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BEHAVIORAL HEALTH
ISSUE
Greater than one-third of the demands made on health facilities in Indian country involve concerns related to mental health, alcoholism, and substance abuse.
BACKGROUND
The Indian Health Service (IHS) Behavioral Health programs include community-oriented clinical and preventive services that are part of a broader, multidisciplinary health team that includes IHS, tribal, and urban Indian health facilities and staff. Over the last 15 years, most of these programs have transitioned from IHS to local community control via tribal contracting and compacting. Challenges facing American Indian and Alaska Native (AI/AN) communities and programs include substance abuse, trauma, forced cultural change, poverty, lack of economic opportunity, and limited access to services.
SITUATION
Considerable disparities exist in the psychological well-being of AI/AN people compared to the general population. In 2002-2005, AI/ANs were more likely than members of other racial groups to have a past year alcohol and illicit drug use disorder. Suicide rates among AI/AN adolescents and young adults ages 15 to 34 are 1.9 times higher than the national average for that age group. Poverty afflicts AI/AN communities at significant rates and often leads to a lack of housing,
as well as other socioeconomic, educational, and health problems. Economic concerns are often related to domestic violence, sexual assault, and childhood sexual abuse. AI/AN women are 2.5 times more likely to be sexually assaulted than women in the United States in general. The system of services for treating mental health problems among American Indians and Alaska Natives is a complex and often fractured web of tribal, federal, state, local, and community-based services. The availability of these programs varies considerably across communities. The behavioral health needs are largely unmet, services generally are lacking, and access is often difficult and can be costly.
OPTIONS/PLANS
Additional intervention and prevention strategies that meet specific needs of individuals, families, and communities are needed. These strategies should build on the strengths of local kinship networks and traditional cultural practices. Traditional healing practices and spirituality contribute to the health and wellbeing of AI/ANs and complement western based approaches. Developing a full continuum of care, which includes investing in home and community services, in/out patient treatment services, and culturally appropriate life skills support would have a dramatic effect on decreasing the need for direct health services by increasing protective factors in behavioral health related issues.
ADDITIONAL INFORMATION
For referral to the appropriate spokesperson, contact the IHS Public Affairs Staff at 301-443-3593.
June 2008