Transcript Document
One Sky Center The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services Mental Health in Native Communities: Strengthening Our System of Care HHS Region VIII Tribal Consultation Denver, Colorado June 8-9, 2005 Dale Walker, MD Steve Sawmell Patricia Silk Walker, PhD Douglas Bigelow, PhD Laura Loudon, MS 1 For information, contact us at 503-494-3703 E-mail Dale Walker, MD [email protected] Or visit our website: www.oneskycenter.org 2 Overview • • • • • An Environmental Scan Behavioral Health Care Issues Fragmentation and Integration Introduction to One Sky Center SAMHSA Activities 3 4 5 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 6 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 7 Difficulties of Program Integration • • • • • • • 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 8 Different goals Resource silos One size fits all Activity-driven How is it working? (Carl Bell, 7/03) 9 Culturally specific Best Practice Outcome driven Integrating resources We need Collaboration, Integration, and Synergy : Community Mobilization (Carl Bell, 7/03) 10 One Sky Center 11 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 12 One Sky Center Partners Cook Inlet Tribal Council Alaska Native Tribal Health Consortium Northwest Portland Area Indian Health Board Tribal Colleges and Universities One Sky Center United American Indian Involvement National Indian Youth Leadership Project Na'nizhoozhi Center Jack Brown Adolescent Treatment Center 13 Identify Best Practice Best Practice Evidence Based Mainstream Practice Traditional Healing 14 Circle of Care Traditional Healers Primary Care A&D Programs Best Practices Child & Adolescent Programs Boarding Schools Colleges & Universities Prevention Programs Emergency Rooms 15 Community Mobilization Partnered Collaboration Grassroots Groups Community-Based Organizations Treatment-Education-Research 16 SAMHSA Administrator’s Policy on Tribal Eligibility Tribal entities are eligible for all grants for which States are eligible unless there is a compelling reason to the contrary. Any reason for excluding Tribal entities from grant eligibility needs to be justified and approved by the Administrator. SAMHSA AI/AN Grants 2005 • Drug-Free Communities Support Program • • • • New Circles of Care grants New Substance Abuse Treatment Capacity grants Suicide grants, one set-aside for a tribal organization. Child and Adolescent Mental Health and Substance Abuse State Infrastructure Grants • Child Mental Health Systems of Care grants • Youth/Schools Violence Prevention • Recovery Community Services Program 18 SAMHSA National Outcomes Measures • • • • • • • • • • Abstinence Employment/Education Crime and criminal justice Housing stability Access/Stability Retention Social connectedness Perception of care Cost effectiveness Use evidence based practice 19 Technical Assistance to Tribes and Tribal Organizations • • • • Children’s Mental Health Initiative Circles of Care FASD Center for Excellence One Sky Center 20 = OSC Technical Assistance Provision 21 Region VIII Behavioral Health Issues • Addiction – Crow Nation • Suicide – Standing Rock – Red Lake • Domestic Violence – Across regions • Co morbidity – Across Regions 60.0 50.0 48.7 40.0 30.0 20.0 20.0 15.0 10.4 10.0 7.3 6.7 0.0 Alcoholism Suicides Homicides 22 people. Chart indicates deaths per 1000 Blue = AI, Burgundy = U.S. Average 23 24