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Building a Holistic Health Care Approach at IHS During Missing and Murdered Indigenous Persons Awareness Day

by Nicole Stahlmann, MN, RN, SANE-A, AFN-BC, SANE-P, FNE-A/P, Forensic Nurse Consultant, Division of Nursing Services

May 5th is recognized as Missing and Murdered Indigenous Persons (MMIP) Awareness Day. This is a day to help remember and honor our Indigenous relatives who have gone missing or were murdered, and a day to raise awareness to offer prevention efforts within our communities. On this day, we ask that you please wear red to help raise awareness to support an end to this crisis.

Violence remains a health care issue and is a root cause of the MMIP epidemic. Homicide, sexual assault and abuse, human trafficking, and domestic and intimate partner violence relentlessly plague Native American communities. Facing murder rates more than 10 times the national average in some communities, homicide is a leading cause of death for American Indians and Alaska Natives. In 2019, homicide was the fifth leading cause of death for Native males and the seventh leading cause of death for Native females aged 1–54 years. Interpersonal conflict is viewed as a predominant circumstance, with nearly half of all homicides precipitated by an argument, and for female victims, 45 percent are precipitated by intimate partner violence.

The IHS, Tribal, and urban Indian organizations are working to build a holistic and comprehensive health care approach to care for patients following violent crimes. At this time, there are 37 facilities that offer medical forensic examinations by trained health care providers. Each of these Indian health system facilities have trained health care providers who have gone through more than 40 hours of specialized forensic health care training and education. They also receive numerous hours of ongoing training and education to provide culturally responsive, patient-centered, trauma-informed health care to patients, families, and Tribal communities impacted by violent crimes.

Providers are enhancing their policies and procedures based on best practices; establishing a foundation for program development, operations, and sustainability; offering education to Native communities to help with prevention efforts; and working closely with their multidisciplinary team members to improve the response within their communities. They are mindful that prevention efforts are stronger through cultural community connections.

Helpful Resources:

For Providers:

  • The National Human Trafficking Hotline – Report Trafficking (advocates are available 24/7 to take reports of potential human trafficking).
  • StrongHearts Native Helpline – 844-7NATIVE (762-8483). 24/7 safe, confidential helpline for American Indian and Alaska Native relatives impacted by domestic and sexual violence.
  • Administration for Children & Families. SOAR online offers free, self-paced training courses that participants can complete anytime, anywhere. Foundational courses introduce the SOAR (Stop-Observe-Ask-Respond) Framework, equipping participants to identify individuals who may be at risk of, currently experiencing, or have experienced human trafficking, and connect them with appropriate support and services.
  • Are you or someone you know interested in becoming trained as a sexual assault examiner/forensic examiner?
    • Through the Forensic Nursing Consultant Program contract, Texas A&M University Center of Excellence in Forensic Nursing is offering forensic health care related training courses for our IHS, Tribal, and urban Indian organization providers (courses such as forensic examiner training, clinical skills labs, and more. CEs/CMEs are available). Visit their website to register for courses: Continuing Education and Professional Development (tamu.edu).
    • Nurses United Against Human Trafficking – is offering 9 CEs/CMEs of human trafficking training and is free to all IHS, Tribal, and urban Indian organization providers. Reach out to Nicole.Stahlmann@ihs.gov if you are interested in registering for this course.
Nicole Stahlmann, MN, RN, SANE-A, AFN-BC, SANE-P, FNE-A/P, Forensic Nurse Consultant, Division of Nursing Services
Nicole Stahlmann, MN, RN, SANE-A, AFN-BC, SANE-P, FNE-A/P, serves as the forensic nurse consultant with the IHS Division of Nursing Services. Prior to her work with IHS, she served as a forensic nursing specialist with the International Association of Forensic Nurses and was the clinical program manager for the District of Columbia Forensic Nurse Examiners. Stahlmann was an emergency department nurse and adjunct instructor, teaching both undergraduate and master prepared students at Georgetown University. She continues to practice clinically, providing care for patients who have experienced violence.
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