(L to R) Dan Press; Ann Bullock, IHS; Alec Thundercloud, IHS; Camille Loya, HHS Administration for Children and Families; Geoff Roth, IHS; Commissioner Lillian Sparks Robinson.
Commissioner of the Administration for Native Americans Lillian Sparks Robinson met with representatives of the Roundtable on Trauma-Informed Native American Communities on March 30 to address concerns highlighted in a December 17 letter sent to HHS Secretary Sylvia Burwell by 12 U.S. senators. That letter asked for a comprehensive policy for addressing complex trauma, including historical trauma, in Native American communities. In Secretary Burwell’s response of Feb. 26 to the senators, she designated Robinson in her role as chair of the Intra-Departmental Council on Native American Affairs (ICNAA), to develop “a comprehensive, integrated Departmental policy to address complex trauma in Native American communities.”
In her opening remarks, Robinson said that a policy was under development in ICNAA even before the Secretary’s letter and that divisions within the U.S. Department of Health and Human Services (HHS) and other departments such as the U.S. Department of Agriculture are working on resilience-building initiatives, especially aimed at Native youth.
According to Dan Press, who leads the Roundtable and organized its participation in this meeting, the apparent enthusiasm of HHS about this initiative seems to be anchored in a larger vision of building resilience in Native American communities, clearing the way for this to be a well-supported departmental undertaking. Two HHS officials at the meeting who are working with the Commissioner—Geoff Roth, senior advisor, Indian Health Service (IHS), and Camille Loya in the HHS Administration for Children and Families, Administration for Native Americans—were well informed and engaged on the issues raised, according to Press.
Other HHS participants included Dr. Alec Thundercloud, director, Office of Clinical and Prevention Services, IHS, and Dr. Ann Bullock, who heads the IHS Division of Diabetes Treatment and Prevention. Mirtha Beadle of SAMHSA joined by phone.
Also joining by phone were Roundtable members Dr. Tami DeCoteau, a Bismarck, ND, psychologist; and Pilar Gauthier, director, of the Maehnowesekiyah Wellness Center in Wisconsin. Gauthier described a number of programs serving the Menominee Indian Tribe, including the Center’s Wraparound Program that would serve as a model for other tribes. The Wraparound Program is a strength-based process that involves an individual’s family and creates a team of people who will help people develop and implement their own plan to move forward in their lives. Funding for the program is derived from medical assistance and other sources.
Gauthier emphasized the importance of addressing the root causes of the problems that exist on reservations, especially ACEs and historical trauma, in order to reduce their consequences—suicide, substance abuse, obesity, high drop-out rates and poverty. Without “community engagement”, real progress cannot be achieved, according to Gauthier. She believes the tribes’ success stems from this engagement along with education about the science of trauma and breaking down silos to allow access to resources.
A major issue addressed at the meeting was the need to break down silos among agencies serving individuals and creating sustainable sources of funding for programs. Bullock said the IHS diabetes program recognizes that treating and preventing illness requires addressing socio-economic factors and is able to spend money on programs and services that are non-medical. The example she provided was paying for education classes that could improve the economic future of an individual, reducing stress and, by doing so, improve his or her health. Bullock also mentioned the home visiting program as an effective early intervention strategy.
In addition to educating HHS personnel and the tribes about trauma, another key recommendation made to the federal officials was to conduct a pilot in a tribal community that could serve as a model for other tribes seeking to become trauma-informed. Breaking down silos and encouraging cross-agency cooperation was unifying theme of the meeting. President Obama’s recent executive order establishing a mental health and addiction parity task force was cited as an example of a promising approach for structuring inter-agency collaboration on Native American trauma. The conversation will continue on implementing trauma-informed policies and procedures through out the federal government as they affect Native American communities.