The American IndianAlaska Native National Resource Center

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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
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• For information, contact us at
• 503-494-3703
• E-mail
• Dale Walker, MD
• onesky_at_ohsu.edu
• Or visit our website
• www.oneskycenter.org

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Overview

• An Environmental Scan
• Behavioral Health Care Issues
• Fragmentation and Integration
• Introduction to One Sky Center
• SAMHSA Activities

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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 is it working?
(Carl Bell, 7/03)
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Best Practice
Culturally specific
Outcome driven
Integrating resources
We need Collaboration, Integration, and Synergy
Community Mobilization
(Carl Bell, 7/03)
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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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One Sky Center Partners
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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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SAMHSA Administrators 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.

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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

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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

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Technical Assistance to Tribes and Tribal
Organizations

• Childrens Mental Health Initiative
• Circles of Care
• FASD Center for Excellence
• One Sky Center

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OSC Technical Assistance Provision
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Region VIII Behavioral Health Issues

• Addiction
• Crow Nation
• Suicide
• Standing Rock
• Red Lake
• Domestic Violence
• Across regions
• Co morbidity
• Across Regions

Chart indicates deaths per 1000 people. Blue
AI, Burgundy U.S. Average
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