Transcript Slide 1
Behavioral Health: Challenges and Opportunities in Indian Country Pamela S. Hyde, J.D. SAMHSA Administrator National Indian Health Board (NIHB) Board Meeting Washington, DC • January 24, 2012 FOCUS AREAS FOR TODAY’S DISCUSSION 3 BUDGET UPDATE & REVISED APPROACH GRANT-MAKING PREVENTION CHALLENGES: SUICIDE & HEART DISEASE PREVENTION: SUICIDE & HEART DISEASE TLOA UPDATE & INAGUARAL NEWSLETTER SAMHSA REGIONAL ADMINISRATORS BUDGET UPDATE 4 Promising news: SAMHSA ↓ ~1% while others saw sharp cuts • The 1% reduction = strategic and creative decisions to sustain Disappointing news: proposed new BH-TPG not funded • A multi-year non-competitive award in the amount of $50K to prevent substance abuse and suicide SAMHSA still fielding inquiries from tribal communities asking when the RFA will be out this year – w/o appropriation from the ACA Prevention Fund, SAMHSA isn’t able to support the program REVISED APPROACH TO GRANT-MAKING 5 Braided funding within SAMHSA & with partners Engaging with States, Territories & Tribes • Funding for States to plan or sustain proven efforts • Requiring/encouraging work with communities Revised BG application • Tribal impact: • In Section G: Tribal Consultation - States must show evidence tribal consultation was part of planning process • Tribes will not have to waive sovereignty in order to receive BG funds/services • Must include a copy of suicide prevention plan - if no plan then must demonstrate how one will be developed SAMHSA’S STRATEGIC INITIATIVES 6 1. Prevention 2. Trauma and Justice 3. Military Families 4. Recovery Support 5. Health Reform 6. Health Information Technology 7. Data, Outcomes & Quality 8. Public Awareness & Support PREVENTION CHALLENGES AI/AN COMMUNITIES 7 Higher adolescent death rates Higher past month binge alcohol use 1.Prevention Higher past month illicit drug use Higher sexual assault rates against females Higher homicide rates against women Higher rates of intimate partner violence against women Higher rates of incarceration and arrest Higher rates of historical trauma Higher youth suicide rates Higher rates of heart disease 5 Leading Causes of Death, United States AI/AN, Non-Hispanic, Both Sexes 8 Rank <1 1 Congenital Anomalies 68 2 SIDS 43 3 Short Gestation 33 4 5 Unintentional Injury 28 Placenta Cord Membranes 16 Age Groups 15-24 25-34 1-4 5-9 10-14 Unintentional Injury 30 Unintentional Injury 11 Unintentional Injury 21 Unintentional Injury 278 Homicide 7 Malignant Neoplasms 5 Suicide 14 Suicide 128 Suicide 88 Liver Disease 154 Heart Disease 6 Influenza & Pneumonia 4 Homicide 3 Homicide 58 Homicide 68 Heart Disease 117 Malignant Neoplasms 5 Congenital Anomalies 3 Congenital Anomalies 2 Heart Disease 19 Liver Disease 44 Malignant Neoplasms 105 Liver Disease 215 Congenital Anomalies 4 Benign Neoplasms 1 Influenza & Pneumonia 2 Congenital Anomalies 9 Heart Disease 33 Suicide 76 Diabetes Mellitus 87 2008 CDC – WISQARS **Most Recent Data Available 35-44 Unintentional Unintentional Injury Injury 287 292 45-54 55-64 65+ All Ages Malignant Neoplasms 357 Malignant Neoplasms 584 Heart Disease 1,556 Malignant Neoplasms 2,630 Heart Disease 340 Heart Disease 467 Malignant Neoplasms 1,538 Heart Disease 2,549 Liver Disease 191 Diabetes Mellitus 447 Diabetes Mellitus 165 Chronic Low. Respiratory Disease 437 Diabetes Mellitus 754 Cerebrovascular 336 Liver Disease 717 Unintentional Injury 295 Unintentional Injury 127 Unintentional Injury 1,575 http://millionhearts.hhs.gov 9 NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION 10 10 A public-private partnership established in 2010 to revise and advance the National Strategy for Suicide Prevention (NSSP) Leadership: • John McHugh, Secretary of the Army • Former Senator Gordon H. Smith, Pres/CEO, Nat’l Assoc of Broadcasters Vision: The National Action Alliance for Suicide Prevention envisions a nation free from the tragic experience of suicide Priorities: • • • 1: Update/implement the Surgeon General’s NSSP by 2012 2: Public awareness and education 3: Focus on suicide prevention among high-risk populations NATIONAL ACTION ALLIANCE FOR SUICIDE PREVENTION 11 AI/AN SUICIDE PREVENTION ACTIVITIES 12 Next steps being considered by BIA, BIE, IHS and SAMHSA re: suicide prevention and lessons learned from last year’s regional listening sessions and the two Action Summits for suicide prevention (Phoenix & Anchorage) – report coming soon One of the Action Summit workshops on the use epidemiological data to prevent suicide grew out of a workgroup consisting of Tribal and State representatives that was facilitated by SAMHSA’s CAPT SAMHSA’s Office of Behavioral Health Equity is planning a 2-day BH institute in conjunction with the American Indian Higher Education Consortium Student Conference (Rapid City) - March • Focus: National dialogue on BH in tribal college setting • Focus: How students and faculty can promote BH in their communities UPDATES - TLOA SECTION 241 SAMHSA HAS LEAD TO: 13 Create and staff a SAMHSA Office of Indian Alcohol and Substance Abuse (OIASA) • Director’s position: Interviews held, decision soon Develop a MOA with Justice, Interior and HHS Secure operating framework for a Tribal Action Plan (TAP) • SAMHSA’s Collaborative for the Application of Prevention Technologies (CAPT) • Native American Center for Excellence (NACE) Support for Tribes Pursuing Tribal Action Plans under the Tribal Law and Order Act • Tribal Action Plan Guidelines 2011 Establish Inventory/Resource Workgroup Establish an Education Services Workgroup Seek Tribal Leader input (consultation) Establish Newsletter Workgroup NEWSLETTER WORKGROUP LAUNCHES FIRST ISSUE 14 Published quarterly Includes reviews of exemplary alcohol/SA programs Provides valuable information and circulated w/o charge Interagency Council will work together to disseminate the newsletter electronically in order to reach schools, tribal offices, BIA regional offices and agencies, IHS area and service unit offices, IHS alcohol programs, and other entities serving AI/AN Available on the new SAMHSA IASA website, www.samhsa.gov/tloa REGIONAL ADMINISTRATORS 15 • Region I: Boston A Kathryn Power M. Ed. • Region VI: Dallas Michael Duffy RN, BSN • Region II: New York Dennis O. Romero • Region VII: Kansas City Laura Howard, JD • Region III: Philadelphia Jean Bennett • Region VIII: Denver Charles Smith, Ph.D. • Region IV: Atlanta Stephanie McCladdie • Region IX: San Francisco Jon Perez, PhD. • Region V: Chicago Jeffrey A. Coady, Psy.D • Region X: Seattle David Dickinson Among first activities for RAs - HHS Regional Consultation Sessions RAs to communicate SAMHSA’s message and to convey BH challenges and successes from the field to headquarters SAMHSA’S CONTINUED FOCUS 16 People - NOT money People’s lives - NOT diseases Sometimes focus so much on a disease/condition we forget people come to us with multiple diseases/conditions, multiple social determinants, multiple cultural attitudes It’s a public health issue! Behavioral health is essential to health!