that designates the historical legacies of colonization as central for understanding contemporary Indigenous suffering. In so doing, Indigenous advocates of historical trauma creatively recast these problems as postcolonial pathologies, and ardently call for overdue advances in reconciliation, redress, and repair with respect to Indigenous Peoples. Ideally, such advances will be evidenced by societal transformations, structural reforms, and social justice that can enhance and ensure Indigenous futurity and well-being.