Remarks by
A. Kathryn Power, M.Ed.
Director

Center for Mental Health Services
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services

IHS/SAMHSA Behavioral Health Conference
Talking Points

June 12-14, 2007
Albuquerque, NM

PowerPoint Version

Slide 1 [Title Slide]

Slide 2 [Public Health Priority]

Slide 3

• Science has informed us about effective treatments but what we have not done a good job at is finding out what treatments are effective for Native American communities. More research is needed because we cannot just take an intervention and implement in a community and expect it to work

Slide 4 [Global Burden of Disease]

• Native Americans are at a higher risk for mental health disorders than other racial and ethnic groups in the United States, and are underrepresented in mental health service delivery.
• Alcohol abuse is widespread - with Native Americans using and abusing alcohol and drugs at younger ages and at higher rates that all other ethnic groups.
• Depression is also emerging as a dominant health concern -- and -- American Indian youth and young adults (ages 14 - 39) have higher suicide rates than any other ethnic group.

Slide 5 [Need vs. Access]

• Native Americans additional barriers due to:
• Limited access to appropriate services and facilities
• Poor access to health insurances, including Medicaid, Medicare, and private insurance
• Insufficient federal funding
• Quality of care
• Lack of available culturally and linguistically appropriate and competent services
• Disproportionate poverty and poor education
• Behavior and lifestyle choices

Slide 6 [The CMHS Charge]

Slide 7 [CMHS Organization Chart]

• here are 94 Federal employees at CMHS

Slide 8 [CMHS Budget]

• In this fiscal year $16 million has been provided as direct grant support to Tribal communities (through systems of care, SS/HS, Native Aspirations, Child Trauma and Garrett Lee Smith)

Slide 9 [National Initiatives]

Slide 10 [Achieving the Promise]

• The work of Transformation cannot be accomplished by CMHS alone.
• Formation of Federal Partners Senior Workgroup
• Creation of the Action Agenda
• Participation of IHS
• Partners in sponsorship of this Conference
• IHS as part of the Federal Partners Senior Workgroup has identified 15 Action Steps that they will take, or are in the process of taking, to support Mental Health Transformation for Native Americans and Alaska Natives.

A few of these steps include:

• Deployment of a digital Suicide reporting Form to screen individual for potential suicide risk
• Awarding of Cooperative agreements for Children and Youth projects to help tribes and urban Indian rganizations promote healthy child development, school success and other related outcomes.
• Supporting suicide prevention and youth leadership initiatives for youth 15 - 19 years of age

Slide 11 [Transforming Workforce]

• CMHS is currently working to identify culturally competent behavioral health training and curricula for minority populations, including Tribal communities and colleges
• CMHS is working on a project in Indian Country, tele-psychiatry with Indian Veterans and culturally specific social marketing materials through our Eliminating Mental Health Disparities contract.

Slide 12 [Expanding the Knowledge Base]

• In 2005 CMHS began funding the Native Aspirations project which is designed to help tribal communities develop, implement, and evaluate a comprehensive, community-based youth violence, bullying, and suicide prevention program
• This is a program that is community-driven and is responsive to the unique strengths and barriers that exist within each of the participating communities.
• From this initiative we have already learned important information that we are using to strengthen these efforts:
• The importance of a grassroots focus when working with tribal communities
• Programs and activities need to be community specific -- or --responsive to the unique strengths and barriers that exist within each community
• Program development must be community-driven so that community buy-in and ownership is fostered from the very beginning
• Involving youth leaders in community planning -- not only gets youth involved, but has also lead to sustained funding for youth planning.
• We are excited about this initiative and have just announced a call for proposals for an evaluation contract we will be awarding this fiscal year in order to formally evaluate outcomes AND “Expand the knowledge base”.

Slide 13 [NREPP]

• SAMHSA and CMHS are aware that there is a gap in evidence for interventions for minority populations. As communities adapt existing interventions for these populations, we are working to ensure they are evaluated for potential inclusion in NREPP.

Slide 14 [Consumer Participation]

Slide 15 [Policy Acadamies]

• MHS is sponsoring a tribal specific Policy Summit focused on Suicide Prevention, Intervention and Healing. We anticipate that 6-7 tribes will participate and have also secured partnerships with the Bureau of Indian Affairs and the University of Oklahoma to support additional communities to participate. The Summit is Sept 25-27 at the Pechanga Indian Casino in Temecula, CA.
• The Circles of Care grantees from Oklahoma will be doing a workshop on the first day to discuss “Bridging state and tribal systems to build and sustain systems of care”…

Slide 16 [MH Block Grant]

• Currently, Tribes receive funds through the States from the Substance Abuse Prevention and Treatment Block Grant (SAPT) and Community Mental Health Service Block Grant (CMHSBG). We are exploring methods to track how State block grant funds are disbursed at the local and community level through contractual arrangements with Tribes and Tribal organizations. SAMHSA is interested in talking further with Tribes about a proposal for a Block Grant that would provide substance abuse and mental health services for Tribes.

Slide 17 [Local and Regional Efforts]

• CMHS has 38 Programs of Regional and National Significance. I’m only going to talk about a few of them today.

Slide 18 [Youth Violence Prevention/SSHS]

• Since 1999, 8 tribal communities have received nearly $20 million dollars, and Native American youth have also been served through grants awarded to non tribal communities.
• The 2007 call for applications will close on June 19th and SAMHSA and the Department of Education expect to award approximately 21 new grants.

Slide 19 [Bullying Prevention]

• Through a new Communications/Social Marketing contract that we expect to award this fiscal year, we will be adapting these materials and developing new materials on bullying prevention for use by Native American/Alaska Native communities.
• And - drawing on what we have learned from Native Aspirations, we will be creating mechanisms for community input on the development of those materials in order to assure that the material are relevant and useful.

Slide 20 [Suicide Prevention/SPRC]

• SPRC recently hired Vickie LaFromboise as a Tribal Prevention Specialist -- and she is here at the conference and will be staffing the SPRC booth in the exhibit area. Please stop by to meet her.

Slide 21 [Suicide Prevention Lifeline]

• Suicide Prevention Lifeline has developed a Native American Community Liaison Initiative - to strengthen collaboration and communication between crisis centers and the communities they serve where there are populations of indigenous people. Crisis centers in Wyoming, Montana, North and South Dakota, and Minnesota are participating.

Slide 22 [Garrett Lee Smith]

• The State and Tribal Youth Suicide Prevention and Early Intervention grant program currently funds 7 tribes or tribal organizations and 31 states. Several of these states are working with tribes.
• Grants provide up to $400,000 per year for three years.
• We anticipate a new competition in 2008.
• The Campus Suicide Prevention Program provides support to 55 colleges for a variety of suicide prevention activities.
• Grants provide up to $75,000 per year for three years, with colleges providing a dollar for dollar match.
• The University of North Dakota is working with Tribal colleges in North Dakota to promote suicide prevention.
• We anticipate a new competition in 2008.

Slide 23 [Native Aspirations]

• The Native Aspirations initiative currently serves 15 communities. Nine additional communities will be invited to participate in this initiative in Fall of 2007. Staff from Kauffman and Associates is presenting at the conference and has staffed a booth. Please stop by to learn more.

Slide 24 [Traumatic Stress]

• In the National Child Traumatic Stress Network includes 8 Tribal grantees. The 2007 request for application period just concluded. We expect to make approximately 15 new awards.
• The “Indian Country Child Trauma Center” (ICCTC) has been established as part of the SAMHSA’s National Child Traumatic Stress Initiative (NCTSI). The ICCTC has developed four trauma-related treatment protocols, outreach materials, and service delivery guidelines specifically adapted and designed for Native American children.
• Community partners from the Midwest and rural Alaska have stated that because of ICCTC”s training they were finally able to provide culturally appropriate services to American Indian Children in the community.

Slide 25 [Children’s Mental Health]

• 7 Native American System of Care communities, 6 Circles of Care grantees and funding a Native American TA Center and Evaluation Contractor to work with those grantees
• We anticipate releasing a new RFA in the Fall for the Comprehensive Community Mental Health Services for Children and their Families Program (otherwise known as the Children's Services Program, Children's SOC Program or CMHI).
• These are 6 year cooperative agreements with an increasing ratio of non-federal to federal matching dollars (required by statute). First year funding is a maximum of $1mil. (planning year) and total 6-year award (not counting match) is about $9mil. CMHS hopes to be able to fund a significant new cohort of System of Care sites.

Slide 26 [Mental Health Information Center]

• CMHS has many other initiatives you may be interested in. Please visit the National Mental Health Information Center website or the SAMHSA website for updates on our programs or funding opportunities.