Located in the beautiful and rugged inland mountain region of California, the Toiyabe Indian Health Project serves a consortium of seven federally recognized Tribes and two American Indian Communities. Toiyabe works to address a range of health-related hardships endured by the communities they serve, using medical services as well as public health and wellness programing. As part of their health promotion work, they have focused on increasing the resiliency and coping skills of the youngest members of their communities.
As part of their Methamphetamine and Suicide Prevention Initiative (MSPI), Toiyabe adapted the evidence-based American Indian Life Skills Curriculum to create the Numa Life Skills Program for Tribal youth attending one of the local Elementary schools. While the American Indian Life Skills Program seeks to increase resiliency in high school aged youth, the curriculum Toiyabe created looks to build coping skills in younger children. Sheila Turner, Toiyabe Behavioral Health Director, explained the strategy this way: "Our communities face the same problems as communities everywhere. We see substance abuse, depression, and people at- risk. We thought a good way to address these issues was to make sure people have the resilience and coping skills they need to face life’s problems, starting at a young age."
Resilience – the quality that allows people to withstand adversity and still thrive – develops over time, and touches upon many different aspects of a person’s life. Resilience comes from supportive relationships with family and friends, and the support that culture and traditions provide. Resilience also requires a set of personal life skills; these skills allow a person to navigate difficult situations by managing their thoughts, emotions and behaviors in constructive ways. Resilience can be developed across the life span by cultivating supportive relationships, by engaging with culture and traditions, and by learning life skills. A number of evidence-based curricula focus on building resiliency, including the program Toiyabe used as a model – American Indian Life Skills.
American Indian Life Skills (AILS) (formally the Zuni Life Skills) Development program is a school-based program that aims to build protective factors in youth and prevent suicide ideation. The AILS curriculum includes anywhere from 28 – 56 lesson plans covering topics such as: building self-esteem, identifying emotions and stress, recognizing and eliminating self-destructive behavior, and increasing communication and problem-solving skills. The design of the lessons allows for them to be easily adapted to incorporate situations and experiences relevant to the youth community served. Importantly, the curriculum has been rigorously tested and shown to be effective.
The success of the AILS program helped when it came time to propose the idea to Bishop elementary school. The project also required building relationships with the school administration, carefully explaining the vision of the project, and getting feedback from parents, teachers and the community. Natalie Vega, Behavioral Health Therapist Intern at the Toiyabe Indian Health Project and the core developer Numa Life Skills explained the process: "Initially, we worked with the Native American liaison as the school. She was really helpful in the process and she knew about the needs of the Native students, especially those at risk. After working with her, we had meetings with the school principle and vice principle, we conducted surveys with the teachers, and we shared information with parents. After this groundwork, the program was accepted into the school."
Ms. Vega has put many hours into the adaptation of the AILS program to make it more kid-friendly and culturally relevant. For example, some components in the AILS curriculum, like directly speaking to students about suicide, are hard to translate to 5 – 10 year olds. The Numa Life Skills curriculum adapts this material. In the example of talking about suicide, death is discussed in more general terms to level with the younger population while teaching coping skills to deal with the tragedy of death in the family.
Vega and Turner have also worked to incorporated many cultural practices and traditions to teach children about their heritage. The curriculum works various Paiute words into their activities to familiarize the children with a Native language. Turner and Vega also reach out to community members to share legends and traditional stories to teach lessons, as well as songs and dances that help children learn how to express themselves and understand how to deal with difficult situations. Numa Life Skill has even incorporated sign language into their curriculum. "Different languages can give kids the skill sets and tools to communicate in new ways and to express the things they don’t know how to before," offered Turner.
"The initial planning is the most difficult, but once you put the work in and get the program, going, it speaks for itself," Vega reported. She explained that the kids enjoy these activities so much that they don’t realize they are learning at the same time. Positive feedback from children, parents and teachers has led to overwhelming participation in the program. Now in its fourth year, the program began with 30 kindergarteners and has grown to 70 participants. The course is offered for a length of 5 months over the spring semester, and convenes twice a week so that students have the opportunity to attend at least one session a week.
The children are split up into groups roughly according to age, with some grade levels mixed. Vega and Turner have seen this structure benefit students in ways they never expected: "With the mix of older and younger and previous and new students in the program, we are seeing kids becoming leaders and taking on the role of peace builders. The older students who have been through the program are learning how to help new and younger kids who are struggling."
While the program is open to all students within this non-Native school, the curriculum is culturally geared toward American Indians and 98% of the students are Native. Enrollment is on a first come, first serve basis, but referrals from the Native American Liaison are taken into consideration. The Native American Liaison plays a special role in the success of this program, and has the advantage of observing the students’ behavior and well-being on a day-to-day basis. She not only helps to reach out to the students who need the most help, but she also reports on the many significant changes and tangible positive effects the program has within the school.
Toiyabe Indian Health Project’s partnership with the Bishop Elementary School makes a large impact on the program. Through outreach to administration and teachers, the project secured an outlet to reach the youth, staff to assist with the program, and a location to hold the sessions. While there were some hesitations from staff that the program was too focused on one group of students, the need presented was very great in the eyes of most teachers and administrators, who overwhelmingly have supported the Numa Life Skills Development program. By keeping in touch with staff and faculty through surveys and on-going discussions, the program has allowed for continuous quality improvement in order to find ways to best serve students and kept up their positive relationship with the school.
Beyond the school, the Numa Life Skills Development program also has reached out to parents throughout the process. Seeking parents’ opinions while building the program, engaging them through meetings during the first couple years, and sending home newsletters to update parents on program activities has built valuable partnerships with the community as well. Through this collaboration, the program has been able to call on parents as volunteers for much of their programing. Involving parents and the community has also expanded the outreach of behavioral health staff in general. These meetings and other interactions acquaint families and community members with the behavioral health staff and build relationships that encourage more individuals to seek the clinical care they need.
Numa Life Skills also has engaged in important partnerships with other community programs like Temporary Assistance for Needy Families (TANF). Twice a week, during the lunch hour lessons, TANF provides all the food for the students, saving the program time and money. Additionally, much of the staff for the program are already staff of the school, the Toiyabe Indian Health Project, or volunteers, which make the costs of the program extremely manageable.
Understanding the need, choosing a successful approach, and building essential partnerships has allowed Toiyabe to make impressive strides in their goal of promoting resiliency in their youth. The success of Toiyabe’s MSPI project and the Numa Life Skills Development program rely upon the collaborative relationships that staff have cultivated – all reinforcing each other and hold the promise of long-term sustainability, and the long term positive impacts on the communities they serve.
To learn more about Numa Life Skills, please contact:
Natalie Vega, M.S.
Behavioral Health Therapist
52 TuSu Lane, Bishop, CA 93514
760-873-6394
[email protected]
National Indian Health Board