American Indian and Alaska Natives (AI/AN) experience higher rates of many mental health and substance use conditions than other Americans. The rural nature of most reservations, provider shortages, and lack of culturally relevant care create challenges to delivering appropriate behavioral health services to AI/AN. However, there is a growing body of evidence-based practices to treat AI/AN and more tribes are taking on management of the services for themselves.  Some states and tribes are working together to improve the behavioral health care delivered to AI/AN.   

This webinar will begin with an overview of the behavioral health delivery system for AI/AN followed by an exploration of two state strategies and offer both state and AI/AN perspectives on each.  

• Oregon, primarily through the work of the Oregon Health Authority (OHA), has dedicated significant resources to improving the delivery of behavioral health services to AI/AN. These include changes to the Medicaid program to better support tribal traditional health workers and enable tribal programs to dedicate more resources to behavioral health services. Oregon also developed intergovernmental agreements with Tribes to administer multiple programs and made a direct investment of over $11 million through Tribal Behavioral Health Resource Networks to make treatment for substance use disorder more readily available. 
• Oklahoma’s Department of Mental Health and Substance Abuse Services has worked to ensure that the needs of AI/AN are considered in implementation of state policies including the 988 suicide hotline rollout and expansion of mobile crisis teams. This has provided opportunities which some tribes have leveraged to deliver services to members. For example, the Choctaw Nation worked with the 988 contractor to develop a referral program to ensure that members could access the Nation’s mental health providers.