Psychiatric News June 3, 2005
Volume 40 Number 11
© 2005 American Psychiatric Association
p. 4
APA Makes Case for Increased IHS Budget
Christine Lehmann
American Indians and Alaska Natives need better access to mental health
care to reduce their high rates of suicides and alcoholism, APA tells
Congress.
APA and the Friends of Indian Health, a coalition of about 50 organizations
of which APA is a member, are urging Congress to increase significantly the
president's proposed Fiscal 2006 budget for the Indian Health Service
(IHS).
IHS, an agency of the Department of Health and Human Services, is charged
with improving the health of American Indians and Alaska Natives (AI/ANs).
"It is imperative that IHS first and foremost address the disparity
in disease rates and access to care that exists in Indian
neighborhoods," stated psychiatrist Brian Benton, M.D., on behalf of the
coalition to the House Appropriations Subcommittee on Interior, Environment,
and Related Agencies in April.
A disproportionate number of AI/ANs suffer from alcoholism, substance
abuse, and suicide compared with all other ethnic and racial groups in the
United States, said Benton. He is of Cherokee descent and a member of APA's
Committee of American Indian, Alaska Native, and Native Hawaiian Psychiatrists
and the Assembly caucus representing these same groups.
The suicide rate for American Indians is 60 percent higher than that for
the general population, and studies have shown that 70 percent of completed
and attempted suicides on Indian reservations involved alcohol use, according
to the testimony submitted by the Friends of Indian Health.
More than half of the American Indians who commit suicide have never seen a
psychiatrist or mental health professional, said Benton. As medical director
of psychiatric services at William W. Backus Hospital, a general community
hospital in Norwich, Conn., Benton sees and treats a large number of American
Indians for co-occurring depression and substance abuse.
"American Indians in New England have been mired in a culture of
poverty, substance abuse, and domestic violence for centuries. This is a
result of oppression, forced assimilation and loss of cultural identity,
inadequate health care, and lack of educational opportunities," Benton
told Psychiatric News.
The IHS has lacked the resources it needs to meet the health care needs of
Native Americans. "The IHS has been a low priority for the federal
government," said Benton.
Some Indian tribes own and operate casinos, which have become a source of
significant income for them. Benton mentioned that tribes on two reservations
in Connecticut near his hospital own successful casinos and have spent the
income on establishing new health care services.
To improve the access of AI/ANs to general health care and mental health
services, Congress needs to increase the Fiscal 2006 IHS Health Services and
Health Facilities budget proposed by the president by $170 million, to bring
it to a total of $3.22 billion, Benton testified.
The president requested an increase of $118 million in Fiscal 2006 for the
health services program and a decrease of $85 million for the health
facilities program for a total IHS budget request of $3.05 billion, according
to the president's Fiscal 2006 IHS budget justification.
APA and the Friends of Indian Health requested that Congress appropriate
the additional $170 million in the IHS Fiscal 2006 budget to accomplish the
following:
- Fully fund the educational loans of health care professionals to retain
more of the existing workforce and attract new health care professionals to
careers in the IHS ($22 million).
- Increase prevention activities to decrease mortality rates and prevent
diseases such as obesity, alcoholism, and HIV/AIDS ($8 million).
- Fully fund the recently established Tribal Epidemiology Centers so they can
develop adequate surveillance and epidemiological systems to prevent and
control diseases ($2 million).
- Increase funding for IHS to pay for specialized health care services that
American Indians need but are not provided by IHS health care professionals,
inflation-related increases, and salaries to support and maintain vital health
programs ($53 million).
- Restore funding to IHS to maintain, improve, and replace outdated health
care facilities on Indian reservations ($85 million).
The oral testimony presented on the IHS budget can be accessed
online at
<www.psych.org/advocacy_policy/leg_res/apa_testimony/testimonys.cfm>
by clicking on "Testimony of Dr. Brian Benton before the House
Appropriations
Subcommittee...."
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Brian Benton, M.D., in the House Rayburn Office Building of Congress
after he testified on increasing the Fiscal 2006 budget of the Indian Health
Service.
Photo: Alison Bondurant
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