Of the more than 5 million American Indian/Alaska Natives living in the US, 71 percent reside in urban communities—a majority that grew by 1 million people between 2000 and 2010.1 Urban Native Americans can feel disconnected from their heritage and have less access to cultural-specific resources as compared to their counterparts living on reservations.2 They may also lack the benefit of cultural beliefs and practices known to protect against the stressors that can lead to substance misuse in Native American populations.3
For native youth growing up in cities, feelings of isolation and lack of cultural identity can put them at greater risk for making unhealthy choices, including the use of alcohol and other drugs.
"Urban communities, especially those with gang activity, pose many challenges for Native youth," says Janet King, Program Manager of Policy and Advocacy for the Oakland-based Native American Health Center (NAHC), a Partnerships for Success 2015 grant recipient. Low income, perceived racial discrimination, and feelings of depression and anger can put Native youth at greater risk of using drugs and alcohol, as well as engaging in gang activity.4
To address these risk factors, NAHC sought to create an opportunity where local youth could come together and reconnect with their tribal culture. "We needed to create a safe place, free from inner-city distractions, to strengthen awareness of Native American cultural values and practices, and to build resiliency and interconnectedness," says NAHC Director of Youth Services Crystal Salas. “We found that forum in SAMHSA’s Gathering of Native Americans (GONA) curriculum.”
The curriculum has become a mainstay in the center’s youth prevention strategy. Since 2001, NAHC has delivered the GONA curriculum to more than 800 urban native youth in the Bay Area.
Recognized by SAMHSA as an effective culture-based intervention, GONA—and its Alaskan counterpart, the Gathering of Alaska Natives—helps communities establish a safe and supportive environment where youth can learn how to “thrive, grow up in balance, and pave the way for healthy futures.”5 The two- to three-day, on-site program focuses on "the underlying reasons causing individuals, families and communities to become at risk for addictions and self-destructive behaviors while recognizing the importance of cultural values, traditions and spirituality in healing."6
GONA focuses on four themes: belonging, mastery, interdependence, and generosity. The gathering is held in a wilderness location, and begins and ends with traditional Native American ceremonies. Youth are arranged in "clans" to experience belonging—something many urban Native youth may never have experienced. Activities such as storytelling, role play, skits, and art projects empower youth to express themselves honestly without fear of judgment. Teens engage in trust-building exercises, learn how to identify community cultural attributes, and develop ways to "put our world back together."
By immersing themselves in the GONA experience, youth learn what it means to be part of a broader tribal community and how to build upon the strengths of their Native culture.
"Many of our youth are pretty isolated when it comes to the Native community," Salas says. "In their schools, they may be the only Native student. In their neighborhoods, they may be the only Native family. So a lot of our urban youth adopt other social circles just to survive. GONA is a way of creating a mini-community within the larger community."
Understanding Historical Trauma
A primary goal of the GONA curriculum is to help youth understand and heal from historical trauma—what Native American clinical social worker and mental health expert Dr. Maria Yellow Horse Brave Heart describes as the “cumulative emotional and psychological wounding across generations, including the lifespan, which emanates from massive group trauma.”7 Historical trauma can lead to alcohol and other substance use and misuse, as well as depression, anxiety, suicidality, feelings of hopelessness; and other problems.8
"GONA reviews history not commonly taught in K–12 programs," King says. "This review of history puts the prevalent health conditions suffered by Native Americans in a context that helps youth understand why these problems are prevalent. It takes blame off of Native American individuals and looks at systemic policies that produced bad health for Native Americans. GONA teaches responsibility for our health by making choices that are different from the oppressor patterns that many of us have internalized. GONA helps us to understand the effects of trauma on individuals and communities and provides tools to heal from trauma."
Participants also explore the relationship of historical trauma and substance misuse. They learn how the stress of intergenerational trauma can contribute to alcohol and other drug use, and explore the effects of this use on individuals, families, and communities. "We bring up a lot of the really tough subjects," Salas says, with youth sharing how drug and alcohol use and misuse has impacted their lives and the lives of those around them.
"When we learn that we are contributing to each other’s health and that we have responsibility to each other, there is less incentive to use alcohol and drugs," she says. "When we learn about trauma and traditional, cultural ways to treat and prevent it, there is no need to use drugs and alcohol to medicate it. Drugs and alcohol are often spoken of as one of the things that broke apart the Native American world. [GONA teaches youth] that sober lifestyles and Native American tradition will help to restore it."
GONA in the Bay Area
NAHC delivered its most recent GONA in July 2017. Forty-seven teens from Oakland, San Francisco, and Richmond attended, referred by several urban tribal health centers in the region. The three-day event took place at the NatureBridge retreat center in the Marin Headlands, north of the Golden Gate Bridge, overlooking the Pacific Ocean. "It's close by, but it's out in the middle of a place where a lot of youth never really get to go," says Salas. “The peaceful location also made it easier for the young people to reconnect with their Native culture, and with each other."
NAHC staff were encouraged by the honesty and bravery of the youth to take charge of their lives, and to envision positive futures for themselves and their communities. "They talked about [addiction and] counseling in their skits,” says Salas. They identified alcohol and drug use as problems that need to be addressed to restore healthy communities. They’re breaking down their stigma within their own youth community."
For many participants, GONA is a transformational experience, shaping how they view themselves and others. "They feel so safe and comfortable and empowered, that they understand they can be leaders and change makers within their community," Salas says.
A Lasting Impact
NAHC is currently collaborating with other Native urban health centers in California to conduct an ongoing evaluation of GONA, looking at community and cultural connectedness, resilience, and other protective factors. Preliminary results are encouraging. "We know the GONA outcomes [of hope and resiliency] are associated with decreases in depression, suicide, and alcohol and drug abuse," says NAHC evaluator Paul Masotti. In addition, NAHC recently received a grant from the California Reducing Disparities Project to conduct a five-year evaluation of their GONA to examine best practices and the program's effectiveness.
In the Bay Area, preliminary evaluation findings show that GONA is helping to prepare the next generation of urban tribal youth to make healthy choices for themselves and be positive agents of change in their communities. They are learning how to be resilient and cope with problems without turning to drugs or alcohol.
Salas, who has attended every GONA since her organization began offering them, reports changes in attitude and perception seen in youth from the time they arrive to the program to when they depart. "Our GONA youth learn that they are part of a community that is bigger than just where they live," she says.
"My biggest hope is they take away that their voice matters, that they matter, and that we need them,” Salas adds. “We need our Native youth to be at the table with us, as our partners in prevention. When youth have a lifestyle of healthy behaviors that support one another, there is less incentive to use drugs and alcohol."
1. Urban Indian Health Institute. (2013, February 28). U.S. Census Marks Increase in Urban American Indians and Alaska Natives. Available at http://www.uihi.org/wp-content/uploads/2013/09/Broadcast_Census-Number_FINAL_v2.pdf.
2. Weaver, Hilary N. (2012, December 26). Urban and Indigenous: The Challenges of Being a Native American in the City. Journal of Community Practice, vol. 20, issue 4, pp. 470-488. Available at http://www.tandfonline.com/doi/abs/10.1080/10705422.2012.732001
3. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for the Application of Prevention Technologies. (In press.) Cultural Approaches to Prevention: Cultural Factors that Protect Against Substance Misuse in American Indian/Alaska Native Populations.
4. Gayman, Deann. (2015, June 1). Study Signals Risk Factors for Gang Involvement among Native Youth. Nebraska Today. Available at http://news.unl.edu/newsrooms/today/article/study-signals-risk-factors-for-gang-involvement-among-native-youths/
5. Substance Abuse and Mental Health Services Administration (SAMHSA). (2016, December.) Gathering of Native Americans Fact Sheet. Available at https://store.samhsa.gov/shin/content/SMA16-4994/SMA16-4994.pdf
6. del Vecchio, Paolo. (2015, November 25). The Impact of Historical and Intergenerational Trauma on American Indian and Alaska Native Communities. SAMHSA blog. Available at https://blog.samhsa.gov/2015/11/25/the-impact-of-historical-and-intergenerational-trauma-on-american-indian-and-alaska-native-communities/#.WgH7BI9Sy71
8. Substance Abuse and Mental Health Services Administration (SAMHSA). (2014, September). Tips for Disaster Responders: Understanding Historical Trauma When Responding to an Event in Indian Country. Available at https://store.samhsa.gov/shin/content//SMA14-4866/SMA14-4866.pdf