Academic Psychiatry 23:222, December 1999
© 1999 Academic Psychiatry
A Unique Academic Committee on Native American Psychiatry
Scott H. Nelson, M.D.,
Mary Roessel, M.D.,
Michael Biernoff, M.D.,
Philip A. May, Ph.D. and
Tina Lujan, Dr. Nelson was chief of the Mental Health and Social Services Program for Indian Health Services (IHS) Headquarters and chair of SCONAP from 1989–1997. Dr. Roesel is a psychiatrist at the Shiprock Indian Medical Center. Dr. Biernoff was chief of Behavioral Health Services of the Albuquerque Area Office, IHS, and chair of SCONAP (1997–1998). Dr. May is Director of the Center for Alcoholism, Substance Abuse, and Addictions at the Department of Psychiatry, University of New Mexico (UNM) Health Sciences Center and vice chairman, SCONAP. Tina Lujan is administrative assistant to the chair of the UNM Department of Psychiatry and Recording Secretary for SCONAP.
Key Words: Native Americans • Alaska Natives • Minorities
TO THE EDITOR: We are writing to inform you of the development and activities of a unique academic committee that was formed specifically to address mental health issues of Native Americans in New Mexico. We believe that the committee's unique process and varied work products demonstrate the usefulness of similar cultural efforts at other academic departments of psychiatry.
In 1989, Mary Roessel, M.D., a second-year Navajo psychiatric resident at the University of New Mexico proposed an Office of Native American Psychiatry within the Department of Psychiatry. The primary reason for the proposal was to increase the number and cultural sensitivity of activities conducted by the department. The committee developed goals and objectives that included the fostering of research, cross-cultural teaching, development of resident rotations, and sharing of information with the Indian Health Service (IHS), which maintains both Area and Headquarters West Mental Health offices nearby in Albuquerque.
In 1991, the office was renamed the Steering Committee on Native American Psychiatry (SCONAP). A survey was sent to all faculty and staff of the department asking about interest and expertise in Indian mental health and willingness to participate in the committee's activities. Remarkably, 46 responses were received.
SCONAP membership was originally limited to about a dozen professionals selected by the department chair from the faculty and IHS, but in 1992 membership became voluntary rather than appointed. This change allowed all department faculty, residents and staff, IHS officials, and interested others to participate.
Most American Indian initiatives of the department would not have been undertaken without SCONAP's energy and organization. The range of activities undertaken by SCONAP has been limited only by the creativity of its members. Examples of SCONAP activities have included the following:
1. Development of three American Indian Mental Health courses at the university. Each course attracted almost 100 registrants, who learned about Navajo, Apache, and Pueblo culture and language, concepts of mental health and mental illness, and specific cross-cultural approaches to counseling and healing.
2. Ongoing review and comment on major Indian mental health plans and studies. These included a year-long major state study on mental health programs and service needs of New Mexico Indians, a study of urban Indian mental health needs, and a national Indian Suicide Prevention Report.
3. Development of a new policy on treatment and referral of Indian patients who presented at UNM Mental Health Center (MHC) during off hours.
4. Feedback and input on several proposed and ongoing Indian research projects conducted by department faculty and trainees and related to anxiety, substance abuse, Indian teen centers, and symptom screening.
5. Encouragement of psychiatric resident rotations in IHS mental health programs, with subsequent reports to the committee from participants. IHS rotations have been one of the most popular rotations in the department's well-established rural psychiatry program.
6. Contributions to various conferences, including the annual "Navajo Values Conference" organized by Dr. Roessel's family, the "National Conference on Native American Persons With Serious Mental Illness," and the annual departmental multicultural conference.
7. Review and encouragement of various other collaborative Indian projects, including the National Institute of Mental Health–funded "Depression Awareness Program," which the department implemented in three IHS areas: the state Indian family advocacy and crisis-response team projects funded by SAMHSA (Substance Abuse and Mental Health Services Administration) and the establishment of the annual child mental health fellowships for Indian social workers at the University of New Mexico Children's Psychiatric Hospital.
Perhaps equally beneficial to these substantive accomplishments, however, is the opportunity that SCONAP meetings provide for communication, collaboration, and support among committee members. It is common after a meeting to find two or more SCONAP attendees discussing issues of common concern, setting up meetings to pursue a new initiative, or just getting acquainted.
SCONAP meetings last for 1 hour and are held once a month. Uusally, 10 to 15 persons attend. Minutes are prepared by the chair and Ms. Lujan, and are distributed along with other key documents to those who are not able to attend meetings.
SCONAP has proved of great benefit to all parties concerned. It serves as a source of current information on Indian mental health issues for the department so that the departmental initiatives can be realistic and culturally sensitive. It has led to department support for issues of training and research of interest to the IHS, New Mexico tribes, and others. It has served as a forum for professional support, sharing of information on diverse topics ranging from legislation to research, and development of creative initiatives. It seems safe to say that many collaborations of mutual benefit would not have occurred without the opportunity provided by SCONAP meetings.
Key factors in the success of SCONAP include 1) the presence of culturally unique underserved populations, that is, the 22 tribes of American Indians in New Mexico and a substantial population of Indian persons living in urban areas; 2) support of the key actors in the academic, Indian, IHS, and state mental health programs; and 3) the committment of committee members to attend meetings, identify new and creative initiatives and solutions to problems, and to make time and effort to follow activities through to completion.
Table 1 provides a list of other references for further reading. We believe that a modified SCONAP model can be useful in developing similar collaborative efforts among academic departments of psychiatry, state mental health programs, mental health programs that serve multiple ethnic groups, and others who are interested in improving mental health services for persons of color.
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