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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
Dale Walker, MD
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