Knowledge of tribally-specific cultural beliefs and practices is essential for successfully assisting tribal communities in disasters. Public health planners and emergency responders will be better prepared to support Tribes if they have the advance training and preparation, along with some level of cultural and linguistic understanding, to provide culturally competent services. The 566 federally-recognized American Indian and Alaskan Tribes represent a rich array of diverse cultures, traditions, and histories. When coordinating or providing disaster health, behavioral health or medical services, the sovereign political structures and the diverse cultural histories can present challenges. Because of the diversity of cultural characteristics and governmental structures, it is important for those providing disaster-related support to respect the authority of elected and appointed Tribal Leaders, and their governments, and seek their input and permission before making assumptions regarding what is best for the Tribes. It is equally important to become familiar with the relevant coordination processes, roles and responsibilities of Federal, State, Tribal, local and non-governmental organizations (NGO) that are integral to tribal disaster response.
Research suggests that disasters can create difficulties, specifically among American Indian and Alaskan Natives who are at higher risk of disaster exposure and are often disproportionally affected. The reported rates of psychological distress, substance abuse and/or dependence are twice as high among American Indian and Alaskan Natives as compared to the general population (SAMHSA, 2007
This tool provides some basic resources and best practices to help disaster behavioral health and emergency responders better understand the general status of tribal behavioral health issues, and also provides information on emergency disaster services and/or organizations that support tribal communities. The goal is to provide a beginning frame of reference and several resources that will promote responders’ cultural awareness, as well as help introduce some of the rich culture, values, and traditions that are so important for respectfully assisting tribal communities. Enhanced understanding of the behavioral health specifics, and developing trusted sources of assistance for American Indians and Alaskan Natives can help providers mitigate the adverse effects disasters may have in tribal communities.
Tribal Declaration and Disaster Assistance
On January 29, 2013, President Obama signed the Sandy Recovery Improvement Act of 2013, which amended the Stafford Act. The 2013 Act included a provision to provide federally-recognized American Indian and Alaskan Tribal Governments the option to request a Presidential emergency or major disaster declaration independent of a state. Tribal governments may still choose to seek assistance under a state declaration request. Each region has a tribal liaison who can help tribes seek assistance and who may be able to provide information to disaster responders.
General American Indian and Native Alaskan Behavioral Health Information
American Psychiatric Association
- Let's talk Facts Brochures : American Indians/Alaskan Natives: This resource enhances the ability for behavioral health clinicians to understand some of the behavioral health issues and traditional healing methods of American Indians and Alaskan Natives.
- Mental Health Disparities Fact Sheet : American Indians and Alaskan Natives: This fact sheet provides valuable information on understanding behavioral health status among American Indians and Alaska Natives.
Gift From Within (GFW): PTSD Resources for Survivors and Caregivers
Indian Health Service (IHS)
- Behavioral Health Fact Sheet : This fact sheet provides an overview on the behavioral health status of American Indian and Alaskan Natives while providing background information on the evaluation of behavioral health delivery services in Indian Country.
- Telebehavioral Health LISTSERV : This resource pertinent to behavioral health services provides a venue for tribal behavioral health specialists to share information and provide promising practices to clinicians working in Indian Country.
National Association of State Mental Health Program Directors (NASMHPD)
- Meeting the Mental Health Needs of American Indian and Alaskan Natives: Cultural Diversity Series : This report provides a framework for understanding tribal population’s behavioral health needs, relevant cultural characteristics and traditions, perceptions about mental illness, and preferences for services and supports among Native Americans and Alaskan Natives. In addition, it describes several behavioral health programs that have successfully tailored their services to meet the needs of diverse consumers and contains a comprehensive resource section with recommended readings and organizational resources.
Substance Abuse and Mental Health Service Administration (SAMHSA)
Disaster Behavioral Health Resources
U.S. Department of Health and Human Services – Assistant Secretary for Preparedness and Response- Division of At-Risk, Behavioral Health and Community Resilience (ABC)
U.S. Department of Health and Human Services – Indian Health Service (IHS)
- The Indian Health Service is the principal federal health care provider and health services, including behavioral health services, for all federally recognized Tribes. This website provides an abundance of information and resource links that will aid responders in locating IHS Area Offices and contact information for personnel that manage most health services in Indian Country. Moreover, IHS Areas and Service Units have long established relationships with all Tribes, and are critical partners to aid responders with an integrated and coordinated response and recovery.
Federal Emergency Management Assistance (FEMA)
- Crisis Counseling Assistance and Training Program Fact Sheet : This webpage provides an overview of the Crisis Center Program tailored to provide disaster crisis counseling to individuals and/or communities recovering from the effects of natural and human-caused disaster.
- FEMA and Tribal Nations - A Pocket Guide : This guide provides brief descriptions of FEMA programs, answers questions on how FEMA engages with tribes, explains FEMA’s tribal policies, and provides contact information of regional FEMA members serving tribal nations.
- Ready Indian Country Video : This video contains information specific to Indian Country and tips on how tribal people prepare for emergency situations.
Indian Country Child Trauma Center (ICCTC)
- Trauma in Indian Country: A Guide for Professionals : This guide/pamphlet provides trauma related information for responders working with children and their families to better help responders understand how trauma is experienced among Native families. This resource was funded by SAMHSA and the Southwest Center for Public Health Preparedness at the University of Oklahoma Health Sciences Center.
National Tribal Emergency Council
Substance Abuse Mental Health Service Administration (SAMHSA)
- Cultural Awareness When Working in Indian Country Post Disaster : This fact sheet provides information related to cultural awareness when working in Indian Country after a disaster.
- Promising Practice Disaster Behavioral Health : This archived presentation contains information and strategies for disaster behavioral health planning; although not targeted specifically toward Indian Country, it provides an overview of disaster behavioral health services when working with diverse communities.
- Tribal Disaster Behavioral Health Information Series (TBHIS) Installment : This webpage focuses on working with tribal organizations and offers an extensive list of tribal resources available. It is organized into four categories: (1) Disaster Recovery for Tribal Organizations, (2) Traditional Healing in Disaster Behavioral Health Response, (3) Suicide Preparedness and Response Information, and (4) Cultural Competence When Working with Tribal Populations. The collection includes an annotated bibliography , as well as a helpful links section, which includes links to organizations, agencies, and other resources that address disaster-specific preparedness and response.
- Tribal Training and Technical Assistance Center : This site offers information on Tribal training and Technical assistance services for mental and substance use disorders, suicide prevention, and the promotion of behavioral health to federally recognized tribes, other American Indian/Alaska Native communities, SAMHSA tribal grantees, and organizations serving Indian Country.
- Understanding Historical Trauma When Responding to an Event in Indian Country : This tip sheet helps disaster responders better understand intergenerational trauma in the Native American cultures inflicted over the course of generations, and it offers some strategies for providing more culturally sensitive disaster behavioral health assistance.