Behavioral Health Among American Indian and Alaska Natives: An Overview

Summary

Behavioral health problems (e.g., mental disorders, substance use disorders, and suicide) among the American Indian and Alaska Native (AI/AN) population have been the subject of multiple congressional hearings, introduced bills, and Administration initiatives in recent years.

Research on AI/AN behavioral health demonstrates three key points: Relative to the general U.S. population, the AI/AN population has (1) a high prevalence of risk factors for behavioral health problems, (2) a high prevalence of behavioral health problems, and (3) limited access to care for behavioral health problems. Improving behavioral health among the AI/AN population is a challenging task that requires collaboration among federal agencies, tribal governments, other organizations, communities, and individuals, especially in a resource constrained budget environment.

Within the U.S. Department of Health and Human Services (HHS), two key agencies conduct activities designed to improve AI/AN behavioral health: the Indian Health Service (IHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). IHS is the lead federal agency on health care (including behavioral health care) among the AI/AN population. SAMHSA is the lead federal agency on behavioral health care among the general population (including the AI/AN population).

This report describes IHS and SAMHSA programs (listed below) that specifically target behavioral health in the AI/AN population; it does not include every IHS or SAMHSA program available to support behavioral health in the AI/AN population.

IHS Programs

Fetal Alcohol Spectrum Disorders

Integrated Substance Abuse Treatment in Primary Care

Methamphetamine and Suicide Prevention Initiative

Youth Regional Treatment Centers

Behavioral Health Integration with Primary Care

Telebehavioral Health and Workforce Development

Zero Suicide Initiative

SAMHSA Programs

Systems of Care

Circles of Care

Garrett Lee Smith (GLS) Youth Suicide Prevention—Campus

GLS Youth Suicide Prevention—State/Tribal

Native Connections

Project LAUNCH

Strategic Prevention Framework–Partnerships for Success

Drug Courts

Understanding the relationship between AI/AN behavioral health problems and related federal programs may help policymakers consider policy options affecting the AI/AN population. Policymakers could amend, eliminate, or create programs; require different types of coordination or information; and/or provide additional oversight.