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The Journey Of Native American People with Serious Mental Illness
Executive Summary

Common Themes, Specific Issues and Related Recommendations - Theme B

The systemic, structural, and jurisdictional barriers to accessing services must be addressed collaboratively by all key parties.

Issues	Recommendations
1. Lack of clarity regarding jurisdictional boundaries and the roles and responsibilities of IHS, BIA, States, and tribes in meeting the mental health needs of Native Americans.	1a. Mandate that mental health planning begin by considering access and Jurisdictional issues. 1b. Encourage States to facilitate bringing key groups together to discuss jurisdictional issues. Ensure that these key groups and all discussion are advised by consumers and families. 1c. Develop a resource document on State/ tribal relationships and current status of service provided. 1d. Encourage tribes, States, and IHS to establish procedures for patients receiving inpatient services, especially in State facilities, with the goal of minimizing inpatient care.
2. Given the prevalence of and unique issues related to substance abuse and alcoholism among Native Americans, there is a need for better integration of Substance abuse and mental health services.	2a. Require that substance abuse and mental health programs collaborate to provide services to dually diagnosed consumers. 2b. Begin collaboration among tribes, States, IHS, and others to obtain more community residential facilities for dually diagnosed Native Americans.
3. A well coordinated continuum of services is often lacking for Native American consumers.	3a. Develop a continuum of services at all levels. 3b. Expand and more fully utilize support services, including vocational rehabilitation, consumer support and self-governing groups.
4. Lack of transportation is often a barrier to accessing service.	4a. Collaborate to provide for consumers who need transportation in order to receive services.

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