The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services

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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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Native Communities
Advisory Council / Steering Committee
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

• 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
Tribal Colleges and Universities
Cook Inlet Tribal Council
Alaska Native Tribal Health Consortium
Prairielands ATTC
Red Road
Northwest Portland Area Indian Health Board
One Sky Center
Harvard Native Health Program
United American Indian Involvement
Jack Brown Adolescent Treatment Center
National Indian Youth Leadership Project
Tri-Ethnic Center for Prevention Research
Na'nizhoozhi Center
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One Sky Center Outreach
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What Its All About!
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Presentation Overview

• 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
• State and Local Agencies
• Federal Agencies SAMHSA, VAMC

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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

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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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Best Practice
Culturally Specific
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
Child Adolescent Programs
Primary Care
AD Programs
Best Practices
Boarding Schools
Colleges Universities
Prevention Programs
Emergency Rooms
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Community MobilizationPartnered Collaboration

Community-Based Organizations
Grassroots Groups
Treatment-Education-Research
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Native Aspirations!
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Activities and Products

• 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 onesky_at_ohsu.edu Or visit our
website www.oneskycenter.org