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Reducing and Eliminating Disparities in Mental Health Service Delivery: Recommendations for More Effective Access for Indigenous Native American Nations. Ethleen Iron Cloud-Two Dogs, M.S. Vision Statement.

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Reducing and Eliminating Disparities in Mental Health Service Delivery: Recommendations for More Effective Access for Indigenous Native American Nations

Ethleen Iron Cloud-Two Dogs, M.S.

Vision Statement

  • Indigenous Native American peoples will overcome the historical trauma and shame that has been internalized, through their own cultural ways of healing.

  • Goal: To provide mental health resources and training that are culturally and community competent, accessible and affordable.

Today’s Situation

  • Young Native Americans, age 15-24 killing themselves at a rate of 4-6x national average (source: Indian Health Service Mortality Rates)

  • Pine Ridge Indian Reservation: Every 2.5 days, someone tries to kill him/herself

How Did We Get Here?

  • Centuries of Genocidal and Oppressive Policies and Practices that are largely unacknowledged

  • Trauma that is generational and unresolved (e.g. 1890 Wounded Knee Massacre) and has resulted in “killing of the spirit of a people”

Available Options

  • Currently Indian Health Services Mental Health resources are severely underfunded, e.g., only funded at a 30-40% of actual need.

  • Geographic isolation limits access to services

  • Crisis response, “putting out fires”, is the nature of the current mental health service delivery system which prevents long-term therapeutic services

Available Options cont.’

  • Grant funded mental health initiatives that are legislatively deemed competitive ignore the treaty rights of tribes and ignore the lack of a tribal government tax base

  • Tribal – states relations are often historically troubled and “collaboration” among state, tribal and federal programs often have jurisdictional and sovereignty issues beyond the scope of a mental health initiative


  • #1: Acknowledgement through policy and practice that most tribal nations have a unique and historical treaty relationship with the government

  • #2: Increase mental health funding to a level where actual therapy can take place within individuals, families and communities

Recommendations Cont.’

  • #3: Provide ongoing mental health training resources for consumers and communities (families and communities live with, respond to mental health needs “24-7”)

  • #4: Research methods and findings must be culturally relevant in order to be applicable to the tribal nation or community.


Thank you

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