HHS agenda aims to improve behavioral health for Natives

01/02/2018 12:00 PM
WASHINGTON – The U.S. Department of Health and Human Services recently announced the release of the Tribal Behavioral Health Agenda, a collaborative tribal-federal blueprint highlighting the extent to which behavioral health challenges affect Native communities.

The agenda also includes strategies and priorities to reduce these problems and improve the behavioral health of American Indians and Alaska Natives.

According to the HHS, American Indians and Alaska Natives represent 2 percent of the total U.S. population (6.6 million people), but experience disproportionately high rates of behavioral health problems such as mental and substance use disorders. In addition, these communities’ behavioral health needs have traditionally been underserved, the HHS states.

Mental and substance use disorders – which may result from adverse childhood experiences, historical and intergenerational trauma and other factors – are also reflected in high rates of interpersonal violence, major depression, excessive alcohol use, suicide and suicide risk, HHS officials said. Overall, these problems pose a corrosive threat to the health and well-being of many American Indians and Alaska Natives, HHS officials said.

“This new initiative represents an important step in our government-to-government relationship and gives American Indian and Alaska Native tribes a greater role in determining how to address their behavioral health needs with urgency and respect,” Kana Enomoto, Substance Abuse and Mental Health Services Administration principal deputy administrator, said.

The Tribal Behavioral Health Agenda blueprint includes the following tenants:

• Provides a clear national statement about the extent and impact of behavioral health and related problems on the well-being of tribal communities,

• Recognizes and supports tribal efforts to incorporate their respective cultural wisdom and traditional practices in programs and services that contribute to improved well-being,

• Establishes five foundational elements that should be considered and integrated into existing and future program and policy efforts, and

• Elevates priorities and strategies to reduce persistent behavioral health problems for Native youth, families, and communities.

Findings from SAMHSA’s National Survey on Drug Use and Health indicate that adult (ages 18 and older) American Indians and Alaska Natives had experienced higher rates of past year mental illness compared with the general population (21.2 percent versus 17.9 percent). Similarly, American Indians and Alaska Natives ages 12 and older had higher levels of past year illicit substance use than the general population (22.9 percent versus 17.8 percent), the survey states.

According to the agenda, its framework is organized around the f0llowing elements that provide content and direction for collaborative efforts:

• Focusing on healing from historical and intergenerational trauma,

• Using a socio-cultural-ecological approach to improving behavioral health,

• Ensuring support for both prevention and recovery,

• Strengthening behavioral health systems and related services and supports, and

• Improving national awareness and visibility of behavioral health issues faced by tribal communities.

“The IHS is committed to improving behavioral health care for the American Indian and Alaska Native people by using the Tribal Behavioral Health Agenda to integrate care within community health systems,” IHS Principal Deputy Director Mary L. Smith said. “This agenda recognizes that successful and sustained behavioral change requires cultural reconnection, community participation, increased resources, and the ability of those serving American Indian and Alaska Native populations to be responsive to emerging issues and changing needs.”

The agenda also includes the American Indian and Alaska Native Cultural Wisdom Declaration, which acknowledges that cultural wisdom and traditional practices are fundamental to achieving improvements in behavioral health. In addition, the agenda uses historical and current contexts for developing the recommendations that form the blueprint. It also incorporates shared priorities and strategies that can be addressed by tribes, federal agencies, and other entities working together.

According to the HHS, tribal leaders called for improved collaboration with federal agencies to address behavioral health challenges. The agenda is the result of consultation among tribal leaders, the SAMHSA, IHS and the National Indian Health Board.

“Tribal leaders and stakeholders provided meaningful and comprehensive input to create the Tribal Behavioral Health Agenda, which will be a valuable tool and resource to address the critical behavioral health needs we see across Indian Country,” NIHB Executive Director Stacy Bohlen said.

HHS officials said the agenda honors the relationship the U.S. government has with federally recognized tribes and reflects effective government-to-government interactions. They said the agenda’s development was based on identifying the perspectives of tribes while building strategies based on their shared values and beliefs.


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