By Patricia L. Kirk

The Denver Indian Family Resource Center (DIFRC) has received a five-year, $60,000 annual grant from the Colorado Trust to implement a culturally appropriate mental health system network in the Denver area for vulnerable Native American children and their families.

The grant enables the organization to hire a family therapist to provide direct mental health services to children and their families and serve as a liaison and cultural resource to the region’s mental health community to educate providers in providing culturally appropriate care for Native Americans. “This therapist will work with patients and the broader mental health provider community to build a network of culturally appropriate care,” said Isabelle Medchill, DIFRC program development director.

The Colorado Trust grant program is part of an equality in health care initiative aimed at increasing cultural competency among providers serving ethnic groups to decrease health disparities, explained Ginger Harrell, program officer for the Colorado Trust, noting that DIFRC was selected to receive this grant based on a demonstrated readiness and commitment to increasing cultural competencies. “The staff there is extremely committed, and the passion they have for moving forward is really beautiful to see,” she added. “This grant will allow them to build on what they’re already doing and expand on
services.”

DIFRC previously received a three-year, $319,714 planning grant from the Substance Abuse and Mental Health Services Administration for Circles of Care, a cooperative project of the Indian Health Service and National Institute of Mental Health.

Circles of Care was established to create a culturally appropriate mental health service model for Indian children by developing a strategy for educating a network of providers in the broader mental community about shared beliefs and tribal differences, customs, norms and histories to remove cultural barriers and improve access and the quality of care provided. Grant recipients receive support services from the National Indian Child Welfare Association and Circles of Care Evaluation and Technical Assistance Center at the University of Colorado Denver Health Sciences Center.

The SAMHSA project was launched following a report from the Institute of Medicine indicating that prejudice and stereotyping by providers is contributing to disparities in the quality of health care services provided to racial and ethnic minorities compared with whites, even when access factors ,such as ability to pay, are equal.

In the case of Native Americans, disparities are a result of both environment and culture. Native Americans as a group suffer from a disproportionately high degree of social problems, along with “historical trauma” caused by genocide and other abuses inflicted on them by government over the last 200 years, pointed out Maria Yellow Horse Brave Heart, a Lakota tribal member, professor of Native American cultural Studies at Columbia University and Circles of Care technical team member.

Consequently, Native Americans are distrustful of public health care institutions and, to a lesser extent, private, non-Indian providers, she added, explaining that mainstream providers generally lack understanding of how intergenerational trauma plays out in relationships and the resulting cultural nuances and behaviors.

DIFRC used SAMHSA funding to launch Keeping the Circle Whole, a project developed to close the gap in mental health services for Native American children by creating a culturally sensitive network of mental health providers and providing access to services that strengthen families.

The project initiated a needs assessment by Denver-baser JVA Consulting LLC that provided a first-ever look at the American Indian/Alaska Native (AI/AN) population in the Denver metropolitan area, according to Naomi Harris, grant writing and communications associate for JVA Consulting. She said the size of Denver’s Native population, which totals 27,000 people from 60 different tribes, was unknown until the 2000 Census, when respondents were allowed to check more than one box for race.

The study produced a profile of people who derive strength from their heritage and fear losing their traditional values and disconnection from historic culture. They also experience a high degree of racial discrimination, suicide, alcohol and drug abuse, depression and other social problems.

The needs assessment, which included members of both the Native American and mental health provider communities, identified environmental and cultural barriers that contribute to disparities in health care in the Native American community, including lack of transportation, health insurance, jobs, childcare and decent housing, as well as stereotyping by mental health providers who lack knowledge of Native American culture and the role it plays in the daily lives of this group.

“There is a huge mix of people from all backgrounds and mix of ethnic groups,” Harris said, pointing out that the Denver Native American community is a result of dissolving reservations and resettlement of Indians off reservations to find gainful employment.

“An interesting thing is that in order for the