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National Native American Heritage Month

The United States recognizes November as National Native American Heritage Month. As a federally funded program, the ATTC Network Coordinating Office supports this effort annually by shining a light on topics and resources related to the behavioral health of American Indians and Alaska Natives in the feature article of the November issue of the ATTC Messenger. This year, we asked members of the tribal community and/or individuals who work in tribal health to share their thoughts on what is important for our readership to know about mental health and substance use prevention and treatment in native communities. We hope these comments lead to ongoing, larger conversations for how to advance health and wellness.


“Understanding the cultural context of the life of a tribal person is fundamental for effective behavioral health practice. Knowing how to build on the inherent strengths, intelligence, and cultural assets of tribal people can result in treatment that is meaningful and recovery that is lasting. As tribal members, Indigenous people are part of something larger than self and effective treatment addresses the collective, not just the individual.” – Holly Echo-Hawk, MSc


“I have been a Family Physician working for the Indian Health Service for 23 years. Having lived and worked on the Navajo Nation in Arizona and the Jicarilla Apache Nation in New Mexico, I have seen the devastating effects of substance use disorders, especially alcohol and methamphetamine. I applaud the use of evidence-based prevention and treatment practices in addressing these problems. If we want to make progress in this area, we need to be mindful of the historical trauma that has been endured over generations for Native Americans.  Recovery efforts rooted in the traditional ways are meaningful and powerful and should also be encouraged.” – Joan Kandel, DO, FAAFP


“When we’re suffering, it can be helpful to remember that emotions are physical as well as spiritual. Feelings happen in our brains and bodies. It comes as no surprise and isn’t new information that Native cultural traditions and practices are healing. Activities that may be practiced by members of AI/AN communities and that may be thought of as cultural or traditional (such as dancing, weaving, drumming, and quilting just to name a few) – especially when done in community with others, have been shown to be healing to emotional trauma by literally changing the parts of the brain and body that process emotions. These cultural practices can heal by calming our fight or flight mechanisms, by sending chemicals into our bodies that make us feel relaxed, peaceful and hopeful, and by letting our bodies rehearse feeling safe. Thinking about Indigenous cultural practices as a brain thing reminds us what we already know, reminds us of the power of Indigenous ways of being and knowing, and affirms the wisdom of contemporary Native communities and the wisdom of those that came before - that Tribal traditions and cultural practices (contemporary and historic) can be an important part of taking care of ourselves and our communities and are key to Native people's resiliency.” – Troy Montserrat-Gonzales, LPC 


“Holistic health is an important concept to understanding Indigenous health to include physical, mental, emotional and spiritual components of individuals overall understanding of their health wellness.  In some tribal perspectives, if one component is not addressed or is ‘out of balance’ then a person's overall health is compromised. For some tribes, there are cultural perspectives that reflect values, stages of life, directions, etc. There is still stigma that exist in Native communities around mental health. Most times, it is because of the cultural interpretations or ‘out of balance’ mentality that limits individuals of discussing their mental health issues and/or needs.  Sometimes, mental health issues can be viewed to mean the imbalance and the need for spiritual renewal through songs, prayers, and/or ceremonies. Hence, when discussing mental health among AIAN communities, it may be best to discuss Holistic Health as a means to address such issues in a sensitive manner.” – Elton Naswood, MA  


“Experience-based practices, wisdom-based practices, and spiritually-based practices must be brought to the forefront of the behavioral health field, not to replace the evidence-based practice, but rather to blend with them the time-tested principles of native healing and recovery. The circle always leads back to itself so perhaps it is time to complete the circle.” – Steven G. Steine, MA, CADC


“I advocate for a balanced view around Native Americans and addiction: that we have very high rates of abstinence and also higher rates of alcohol and substance use disorders. So we have strengths of our people who do not use any substances that we can use to help those who are struggling with addiction. We should treat addiction like we do any other illness or imbalance - with compassion and continued efforts to manage. We do not expect perfection when people manage chronic illnesses such as diabetes or heart disease, so we should not expect perfection from people with addiction. In order to reduce these health inequities, we need all effective methods available including treatment and traditional healing for the individual, couple, family, and community.” – Kamilla Venner, PhD


For information about how SAMHSA address mental health and substance use issues among American Indians and Alaska Natives through the National Tribal Behavioral Health Agenda and other initiatives, please visit