§1667 Findings and Purpose

Summary

Lets the Secretary run a telemental health test project to prevent, intervene in, and treat suicide among American Indian and Alaska Native youth. Congress found suicide is much higher in these communities: the overall rate is 1.9 times the U.S. average, youth 15–24 are 3.5 times higher and have the highest rate of any group, and in 2005 suicide was the second-leading cause of death for ages 10–34. Males 15–24 can have rates 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 over their lives. Some tribes, especially in the Great Plains, have rates up to 10 times the national average. Risk factors like past attempts, family history, mental illness, substance abuse, health gaps, stress, easy access to lethal methods, exposure to others’ suicidal behavior, isolation, and incarceration are more common. Deaths are often undercounted. In 2007 the Indian Health Service had about 17% physician and 18% nursing vacancies. Ninety percent of teens who die by suicide have 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 agencies have had suicide prevention efforts, including a 2001 National Strategy and a Service initiative since 2003. The project can use psychotherapy, psychiatric assessments, diagnostic interviews, treatments for mental illness and substance abuse, and provide clinical advice and training for frontline providers. It can train community leaders, families, and school or health workers, create culturally relevant education materials, and collect and report data. The law also encourages tribes and providers to use predoctoral psychology and psychiatry interns and to strengthen services through existing SAMHSA grant programs.