The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services

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The American Indian/Alaska Native National
Resource Center for Substance Abuse and Mental
Health Services
Mini-summit Alcohol and Native Children CWAG
2005 Annual meeting Kapalua, Maui, Hawaii August
1-4, 2005
Dale Walker, MD Patricia Silk Walker, PhD
Douglas Bigelow, PhD Bentson McFarland, MD,
PhD Laura Loudon, MS Michelle Singer
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• For information, contact us at
• 503-494-3703
• E-mail
• Dale Walker, MD
• onesky_at_ohsu.edu
• Or visit our website
• www.oneskycenter.org

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Overview

• An Environmental Scan
• Behavioral Health Care Issues
• Fragmentation and Integration
• Introduction to One Sky Center
• Our Children
• Introduce the SAMHSA Family

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Health Problems

• Alcoholism 6X
• Tuberculosis 6X
• Diabetes 3.5 X
• Accidents 3X
• 60 Over 65 live in poverty
  (US 27)

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American Indians

• Have same 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 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

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Different goals
Resource silos
One size fits all
Activity-driven
How are we functioning? (Carl Bell, 7/03)
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Best practice
Culturally specific
Outcome driven
Integrating resources
We need Synergy and an Integrated System (Carl
Bell, 7/03)
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Program Goals

• Promote and nurture effective and culturally
  appropriate prevention and treatment
• Identify and disseminate evidence-based
  prevention and treatment practices
• Provide training and technical assistance
• Help to expand capacity

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One Sky Center Partners
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Circle of Care
Traditional Healers
Child Adolescent Programs
Primary Care
Best Practices
AD Programs
Boarding Schools
Colleges Universities
Prevention Programs
Emergency Rooms
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Lifetime, Annual and 30 Day Prevalence of
Intoxication Among 224 Urban Indian Youth
R. Dale Walker, M.D. 100 completion sample
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Changes in Lifetime Substance Use Among Urban
Indian Youth Over Nine Years
Percentage ever used
R. Dale Walker, M.D.
100 Completion Sample
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Age of Onset of Substance Use Among Urban
American Indian Adolescents, by Substance Used
R. Dale Walker, M.D. (5/2000) Cohorts 4 5
were sampled every third year recall and
sampling bias apply
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SUBSTANCE ABUSE AND MENTAL HEALTH SERVICE
ADMINISTRATION (SAMHSA) www.samhsa.gov

• Grant Opportunities, Website links, Publications
• 1-800-729-6686
• 1-800-487-4889 (TDD)

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The SAMHSA Matrix
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The State Incentive Grants

• Implements SAMHSAs Strategic Prevention
  Framework to
• 24 States, 2 Territories, 5 years _at_ 2.3 million
  per year
• Prevent onset and reduce progression of substance
  abuse
• Reduce community substance abuse problems
• Build State and community prevention capacity and
  infrastructure
• Uses National Outcome Measures and builds
  Epidemiological Workgroups at the State and
  Community level.
• Places emphasis on Underage Drinking

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Drug-Free Communities Program

• The GOALS are to
• Reduce substance abuse among youth and adults by
  addressing the factors in a community that
  increase the risk of substance abuse and
  promoting the protective factors that reduce risk
  of substance abuse.
• Establish and strengthen collaboration among
  communities, drug courts, private nonprofit
  agencies, and federal, state, local and tribal
  governments to support the efforts of community
  coalitions to prevent and reduce substance abuse
  among youth.
• The Drug-Free Communities Act (Pub. L. No.
  105-20) was signed into law on June 27, 1997. On
  December 14, 2001, Public Law 107-82, 115 Stat.
  814 (2001), reauthorized the program for 5 years.
  

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Fetal Alcohol Spectrum Disorders (FASD) Center
for Excellence

• The FASD Center For Excellence builds FASD State
  systems through
• Drug Courts and Family Courts
• Training and technical assistance
• Women in recovery summit
• Birth mothers video
• Materials/ resources for SA treatment systems
• Public education materials for general audiences
• Data analysis of SAMHSAs national survey on drug
  use and health (NSDUH)
• Inventory of prevention and treatment programs
• State system meetings
• Web site www.fascenter.samhsa.gov

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Centers for the Application of Prevention
Technologies (CAPTs)
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Addiction Technology Transfer Centers (ATTC)
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Prevention Technology Platform

• Web-based Application To Help Communities
• Assess their needs, readiness and resources
• Plan strategically to develop infrastructure and
  sustainability
• Select implement evidence-based prevention
  approaches and
• Conduct evaluations measuring progress, impact,
  outcomes.
• Regularly updated database of on-line training
  curricula
• A readiness roadmap and user-paths customized to
  individual responses
• Geo-mapping resources
• Access to national databases and
• Access to SAMHSAs National Outcome Measures.

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National Registry of Effective Programs and
Practices (NREPP)

• SAMHSAs new and improved NREPP
• Will establish review criteria for the
  identification and rating of strategies,
  programs, policies, and activities and
• Will expand to include community coalitions,
  which will be rated by criteria that will be
  developed by a panel of leading researchers,
  evaluators and coalition experts.

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