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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Today’s
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
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