For American Indians and Alaska Natives, multiple factors influence health outcomes, including historical trauma and a range of social, policy, and economic conditions such as poverty, under-employment, lack of access to health care, lower educational attainment, housing problems, and violence.
These disparities have consequences. Suicide is the second leading cause of death among American Indian and Alaska Native youth ages 8 to 24. Also, while there is general awareness that Native Americans experience higher rates of alcohol and substance use, the scope of these behavioral health problems is not fully understood.
Native communities face service delivery issues that are complicated by personnel shortages, limited health care resources, and distances to obtain services. There also are other issues that inhibit access to appropriate behavioral health services such as referrals from school, detention, court, housing, primary care, child welfare, and other systems.
SAMHSA’s efforts reflect a commitment to upholding the federal government’s historical and unique legal relationship with American Indian tribes through consultation, outreach, education, and engagement. SAMHSA’s mission is to provide efficient and effective delivery of resources and services to ensure that American Indians and Alaska Natives have access to prevention, treatment, and recovery support services that reflect the best of modern science and traditional cultural practices.
The Office of Tribal Affairs and Policy (OTAP) is organizationally housed within the Office of Intergovernmental and External Affairs (OIEA) and serves as SAMHSA’s primary point of contact for tribal governments, tribal organizations, federal departments and agencies, and other governments and organizations on behavioral health issues facing American Indians and Alaska Natives. OTAP brings together SAMHSA’s tribal affairs, tribal policy, tribal consultation, tribal advisory, and Tribal Law and Order Act responsibilities to improve agency coordination and meaningful progress. The Office of Indian Alcohol and Substance Abuse (OIASA) is an organizational component of OTAP. Under TLOA guidelines, OIASA coordinates federal partners and provides tribes with technical assistance and resources to develop and enhance prevention and treatment programs for substance use disorders, including the misuse of alcohol.
SAMHSA considers consultation an enhanced form of communication which emphasizes trust, respect, and shared responsibility. Consultation is an open and free exchange of information and opinion among parties which leads to mutual understanding and comprehension, the purpose of which is reaching consensus to the greatest extent possible. SAMHSA’s Tribal Consultation Policy is available at SAMHSA-specific Tribal Consultation Policy (TCP) — 2017 (PDF | 7 MB). Tribal input on consultation topics may be provided through the following e-mail address: email@example.com.
SAMHSA Tribal Technical Advisory Committee (TTAC)
The SAMHSA TTAC was established in 2008. TheTTAC meets in-person twice per year and by conference call as necessary to provide advice on AI/AN behavioral health concerns and workable solutions. Find more information about the TTAC.
National Tribal Behavioral Health Agenda
SAMHSA worked with tribal leaders, the Indian Health Service, and the National Indian Health Board to develop the National Tribal Behavioral Health Agenda. The TBHA is a blueprint for collaborative action by tribes, federal partners, states, and other stakeholders on five foundational elements: (1) healing from historical and intergenerational trauma; (2) advancing socio-cultural-ecological approaches to addressing behavioral health in tribal communities; (3) expanding prevention and recovery support; (4) improving behavioral health services and systems; and (5) building national awareness and visibility related to the behavioral health experiences of tribal communities. In support of the TBHA tribal entities are encouraged to address the foundational elements or priorities in their SAMHSA grant applications. SAMHSA also worked with the National Indian Health Board, National Congress of American Indians, and National Council of Urban Indian Health to begin implementing the TBHA and is currently considering future collaborative actions.
Tribal Funding Opportunities
Tribes, tribal organizations, and urban Indian organizations are eligible to apply for most of SAMHSA’s discretionary grant programs. Each grant program has its own application deadline. Find information on open grant opportunities. SAMHSA offers three programs that are specific to tribes and tribal organizations: Tribal Behavioral Health Grant (Native Connections), Circles of Care, and the Tribal Opioid Response (TOR) program. SAMHSA’s grants address a range of issues including:
- Behavioral health systems and workforce
- Homelessness and housing for people with mental and/or substance use disorders
- Issues related to behavioral health and the criminal justice system
- Opioids and other substances of abuse (i.e., methamphetamines, alcohol, etc.)
- Prevention, treatment, and recovery from mental and substance use disorders
- Suicide Prevention
**UPDATE: The Tribal Opioid Response (TOR) grant is now supported as a component of OTAP.
Tribal Technical Assistance
SAMHSA supports an innovative training and technical assistance project that helps tribal communities develop and implement community-based prevention plans to reduce violence, bullying, and suicide among American Indian and Alaska Native youth.
SAMHSA Tribal Training and Technical Assistance (TTA) Center
The SAMHSA TTA Center uses a culturally relevant, evidence-based, holistic approach to support Native communities in their self-determination efforts through infrastructure development and capacity building, program planning, and implementation. The Tribal TTA Center provides training and technical assistance on mental and/or substance use disorders, suicide prevention, and mental health promotion. Find more information on the Tribal TTA Center.
SAMHSA Technology Transfer Centers (TTCs)
In 2018, SAMHSA established new Technology Transfer Center Networks (TTCs) focusing on addiction, prevention and treatment that addresses substance use disorders and serious mental illness. The purpose of the TTCs is to develop and strengthen the specialized behavioral healthcare and primary healthcare workforce that provides substance use disorder and mental health prevention, treatment and recovery support services. The TTC Network is comprised of the Addiction Technology Transfer Centers (ATTC), the Mental Health Technology Transfer Centers (MHTTC) and the Prevention Technology Transfer Centers (PTTC). Each TTC includes dedicated Centers that focuses on improving service delivery to American Indian Alaska Native populations.
National American Indian/Alaska Native Addiction Technology Transfer Center
SAMHSA’s American Indian and Alaska Native Addiction Technology Transfer Center (AI/AN ATTC) continues to develop and strengthen the specialized behavioral healthcare and primary healthcare workforce that provides substance use disorder (SUD) treatment and recovery support services to tribal communities. In response to SAMHSA announcing the Tribal Opioid Response (TOR) awards, the AI/AN ATTC developed a webinar series that provides technical assistance to TOR grantees on developing successful strategic plans to address the opioid crisis in their communities. In addition, the AI/AN ATTC began a webinar series focused on building essential substance abuse skills for practitioners to improve the quality of service delivery to tribal communities. The topics range from addiction counseling competencies, principles of drug effective treatment, and professional and ethical responsibilities. Find more information on ATTC.
National American Indian and Alaska Native Mental Health Technology Transfer Center
The National American Indian and Alaska Native Mental Health Technology Transfer Center (AI/AN MHTTC) works with treatment practitioners to improve the delivery of mental health services to AI/AN individuals, families, and tribal and urban Indian communities. The AI/AN MHTTC aims to strengthen their capacity to deliver effective evidence based practices, including the full continuum of services spanning mental illness prevention, treatment, and recovery support. Among many services, the AI/AN MHTCC provides education and training for certification exams and clinical supervision opportunities for mental health professionals, a Native American Leadership Academy to enhance leadership skills in mental health promotion, treatment, and recovery, and technical assistance for Tribal Action Planning. Find more information on MHTTC.
National American Indian and Alaska Native Prevention Technology Transfer Center
The National American Indian and Alaska Native Prevention Technology Transfer Center (AI/AN PTTC) is a newly launched SAMHSA program that will develop and disseminate tools and strategies needed to improve the quality of substance abuse prevention efforts. The AI/AN PTTC will provide training and technical assistance to national substance use disorder prevention professionals in order to improve their understanding of prevention science, how to use epidemiological data to guide prevention planning, and selection and implementation of evidence-based and promising prevention practices in tribal communities. Find more information on PTTC.
- eRA Commons – All post award amendments are exclusively processed through the eRA system.
- eRA Commons tutorial videos – Detailed tutorials on common eRA tasks.
- SAMHSA’s Performance Accountability and Reporting System (SPARS) – The online data entry and reporting system to support grantees in reporting timely and accurate data to SAMHSA. GPRA training is available under the “Training” tab, in CSAT Specific Courses.
- The HHS Payment Management System – Provides guidance and instructions on submitting required financial reports for SAMHSA grants.
- The SAMHSA Grants Management – The go-to resource for SAMHSA grant requirements and instructions on submitting grant changes.
- Treatment Improvement Protocol 61: Behavioral Health Services for American Indians and Alaska Natives - TIP 61 describes the effects of substance use and mental illness among American Indians and Alaska Natives and discusses the importance of delivering culturally responsive, evidence-based services to address these behavioral health challenges.
If you have any questions related to SAMHSA’s Tribal Affairs and Activities, you may contact the Office of Tribal Affairs and Policy at: