Transcript Document

The American Indian/Alaska Native National Resource Center
for Substance Abuse and Mental Health Services
Disparity of Health Services and
Research: A National Strategy for Native
Mental Health and Addictions Prevention
and Treatment
NAMI National Meeting, Washington, DC, June 30, 2006
Dale Walker, MD Patricia Silk Walker, PhD Douglas Bigelow, PhD
Bentson McFarland, MD, PhD Michelle Singer
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One Sky
Center
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Program Goals
• Promote and nurture effective and culturally
appropriate prevention, treatment, and
mental health services
• Identify and disseminate evidence-based
prevention, treatment, and mental health
practices
• Provide training and technical assistance
• Help to expand capacity
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Projects
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Review SAMHSA portfolio: 134 projects
Mental health liaison – SAMHSA/ IHS
Medicaid, state, Indian funding
Best practices consensus project
National traffic safety – drivers training
Suicide and substance abuse
Suicide prevention
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One Sky Center Partners
Cook Inlet Tribal Council
Alaska Native Tribal
Health Consortium
Northwest Portland Area
Indian Health Board
Tribal Colleges
and Universities
Prairielands ATTC
One Sky
Center
Red Road
United American
Indian Involvement
Harvard Native
Health Program
Jack Brown
Adolescent
Treatment Center
National Indian Youth
Leadership Project
Tri-Ethnic Center for
Na'nizhoozhi Center Prevention Research
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One Sky Center Outreach
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What It’s All About!
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Presentation Overview
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Introduce One Sky Center
An Environmental Scan
Native Behavioral Health System Issues
Fragmentation and Integration
Integrated care approaches and interagency
coordination are best overall solutions
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Six Missions Impossible?
• How do we define health, education, and
social problems?
• How do we define disaster?
• How do we ask for help?
• How do we get Federal and State agencies to
work together and with us?
• How do we build our communities?
• How do we restore what is lost?
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A Quiet Crisis: Federal Funding
and Unmet Needs in Indian
Country, July 2003
Funding not sufficient to meet needs for:
• Health care
• Education
• Public safety
• Housing
• Infrastructure development needed
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American Indian and Alaska
Native Health Disparities
• Have same health disorders as
general population
• Greater prevalence
• Greater severity
• Much less access to Tx
• Cultural relevance more challenging
• Social context disintegrated
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Agencies Involved in B.H. Delivery
1. Indian Health Service (IHS)
A. Mental Health
B. Primary Health
C. Alcoholism / Substance Abuse
2. Bureau of Indian Affairs (BIA)
A. Education
B. Vocational
C. Social Services
D. Police
3. Tribal Health
4. Urban Indian Health
5. State and Local Agencies
6. Federal Agencies: SAMHSA, VAMC
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Difficulties of Program
Integration
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Separate funding streams and coverage gaps
Agency turf issues
Different treatment philosophies
Different training philosophies
Lack of resources
Poor cross training
Consumer and family barriers
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Different goals
Resource silos
One size fits all
Activity-driven
How are we functioning?
(Dale Walker, Carl Bell, 7/03)
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Culturally
Specific
Best
Practice
Outcome
Driven
Integrating
Resources
We need Synergy and an Integrated
System: Community Mobilization
(Dale Walker, Carl Bell, 7/03)
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Identify Best Practice
Best Practice
Evidence
Based
Mainstream
Practice
Traditional
Healing
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Circle of Care
Traditional
Healers
Primary Care
A&D
Programs
Best
Practices
Child &
Adolescent
Programs
Boarding
Schools
Colleges &
Universities
Prevention
Programs
Emergency
Rooms
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Community Mobilization
Partnered Collaboration
Grassroots
Groups
Community-Based
Organizations
Treatment-Education-Research
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Native Aspirations!
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Activities and Products
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Motivational Interviewing Manual
Best Practices Monograph
Promising Programs Review
Suicide – Consultation List
Suicide Program Directory
Community Assessment Instrument
Traffic Safety Programs in Native Areas
School List of Native Students
Service Learning Program
Methamphetamine Treatment and Prevention
Suicide Prevention Website
Cognitive Behavior Therapy Manual
Schools/Colleges
HIV – AIDS
Tele Health
CDC
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Contact us at
503-494-3703
E-mail
Dale Walker, MD
[email protected]
Or visit our website:
www.oneskycenter.org
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