Behavioral Health

Behavioral Health Care and Tribal Wellness

Behavioral health care refers to an integrated, interdisciplinary system of care related to mental health and substance use disorders that approaches individuals, families, and communities as a whole and addresses the interactions between psychological, biological, sociocultural, and environmental factors.

The National Indian Health Board’s (NIHB) Behavioral Health programs strive to support the development of programs that respect culture and Tribal sovereignty, and promote the balance between the mind, body, heart and spirit. In keeping with this focus, NIHB brings Tribal governments timely information to support health care policy analysis and decision-making.

Adverse Childhood Experiences

Adverse Childhood Experiences (ACEs) are traumatic events occurring before age 18, such as abuse, neglect, or exposure to household dysfunction. In Indian Country, ACEs disproportionately affect our communities, leading to heightened risks for chronic health conditions, mental health challenges, and substance use disorders. These impacts are compounded by historical and intergenerational trauma caused by colonization, forced assimilation, and systemic inequities. Addressing ACEs within a cultural context is essential to fostering resilience and promoting healing in Tribal communities.

Substance Abuse

Substance abuse, including alcohol and drug use, is a critical issue in Indian Country, where higher rates of addiction and overdose have devastating effects on individuals, families, and communities. Contributing factors include historical trauma, systemic inequality, and limited access to culturally relevant prevention and treatment resources. Addressing substance abuse in Tribal communities requires a comprehensive, culturally grounded approach that incorporates traditional healing methods, community engagement, and improved access to mental health and substance use treatment services. Building resilience through support systems and education is essential for long-term recovery and healing.

Opioid Crisis

The opioid crisis has profoundly impacted Tribal communities, leading to higher rates of addiction, overdose, and related health disparities. Contributing factors include historical trauma, underfunded healthcare systems, and limited access to culturally tailored prevention and treatment resources.

Suicide Prevention: Suicide rates in AI/AN communities are among the highest, driven by historical trauma and limited mental health access. Prevention requires culturally responsive approaches, community engagement, and traditional practices. Strengthening mental health resources, reducing stigma, and fostering resilience can promote healing and hope.

Injury/Violence Prevention
Injury and violence, including the crisis of Missing and Murdered Indigenous People (MMIP), have devastating effects on American Indian and Alaska Native communities. Violence such as domestic abuse, child abuse, and intimate partner violence is compounded by systemic issues like historical trauma, poverty, and jurisdictional gaps. The MMIP crisis disproportionately affects Native women, with many cases remaining unsolved due to inadequate resources and legal complexities. Addressing these issues requires culturally responsive, community-driven prevention programs, better access to safety resources, and stronger Tribal sovereignty to ensure justice and healing.

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Upcoming Events
March 4, 2025 - March 5, 2025

National Indian Health Board will host the Tribal Health Data Symposium on March 4–5, 2025

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NIHB Response to Executive Orders

President Trump’s recent Executive Orders on federal funding could have serious implications for Tribal health. NIHB is actively advocating for Tribal Nations and providing key updates—click to learn more and access resources.