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Sequestration Hits Indian Country's Mental Health Services

BY LAUREL MORALES -- Indian reservations are being hit particularly hard by sequestration. Centuries-old treaties tie them to federal funds for things like health care, education and housing, but time and time again those funds are cut.

Mental health services are most vulnerable. Suicide rates in Indian country are nearly four times the national average.

Amber Ebarb said sequestration undermines American Indian treaty rights and makes a dire situation even worse.

"The suicide epidemic is symptomatic of something that’s much deeper," Ebarb said. "There’s also the issues of historical trauma that continue to plague our communities."

Ebarb is policy and budget analyst for the National Congress of American Indians. Her fears were echoed by Cathy Abramson speaking before a Senate Committee last spring.   

"We can’t take any more cuts," Abramson said. "We just can’t."

Abramson heads the National Indian Health Board. She says the sequestration cuts are literally a matter of life or death for American Indians.

"Since the beginning of the year there have been 100 suicide attempts in 110 days on Pine Ridge," Abramson said. "Because of sequestration they will not be able to hire two mental health service providers."

And that South Dakota tribe isn’t unique. American Indians and Alaska Natives have the highest rates of suicide of any ethnic group. The Navajo Nation in Arizona is trying to curb those numbers with programs now threatened by sequestration cuts.

A youth conference in Flagstaff was possible because of federal dollars. More than 200 Navajo teens were here, learning self-reliance to stay off drugs, out of gangs and away from feelings of isolation.   

"As young as 9 years old we’ve heard of kids committing suicide, all the way up to the elders, you know, grandmas and grandpas," said Ty Etsitty, a behavioral health counselor. "It doesn’t discriminate."

Native Americans for Community Action, or NACA, works at the grassroots level to combat suicide among American Indians. The organization provides free or low-cost mental and physical health care in Flagstaff.

Brandy Judson manages NACA’s suicide prevention program.

"Having done a screening in a school and identified several youth who had either prior attempts or extreme thoughts of suicide," Judson said. "Seeing them now almost a year later having gone through counseling and feeling much better and no longer having those thoughts it’s really powerful."

Behavioral Health Counselor Ty Etsitty teaches teens to connect with their culture to feel less isolated.

But NACA has constantly faced funding cuts, threatening their ability to help the community over time.

"This isn’t a three-year job," Judson said. "You don’t do suicide prevention for three years and fix the problem. This is a long-term problem that is going to take decades."

Eighty percent of NACA’s budget comes from the federal government. They’ve already seen a 5 percent cut in funding this year, and there’s no certainty that suicide prevention funds will be available in coming years.

"Everything in the facility gets squeezed tighter and tighter and tighter," said Don Downey, NACA's chief financial officer. "Sequestration ends up hitting the person on the street the hardest. People who are relying on services they are the ones who are going to suffer from all of this. We are at the very beginning of something that I feel is as big as an iceberg."

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