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  1. #1

    American Indians get scant help on mental health

    American Indians get scant help on mental health
    April 11, 2005
    Duluth News Tribune

    Trying to get needed mental-health services to remote American Indian reservations has long been a problem for providers such as Jo Ellen Anywaush. As director of the White Earth Reservation Health Services in northern Minnesota, her staff is dedicated but small, and money is tight.

    "It's a real problem, because of the lack of services on the reservation," Anywaush said.

    American Indians face significant health challenges. Their average life expectancy is five years less than that of the general population. They are afflicted more severely than other ethnic groups with many health problems, including tuberculosis, alcoholism and diabetes. And in terms of mental health, American Indians are twice as likely to suffer from depression and almost twice as likely to commit suicide as the general population.

    American Indian communities' struggles with mental-health issues are nothing new. But national attention was focused on the issue after the March 21 slayings at Red Lake High School, in which student Jeff Weise shot and killed a security guard, a teacher and five students, as well as two people outside of the school, before committing suicide.

    Weise's actions were extreme and probably say no more or less about the state of mental health in Indian Country than the 1999 Columbine High School shootings in Littleton, Colo. -- which claimed 15 lives -- say about the state of mental health in affluent, predominantly white suburbia. But because of limited money and the logistical realities of rural health care, tribal health officials such as Anywaush often find that even tending to the more everyday mental-health needs of the tribes is as difficult as it is necessary.

    "The whole rural area has trouble with providers," said Peg Blakely, program coordinator for Anishinaabeg Minosewag, the Leech Lake band's community-wellness program.

    Blakely's office provides counseling services and presentations on suicide awareness, both of which are supported by state grants. But the money for the whole program is only enough for a two-person staff, and that money may be jeopardized by further state budget cuts.

    Anishinaabeg Minosewag isn't the only mental-health resource on Leech Lake -- there's also a child psychologist who commutes to the reservation from Bemidji once a week. But even so, Blakely said the reservation would need double the number of mental-health workers it now has to provide full service.

    "We've had three suicides in the past year and a half," Blakely said. "There's a lot of grief and loss issues that aren't addressed adequately, because there aren't enough providers."

    Dr. Jon Perez, director of behavioral health for the Indian Health Service, said that such problems aren't unique to Minnesota's tribes. His agency is the arm of the U.S. Department of Health and Human Services that oversees federal services for American Indian health care, including about $3.1 million a year for mental-health and substance-abuse programs in Minnesota.

    Three Ojibwe communities in northern Minnesota -- the White Earth, Red Lake and Leech Lake bands -- account for almost two-thirds of the money. But even for the White Earth band, the state's largest recipient, that works out to only about $34 a year for each tribal member.

    The limited funding means the agency and its contractors must focus on emergency situations, without the luxury of extended psychiatrist-patient relationships that often are necessary to treat mental-health problems, Perez said.

    A September report by the U.S. Commission on Human Rights found that the Indian Health Services did well with the money provided to it, but that the agency was "long-neglected and underfunded" by Congress. Some are concerned that the situation could get worse with the Bush administration proposing a 2006 budget that includes cuts to Indian Health Services.

    In the meantime, tribes make do with a combination of the federally funded services the Indian Health Services pays for and the tribal services that usually are bankrolled with state and federal grants. Red Lake, for example, has a half-dozen workers who help tribal members with everything from basic coping skills to crisis-level treatment, said James Brown, director of behavioral health for the Indian Health Services' Bemidji office. Mental-health officials at Red Lake were unavailable to comment for this story.

    Robert Cole, CEO of the Upper Mississippi Mental Health Center, a Bemidji-based nonprofit clinic, said his program partners with the Red Lake School District and other community organizations in the area to provide visiting psychiatrists for schools on the reservation. He said the service helps students who may not have emergency-grade problems, but who still need help working things out.

    "Kids get depressed, kids get anxious, and it's nice to have somebody there that the school can refer you to," Cole said.

    Cole said his clinic and other county-based services are useful in that they give those who need help a greater degree of anonymity than they might have at tribal facilities.

    "The tribe is a fairly small community, and sometimes people want a little more confidentiality than going into an agency where your friends and neighbors and relatives work," he said.

  2. #2

    American Indians get scant help on mental health

    Note that the situation isn't a whole lot better for First Nations and Inuit people in Canada. Health Canada does fund health care programs, including mental health care programs, for these clients but that doesn't help them, much in remote communities where, funding or no funding, the services are few and far between.

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