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

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.

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

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  1. 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

  2. Native Communities Advisory Council / Steering Committee One Sky Center

  3. 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

  4. 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

  5. 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

  6. One Sky Center Outreach

  7. What It’s All About!

  8. 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

  9. 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?

  10. 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

  11. AmericanIndian 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

  12. 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

  13. 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

  14. Different goals Resource silos One size fits all Activity-driven How are we functioning? (Dale Walker, Carl Bell, 7/03)

  15. Best Practice Culturally Specific Outcome Driven Integrating Resources We need Synergy and an Integrated System: Community Mobilization (Dale Walker, Carl Bell, 7/03)

  16. Identify Best Practice Best Practice Evidence Based Mainstream Practice Traditional Healing

  17. Circle of Care Traditional Healers Child & Adolescent Programs Primary Care A&D Programs Best Practices Boarding Schools Colleges & Universities Prevention Programs Emergency Rooms

  18. Community MobilizationPartnered Collaboration Community-Based Organizations Grassroots Groups Treatment-Education-Research

  19. Native Aspirations!

  20. 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

  21. 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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