Reducing and Eliminating Disparities in Mental Health Service Delivery: Recommendations for More Effective Access for Indigenous Native American Nations

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Reducing and Eliminating Disparities in Mental
Health Service Delivery Recommendations for
More Effective Access for Indigenous Native
American Nations

• Ethleen Iron Cloud-Two Dogs, M.S.

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Vision Statement

• Indigenous Native American peoples will overcome
  the historical trauma and shame that has been
  internalized, through their own cultural ways of
  healing.

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• Goal To provide mental health resources and
  training that are culturally and community
  competent, accessible and affordable.

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Todays Situation

• Young Native Americans, age 15-24 killing
  themselves at a rate of 4-6x national average
  (source Indian Health Service Mortality Rates)
• Pine Ridge Indian Reservation Every 2.5 days,
  someone tries to kill him/herself

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How Did We Get Here?

• Centuries of Genocidal and Oppressive Policies
  and Practices that are largely unacknowledged
• Trauma that is generational and unresolved (e.g.
  1890 Wounded Knee Massacre) and has resulted in
  killing of the spirit of a people

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Available Options

• Currently Indian Health Services Mental Health
  resources are severely underfunded, e.g., only
  funded at a 30-40 of actual need.
• Geographic isolation limits access to services
• Crisis response, putting out fires, is the
  nature of the current mental health service
  delivery system which prevents long-term
  therapeutic services

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Available Options cont.

• Grant funded mental health initiatives that are
  legislatively deemed competitive ignore the
  treaty rights of tribes and ignore the lack of a
  tribal government tax base
• Tribal states relations are often historically
  troubled and collaboration among state, tribal
  and federal programs often have jurisdictional
  and sovereignty issues beyond the scope of a
  mental health initiative

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Recommendations

• 1 Acknowledgement through policy and practice
  that most tribal nations have a unique and
  historical treaty relationship with the
  government
• 2 Increase mental health funding to a level
  where actual therapy can take place within
  individuals, families and communities

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Recommendations Cont.

• 3 Provide ongoing mental health training
  resources for consumers and communities (families
  and communities live with, respond to mental
  health needs 24-7)
• 4 Research methods and findings must be
  culturally relevant in order to be applicable to
  the tribal nation or community.

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PILA MAYA YE Thank you