SAMHSA’s Award-Winning Newsletter
November/December 2010, Volume 18, Number 6 

Circles of Care: Creating Models of Care for American Indian and Alaska Native Youth

The blueprint might address workforce development, for example. “It’s hard to find professionals willing to go out to remote reservation communities,” said Captain Hunt. “The number of Indian mental health professionals is very small.” The blueprint might also address the lack of coordination among mental health, child welfare, juvenile justice, and other systems. Or the blueprint might identify ways to incorporate traditional healers or ceremonies into a youth’s care.

As a way of increasing their community’s sense of relatedness to the process, grantees may develop their own definitions of “serious emotional disturbance.” Doing so helps communities reduce the stigma of behavioral health services and incorporate indigenous beliefs about illness and wellness, explained Candace Fleming, Ph.D., Associate Director of the Circles of Care Evaluation Technical Assistance Center at the University of Colorado Denver.

“There’s one grantee that uses a phrase meaning ‘a strong suffering of the mind and heart,’ ” she said. “You can see there’s a different emphasis here compared to the English phrase ‘serious emotional disturbance.’ ”

The Circles of Care approach is working well, added Dr. Fleming.

Of the 23 grantees that “graduated” from Circles of Care since the program’s inception, 9 have obtained direct funding from SAMHSA’s Comprehensive Community Mental Health Services for Children and Their Families Program—also known as the Child Mental Health Initiative (CMHI). This funding helped put their plans, developed during their Circles of Care grant, into practice. Four others obtained additional funding by partnering with other CMHI grantees. Others used alternative strategies to activate their models developed through Circles of Care.

What’s more, said Dr. Fleming, the Circles of Care approach appears to be spreading throughout Indian Country. “With each cohort applying to Circles of Care, there are greater levels of community engagement,” she said. “Indian communities are embracing this concept.”

For more information about the Circles of Care grantee program, please contact Captain Andrew Hunt at SAMHSA at

Circles of Care I
1998 to 2001
Grantee Project Name
Inter-Tribal Council of Michigan Nbwakawn
Fairbanks Native Association, AK Circle of Children
Choctaw Nation of Oklahoma Chi Hullo Li, C.A.R.E.S. Project
Native American Health Center, Oakland, CA Circle of Care
Cheyenne River Sioux Tribe, SD Restoring the Balance Project
In Care Network, MT Shared Vision Project
Feather River Tribal Health, CA Circles of Care
Oglala Sioux Tribe, SD Wkanyeja Wape Tokeca (Children of a Different Way)
First Nations Community HealthSource, NM Circles of Care


Circles of Care II
2001 to 2004
Grantee Project Name
Blackfeet Nation, MT Blackfeet Family Circles of Care
Central Council Tlingit and Haida Indian Tribes of Alaska Southeast Alaska Native Youth Mental Health Services Initiative
Pascua Yaqui Tribe, AZ Sewa Uusim (flower children, our hope, our light, our future)
Puyallup Tribal Health Authority, WA Helping Hand Project
Salt River Pima Maricopa Indian Community, AZ Toward a Healthy Himdack/Huudoishizish
United American Indian Involvement, CA UAII Circles of Care
Ute Indian Tribe, UT Peemchuenum (love, value and cherish)


Circles of Care III
2005 to 2008
Grantee Project Name
Denver Indian Family Resource Center, CO Keeping the Circle Whole
Native American Rehabilitation Association, OR Strengthening Our Families
Muscogee (Creek) Nation, OK Momen Ayeckvtes (To Carry On)
* Rosebud Sioux Tribe, SD Sinte Gleska University Circle of Care
Quileute Nation, WA Quileute Circles of Care
Cook Inlet Tribal Council, AK Cherish the Children
Indian Health Care Resource Center of Tulsa, OK Strengthening Our Children


Circles of Care IV
2008 to 2011
Grantee Project Name
American Indian Center of Chicago, IL Leading, Engaging, Empowering and Providing for Youth and Families (LEEP)
American Indian Health and Family Services of Southeast Michigan – Detroit, MI Gda’shkitoomi (We are Able!)
Crow Creek Sioux Tribe, SD Circles of Care Project
Karuk Tribe of California, CA Hav pa anav (The medicine is good)
Pueblo of San Felipe, NM Children’s Mental Health Systems Development Project
Standing Rock Sioux Tribe, ND Circles of Care Project
Indian Center, Inc., Lincoln, NE Nebraska Urban Indian Centers System of Care Program
Mashantucket Pequot Tribal Nation Mashantucket Pequot Tribal Nation

† Urban Indian organization

* Tribal College

  From the Administrator  
Your Comments Are Heard

Your Comments Are Heard

SAMHSA Administrator Pamela S. Hyde, J.D., talks about changes made to SAMHSA’s Strategic Initiatives based on comments received about Leading Change.

  Behavioral Health  
Mental Health Repor

Mental Health Report

SAMHSA recently released 2009 data on mental illness and suicidal ideation.

Youth and Mental Health

Youth and Mental Health

See statistics about youth age 12 to 17 on depression, treatment, and co-occurring substance use.

30 Million Drove Under the Influence Last Year

30 Million Drove Under the Influence Last Year

Some people drink alcohol or use illicit drugs and get behind the wheel.

  Multimedia Outreach  
Homelessness Video Series

Homelessness Video Series

“Street Outreach” videos help service providers by showing scenarios in real-world settings.

Seclusion & Restraint Alternatives

Seclusion & Restraint Alternatives

A training DVD educates providers about alternatives to these trauma-inducing practices.

  Evidence-Based Practices  
National Registry: Update

National Registry: Update

New resources help organizations looking for evidence-based updates on successful programs and interventions.

Science and Service Awards to 28 Organizations

Science and Service Awards to 28 Organizations

Many organizations received awards for their use of evidence-based practices.

  Gulf Oil Spill Update  
Grants Distributed To Help Gulf States, PSAs in Progress

Grants Distributed To Help Gulf States, PSAs in Progress

SAMHSA has developed a public education campaign to connect people in the Gulf states to services.

Awards Announced

Awards Announced

Recent awards include Access to Recovery, Project LAUNCH, and many other grantee programs.

  Recovery and Prevention  
Recovery Happens!

Recovery Happens!

Event photos on the Recovery Month website illustrate the power of recovery.

Community Prevention Day Is February 7

Community Prevention Day Is February 7

Register now to attend SAMHSA’s free event!

  Also in this Issue  
Prescription Pain Relievers in the News

Prescription Pain Relievers in the News

Concern over the nonmedical use of prescription pain relievers is increasing across the Nation.

In the ER: Young Children & Accidental Drug Use

In the ER: Young Children & Accidental Drug Use

SAMHSA data show 69,121 children age 5 or younger were treated in the ER for accidentally ingesting drugs.

  Visit the SAMHSA Store  

Free Publications at Your Fingertips

SAMHSA’s website includes the new SAMHSA Store for publications and other Agency products. Visit

SAMHSA Store Video Tour

View the story of the SAMHSA Store. Find out how keyword taxonomy helps your search.

2010 Annual Index (PDF 323KB)

2010 Annual Index (PDF 323KB)

This issue’s print PDF and the newsletter’s hard copy include the annual index of topics.