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
CSAT Best Practices in Substance Abuse Treatment for American Indians and Alaska Natives Forum
San Diego, CA
June 27, 2005
Attached is the text prepared for delivery; however, some material may have been added or omitted at the time of delivery.
Good morning. Two weeks ago, the Senate Subcommittee on Indian Affairs held a hearing about the tragically high rate of suicide among American Indian teens, which is similar to that of Alaska Native teens. Suicide is now the second leading cause of death for American Indian and Alaska Native youth ages 15 to 24. The suicide rate for this population is 250 times higher than the national average. For some tribal communities, the suicide rate may be 1,000 times higher.
Surgeon General Richard Carmona testified before the Senate subcommittee. He stated: “Suicide is not a single problem; rather, it is a single response to multiple problems.”
Depression and substance abuse are among those problems. These two disorders are the most common risk factors associated with completed suicides. We have a call to action here. Suicide is robbing native communities of their most valuable resources: their children and their future. Mental and substance use disorders play a major role in this tragedy. We must play an equally strong role in ending it.
We in the Center for Mental Health Services, together with SAMHSA and its other centers, are jointly committed to improving the health and well-being of our country’s native communities. Together, we are working to prevent and treat mental and substance abuse disorders, which all too often overlap.
Consider the statistics: Fifty to 75 percent of individuals in substance abuse treatment programs have co-occurring mental illnesses. Twenty to 50 percent of those treated in mental health settings have a substance abuse problem.
At CMHS, suicide prevention is the focus of most activities involving American Indians and Alaska Natives. Grants, technical assistance, public education, database development—We are doing everything within our power to stem the horrible loss of life and the anger, guilt, blame, and shame experienced by the surviving family and friends of the victim.
Suicide is the final, hopeless act by individuals whose mental health needs have been unidentified, untreated, or inadequately addressed. My center leads SAMHSA’s ongoing effort to transform mental health care for all Americans. Our goal is to create a mental health system that will provide each adult and child with full access to the services and supports he or she needs to promote sound mental health or to recover from a mental illness.
A serious challenge to achieving our goal is the current disparities of care for minorities and for individuals living in underserved geographic areas. As a tragic example, more than one-half of all American Indians who commit suicide have never been seen by a mental health professional. One reason is that there are too few providers in remote locations. We can use recent advances in telehealth to remedy this problem.
Here’s another reason—lack of cultural competency in our programs and provider training. We simply don’t know enough about native cultures and the differences between them. Right now, we are working hard within the constructs of mental health programs primarily designed by and for non-natives.
We, however, are working even harder to increase our understanding of native cultures and our level of response consistent with what we learn. We have asked American Indian and Alaska Natives to help guide our efforts to develop and evaluate evidence-based practices. This is how we can create stronger, more effective programs—through collaboration and by making services more consumer driven.
I’m delighted that this forum emphasizes the potential of traditional interventions to prevent and treat substance abuse. For centuries, native communities have found strength and healing within their cultural heritage. By acknowledging that traditional interventions can be best practices, we are honoring and affirming their heritage and its power to change lives.
In closing, I’d like to share a poem written by an unknown Inuit. It is a poem of hope because it celebrates life. We at this meeting have a collective responsibility to ensure that all Americans can find hope in a future free of mental and substance use disorders. I sincerely wish that the sentiments expressed in the following words will soon echo among Native American and Alaska Natives of all ages.
I think over again my small adventures
My fears, those small ones that seemed so big
For all the vital things I had to get and reach
And yet there is only one great thing
The only thing
To live to see the great day that dawns
And the light that fills the world.
Have a wonderful conference. May the information you share at this meeting shed greater light on how we can collaboratively—and respectfully—serve the mental health needs of our native communities. Thank you.
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