Last week we announced the launch of Tribal Behavioral Health, our new line of services intended to address the shortage of behavioral health resources in Indian Country. Tribal Behavioral Health offers a full spectrum of services to treat mental illness, mood disorders, and substance misuse. On the surface, this might seem an expansion of our mission – bringing quality improvements, top-tier providers, and culturally intelligent care to behavioral health facilities in Tribal nations.

But Tribal Behavioral Health is a little different. While we’re still bringing those standards to every engagement, our partnerships will also offer:

• Integrated medical and behavioral care
• Design and implementation of clinical programs
• Wraparound services and reintegration programs
• Guidance regarding regulatory compliance
• High-quality locums and long-term staff for behavioral health programs
• Long term management and operations of behavioral health facilities

Tribes can start from scratch, working with us to create any kind of behavioral health program they need. From adding psychiatrists or counselors to an existing clinical program to designing an inpatient substance abuse treatment center, we can tailor our services to meet any facility’s needs.  We also work with our architectural partner to build facilities – from clinical buildings to patient housing to community wellness centers.

The Treatment Shortage in Tribal Nations

Nearly 1 in 5 U.S. adults live with a mental illness. Historical trauma, underfunding of healthcare, and poverty have put Native Americans at higher risk for substance abuse and mental illness; the pandemic has also seen a rise in fatal overdoses, along with increasing levels of anxiety, depression, and trauma.

But while the need for services is clearly there, the services themselves often aren’t. Most rural areas and Tribal nations suffer from an extreme shortage of behavioral health providers. Our Behavioral Health Director Denny Haag, who previously led an Indian Health Service facility, observed that many Indigenous patients cannot find certain components of behavioral health programs in their own communities, such as inpatient psychiatric care after suicide ideation.  Many of these patients experience discrimination in non-Native clinical environments, which can dissuade them from continuing treatment. These patients are often sent to psychiatric care facilities located a significant distance from the patient’s home, which makes it incredibly difficult for families to be there for emotional support when it is needed the most.

That’s why our approach to behavioral health is different on several fronts. Here’s what that looks like.

Load-Balancing Behavioral Healthcare

Mental illness isn’t an ear infection or broken bone. A patient reporting to an emergency room with suicidal ideation may be stabilized in a psychiatric unit for a few days before being released with a follow-up appointment. Someone struggling with addiction completes a 28-day program. Yet those are just some of the chapters in the behavioral health story. Mental illnesses and addictions rarely begin and end in clearly defined windows; often they are ongoing and cyclical. Relapse can recur often with some addicts. Someone struggling with a mood disorder or the aftermath of trauma may move in and out of levels of functionality.

To support patients and communities at every stage of the mental health journey, Tribal Health focuses on prevention, education, recovery, and reintegration services too.

Integrated Care: Primary, Emergency and Behavioral

Another gap we’re addressing is the separation of medical and behavioral treatment. Mental illnesses are often accompanied by medical conditions. People with depression have a 40% higher risk of developing cardiovascular and metabolic diseases than the general population; patients with serious mental illness are nearly twice as likely to develop those conditions. But it’s all too common for medical and psychiatric treatment to occur in siloes, or for a patient’s treatment for a chronic condition get put on hold when they’re admitted to an inpatient program.

Tribal Behavioral Health is closing these gaps by providing an integrated, holistic experience that treats the whole patient. Cross-coordinated primary, emergency and behavioral care ensures we connect patients to the right resources, while their providers collaborate and communicate more effectively.

Full Spectrum of Services

Patients can enter a behavioral health system at any point in their illness. A fifteen-year-old boy may be admitted into the ER for alcohol poisoning; a fortysomething woman with untreated bipolar disorder may encounter police. A senior experiencing depression for the first time may contact a telehealth service or request an appointment with a psychiatrist. An opioid dependence may be discovered during treatment for a chronic condition or injury.

To ensure these patients receive the right treatment at the right stage, we offer assistance with the design of complete behavioral health ecosystems for:

• Detox and addiction recovery services
• Residential services, with housing and structured space for individual, group, and experiential care
• Partial Hospitalization Programs (PHP), with separate housing and programming depending on Tribal preference
• Intensive Outpatient Programs that include evidence-based approaches
• Ongoing Medication Assisted Treatment (MAT) programming, including longer-term detox from opiates
• Reintegration services, such as back-to-work programs and recovery support

Finally, every great project or program improvement begins with a well thought out plan. Tribal Behavioral Health clients can count on cohesive program design and operations. The facilities we work with don’t have to worry about managing a variety of disconnected consultants. We pull all Tribal input, healthcare, and project design experts together to create a smoothly coordinated and high-performing team.

Our desired results are three-fold: to assist in creating stronger tribal behavioral health facilities and programs; to assist in the creation of healthier communities; and to assist in the development of a kinder, more transformative healthcare experience for Indigenous patients.

Get Involved with Tribal Behavioral Health

If you’re interested in working with Tribal Health – or working for us – reach out to Denny Haag, Director of Behavioral Health, at dhaag@tribalhealth.com or 712-899-8624. And be sure to visit www.tribalbehavioralhealth.com to find out how we can partner with you to create a world-class behavioral health and substance disorder treatment solutions.