Building Cultures of Recovery in Tribal Communities

项目总结： 七国医治小屋(HL)是一家美国原住民青少年住宅式化学依赖治疗中心。青少年来自部落社区，包括Coeur d‘Alene部落、Kotenai部落、Nez Perce部落、科尔维尔保留地的邦联部落、卡利斯佩尔印第安人部落、印第安人的斯波坎部落和乌马提拉保留地的邦联部落。我们将这些社区称为七个HL部落分支。认识到缺乏关于在部落国家内支持青少年康复的最佳做法的方案研究，HL与哈佛医学院教学医院剑桥健康联盟成瘾问题司(该司)建立了研究伙伴关系。这一伙伴关系是本土研究、合作、学习和卓越中心(CLOCK)。作为Circle的NARCH八计划的一部分，促进部落社区的恢复文化，我们与这七个部落国家合作并向他们学习。我们进行了力量和需求评估，以了解社区如何寻求支持他们的年轻人从药物使用障碍中恢复。拟议的NARCH X计划是这项工作的合乎逻辑的扩展。拟议的方案将使用部落参与式方案开发方法来建立以土著价值观、优势和需求为基础的心理健康优先反应系统。我们预计，我们的护理系统暂定为x̌aʔtus(发音为hah-toos；;，即First Face)，将使社区成员成为有需要的青年与专业医疗保健之间的桥梁。部落社区中的任何人都可以使用First Face来支持正在与心理健康问题或危机作斗争的年轻人。这一系统将特别有助于青少年从物质使用障碍(SUDS)中恢复。此外，它还将通过支持因精神健康问题而特别有可能患肥皂水的年轻人，帮助预防肥皂症的发展。在开发了这个护理系统后，我们将进行一项多点随机对照试验，以测试其有效性，并根据试验参与者的反馈对其进行修改。随后，我们将培训数百名部落社区成员使用这一创新的、适合文化的、以社区为基础的心理健康支持系统。我们将通过在HL内建立研究和培训能力以及在七个部落社区内建立干预能力来确保长期可持续性。

PROJECT SUMMARY  The Healing Lodge of the Seven Nations (HL) is a Native American youth residential chemical dependency treatment center. Youth come to the Healing Lodge from tribal communities including the Coeur d’Alene Tribe, the Kootenai Tribe, the Nez Perce Tribe, the Confederated Tribes of the Colville Reservation, the Kalispel Tribe of Indians, the Spokane Tribe of Indians, and the Confederated Tribes of the Umatilla Reservation. We refer to these communities as the seven HL tribal affiliates. Recognizing the lack of programmatic research regarding best practices for supporting adolescents’ recovery within tribal nations, HL has developed a research partnership with the Division on Addiction, Cambridge Health Alliance, a Harvard Medical School teaching hospital (the Division). This partnership is the Center for Indigenous Research, Collaboration, Learning, and Excellence (CIRCLE). As part of CIRCLE’s NARCH VIII program, Promoting Cultures of Recovery in Tribal Communities, we worked with and learned from these seven tribal nations. We conducted strengths and needs assessments to learn how communities seek to support their youth in recovery from substance use disorders. The proposed NARCH X program is a logical extension of this work. The proposed program will use a Tribal Participatory Program Development approach to build a mental health first response system grounded in indigenous values, strengths, and needs. We anticipate that our system of care, tentatively titled, x̌aʔtus (pronounced hah-­toos;; i.e., First Face), will equip community members to serve as a bridge between youth in need and professional healthcare. Anyone in the tribal community will be able to use First Face to support a young person struggling with mental health problems or crises. This system will be particularly helpful for youth in recovery from substance use disorders (SUDs). Moreover, it will help prevent the development of SUDs by supporting young people who are especially at risk for SUDs due to mental health concerns. After developing this system of care, we will conduct a multi-­site randomized controlled trial to test its effectiveness and revise it based on feedback from trial participants. Subsequently, we will train hundreds of tribal community members to use this innovative, culturally-­appropriate, community-­based mental health support system. We will secure long-­term sustainability by building research and training capacity within the HL and intervention capacity within seven tribal communities.