Prepaid Mental Health Care Plan for Native Americans/Alaskan Natives
by Terri Crawford Hansen
News from Indian Country
Mount Vernon, Wash.—Federal and state laws now require collaboration with tribes to access traditional and cultural mental health services for enrolled Native Americans and Alaskan Natives, in addition to or instead of incorporating standard psychological or psychiatric services.
According to the North Sound Regional Support Network, a network of eight tribes within the Pacific Northwest North Sound region, when a client so requests, providers are required to make arrangements with one or more tribes to provide treatment from traditional or cultural practitioners, such as tribal healers, medicine men and women. Services will be reimbursed by the program to those practitioners.
These services help providers assure that treatment is culturally appropriate, that client history is complete, and that the necessary follow-up will be in place. This partnership gives Native Americans and Alaskan Natives greater opportunities, where traditions can be essential for recovery.
Each tribe has its own culture, beliefs, and practices. In a Rapid City Journal article, Ethleen Iron Cloud-Two Dogs, of the Lakota Nagi Kicopi (calling the spirit back) children's mental-health program, said, "In Western beliefs, when a person hears voices or sees hallucinations, they are considered symptoms of mental illness. In our Lakota culture, it is our belief that they may have a spiritual meaning. That is the first thing we have to find out -- and it can mean there is a mental illness.”
The newspaper reported that research provided by Mark Daniels, a psychology professor at the University of South Dakota, Vermillion, and a member of three tribes, has so far has revealed that Indians, depending on the tribe, used many traditional ceremonies to deal with mental illness.
In February 2001, Indian Health Service statistics indicated that more than one-third of the demands made on tribal health facilities involve mental illness and social service related concerns. The IHS related that Native Americans and Alaskan Natives “tend to underutilize services, experience higher therapy drop-out rates, are less likely to respond to treatment, and have negative opinions to non-Indian providers.” They also reported that the suicide rate for Native Americans is 72 percent higher than the general population.
A 1999 Surgeon General’s Report on the need for a mental health care study for Native Americans and Alaskan Indians has not yet been published on a large-scale, epidemiological basis, although much smaller studies have been done.
NSRST, federal and state programs provide a grievance process for any individual who is not satisfied with the services he or she receives from any contracted provider. That client has the right to complain to an Ombudsperson, who is required by law to keep all complaints strictly confidential. On the client’s behalf, the Ombudsperson will contact the provider to attain a satisfactory resolution. If the client is still not satisfied, the Ombudsperson will file a formal complaint and/or grievance on their behalf. If the client is not satisfied with the results of the formal complaint, the Ombudsperson will arrange for a fair hearing before a judge.
For further information, contact your tribal Mental Health and Social Services program, or the IHS Public Affairs Staff at 301-443-3593.