Issue 2: Lack of Culturally-based Service Models
Goal: Support the development of more culturally-based service models that are locally determined and have broad-based community involvement.
Traditional healing seeks a sense of wholeness with people, cultures and communities. Before contact with Western civilization, the indigenous people of Alaska depended on a knowledge of anatomy, herbal medicine and other healing practices for health maintenance. Generally, traditional healing focused on the person in the context of their community, rather than on a discreet biomedical illness. The emphasis was on health, not disease. Disease and illness, including mental illness, were not perceived as items to be conquered and removed from life, but as natural parts of the person and life itself.
In many Native nations, the power of healing came from a spiritual source and was given to the people. This power was seen as a renewable resource--the more healing was received, the more there was to give. Healing became continually available to all as a gift to be shared, seeking to empower people and liberate them from obstacles to their well being.
In the 1900's, Western-trained medical practitioners became an increasingly important source of health care for Alaska Natives. This occurred simultaneously with the discouragement of traditional beliefs and practices by Native persons. In this way, a healing-oriented social system that had been ideally suited to its purpose, was replaced by another system which was ill suited to the social, physiological and psychological needs of Alaska Natives.
To ensure greater local ownership of mental health issues, there is a need to support rural communities in validating their cultural framework, and applying this framework to the development of service models and prevention efforts. Traditional practices such as mentoring relationships with elders can be an especially effective prevention and early intervention strategy. Each community must establish and maintain a process for broad-based community involvement to define its approach to mental health issues. In many communities, this process has already begun.
At the same time, it is important to recognize that traditional culture is stronger in some communities than in others. The extent and form of culturally-based service and prevention models should be determined through the coordinated input of village councils, elders, community leaders, mental health and substance abuse service providers, legal personnel, school officials, health practitioners, etc. In this way each community can decide for itself how traditional its approaches to prevention and mental health service provision will be.
131. Sponsor regional and statewide forums to highlight and validate current village-based cultural approaches to mental health service provision.
Responsible party: Alaska Mental Health Board, Division of Mental Health and Developmental Disabilities, Division of Alcoholism and Drug Abuse, regional health corporations
132. Increase cultural awareness training for providers of mental health services to rural communities; whenever possible, this training should be provided by rural community members.
Responsible party: Division of Mental Health and Developmental Disabilities, Division of Alcoholism and Drug Abuse
133. Provide technical assistance/funding incentives to rural communities that demonstrate a commitment to broad-based community involvement in addressing mental health-related issues.
Responsible party: Division of Mental Health and Developmental Disabilities, Division of Alcoholism and Drug Abuse, Division of Family and Youth Services, Alaska Mental Health Board, Alaska Mental Health Trust Authority
134. Work with the Department of Social Work, School of Nursing and other pertinent University programs to increase the enrollment of rural students, enhance distance delivery of degree programs, and maximize curriculum emphasis on culturally-responsive service provision.
Responsible party: University of Alaska (especially the College of Rural Alaska), Alaska Mental Health Board