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*All rates are age-adjusted to the standard 2000 population and were collected from the Centers for Disease Control (WISQARS Database), http://www.dcd.gov/injury/wisqars/index.html
Most youth wont go to the mental health clinic. The stigma and shame keeps people away.
--Young Apache
Native American testifying before Congress
Mental health concerns. The reasons why suicide rates are high among the AI/AN population, and especially among youth, are multifaceted and complex. In particular, AI/AN individuals tend to have more serious mental health disorders that are related to suicide, including anxiety, substance abuse, and depression. For AI/AN youth, studies suggest that those who died by suicide were frequently responding to external stimuli such as significant family or interpersonal problems, had been using alcohol, drugs, or both, and tended not to have been seen previously in any behavioral health clinical setting. Stigma. In addition to the issues which can lead up to suicide, the stigma associated with receiving mental health treatment keeps AI/AN individuals from seeking and ultimately receiving care. Barriers to treatment. Because 90% of individuals who die by suicide had a diagnosable psychiatric disorder at the time of their death, it is clear that mental health treatment can prevent suicides. However, treatment is not easily accessible in AI/AN communities because of a lack of funding, culturally inappropriate services, and mental health professional shortages compounded by high turnover rates. This harsh reality is further demonstrated by the fact that there are less than 200 doctoral-level American Indian Psychologistsa severely inadequate number to serve the approximately 1.6 million AI/ANs eligible for health care from the Indian Health Service. All of these barriers to mental health care must be removed. Easily accessible treatment that is both evidence based and culturally appropriate must become available to all AI/AN communities. Such programs must also address suicide postvention that responds quickly and appropriately to one suicide in a community, reducing the risk that others in the community will attempt or die by suicide.
While making treatment readily available is crucial to preventing suicides, there is another element to ensuring a reduction in suicides among AI/NA peoples: stigma on mental health must be broken. As with making treatment available, this can only occur through the implementation of culturally appropriate programs to bring about a proper understanding of mental illness and mental health treatment.
AFSP 1010 Vermont Avenue, NW, Suite 408 Washington, DC 20005 (202) 449-3600 phone (202) 449-3601 fax www.afsp.org
March 29, 2010 AFSP submitted outside witness testimony to the House Appropriations Interior Subcommittee urging the Committee to provide increased funding for the Indian Health Service (IHS) to address its incapacity to provide adequate health care in Indian Country. Currently: The IHS is operating on approximately 59% of what is needed to provide adequate care to AI/AN populations. The National IHS Tribal Budget Formulation Workgroup estimates that the IHS would need a total of $21.2 billion to achieve parity in health care with the general American population. Behavioral health services within the IHS (which includes both mental health and substance abuse) has a total budget of $267 million. This represents only 6.7% of a seriously underfunded IHS budget. Out of 242 Tribal health facilities nationwide, ten percent reported that no mental health services were being provided at all.
AFSP 1010 Vermont Avenue, NW, Suite 408 Washington, DC 20005 (202) 449-3600 phone (202) 449-3601 fax www.afsp.org