Villagebased Behavioral Health Services Within the Alaska Tribal Health System . . . Prevention, Ear

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Village-based Behavioral Health Services Within
the Alaska Tribal Health System . . . Prevention,
Early Intervention, Case Management
Scot Prinz, MA Director, Behavioral Health
Rural Services Community Health Service Alaska
Native Tribal Health Consortium [phone]

sprinz_at_anmc.org
www.anthc.org/cs/chs/behavioral
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Average distance to next level of care is about
450 miles
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Behavioral Health Aide A new kind of
village-based behavioral health provider
Mission Provide village-based behavioral health
services to help ensure the viability and
survival of rural and remote Alaska Native
villages. Values The behavioral health aide
values the emotional, physical, spiritual,
family, social and cultural well-being and health
of individuals, their families, and the
communities where they live. Goal Young people
who are personally competent, capable, and
culturally connected.
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Why?

• Centralized behavioral health programs using
• itinerant behavioral health services . . .
• Not cheap
• Not consistent
• Not always trusted
• Not always familiar with individual village
• Not always familiar with cultural context, AND
• Not focused on prevention, early intervention,
  and community-based case management

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• Continuum of Care
• Least intensive
  most intensive.
• Community based (left) vs facility based (right).
• Currently the application of funding is nearly
  all being focused toward the most intensive parts
  of the continuum.
• If the funding application and focus of services
  continues as is, costs will continue to rapidly
  increase and the typical solution will be to
  reduce access.

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Levels of Practice Certification

• BHA Trainee (Non-certified) Is the newest to
  the field of BH they will be going through
  initial BHA training.
• BHA I (Certified) Has received initial BHA-I
  competency-based training and completed clinical
  practicum.
• BHA II (Certified) - Along with specific
  training, supervised clinical practice and
  applied experience, they may have some specific
  college level training in a behavioral health
  discipline.
• BH Associate BHA III (Certified) -Along with
  specific training, supervised clinical practice
  and applied experience, they may have some
  specific college level training, or have
  completed a Bachelors degree in a behavioral
  health discipline.
• BH Practitioner BHA IV (Certified) The
  highest level of professional qualifications
  and/or credentials for BHAs. In most work
  environments, they will likely provide some
  supervision for other BHAs and have some
  programmatic responsibility.

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How BHAs are making a difference

• Focus on prevention, early intervention and case
  management.
• Increase Capacity within villages.
• Help to reduce outpatient, emergency and
  inpatient medical workload as well as cost.
• Help to reduce long term chronic health problems
  and family / community disruption.
• Promote individual and community health to
  support economic development / viability, which
  will also contribute to overall improvement in
  health status.

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Village-based Prevention, Early Intervention, and
Case Management

• Activities and Messages that are intended for the
  whole community regarding healthy choices and
  living.
• Targeting high risk groups within the community
  such as
• Children from alcohol or drug abusing families
• Children from families with a recent suicide or
  other trauma
• Case management of group

• Targeting individuals with early signs of none
  diagnosed behavioral health problem.
• Individualized assessment and intervention
  activities may include
• Tutoring, mentoring, decision-making skill
  development and/or leadership development
• Parenting education and support program/s
• After-school programs (employment, educational
  and recreational)
• Intense Case management.

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Safety Security Health
Grounded Healthy Whole
Nurtured Happy Grounded
Connected Sensitive Capable