Researchers have long pointed to the importance of incorporating cultural practices into behavioral health care for Native Americans.
By Laura Bargfeld Cronkite News HOUCK – In a remote hogan near the southern edge of the Navajo Nation, Wayne Wilson lights a fire, lays out eagle feathers and remembers his grandfather’s teachings.
Native Americans report experiencing serious psychological distress 2.5 times more than the general population, federal data show. And although overall suicide rates are similar to those of white people, there are key differences among certain age groups – with suicides among Native Americans ages 15 to 19 more than double that of white youth.
Traditional healing rituals have always been a part of Indigenous culture. Whereas Western medicine focuses on curing, often through the use of medication, Indigenous healing aims to reestablish harmony and balance – more akin, experts say, to “recovering one’s wholeness.” The health center in Chinle has four traditional healers on staff to provide services and two hogans and sweat lodges for ceremonies. At a patient’s request, traditional healing can be integrated alongside Western medicine, all at no cost.
One of the rare studies published on Native healers, a 1998 study in the Archives of Internal Medicine, found that more than 60% of Navajo patients surveyed had seen a traditional healer and about 40% used them regularly. A 2011 federal report found just 33% of 514 IHS and tribal facilities providing mental health services offered traditional healing. And many of those clinics are located on or near reservations, even though 70% of Native Americans live in urban areas.
In 2015, Arizona established a workgroup to help develop parameters and potential payment methodology related to traditional healing for federal and state Medicaid officials to consider. CMS declined additional comment about why the change has taken so long. It so far has not approved reimbursement for traditional healing for any state. A spokesperson said the requests “are still under review.”
“This has the potential to sustain them … and to maybe even increase the number of traditional providers that are in their systems,” said Kim Russell, director of the Arizona Advisory Council on Indian Health Care, which works to increase access to health programs for the 300,000 Native Americans living in Arizona.
“Some of the services can only happen in our traditional dwellings,” she said. “Would I have to travel all the way back five hours north to get that service?”Alaska’s Behavioral Health Aide Program, founded in 2009 by the Alaska Native Tribal Health Consortium, trains people in the state’s rural and Indigenous communities to provide culturally appropriate behavioral health prevention, treatment and recovery services.
Beyond financial barriers, one of his biggest concerns is how to ensure these practices carry on for generations to come. He strokes a feather as he speaks. Wilson uses this particular feather in talking circles for youth who struggle with alcohol and drugs. It once belonged to his daughter, Nesbah.Nesbah died of an overdose last year after a long battle with drug addiction. She was 27. Wilson shares pictures of her on Facebook, speaks about her to anyone who will listen, and carries pieces of her with him.He holds up another feather that once was hers. He’d hoped to give it back to her when she got sober.
On a weekday morning at Diné College, Denny stands in front of 13 students for an introductory class on Navajo culture. The glow of a projector illuminates him. Windows frame a scenic landscape of mountains and trees.He assigns them homework, including an essay they must write about themselves. He wants the next generation to know who they are and where they come from – to find personal stability and balance but also to preserve their culture.
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