The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead Agency responsible for improving the quality and availability of prevention, treatment, and rehabilitation services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses.

SAMHSA has a well established track record in working with Native American tribes and communities. An important aspect of this work has involved consultation with tribal leaders, Native American providers, experts and elders at different phases of project development and implementation. SAMHSA adheres to the belief that early and meaningful community input is an essential factor in successful program outcomes. When SAMHSA was originally established in 1992, it conducted a series of regional meetings to obtain input from constituency groups on the new organization. Tribal leaders and representatives from Native American organizations were actively involved in this consultation process.

SAMHSA has ongoing consultation with its 140 existing Native American grantees. This is a rich source of information that serves to shape learning. In addition to the excellent programmatic efforts that SAMHSA and its three Centers (CSAT, CSAP and CMHS) have undertaken in Indian Country, the Director and IHS Director, Dr. Michael Trujillo have met frequently to discuss areas of mutual interest and concern, to assess the status of joint projects and to explore options for future collaboration. At the staff level, SAMHSA and IHS have built strong relationships that have resulted in numerous exchanges and collaborations.

In the past two years, the SAMHSA personnel office has made a more deliberate effort to reach out to Native American organizations as a way of disseminating job vacancy announcements and other information related to positions in SAMHSA. Additionally, its Office of Extramural Activities Review has worked closely under the Tribal Access Initiative to ensure a significant increase in the number of American Indians who serve on review panels, national advisory councils, and work groups. Since 1987, the American Indian participation rates have increased significantly.

In designing its Strategic Plan, SAMHSA held meetings throughout the country to gain input from diverse constituents. Three focus groups were held with members of the Native American community to obtain their view; their comments and concerns were subsequently incorporated into the plan. More recently, during the regional meetings on performance measurements, SAMHSA ensured that Native American consumers, providers and health officials were represented in substantial numbers at those meetings.

The Center for Mental Health Services has an advisory group, the Native American Children’s Mental Health Partnership Group, comprised of members from 12 tribes, that meets twice a year to provide consultation to the Center on programmatic and policy issues.

The Office of Womenís Services has an advisory committee whose American Indian representatives provide consultation on issues related to this population. CSAP also regularly convenes American Indian Cluster Groups, made up of community partnership and coalition grantees, for consultation. In addition, SAMHSA has had a longstanding working relationship with the National Association for Native American Children of Alcoholics.

• During 1996, SAMHSA and the Indian Health Service collaborated in the design, development and implementation of a special conference, “Expanding the Circle 1996.” The conference was a jointly funded effort and the first intra-agency activity specifically designed to bring together grassroots organizations, tribal leaders, IHS representatives and SAMHSA experts to address critical public health issues plaguing American Indian Nations. The conference was a forum through which American Indians and Alaska Native grantees and programs could exhibit their successes and accumulated knowledge in substance abuse and mental health services treatment and prevention. In 2 ‡ days, in an atmosphere charged with hope and encouragement, the 293 attendees participated in ceremonies and activities through which they experienced belonging, interdependence and generosity firsthand. The recommendations generated by the participants is currently being reviewed for implementation by both IHS and SAMHSA.



• SAMHSA and IHS jointly sponsored a feasibility study of the Cottonwood Treatment Center in Isleta, New Mexico. The purpose of the study is to assess how to convert the facility into a regional substance abuse and mental health center. The Cottonwood Treatment Project will assess the facility construction/design, the program currently in place and their management, the financial management, policies, accreditation/licensure, and quality management. Currently the facility is up and running. Announcements of its opening were made in the September issues of the Isleta Pueblo Tribal newsletter. Arrangements have been made for those in need of transportation. The following services are available under the substance abuse program: prevention and community education, intensive outpatient counseling and aftercare counseling

• In October, 1995, the CMHS sponsored a second national conference ($100,000) in Rapid City, South Dakota to develop and implement strategies that would improve access to State mental health services systems and promote mental health service delivery that is culturally competent and acceptable to the Native American consumer.



• In FY 1995 five American Indian Projects (Arizona, Idaho, New Mexico, North Dakota, South Dakota) and one Alaskan Native (Alaska) Demonstration Project received a total of $2,176,000 from CMHS. These projects focused upon mental health services delivery issues affecting native Americans moving from reservations into states, cities and local communities. Using the knowledge gained from these American Indian projects, several states (Alaska, Oklahoma, Utah, total $305,000 of FY 1995 funding) have new initiatives directed at the native American community.



• Additionally, CMHS has a major employment intervention in Arizona to develop, implement and evaluate models that identify distinct differences with regard to vocational and employment support needs of Native Americans. This five year project is receiving $371,847 for the first year and $2,108,580 for the five year period.

For more information concerning these projects you may contact Mike English, J.D., Director, Division of Knowledge Development and System Change, CMHS, 301-443-3606 or by fax at 301-443-0541.

The CSAP has provided direct assistance to American Indians through 39 grants in FY 1996. SAMHSA has concentrated its prevention work on the American Indian youth and on building strong community coalitions and partnerships. SAMHSA believes that investing in the youth of the American Indian community and building on the American Indian nations strong community bonds will produce the greatest positive impact in the area of substance abuse prevention.

• CSAP grant support has been primarily through the High Risk Youth Program with 19 projects. These projects are conducted in the State of Michigan, Rhode Island, Minnesota, Montana, Wisconsin, New Mexico, Washington, Indiana, Arizona, Alaska, Wyoming, and Oklahoma. Interventions range from individual case management to holistic approaches incorporating traditional health modalities.



• Under the Community Coalition Grant Program, 10 Native American projects are funded. These projects seek to reinforce the intrinsic strengths and values of the American Indians and to use this communal power to prevent problems of alcohol and other substance abuse. These projects are conducted in the states of Alaska, Arizona, California, North Dakota, New Mexico and Nevada.



• CSAP has also funded 2 additional Community Partnership Grants in Oklahoma. The Cherokee Nation, partner in Prevention Project, targets a 14-county area in rural Northeastern Oklahoma, which is commonly referred to as the jurisdictional boundaries of the Cherokee Nation. The predominantly Cherokee population resides in a five-county area. The Tribal membership is approximately 170,000 and about half of this number reside in the jurisdictional boundaries. The Project uses a variety of activities to promote partnerships such as the Youth Educational Summit, the Honoring Our Families conference, and the Youth and Elder Camps. The total funding of these grants for FY 1996 was $3,983,103.



• In addition to the grants mentioned above, CSAP has conducted many other activities that provide opportunity for increased communication and dialogue with American Indian Nations.



• CSAP invited seven Rural and Frontier States to participate in a 4-day Community Team Training Institute (CTTI) in Las Vegas, Nevada, in October/November 1995. The training provided a forum for representatives of State-supported services and representatives of Native American communities to communicate and collaborate in order to improve alcohol, tobacco, and other drug prevention health service for Native American women. At the training, seven teams comprised of both State and American Indian representatives, met to discuss the changing roles and relationships between the Federal government, State governments, managed care organizations and tribal and community programs. Each of the seven teams developed an Action Plan that now has input into program evolutions, service delivery, and constituency building at the State and tribal and community levels.

For additional information regarding the High Risk Youth program, you may contact Mary Jensen, Ph.D., Director, Division of Knowledge Development and Evaluation, CSAP, 301-443-9110 or by fax at 301-443-8965. For information regarding the Community Partnerships program, contact Ruth Sanchez-Way, Ph.D., Director, Division of State and Community Systems Development, CSAP, 301-443-0369 or by fax at 301-443-0526

• CSAT administers the Substance Abuse Prevention and Treatment (SAPT) Block Grant, which is one of the oldest State-Federal partnerships in DHHS. This block grant supports from 12 to 87 percent of the Stateís substance abuse treatment expenditures in 16 States and provides the majority of substance abuse funding. While the SAPT Block Grant provides Federal support to substance abuse prevention and treatment services nationally, it also assists State with designing programs that respond to unique local treatment needs through the technical review process and targeted technical assistance activities. In addition, CSAT is recognized for bringing resources among Native Americans and supporting collaborations between Tribal governments and the State agencies.



• One direct program impacting Native Americans is the Addiction Training Centers Program (ATC). In FY 1996, ATC began training approximately 106 American Indian providers. Funding for this program in FY 1995 totaled $7,448,173 and in FY 1996 it totaled $5,163,665.



• CSAT also provides American Indians support for treatment through programs such as the AIDS Outreach and Linkages Program, the Critical Populations Programs, the Rural, Remote and Culturally Distinct Programs, the Public Housing Program, the Criminal Justice Program, the Pregnant and Postpartum Women Program, and the Residential Women/Children Program.



• The Red Lake Chippewa Indians receive $442,364 through the SAPT Block Grant, to provide substance abuse treatment and prevention services to 4,000 Chippewa Indians in Minnesota. These funds have been targeted for outpatient treatment and prevention services and include individual counseling, group counseling, and peer group counseling. The majority of these services are culturally sensitive and embrace the customs, beliefs and values of the tribe. Several technical assistance activities are on-going to enhance administrative and clinical practices.



• CSATís discretionary grants awarded through difference CSAT programs that serve Native American nations include: the Critical Populations Demonstration Grant Program; the Rural, Remote, Culturally Distinct Populations Demonstration Grant Program; the residential Treatment for Pregnant and Postpartum Women; and the Residential Treatment for Women and Their Children.




Although now in a close-out phase, the CSAT Critical Populations Demonstration Grant Program has served Native Americans since fiscal year 1990, in the following program areas: adolescents; adolescent/juvenile justice; racial and ethnic minority populations; and rural health.

Under the Rural, Remote, Culturally Distinct Populations Demonstration Grant Program, an additional 5 grants have been awarded.

CSAT provides grant funds for specialized treatment for women and their children, including pregnant and postpartum women and their children. These 5-year grants provide comprehensive substance abuse treatment services in residential settings that permit children to live with their mothers during treatment. There are five Residential Treatment for Women and Children (RWC) grants that serve Native American women and their children. Grants are in the following States: Alaska, Minnesota, Oklahoma, South Dakota and Vermont. In addition, Alaska and Wisconsin each have Residential Treatment Programs for Pregnant and Post Partum Women (PPW) grants that serve Native American pregnant and postpartum women and their infants (ages 0-3).

Information concerning Addiction Training Centers may be obtained from Jerome Jaffe, M.D., Director, Office of Evaluation and Scientific Analysis and Synthesis, CSAT, 301-443-6549 or by fax at 301-480-3144.

For further information regarding American Indian targeted activities in SAMHSA, contact Ruth Sanchez-Way, Ph.D., at 301-443-0369 or by fax at 301-443-0526.