1. 1 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.

2. 2 Vision Statement Indigenous Native American peoples will overcome the historical trauma and shame that has been internalized, through their own cultural ways of healing.

3. 3 Goal: To provide mental health resources and training that are culturally and community competent, accessible and affordable.

4. 4 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

5. 5 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”

6. 6 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

7. 7 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

8. 8 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

9. 9 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.

10. 10 PILA MAYA YE Thank you