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ACES in Indian America

August 5, 2010

Studies in the United States are demonstrating what I intuitively know from my experience in Alaska Native country. We have a disproportionately high level of Adverse Childhood Experiences (ACES) among our people. In a letter published in the American Journal of Public Health, December 2005, Vol 95, No 12, the authors related that American Indians had a higher rate of exposure to any trauma (86% vs 52%), and that their exposure to 4 or more categories of trauma was 5 times the norm (33% vs 6.2%). It’s little wonder that the level of adoption of risky behaviors and poor health consequences are so high for Indian Country.

What has been missing are the resources to address the needs of tribal communities. The Indian Health Service, under Dr. Chuck Grimm, tackled the issue of behavioral health by proposing screening for behavioral health issues in their primary care clinics. But the initiative was not funded appropriately or adequately. Screening does nothing to help clients identify their unresolved trauma nor provide the resources to help them process and resolve that trauma. The course of treatment is not always easy, even if you can find a therapist trained in Trauma Informed methods.

What has also been missing is the holistic approach to family healing. Instead, we pursue criminal remedies, such as the initiative pursued by Governor Sean Parnell and his Attorney General, Dan Sullivan. With 39% of Alaska’s prison population already consisting of Alaska Native men, and a high percentage of them there as a result of criminal acts committed while drunk, Adverse Childhood Traumas are perpetuated for the children of those prisoners.

The Indian Health Service and the State of Alaska are also severely underfunding substance abuse treatment. A 30 day inpatient program is difficult to find in Alaska, and aftercare almost impossible to find for Village residents.

Despite all of these strikes, Chugachmiut is committed to building a system to address each of the needs required for a Village based, holistic approach to the elimination of Adverse Childhood Trauma. This means the availability of appropriate types of therapy for those who want it, education and training for appropriate family behaviors, creation of employment opportunities, substance abuse services and great health care.

We have a steep mountain to climb, and it would certainly be nice if our State and Federal Governments got on board.

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