1. 1 The American Indian/Alaska Native National Resource Center for Substance Abuse and Mental Health Services Disparity of Health Services and Research: A National Strategy for Native Mental Health and Addictions Prevention and Treatment NAMI National Meeting, Washington, DC, June 30, 2006 Dale Walker, MD Patricia Silk Walker, PhD Douglas Bigelow, PhD Bentson McFarland, MD, PhD Michelle Singer

2. 2 One Sky Center

3. 3 Program Goals Promote and nurture effective and culturally appropriate prevention, treatment, and mental health services Identify and disseminate evidence-based prevention, treatment, and mental health practices Provide training and technical assistance Help to expand capacity

4. 4 Projects Review SAMHSA portfolio: 134 projects Mental health liaison – SAMHSA/ IHS Medicaid, state, Indian funding Best practices consensus project National traffic safety – drivers training Suicide and substance abuse Suicide prevention

5. 5 One Sky Center Partners 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 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

6. 6 One Sky Center Outreach

7. 7 What It’s All About!

8. 8 Presentation Overview Introduce One Sky Center An Environmental Scan Native Behavioral Health System Issues Fragmentation and Integration Integrated care approaches and interagency coordination are best overall solutions

9. 9 Six Missions Impossible? How do we define health, education, and social problems? How do we define disaster? How do we ask for help? How do we get Federal and State agencies to work together and with us? How do we build our communities? How do we restore what is lost?

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12. 12 A Quiet Crisis: Federal Funding and Unmet Needs in Indian Country, July 2003 Funding not sufficient to meet needs for: Health care Education Public safety Housing Infrastructure development needed

13. 13 American Indian and Alaska Native Health Disparities Have same health disorders as general population Greater prevalence Greater severity Much less access to Tx Cultural relevance more challenging Social context disintegrated

14. 14 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 5.State and Local Agencies 6.Federal Agencies: SAMHSA, VAMC

15. 15 Difficulties of Program Integration Separate funding streams and coverage gaps Agency turf issues Different treatment philosophies Different training philosophies Lack of resources Poor cross training Consumer and family barriers

16. 16 How are we functioning? (Dale Walker, Carl Bell, 7/03) One size fits all Different goals Resource silos Activity-driven

17. 17 We need Synergy and an Integrated System: Community Mobilization (Dale Walker, Carl Bell, 7/03) Culturally Specific Best Practice Integrating Resources Integrating Resources Outcome Driven

18. 18 Identify Best Practice Best Practice Evidence Based Traditional Healing Mainstream Practice

19. 19 Circle of Care Best Practices Child & Adolescent Programs Prevention Programs Primary Care Emergency Rooms Traditional Healers A&D Programs Colleges & Universities Boarding Schools

20. 20 Community Mobilization Partnered Collaboration Treatment-Education-Research Grassroots Groups Community-Based Organizations

21. 21 Native Aspirations!

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23. 23 Activities and Products Motivational Interviewing Manual Best Practices Monograph Promising Programs Review Suicide – Consultation List Suicide Program Directory Community Assessment Instrument Traffic Safety Programs in Native Areas School List of Native Students Service Learning Program Methamphetamine Treatment and Prevention Suicide Prevention Website Cognitive Behavior Therapy Manual Schools/Colleges HIV – AIDS Tele Health CDC

24. 24 Contact us at 503-494-3703 E-mail Dale Walker, MD onesky@ohsu.edu Or visit our website: www.oneskycenter.org