Child Abuse and Neglect in American Indian/Alaska Native Communities and the Role of the Indian Health Service

This report is the first study to provide national information regarding the incidence of child abuse or neglect in Indian communities. It also provides comprehensive assessments of the effectiveness of Indian Health Service (IHS) and tribal policies, procedures, and personnel in the recognition and treatment of child abuse and neglect. The report also designs an intervention program flexible enough to be used by American Indian and Alaska Native AI/AN communities across the country. The project described in the report was conducted in three phases. Each phase contained several distinct, but interrelated, components. Phase I included a review of IHS policy and procedures on child abuse and neglect, and a survey and on-site data collection regarding the incidence of child abuse and neglect. Phase II included evaluation of the data obtained in Phase I,additional research and on-site assessments, and the development of a model intervention program. Phase III involved surveying tribal service providers, implementing the model program (New Beginnings) at a pilot site, and disseminating information about this project to Indian communities. The report also discusses the role of IHS in addressing issues of child maltreatment and makes recommendations about how IHS can better fulfill its responsibilities in this area. The report concludes that IHS should promote individual, family, and community wellness; identify families at-risk and provide needed services and links to community resources; and provideadequate treatment and services for identified cases. The report includes an eleven page executive summary

Exploring the Future of Indian Health Information Systems

The Data Policy Roundtable - The Future of Indian Health Information Systems was convened to explore options and develop strategies for future Indian Health Service/Tribal/Urban (I/T/U) program information systems. The concerns and needs of both tribes who chose to contract/compact and those who did not were considered.The focus was on developing strategies to create a new Indian health information system, one that was not an Indian Health Service system but rather a system designed and supported by tribal and urban health care delivery organizations and the Indian Health Service.The participants represented a broad range of concerns and needs. They identified problems, issues, and solutions. Participants generously shared information and reports about the often extensive work their groups have done to assess their needs and study the options available to them to improve their systems to meet their needs.The group benefited from the candid expression of viewpoints coming from representatives of the tribes and urban groups, members of national and regional tribal health boards, medical professionals, and staff from various Indian Health Service divisions, industry experts, and interested observers. As the roundtable discussion of issues, concerns, and options progressed it became clear that in the future an Indian Health Information System would be driven increasingly by the needs of and ultimately directed by the tribes (both those who chose to contract/compact and those who did not) and urban Indian organizations. This report summarizes ten recommendations resulting from the roundtable

Evaluation of the Indian Health Service Adolescent Regional Treatment Centers

This study evaluated the effectiveness and efficiency of, and consumer satisfaction with, the nine regional treatment centers (RTC\u27s) that provide alcoholism and substance abuse rehabilitation treatment to American Indian and Alaska Native youth. The following conclusions are based on the findings of this study. The RTC\u27s have developed effective adolescent alcohol and substance abuse programs, but continuity of care and after-care are the biggest problems in the programs. RTC\u27s need additional mental health staff resources, client-charting improvements, and innovative ways to increase family involvement. Recommendations include improving the continuum of care to adolescent abusers, self-evaluation, and regional treatment centereffectiveness and efficacy

Evaluating the Effectiveness of Alcohol and Substance Abuse Services for American Indian/Alaska Native Women

The major goal of Phase II of this study was to collect and analyze much-needed descriptive, demographic, social, cultural, and clinical information about women receiving treatment in alcohol and substance abuse treatment centers funded in whole or in part by the Indian Health Service. This evaluation provides both qualitative and quantitative information about a group of women who have been traditionally underrepresented in research. The themes and variations that emerged from the evaluation show that the life conditions of the women studied are extreme. For many, adverse or abusive childhood experiences and conditions have carried through into adulthood. The vast majority of women were exposed to physical, sexual, or emotional abuse during their childhood and adult lives. The availability of women-centered, family-focused approaches to alcohol and other drug treatment is severely limited in the United States. The leading obstacle to treatment for women with children is the lack of adequate care for their children while they are in treatment