Treatment and Recovery: Native American Populations

1. Treatment and Recovery: Native American Populations Eva Petoskey, M.S. Director, Anishnaabek Healing Circle Access to Recovery Inter-Tribal Council of Michigan

2. Greetings Anishnaabek Introduction (Name-Clan-Place) Aanii (Hello) Anishnaabek (Indigenous people of Michigan the Odawa, Ojibwa, and Potawatomi Miigwech (Thank you) Spelling taken from: Eastern Ojibwa-Chippewa-Ottawa Dictionary, Richard A. Rhodes

3. My Background • Odawa/ Anishnaabekwe : Member of the Grand Traverse Band of Ottawa and Chippewa Indians. • I have lived in Peshawbestown with my husband and 2 children, for 26 years. • Thirty five years of work experience with issues related to wellness, education, evaluation, and culture. • Served in tribal government for 6 years and was the Vice-Chairperson of our Tribal Council for 4 years.

4. Purpose • Provide background on the Anishnaabek of Michigan • Discuss inter-generational trauma and its impact on tribal people today. • Discuss key health disparities. • Discuss the spiritual and cultural strengths inherent in Native American culture. • Discuss approaches for interfacing with tribal communities, families, and individuals in efforts that support prevention, treatment, and recovery.

5. Our Origins • Anishnaabek creation and migration teachings tell us that we have always resided on turtle island. (North America) • A long time ago, based on the visions of the coming of the Europeans, our ancestors began a journey from the Atlantic coast to the great lakes region. • This was a spiritual journey guided by the dreams and visions of our ancestors leading us to this beautiful place of vast fresh water.

6. There are 12 Federally recognized tribes in Michigan. • Significant urban Indian populations in Detroit and Grand Rapids

7. American Indian Population • Approximately 55,607 enrolled members living on or near reservations in 52 of Michigan’s 83 counties. • The most recent US Census estimate of the number of American Indians in Michigan is 69,269. (U.S. Census, Bureau, 2013 Population Estimates, American Community Survey). This is based on persons responding as American Indian only on the census.

8. Sovereignty • American Indian and Alaska Native tribes are governments with hundreds of treaties, federal laws, and court cases affirming that tribes retain the inherent powers to govern themselves as nations. • The federal government works with tribes in a government-to-government relationship. • The foundation for successful collaboration between states and tribes is an understanding of and appreciation for tribal sovereignty.

9. Change Across the Generations Educational Challenges Indian Wars Loss of Land Children Removed Every Indian Family Has Experienced These Risk Factors Repression of Ceremonial Life Anxiety and Depression Forced Assimilation Poverty

10. Historical Grief and Trauma • The Anishnaabek have endured a remarkable journey over time carrying the seeds of healing deep in our hearts • The grief and trauma resulting from boarding schools, rapid cultural change, lack of economic opportunity, and loss of land have contributed to the high rates of substance abuse and mental health problems experienced by the Anishnaabek families and communities today.

11. Michigan Youth Risk Behavior Survey Data taken from Michigan Department of Education Website Detailed Results by Item Spreadsheet Grades 9-12

12. Alcohol Use (Before Age 13**)

13. Alcohol Use (Past 30 Days)

14. Heavy Drinking(Past 30 Days)

15. Marijuana Use (Before age 13)

16. Marijuana Use (Past 30 Days)

17. Made a Plan to Attempt Suicide (Past 12 Months)

18. Historical Resilience • The seeds of healing have grown into a strong recovery movement with committed people. Over the past thirty years a grass roots substance abuse recovery movement was born. • Many Anishnaabek left behind the self-perpetuating stereotype of a “hard drinking Indian” and transformed their personal identity into that of a sober culturally strong Anishnaabek

19. Tribal Governments • . Tribal governments have created behavioral health departments along with policies and procedures to guide the delivery of services including indigenous healing services that are integrated with western approaches. • Tribes have passed laws supporting health, wellness and recovery.

20. Promising Practices • Indigenous Healing Models based on community empowerment • Helping Healers/Peer Mentors • Cultural Teachings • Motivational Interviewing • Cognitive Behavioral Therapy

21. Workforce Development • Continuing need to recruit and train new certified addiction counselors and prevention staff. • Continuing need to educate non-native staff on how to work effectively with tribal people and communities. • Collaboration between certification boards is important. (MCBAP and UMICAD)

22. An Anishnaabek Perspective The following slides are based on ideas generated from focus groups conducted with Anishnaabek people.

23. Opportunities to Deal with Historical Trauma and Grief It is important for treatment and recovery support initiatives to recognize the multi-generation nature of substance abuse problems in many Native families. This phenomenon needs to be seen as a reality that must be acknowledged. To address the needs of families with generational trauma and grief requires specialized training for counselors so they understand the unique history of Native people and the experiences that have led to the deep grief and sadness that many clients carry.

24. Opportunities to Deal with Historical Trauma and Grief It is important to seek out and incorporate specialized educational materials and healing activities to address these issues. If the treatment system denies the existence of historical trauma then there is little hope for treatment to help break the cycle of addiction in tribal communities.

25. Challenges One challenge is the daunting nature of the problems. It is difficult to not feel discouraged. It is difficult to maintain hope. The other challenges related to the multi-generational nature of the substance abuse problem and the resulting community and family communication and trust problems. Jealousy was mentioned as a barrier to moving forward in constructive community healing initiatives.

26. Challenges Faced by the Service System • Lack of money to support family involvement such as transportation to residential treatment located out of state. • Families have much unfortunate exposure to deficit models of treatment. • Lack of finances available to allow for family participation in treatment. • Lack of adequate specialized programs that are culturally designed for our people. • Convenient times to allow parents to participate.

27. Strategy for change There need to be positive peer role models and mentors available to help support recovery beyond treatment. This is especially critical for people returning to the community from treatment and for youth receiving outpatient services.

28. Strategy for change Recognize that small steps are important. Never give up on the client or family. Accept that recovery is a process that takes time and that relapse and resistance to change are a normal part of the process rather than a deficit.

29. Opportunities Within Family Systems Learning the spiritual teachings of the Anishinaabek is important. Cultivating the spiritual connection to the sacred places, the land, water, and all other living beings is part of the process of spiritual growth. Cultivating spiritual growth from an Anishinaabek orientation was an important theme. However, developing spiritually through other spiritual and religious affiliations was also mentioned as very helpful to people.

30. Tribal Recovery Oriented System of Care • Shifting the model of intervention from acute care of individuals to a sustained recovery management approach relies on partnerships with individuals, families and communities. White & Sanders (2004).

31. Winter Teaching Lodge Behavioral Health Cultural Service Expansion with ATR Saginaw Chippewa Tribe Behavioral Health Residential, Outpatient and Recovery Support Services

32. Access to Recovery Anishnaabek Healing Circle 2956 Ashmun, Suite A Sault Ste. Marie MI 49783 (906) 632-6896 www.atrhealingcircle.com Staff Eva Petoskey, Director Direct line (231-357-4886) epetoskey@centurytel.net Terri Tavenner, Associate Director ttav@itcmi.org Connie DePlonty, Voucher Coordinator connied@itcmi.org Cora Gravelle, Call In Center Client Access & Outreach cora@itcmi.org Sheila Hammock, Call In Center Client Access & Follow-up shammock@itcmi.org Produced by the Inter-Tribal Council of Michigan with Access to Recovery (ATR) Anishnaabek Healing Circle Grant (1H79TI025514) funds from the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Administration (SAMHSA), U.S. Department of Health & Human Services (HHS). Content is solely the responsibility of the authors and does not necessarily represent the official views of the agency.