Transcript Youth Reg Treatment Center PPT

Skye Bass, MSW
Public Health Advisor
Office of Juvenile Justice & Delinquency
Prevention (OJJDP)
Tribal Juvenile Detention & Reentry
Peer-to- Peer Learning Meeting
October 7, 2011
Agenda
 Need for Treatment
 Youth Treatment Centers
 Clinical Services
 Traditional Healing & Cultural Practices
 Aftercare
 Future Outlook
 Questions & Answers
Need for Substance Abuse Treatment
 Substance abuse of all types is a serious problem, with
AI/ANs reporting a higher rate of marijuana, cocaine, and
hallucinogen abuse compared to other minority groups.
 American Indians/Alaska Natives (AI/ANs) are more likely
than any other race to have a past-year alcohol or illicit
drug use disorder. 1
 The AI/AN alcohol-related mortality rate is 519% greater
than the U.S. all-races rate. 2
1 The National Survey on Drug Use & Health Report, 2007.
2 Indian Health Service/Division of Program Statistics, IHS data years 2003-2005, U.S. data year 2004.
Need for Co-Occurring Treatment
 Alcohol and substance abuse can co-occur with mental health
disorders (Depression, PTSD, Anxiety, etc)
 There is a high rate of co-occurring substance abuse and mental health
disorders within AI/AN communities. 3
 When co-occurring disorders are left untreated (or if only one disorder
is treated), symptoms can become acute and result in far-reaching
complications.
 These complications include risk for physical health problems,
unemployment, homelessness, incarceration, separation from families
and friends, premature death, and suicide.
3 Substance Abuse and Mental Health Administration, National Survey on Drug Use & Health
Risk Factors
Impulsivity
Hopelessness
School Problems
Depression
Unemployment
Withdrawal
Poor Interpersonal Communication
Limited Social Support
Stigma
Anxiety
Family History
Suicidal Behavior
Domestic Violence
Dual Diagnosis
Geographic Isolation
Child Abuse
Personal Losses
Suicide Clusters
Behavioral Problems
Need for Early Intervention
• Adolescence is a period of growth and change
• Maladaptive habits, attitudes, and behaviors that take root
at this stage can have serious health repercussions
• Unhealthy behaviors that begin in adolescence can
continue to affect an individual throughout adulthood
• National surveys of adolescent drug use report that AI/AN
have higher rates of alcohol and drug use than any other
racial-ethnic group
What does Hope Look Like?
YRTCs
 Indian Health Service (IHS) currently provides
recurring funding to 11 Tribal and Federally operated
Youth Regional Treatment Centers (YRTCs) to address
the on-going issues of substance abuse and cooccurring disorders among American Indian/Alaska
Native youth.
Authorizing Legislation
• Advocacy by Tribes and AI/AN organizations, combined with
support of Congress resulted in the enactment of:
• Indian Alcohol and Substance Abuse Prevention and Treatment
Act of 1986 (P.L. 99-570)
• The Anti-Drug Abuse Act of 1988 reauthorized P.L. 99-570 and
authorized funding for construction, renovation and staffing of
treatment centers for AI/AN youth
• Section 704 of P.L. 102-573 amended the Indian Health Care
Improvement Act to provide additional support for the regional
treatment centers for AI/AN youth.
Establishment of YRTCs
• The original statute specified that tribes in each IHS Area
would agree upon a structure and location
• The tribes were to formulate a “Tribal Action Plan”
addressing their needs and plans with regard to alcohol
and substance abuse
• In 1988, the first YRTCs to begin operation were New
Sunrise Youth Regional Treatment Center in New Mexico,
and Jack Brown Youth Regional Treatment Center in
Oklahoma
• Tribes in three IHS Areas: Phoenix, Alaska and Portland
chose to develop two YRTCs in their respective areas
YRTCs in Development
• The Indian Health Service is purchasing land for the
development of two YRTCs in Northern and Southern
California (P.L. 108-447)
• Construction is expected to begin in April 2013 to
develop the first YRTC in Sage, Riverside County,
California
YRTC Mission Statement
To provide quality holistic Behavioral
Health care for American Indian/Alaska
Native adolescents and their families in
a substance free residential
environment that integrates traditional
healing, spiritual values, and cultural
identification
YRTCs
Aberdeen Area Youth Regional Treatment Center
Mobridge, SD
Desert Visions Youth Wellness Center
Sacanton, AZ
Nevada Skies Youth Wellness Center
Wadsworth, NV
New Sunrise Youth Regional Treatment Center
San Fidel, NM
Unity Regional Treatment Center
Cherokee, NC
Graf Rheeneerhaajii Adolescent Treatment
Facility
Fairbanks, AK
The Healing Lodge of Seven Nations
Spokane, WA
Jack Brown Youth Regional Treatment Center
Tahlequah, OK
Klamath Falls Youth Regional Treatment Center
Klamath Falls, OR
Navajo Regional Behavioral Health Center
Shiprock, NM
Raven’s Way Treatment Center
Sitka, AK
YRTC Services
Service Population
• American Indian/Alaska Native Adolescents
• Typically 12-17 years old at time of admission
• Males & Females
• Average Length of Stay of 90 days
• Admissions Process: Open Enrollment Model or Cohort
Model
• Capacity: Varies, 12-24 beds depending on the YRTC
Youth Served
• In Fiscal Year 2010, the YRTCs served 585 youth
• Of the 585 youth, 358 (61%) were court ordered
• Desert Visions Youth Regional Treatment Center reported serving 96 youth, of
which 36 youth (37.5%) reported gang involvement
*Two YRTCs did not report data
Substances Used
Most Common
Substances Reported
1) Alcohol
Diagnosis
• Alcohol Dependence
303.90
• Alcohol Abuse 305.00
2) Marijuana
• Cannabis Dependence
304.30
• Cannabis Abuse 305.20
3) Multiple Drugs
• Polysubstance
Dependence : 304.80
4) Opioids
Opioid Abuse: 305.50
Services
 Psychosocial Assessments
 Substance Abuse
Education
 Academic Education
 Individual, Group,
Psychotherapy
 Family Counseling &
Education
Online Education
Services
 Health, Nutrition, & Life Skills
Instruction
 Support Groups
 Narcotics Anonymous and
Alcoholics Anonymous
Meetings
 Medication and Health
Monitoring
Job Interview
Practice
Parenting Skills
Life Skill
Lessons
Services
 Adventure Based Therapy
 Recreation
 Equine/Animal Assisted
Therapy
 Wilderness Expedition
Hiking
Rock Climbing
Equine Therapy
Evidence- and Practice- Based
Models In Use
 Cognitive Behavioral Therapy
 Dialectical Behavior Therapy
 Motivational Interviewing
 Teen Matrix Model
 Project Venture, National Indian Youth Leadership
Project
 White Bison: Red Road to Wellbriety
 Acceptance and Commitment Therapy
 Moral Recognition Therapy
Co-Occurring Disorders
 Major Depressive Disorder
 Anxiety Disorder
 Post Traumatic Stress Disorder (PTSD)
 Attention Deficit/Hyperactivity Disorder (AD/HD)
 Bipolar Disorder
 Disruptive Behavioral Disorder
 Conduct Disorder
 Oppositional Defiant Disorder
Cultural-Spiritual Orientation
 Some of the most effective prevention and treatment
programs for AI/AN youth and families are rooted in
culturally-based models which are aligned with local
traditional beliefs, practices and norms.
 Strong identification with culture, therefore, is
preventative in many tribal communities and may be
critical for developing and implementing successful
prevention and treatment intervention.
Traditional Healing
 A life in imbalance, i.e. caused when one suffers from
mental health challenges, addictions, unresolved grief,
theft of ancestral lands, environmental racism, loss of
culture and spirituality, etc., requires a restoration of
balance to the individual through various culturallyand spiritually-based ceremonies.
 These may include prayer, talking circles, healing
ceremonies, or a number of procedures and protocols
rooted in ancient wisdom.
Traditional Healing & Cultural Services
• Drum Making
• Sweat Lodge Ceremonies
• Talking Circles
• Traditional Drumming
• Story Telling
• Beading
• Spiritual Gardening
• Stick Ball
• Hide Tanning
• Rites of Passage Ceremonies
Traditional Healing
Talking
Circles
Spiritual Gardening
Sweat Lodge
Ceremonies
Cultural Activities
Traditional Drumming
Medicine Wheel Teaching
Cultural Activities
Stick Ball
Hide Tanning
Teepee
Ceremonies
Expressive Arts
Traditional Murals
Traditional Murals
Traditional Arts
& Crafts
Expressive Arts: Music
• The Healing Lodge of Seven Nations received the
national iAward, presented by the National
Institute for Addictions Treatment for innovation
in addictions recovery programs.
• The Healing Lodge was recognized for its
Expressive Arts therapy program, which engages
youth in recovery through poetry and music.
U:\youtube\720p 152 kbit HL7N Music Program.mp4
Aftercare Services
• AI/AN youth are referred from numerous Tribes/States
across the U.S. & throughout Indian Country.
• YRTCs provide discharge planning, referral services,
and relapse prevention skills/planning.
• YRTCs all provide follow up services, some at 72 hours, 1
month, 6 months, and 12 months post-discharge.
• Some YRTCs provide tele-behavioral health aftercare
services.
Impacting Future Generations
 Through education and culture
based prevention initiatives,
evidence- and practice-based
models of treatment, family
strengthening, and recreational
activities,
 The Indian Health Service
funded YRTCS believe youth
can overcome their challenges
and recover their lives to
become healthy, strong, and
resilient leaders in their
communities.
Contact
Skye Bass, MSW
Public Health Advisor
Indian Health Service Headquarters
801 Thompson Avenue, Suite 300
Rockville, MD 20852
Phone: (301) 443-2038
Fax: (301) 443-7623
[email protected]
References
1 The NSDUH Report. (2007) Substance use and substance use disorders
among American Indians and Alaska Natives. Office of Applied
Statistics. Retrieved from
http://www.osa.samhsa.gov/2k7/AmIndians.htm
2 Indian Health Service. Office of Public Health Support. Division of
Program Statistics. (n.d.). Trends in Indian Health, 2003-2005.
Unpublished data.
3 The NSDUH Report. (2007) Substance use and substance use disorders
among American Indians and Alaska Natives. Office of Applied
Statistics. Retrieved from
http://www.osa.samhsa.gov/2k7/AmIndians.htm