Native Clinic Expands Services for Behavioral Health

Learn about the Toiyabe Indian Health Project and its efforts to expand behavioral health services to Native youth and other Native populations in California.

Like clinics nationwide, the family services department of the Toiyabe Indian Health Project provides substance use treatment and rehabilitation—along with mental health programs, prevention, and outreach—to area residents. But because it serves a Native population, where another clinic might hold group therapy sessions, Toiyabe providers offer talking circles or a sweat lodge ceremony.

“Otherwise, a lot of the programs just don’t succeed,” says Su Yates, Toiyabe Family Services’ grants and communications director. “The behavioral health department has gone out of its way in taking evidence-based practices for therapy and substance abuse treatment and working with cultural adaptations and making them uniquely Indian.”

Nestled in the foothills of the Eastern Sierra Nevada Mountains, Bishop, California is home to Toiyabe Family Services. The clinic is part of the Toiyabe Indian Health Project, which also has locations in Coleville and Lone Pine, California. They’re not big cities, but the substance use problems they face are the same as anywhere in the United States today: alcoholism, marijuana addiction, and methamphetamine use. Treatment for substance misuse at Toiyabe is based on Warrior Down, a national program to provide relapse prevention and recovery support expressly for Native Americans.

Although there is some homelessness among Toiyabe Family Services’ clients, the tribal sense of family, which extends beyond blood relations, means that’s less about living on the streets and more about having to sleep on someone’s couch temporarily.

Bishop is located on the Bishop Paiute Reservation; that tribe is the fifth largest in the state and the largest member of the Toiyabe consortium. Although the Family Services staff is based at Bishop, some travel to the other locations to provide counseling and youth outreach.

Serving At-risk Native Youth

Youth are a big focus for Toiyabe. In addition to providing counseling and substance abuse treatment, Family Services staffers often help place children in foster care in Indian homes, says Yates, as well as step in to support juveniles who are facing discipline or probation from county courts.

In addition, Toiyabe sponsors many special activities for younger members of the tribes throughout the year to encourage health and wellness, as well as personal goal setting and community awareness. Youth in behavioral health programs are invited to participate in two annual trade walks, which call for some eight weeks of preparation before they hike into Yosemite to meet up with young members of a tribe from the other side of the park. They trade items they made before leaving home and camp for four or five nights. It’s the revival of an old tradition and today, says Yates, “it’s a rite of passage that has grown in significance.”

Toiyabe Family Services also hosts its Indigenous Games every summer, with some 100 youth—many of whom are considered high risk—participating in traditional Paiute and Shoshone games and feats of strength and athleticism. An annual road race that’s open to all is another opportunity to move and socialize and, like the other activities, is a way to promote health and wellness.

Adults may take part in the race and various other special events, including the annual Mule Days Celebration; an assortment of ongoing Family Services webinars; and women’s groups, where the focus is on prevention and participants engage in arts and crafts activities, including beadwork. Fatherhood Is Sacred is a group with its own curriculum whose members spent time in prison or struggled with substance abuse. They give back to their community by supporting struggling families at Christmas or slaughtering a cow to share with not only the group’s members, but tribal elders, as well.

While the Toiyabe Indian Health Project provides medical, dental, optical, dialysis, public health, and preventive medicine services to anyone, funding from the California Rural Indian Health Board and Healing Our Own People dictates that the Family Services department treat only members of its consortium of seven federally recognized tribes and two Indian communities. Because there aren’t many treatment facilities nearby—the two closest cities are Los Angeles and Reno, Nevada, and the nearest is a four-hour drive away—Yates says Toiyabe is hoping to find funding that will allow them to serve non-Native clients as well. That may spread the workload better among the clinic’s counselors, psychologists, and social workers, because many of the Native clients, specifically request appointments with non-Native professionals. Natives, they feel, are too much like family, and they don’t want to feel judged by family.

Learn more about the California Rural Indian Health Board and the Healing Our Own People program at the Suicide Prevention Resource Center (SPRC). Learn how SAMSHA addresses behavioral health and tribal affairs.

This article was originally published to highlight the February 2015 theme of Minority Behavioral Health Conditions. Access more behavioral health and homelessness resources.

Publication Year

Sarah Zobel
Last Updated: 04/19/2016