1. 1 The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services Dale Walker, MD Patricia Silk Walker, PhD Douglas Bigelow, PhD Bentson McFarland, MD, PhD, Laura Loudon, MS Michelle Singer Oregon Health and Science University American Psychiatric Association Annual Meeting Washington, DC May 4, 2008 Developing our Careers, Enhancing our Leadership Skills: Minority Issues

2. 2 Goals For Today

3. 3 What Its All About!

4. Introduce Self Cherokee Physician Psychiatrist Teacher Family Man 4

5. 5 One Sky Center

6. 6 Jack Brown Adolescent Treatment Center Alaska Native Tribal Health Consortium United American Indian Involvement Northwest Portland Area Indian Health Board Na'nizhoozhi Center Tribal Colleges and Universities One Sky Center National Indian Youth Leadership Project Cook Inlet Tribal Council Tri-Ethnic Center for Prevention Research Red Road Prairielands ATTC Harvard Native Health Program One Sky Center Partners

7. The Career Startup Get the geography and history down Finding the right spot Getting the right questions Meeting the right people Building bridges Optimism always 7

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11. Native Health Problems 1.Alcoholism 6X 2.Tuberculosis 6X 3.Diabetes 3.5 X 4.Accidents 3X 5.Depression 3x 6.Suicide 2.5x 7.Violence?

12. 12 American Indians Have same disorders as general population Greater prevalence Greater severity Much less access to Tx Cultural relevance more challenging Social context disintegrated

13. What I do: Professor (1) Center Director for CAIHER –National Mentor Program –Recruitment and Retention –Cultural Competence –Indian OHSU Summit One Sky Center Director –Tribal/ Urban Technical Assistance, Consultation –Develop Evidence Based Treatment/ Traditional –Suicide –Methamphetamine Initiative 13

14. What I do: Professor (2) Community Clinician –Patient Care /Community Care Research –Disparity –Treatment Outcome effectiveness –Multigenerational Bridging/Making Connections, Partnerships 14

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16. What I do: Nationally APA –Minority Deputy Representative to Speaker –Committee of American Indian Psychiatrists –Washington State, Oregon State –Components Strategic Plan Task Force on Minority Affairs Council on Advocacy and Public Policy IHS, BIA, NCAI, NIHB 16

17. Challenges My Identities Political Social Economic Complexity of Issues Your Friends, your Allies, Other 17

18. Rewards You will always be the student Meeting so many Tribes There are some Dedicated People out there The mentorship opportunities 18

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20. 20 Indigenous Knowledge Is local knowledge unique to a given culture or society; it has its own theory, philosophy, scientific and logical validity, which is used as a basis for decision-making for all of life’s needs. Definitions:

21. 21 Traditional Medicine The sum total of health knowledge, skills and practices based upon theories, beliefs and experiences indigenous to different cultures…used in the maintenance of health. WHO 2002 Definitions:

22. 22 Evidence-based Practices Interventions that show consistent scientific evidence of improving a person’s outcome of treatment and/or prevention in controlled settings. SAMHSA 2003 Definitions:

23. 23 Best Practices Examples and cases that illustrate the use of community knowledge and science in developing cost effective and sustainable survival strategies to overcome a chronic illness. WHO 2002 Definitions:

24. 24 Circle of Care Best Practices Child & Adolescent Programs Prevention Programs Primary Care Emergency Rooms Traditional Healers A&D Programs Colleges & Universities Boarding Schools

25. 25 Contact us at 503-494-3703 E-mail Dale Walker, MD onesky@ohsu.edu Or visit our website: www.oneskycenter.org