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Washington Report

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Listening Session on National Strategy for Suicide Prevention

On January 4, 2024, the Substance Abuse and Mental Health Services Administration (SAMHSA) hosted a Listening Session to update Tribal leaders and to receive input on the National Strategy for Suicide Prevention (NSSP). Specifically, representatives from SAMHSA were interested in gaining insight from Tribes to help identify critical issues related to suicide prevention in Tribal communities. The listening session focused on two questions:

  1. After seeing the new Strategic Directions and Goals of the NSSP, what are some critical issues related to Tribal suicide prevention you would like to see represented or discussed in the strategy?
  2. What are the ways we can engage Tribal communities in the implementation of the strategy in the months and years after the strategy’s release?

As to the first question, attendees discussed the need for SAMHSA to take traditional and holistic approaches to healing into account when formulating the strategy, especially strengths-based, trauma-informed approaches that are culturally centered. SAMHSA representatives explained that the NSSP has a focus on “health equity,” which takes into account cultural differences and how suicide prevention can be implemented in disproportionately impacted communities. When asked if there is a set-aside for Tribal emergency medical services (EMS), SAMHSA representatives stated that the NSSP does not currently have a funding mechanism, so it is neither a yes or no at the moment but agreed that issues facing EMS workforces need to be addressed in the NSSP.

As to the second question, attendees inquired as to whether SAMHSA engaged relevant Tribal Advisory Committees (TACs) in the revision of the NSSP. Representatives explained that SAMHSA has engaged with Tribal members and organizations but that TACs have not been formally engaged. Attendees agreed that there is a need for SAMHSA to engage TACs because it offers an effective means to ensure that Tribal communities are able to see themselves in the strategic plan, which enables those communities to take ownership of the plan’s implementation. Attendees asked the SAMHSA representatives how to increase capacity in Tribal communities that lack the workforce to implement the strategic plan, pointing out that federal dollars are prohibitively difficult to spend for smaller Tribes because the programs that the dollars fund usually require the employment of providers with advanced degrees.

The SAMHSA representatives also explained that in creating the strategic plan, the group discussed the various social determinants of health that are unique to Indian Country, adding that SAMHSA is familiar with the rigidity of federal dollars and that the administration will be working towards refiguring how those dollars can be spent. The Indigenous Determinants of Health are divided into three categories, one of which is the intergenerational approach to holistic healing. In every encounter with the federal government, Tribal leaders reinforce the important role that holistic healing has in Tribal health. The issue arises when federal dollars are so restrictive that they cannot be utilized by Tribes that offer services and programs that utilize holistic approaches to healing, which is why Tribal sovereignty is only upheld when Tribes are able to spend those funds on holistic healing without interference from the federal government. Read more about the Indigenous Determinants of Health.

SAMHSA intends to release the NSSP and its action plan in March of this year.

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