§1667 — Title 25 Indians | U.S. Code

Summary

Requires the Secretary to run a pilot project testing mental health care delivered by phone or video (telemental health) to prevent, intervene in, and treat suicide among Indian youth. It says suicide is much higher for American Indians and Alaska Natives: overall 1.9 times the U.S. rate, and youth ages 15–24 are 3.5 times the national rate and have the highest rate of any group. In 2005 suicide was the second-leading cause of death for ages 10–34. Male rates for ages 15–24 can be up to 4 times higher than males of other races and up to 11 times higher than females of other races. Females attempt suicide 2 to 3 times more often than males. Some tribes, especially in the Great Plains, have rates up to 10 times the national average. Many risk factors are more common in Indian country (for example, past attempts, family history, mental illness, substance abuse, health gaps, stress, easy access to lethal methods, exposure to others’ suicidal behavior, isolation, and incarceration). Deaths are often undercounted because of limited local resources. In 2007 the Indian Health Service had about 17% physician and 18% nursing vacancy rates. About 90% of teens who die by suicide had a diagnosable mental illness; more than half had never seen a mental health provider; and one-third of health needs in Indian country are mental health related. Federal programs (including a 2003 initiative) and a 2001 national strategy involve major HHS agencies (SAMHSA, the Service, CDC, NIH, and HRSA) and use technology to help. The pilot must test psychotherapy, psychiatric assessments, diagnosis, treatment for mental health and substance use, and give clinical advice and training to frontline providers. It must support training for community leaders, families, and school or health workers; create culturally relevant education materials; collect and report data; encourage tribes and providers to use predoctoral psychology and psychiatry interns; and strengthen mental health services through existing SAMHSA grant programs.

Title 25, §1667

Indians — Source: USLM XML via OLRC

(a)Congress finds that—

(1)(A)the rate of suicide of American Indians and Alaska Natives is 1.9 times higher than the national average rate; and

(B)the rate of suicide of Indian and Alaska Native youth aged 15 through 24 is—

(i)3.5 times the national average rate; and

(ii)the highest rate of any population group in the United States;

(2)many risk behaviors and contributing factors for suicide are more prevalent in Indian country than in other areas, including—

(A)history of previous suicide attempts;

(B)family history of suicide;

(C)history of depression or other mental illness;

(D)alcohol or drug abuse;

(E)health disparities;

(F)stressful life events and losses;

(G)easy access to lethal methods;

(H)exposure to the suicidal behavior of others;

(I)isolation; and

(J)incarceration;

(3)according to national data for 2005, suicide was the second-leading cause of death for Indians and Alaska Natives of both sexes aged 10 through 34;

(4)(A)the suicide rates of Indian and Alaska Native males aged 15 through 24 are—

(i)as compared to suicide rates of males of any other racial group, up to 4 times greater; and

(ii)as compared to suicide rates of females of any other racial group, up to 11 times greater; and

(B)data demonstrates that, over their lifetimes, females attempt suicide 2 to 3 times more often than males;

(5)(A)Indian tribes, especially Indian tribes located in the Great Plains, have experienced epidemic levels of suicide, up to 10 times the national average; and

(B)suicide clustering in Indian country affects entire tribal communities;

(6)death rates for Indians and Alaska Natives are statistically underestimated because many areas of Indian country lack the proper resources to identify and monitor the presence of disease;

(7)(A)the Indian Health Service experiences health professional shortages, with physician vacancy rates of approximately 17 percent, and nursing vacancy rates of approximately 18 percent, in 2007;

(B)90 percent of all teens who die by suicide suffer from a diagnosable mental illness at time of death;

(C)more than ½ of teens who die by suicide have never been seen by a mental health provider; and

(D)⅓ of health needs in Indian country relate to mental health;

(8)often, the lack of resources of Indian tribes and the remote nature of Indian reservations make it difficult to meet the requirements necessary to access Federal assistance, including grants;

(9)the Substance Abuse and Mental Health Services Administration and the Service have established specific initiatives to combat youth suicide in Indian country and among Indians and Alaska Natives throughout the United States, including the National Suicide Prevention Initiative of the Service, which has worked with Service, tribal, and urban Indian health programs since 2003;

(10)the National Strategy for Suicide Prevention was established in 2001 through a Department of Health and Human Services collaboration among—

(A)the Substance Abuse and Mental Health Services Administration;

(B)the Service;

(C)the Centers for Disease Control and Prevention;

(D)the National Institutes of Health; and

(E)the Health Resources and Services Administration; and

(11)the Service and other agencies of the Department of Health and Human Services use information technology and other programs to address the suicide prevention and mental health needs of Indians and Alaska Natives.

(b)The purposes of this part are—

(1)to authorize the Secretary to carry out a demonstration project to test the use of telemental health services in suicide prevention, intervention, and treatment of Indian youth, including through—

(A)the use of psychotherapy, psychiatric assessments, diagnostic interviews, therapies for mental health conditions predisposing to suicide, and alcohol and substance abuse treatment;

(B)the provision of clinical expertise to, consultation services with, and medical advice and training for frontline health care providers working with Indian youth;

(C)training and related support for community leaders, family members, and health and education workers who work with Indian youth;

(D)the development of culturally relevant educational materials on suicide; and

(E)data collection and reporting;

(2)to encourage Indian tribes, tribal organizations, and other mental health care providers serving residents of Indian country to obtain the services of predoctoral psychology and psychiatry interns; and

(3)to enhance the provision of mental health care services to Indian youth through existing grant programs of the Substance Abuse and Mental Health Services Administration.

Editorial Notes

Codification section 721 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

§1667 Findings and purpose

Summary

Title 25, §1667

Notes & Related Subsidiaries

Editorial Notes

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