Alaska Behavioral Health Aide Program: Formative research to evaluate a rural training and service delivery model to reduce disparities in AN/AI mental health and substance use disorders

点击翻译按钮获取中文摘要

Program Summary Alaska Native (AN) youth suicide is a public health crisis across the 229 rural villages of Alaska. Alcohol and other substance use disorders also disproportionately impact AN people and are a leading cause of death among AN adults. In response, the Alaska Native Tribal Health Consortium (ANTHC) established a Behavioral Health Aide (BHA) Program in 2008. The goals of the BHA Program are to provide culturally relevant training and education for village-based counselors to promote behavioral health and wellness in AN individuals, families and communities. A BHA is an Indigenous community health worker with the requisite skills, relevant training and appropriate placement within their Tribe or health organization to provide chemical dependency assessment and counseling, health education, crisis management and advocacy services. BHAs help address individual and community behavioral health needs, including grief, trauma, depression, suicide and substance misuse. While the BHA training and service model shows promise for increasing access to quality behavioral health care, no research has examined its process or outcomes. The Indian Health Service (IHS) has embraced the BHA model for replication in Tribal health settings across the U.S., and BHA candidates are currently being employed and trained in multiple Tribal health systems across the U.S. utilizing the ANTHC curriculum and certification program. The objective for this application is to test the scope of BHA practice, and the feasibility and acceptability of the BHA program in addressing this practice scope. There is a critical need for place-based, culturally congruent behavioral health services in rural and remote AIAN settings to address current access to care challenges. This need has only intensified as the behavioral health disparities crises with the COVID-19 pandemic. Promising practices such as the BHA model in AK need to be accelerated along the translational science pathway to evidence-based reimbursable service model status for tribal health systems.