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SAMHSA News - September/October 2005, Volume 13, Number 5

Tribes Weave Visions for Healthy Future

The third annual "National Behavioral Health Conference on Alcohol, Substance Abuse and Mental Health: Weaving Visions for a Healthy Future" held in San Diego, CA, in June drew more than 500 American Indian and Alaska Native substance abuse treatment and mental health practitioners, tribal representatives, traditional healers, health care providers, state program directors, consumers, and their families.

Co-sponsored by SAMHSA and the Indian Health Service, the conference was held to develop recommendations, stimulate discussion, and identify opportunities for collaboration and coordination of alcohol and substance abuse treatment and prevention efforts in Indian communities.

The 3-day conference was preceded by a forum on "Best Practices in Substance Abuse Treatment for American Indians and Alaska Natives," which highlighted several current or past SAMHSA grantees.

SAMHSA's Center for Substance Abuse Treatment (CSAT) sponsored the forum.

Dale Walker, M.D., a member of the Cherokee tribe and Director of the One Sky Center, emphasized the symbolism of the conference title. "Weaving our vision is so important in Indian Country," he said. "It's a bringing together of many different resources and efforts."

He explained, "It's like a two gray hills rug. In other words, the partnership is complementary in its ability to work together and produce positive results in the same way that the classic Navajo weave of a two gray hills rug is complementary in color, style, and strength. That should be our metaphor as a system of care reaching out into the Indian community."

The Directors of all three SAMHSA Centers addressed forum attendees, and SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., and Indian Health Service (IHS) Director Charles W. Grim, D.D.S., M.H.S.A., both addressed the conference.

"You are on the cutting edge, on the frontier," said CSAT Director H. Westley Clark, M.D., J.D., M.P.H., to forum attendees. Dr. Clark acknowledged the current lack of evidence-based practices that apply to American Indians and Alaska Natives specifically. "Native communities need to ensure that they are included in research studies and clinical trials. Right now, you can't turn to the academic literature for the answers," Dr. Clark added. "The answers are within you."

SAMHSA's Center for Substance Abuse Prevention Director Beverly Watts Davis told forum attendees that the Agency's Fetal Alcohol Spectrum Disorders Center for Excellence is working on an American Indian and Alaska Native initiative that will focus on FASD in Indian Country.

In addition to recognizing program successes, the conference also recognized the recent tragedies at the Red Lake and Standing Rock reservations involving youth suicides. A multi-agency team including representatives from SAMHSA, IHS, state agencies, and the One Sky Center provided on-site assistance.

With special funding provided by SAMHSA through the One Sky Center, a panel of youth attended the conference to share their feelings about the crisis.

A. Kathryn Power, M.Ed., Director of SAMHSA's Center for Mental Health Services, told participants, "Suicide is robbing Native communities of their most valuable resources: their children and their future."

She acknowledged that a "serious challenge to achieving our goal is the current disparities of care—too few providers in remote locations." She also pointed to a "lack of cultural competency in our programs and provider training. We don't know enough about Native cultures and the differences between them," she said.

At both the forum and the conference, participants not only described substance abuse prevention and treatment programs and practices that are working, but also emphasized the common bonds that Native people share regardless of tribe. "Indian people don't see treatment and prevention as different," said Dr. Walker. "They see them as part of the same holistic system."

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Common Themes

Common themes centered on how traditional Native cultures enhance substance abuse treatment and prevention; how important families are in the recovery process; how communities can heal; and how a vision of success can produce positive results.

"Alaska Natives are resilient people who take their resilience into their programs," said Valerie Naquin of the Cook Inlet Tribal Council. "Alaska Natives have survived thousands of years in some of the worst weather in the world." In developing Alaska Native best practices, she said, "We're a lot farther along than we thought we were. Many of our traditional practices are Medicaid billable now." These practices include walking on the tundra, gathering clams by the shoreline, berry picking, and the traditional steam bath, which is the Alaska Native version of the sweat lodge.

"Usually for grants you have to put in all the horrible things," said Ms. Naquin, who helps locate funding resources for the tribal council. "But we include stories and poems and describe the strengths in Alaska Native culture."

Eva Petoskey, a member of the Grand Traverse Band of Ottawa and Chippewa Indians in Peshawbestown, MI, has many years of experience in evaluation of substance abuse and prevention with rural reservation communities in the Great Lakes area. "Engaging people in evaluation can be part of community healing," she said. "It's important to bring people in when you have the opportunity—members of the community, the tribal council, consumers."

To honor the traditional spiritual basis for change, Ms. Petoskey starts all her evaluation sessions with ceremony and prayer. "Prayer is a healing process," she said. "Prayer helps with your work because we are walking with our ancestors, walking in mutual respect."

The best way to formulate outcomes is to start in a special sacred place," said Ms. Petoskey. "And it's important to feed people who participate in a focus group or survey," she added, "then people will want to be there."

"We know that culture is prevention," said Don Coyhis, a member of the Mohican tribe and president of White Bison, Inc., in Colorado Springs, CO. "When we turn to our Native culture, there are no suicides, no meth, no alcohol. When we start talking about our communities as healthy communities with sober leadership, then our communities are ready to mobilize."

The success of traditional practices in the recovery process was described by Laverne Alexander of the Tanana Chiefs Conference in Fairbanks, AK. "The Old Minto Recovery Camp is unique," she said. "Because entire families come together for the healing of addiction." Old Minto's goal is to bring people back to their culture. "The camp brings us back to our roots, brings us back together as a community, where we started," she said. "The emphasis is on subsistence living and gathering in traditional ways."

Another successful Native program guided by traditional Native values is Project Venture, based in Gallup, NM. McClellan Hall is executive director of Project Venture's National Indian Youth Leadership Project. The national Model Program develops healthy and resilient youth and community through leadership, service, and challenge. Activities focus on developing team building, problem solving, and cooperation skills through the use of experiential games and outdoor adventures including mountain biking.

"In order to be strong in your life, you need a vision of success. You have to be able to see it to believe it," said Iris Heavyrunner, M.S.W., a member of the Blackfeet tribe and a Ph.D. candidate in social work at the University of Minnesota. "Once you have a vision, you have a clear expectation of yourself. Students who graduated from college, for example, told me they could see themselves walking across the stage and reaching their hand out for their diploma. That's how clear their vision was. A vision is powerful."

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