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

Disparity of Education, Services, and Research:A National Strategy for Native Mental Health and

Addictions Prevention and Treatment Las Vegas, NevadaDecember 8, 2005

Dale Walker, MD Patricia Silk Walker, PhD Douglas Bigelow, PhD

Bentson McFarland, MD, PhD Michelle Singer

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For information, contact us at

503-494-3703

E-mail

Dale Walker, MD

onesky@ohsu.edu

Or visit our website:

www.oneskycenter.org

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Native Aspirations!

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Overview

• An Environmental Scan• Behavioral Health Care Issues• Fragmentation and Integration• Introduction to One Sky Center• Opportunities for Partnership

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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 HealthB. Primary HealthC. Alcoholism / Substance Abuse

2. Bureau of Indian Affairs (BIA)A. EducationB. VocationalC. Social ServicesD. Police

3. Tribal Health4. Urban Indian Health5. State and Local Agencies6. 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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How is it working?

One size fits allOne size fits all

Different goals Different goals Resource silosResource silos

Activity-drivenActivity-driven

(Carl Bell, 7/03)

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We need Collaboration, Integration, and Synergy : Community Mobilization

Culturally specific

Culturally specific

Best PracticeBest

PracticeIntegratingresources

Integratingresources

Outcome driven

Outcome driven

(Carl Bell, 7/03)

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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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Jack Brown Adolescent Treatment Center

Alaska Native Tribal Health Consortium

United American Indian Involvement

Northwest Portland Area Indian Health Board

Na'nizhoozhi Center

Tribal Colleges and Universities

One Sky Center

National Indian Youth Leadership Project

Cook Inlet Tribal Council

One Sky Center Partners

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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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Identify Best Practice

Best Practice

Evidence Based

TraditionalHealing

MainstreamPractice

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Circle of Care

Best Practices

Child & Adolescent Programs

Prevention Programs

Primary Care

EmergencyRooms

TraditionalHealers

A&D Programs

Colleges & Universities

Boarding Schools

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Community MobilizationPartnered Collaboration

Treatment-Education-Research

Grassroots Groups

Community-BasedOrganizations

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Native Aspirations!

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= OSC Technical Assistance Provision

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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