Suicide Prevention Week (Sept. 4 – 10, 2016)

by Karen Marshall
Sacred Bundle Outreach and Training Coordinator

Here we are, easing out of summer and casting an eye toward fall and all it represents: Kiddoes back to school, cooler weather, stunning shows of color as the leaves change from luscious greens to their own brilliant hues. Soon, we’ll see the full Harvest Moon rising over the last of this year’s warm weather gardens.

Also arriving within the first few days of September is a day set aside internationally that brings our attention to supporting the lives of people around us who are thinking that life is no longer worth living. September 10^th is World Suicide Prevention Day. The week around September 10 was established by the suicide prevention organizations based in this country as Suicide Prevention Week … and these days, it’s breaking boundaries and expanding to a full month of attention to preventing the preventable.

Yes, suicide is often preventable. And you can be a person who makes all the difference!

You … with or without formal training … have a role to play.

Knowledge and skills can be learned by anyone who has the heart to help and who takes the time to learn how to help save a life from suicide. Here at American Indian Health and Family Services, the Sacred Bundle Youth Suicide Prevention project offers workshops and trainings on a regular basis. Interested in finding out more about what you can learn? Check out the information at the end of this piece, or contact Karen Marshall, our Outreach and Training Coordinator at KMarshall@AIHFS.org or (313) 846-6030, ext. 1404.

In order to mark Suicide Prevention Week this year, a number of national organizations that educate the general public about suicide prevention, intervention and post-vention have joined together in an informal way to promote a theme: It’s called Be The 1 to …

Here are 5 things anyone can do to help a people survive their struggle with thoughts and feelings about ending their life:

1. Be The 1 To…Ask. (About suicide)
2. Be The 1 To…Keep Them Safe. (By removing access to lethal means);
3. Be The 1 To…Be There. (By being present, listening with compassion and without judgment, letting them know you care about them);
4. Be The 1 To…Help Them Stay Connected. (To caring others—friends, family, therapists, clergy, teachers, coaches, etc.—and to the Lifeline and other 24/7 crisis care resources); and
5. Be The 1 To…Follow Up. (By checking in regularly with the person you are concerned about, for days and weeks after the crisis – be sure to let them know you are thinking about them, and that you are there to help if needed).

A similar project is Take 5 To Save Lives that invites you to spend 5 minutes learning 5 ways to be helpful to a person at risk of suicide. Website: http://www.take5tosavelives.org/

In addition to learning the specifics of how you can help a person at risk, you can also be part of changing the conversation around suicide. Stigma, myth, shame and denial have no place in saving lives from suicide. The subject was shrouded in silence for centuries, and it didn’t stop attempts or deaths. These days, we know that a caring community, open and honest conversation about difficult subjects, and access to good resources and care can make all the difference.

Wondering about resources?

AIHFS has affordable services for people of all ages who can benefit from behavioral health and/or medical care. Many times, treatment can include traditional, culturally-based ways and ceremonies for healing.

Trained crisis workers are available by text, chat or telephone through the Lifeline 1 (800) 273-TALK (8255). Website: http://www.suicidepreventionlifeline.org.

Or, text “GO” to 741741. Free, 24/7, confidential.

Do you know a military Veteran at risk? Check this out:

Often, all it takes is 1. Can that be you?

What is a Pow wow?

By John Marcus
Communications Specialist
Turtle Clan
Mohawk, Chippewa, Pueblo

Like a lot of things, a pow wow is going to be different to everyone. According to Wikipedia “A pow wow (also powwow or pow-wow) is a social gathering held by many different Native American communities.” Their article, at least as of this current time, is pretty decent in its description. Check it out if you want to read more about the technical aspects of a pow wow: https://en.wikipedia.org/wiki/Pow_wow

On a more personal note though, I grew up in the 60’s and 70’s dancing at pow wows. My Dad used to tell me about the time when I was less than 5 years old and my family was at a pow wow in Tama, Iowa. We were probably on the way to Taos, New Mexico, where my Dad was born and raised. He said he was doing the pipe dance which involves 2 male dancers, each with a pipe and rattle. The song has several stops in it. My dad said he was out there and the crowd was really applauding at the stops and he thought he was doing really good but then he realized I had went out to dance too and the crowd couldn’t believe this little guy was stopping on time. I had the advantage though of hearing those songs in our family house, sitting on my dad’s knee while he would sing those songs and more.

Dancing was something that was in my blood. My dad grew up with ceremonial dancing and intertribal dancing as part of his life. While still living at home, he even traveled some to dance with his dad, Ben Marcus, and other relatives.

In this picture my dad is on the left. His dad is on the right. He told me of the time they left Taos Pueblo, New Mexico to dance in Texas, probably in the 1940’s and they were sitting in a restaurant waiting to eat and they just kept waiting until finally an employee of that restaurant, who was a minority, approached them and asked them to come outside where he explained it was pointless to stay there because they wouldn’t get served since they were non-whites. After that he said they never went back to dance in Texas.

Times have changed but one of the more important things about pow wows that hasn’t changed is we always have blessings or prayers to begin our pow wows. Here in metro Detroit during the 1970’s, John Shano would be asked to do the honor of spiritually cleansing the circle. He would be wearing a horse tail as part of his regalia as he used a huge turtle rattle dancing from the center of the circle to each of the 4 directions.

At pow wows throughout Michigan Chief Little Elk of Mt. Pleasant would be asked to help begin our gatherings. At the appropriate time he would be announced and he would bring a 2 sided hand drum with him. He would share words and a song. He was one of the oldest people I would see participating as I went to these various gatherings throughout Michigan and Southern Ontario. At the time I didn’t know what it was but it felt good see to this elder slowing making his way up towards the microphone. I don’t remember anyone telling me I had to respect this man but I could see that is what you do because that was how he was being treated. Like they say, children learn by what they see modeled around them.

It’s been more than 30 years since I’ve danced, like in this picture from around 1980, and I can now relate with what I used to hear all the time as a dancer: dance for those that can’t be here or can no longer dance.

These songs and dances came from the spirit world and speak to our spirit. When you are dancing it is part of the cycle of all things natural. The creator gave us these ways to be in rhythm together. What you are seeing in that circle is all things in harmony: the animals (dancer regalia), the humans, the spirits and of course mother earth, the giver of all life.

I hope you have the opportunity to stop by our AIHFS annual pow wow and health fair and join us in this harmony of life. It will be, Saturday, August 27, from noon until 5pm at Romanowski Park which is around the corner from us here at AIHFS. For more info here is the facebook event for it https://www.facebook.com/events/266306410403149/

PrEP for HIV Prevention

by Alice Kachman, M.D.
AIHFS Medical Director/Provider

PrEP = Pre-exposure prophylaxis. It’s a way of preventing HIV infection in people at high risk for HIV exposure but are presently HIV negative. It’s a daily pill with two well-known HIV treatment medications. Studies done so far show a reduction of HIV infection by 92% in people who take the pill EVERY DAY. PrEP does not work this well if it isn’t taken every day.

PrEP is for people who are HIV negative but are at risk of getting HIV. The Centers for Disease Control and Prevention (CDC) recommends PrEP for people who do not have HIV and are at a substantial risk for HIV. This includes HIV transmission by sexual contact and people who inject illicit drugs.

For sexual transmission, HIV risk includes an ongoing relationship with a partner with HIV, gay or bisexual man who has had anal sex without a condom or has a recent diagnosis of a STD in the past 6 months or a heterosexual man or woman who does not regularly use condoms with partners of unknown HIV status but at high risk for HIV (inject illicit drugs or has bisexual male partners).

People who use PrEP must take the drug every day and return to their health provider every 3 months for a repeat HIV test, prescription refill, and follow up.

PrEP is only for people who have a substantial risk for HIV infection.

AIHFS can help. If you are HIV negative and think you are at a high risk for getting HIV, make an appointment to talk about PrEP. It can save your life.

Dental Therapist Bill in Michigan Senate

by Ashley Tuomi,
Chief Executive Officer

There was a new bill introduced (Senate Bill 1013) June 7th that will provide licensure for dental therapists to practice in Michigan. One of the great things about this bill is that it will enable dentists to delegate routine restorative procedures to dental therapists working under their supervision, including assessments, simple cavity preparation, restoration and simple extractions. If you are unsure of what a dental therapist is, you can think of it as similar to a physician’s assistant in the medical realm. Basically a dental therapist is a mid-level dental provider.

Who else is using Dental Therapists?

Some of you may have heard of Dental Therapists before. That is because this model was successfully implemented in Alaska starting in 2004. Recently, tribes in Oregon and Washington have also began adding Dental Therapists to their clinics. The states of Minnesota and Maine have already passed legislations to license dental therapists as well. There are also many other states considering this right now as well.

So why is important?

It can be difficult to find a dentist and especially dentists that take Medicaid in many counties. In fact, 4 million American Indians and Alaska Natives live in counties with dental provider shortage areas, including nearly half of all American Indian children.
In 2014, almost 60% of children on Medicaid did not see a dentist (Michigan is in the bottom 10 states).
Lack of access to oral health leads to tooth-loss, pain, and many other health complications.

If you want to read more about this bill You can read the full text of the bill here.

How to support:

Talk to your senator
Sign-on as a supporter at http://www.midentalaccess.org/

Thank you for taking the time to read this post. When I did my doctoral research on dental anxiety, I became more aware of the issues related to oral health. Through my research I found that lack of access to oral health is a major contributor to dental anxiety and plays a huge role in the vicious cycle of pain and fear.

Question:

Have you had problems finding a dentist that takes your insurance?

Dr. J. Nadine Gracia visits AIHFS

In May, we were fortunate to have some time to meet with Dr. J. Nadine Gracia who is the Deputy Assistant Secretary for Minority Health. Our Chief Executive Officer, Ashley Tuomi, attended the Mayor’s Summit on Health Equity, where she also got the opportunity to meet with a small group of other minority leaders in Detroit and Dr. Gracia. Dr. Gracia then took time out of her busy schedule to come here to American Indian Health and Family Services for a tour. We are very grateful for her time and were happy to show her all of the great things that happen here at AIHFS.

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Lights! Camera! Action!

by Karen M. Marshall,
Outreach and Training Coordinator

For one day in April here at AIHFS, it was “Lights! Camera! Action!!”

No, not Hollywood visiting – the production crew was two people, a producer and videographer up from Atlanta. The cast was made up of agency staff and community members. The scene was our wonderful murals in the Social Hall. Still, it was a day to remember!

AIHFS and the Sacred Bundle Program were selected by the federal agency SAMHSA (Substance Abuse, Mental Health Services Administration) to be featured in its monthly Road to Recovery series. The show appears on the SAMHSA YouTube channel, and on Public Radio and Television stations, throughout this month. A link to the program is at the bottom of this page!

This month’s topic is the roles anyone can play in reducing suicide deaths and attempts. Our Sacred Bundle Youth Suicide Prevention project is designed to make positive differences in the lives of people who may think there is no help and no hope. We are determined to support communities that want and need a safety net for those at risk of suicide. Things are changing in positive ways!

The Road to Recovery program includes a panel discussion with four experts in the field. There are two more Michigan connections there – Amelia Lehto with Common Ground Resource and Crisis Center in Pontiac and Polly Gipson, PhD, from the University of Michigan.

Here is a wrap-up of what Sacred Bundle has achieved so far:

Its first round of grant funding, received in 2012, was for three years. Continuation funding was awarded in 2015, this time for five years.
The major focus includes:
- Suicide awareness, prevention, intervention and post-vention trainings and services in the urban counties in and around Detroit; now expanded to the federally-recognized tribes throughout the state.
- Hope & Wellness screenings of young people ages 10 – 24 for depression, suicidality, and substance use in a variety of community settings including powwows;
- Referral resources, including those that are culturally-appropriate for our community;
- Specialized programs on a variety of topics; and
- Outreach with informational materials at meetings, seminars and events.
Sacred Bundle works at AIHFS with the Dream Seekers youth programming, as well as with Emotional and Spiritual Wellness, Health Education, and the medical team, to make AIHFS a suicide-safer organization.
Formal data collection and evaluation through the University of Michigan.
Partnerships that range from the internal programs mentioned above, to 5 of the 12 tribes, to the State of Michigan (which also has the same SAMHSA grant we do), to a number of smaller, locally-based organizations involved in the same work.

All of this is funded through the Garrett Lee Smith Youth Suicide Prevention grant program, which has supported state and tribal projects for more than a decade. It was an honor to be chosen from the SAMHSA grantees to be featured in this month’s Road to Recovery!

What does all of this mean for you?

First, I hope you’ll take a look at the show, then share it with people you know who wonder what goes on at AIHFS in addition to medical and behavioral health care, and cultural activities. If you have questions or want to be involved in some way, please contact me at (313) 846-6030, ext. 1404, or by email at KMarshall@AIHFS.org.

Second, there truly is a role for all of us in saving lives from suicide … with a little bit of training, you can be the friend, family member, co-worker, or complete stranger who recognizes that a person is struggling with thoughts of suicide, and you can know what to do to help.

We are busy partnering with tribes around the state and supporting the lifesaving work of suicide prevention wherever we can. Please join us …

Here is the program link: http://www.recoverymonth.gov/road-to-recovery/tv-series/june-2016-preventing-suicide
AIHFS is in 2 different sections of the show, at 23:52 and then again at 41:58.

New Direction of Blog!

I am excited to announce that we are going in a different direction with this blog. I will still be contributing to this blog, but I am also opening it up to the other wonderful staff here at American Indian Health and Family Services. Our other staff have a lot of great things to share with you as well.

This blog will be used to share information with you on a deeper level than some of our other sources such as Facebook and our newsletter. We will continue to share information about important policy changes on both a state and national level, trending topics, important health information, and other areas of interest.

So join me in welcoming our other AIHFS staff to the blog. We are hoping that these posts will become interactive and welcome your comments and discussion. If there are any particular topics that you would like us to discuss, please feel free to let us know as well.

Ashley Tuomi, CEO

Supreme Court upholds subsidies in King v. Burwell

So what does this mean?

For those of you how haven’t been following this issue let me start with what this case was about.

When the Affordable Care Act was originally written, the thought was that all of the states would manage their own exchanges. In reality that is not what happened. There are currently 34 states who do not operate their own exchanges and rely on the federal exchange to provide coverage to their constituents.

Those who have been challenging the Affordable Care Act found a part of the law that would have completely undermined the intent of the Affordable Care Act. The part of the law that they challenged was that it was written that subsidies are only available to those who enrolled in a state exchange. According to them, those in the 34 states who enrolled in plans through the marketplace would not be eligible for the subsidies that made coverage affordable. It’s estimated that it would be about 6 Million people who could have been affected by this.

Today the Supreme court voted 6-3 to uphold the subsidies and the interpretation of the Internal Revenue Services that individuals in all 50 states should be able to access these subsidies.

Vote Breakdown:

Roberts filed the opinion with Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan joining

Scalia filed a dissenting opinion with Thomas and Alito joining

The decision was based on the fact that they had to read the law in context and not just plain language. It was determined that in context the words “an Exchange established by the State under [42 U. S. C. §18031]” is ambiguous. Due to the ambiguity, the Supreme Court had to look at the phrase in the greater context of the Act. They also found that other parts of the law would not make sense if this phrase was defined as plain language.

When looking at the greater context of the Act the Supreme Court had to reject the interpretation of the petitioners because “it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid”.

It would have removed the subsidies from the states that didn’t operate their own exchanges and many of those individuals would have been exempt from the coverage requirement because the insurance would not have been affordable. These two facts would have also had a negative impact on the state exchanges as well since they would have struggled to operate in this environment.

So why should we care? Michigan is one those states that participated in the federal exchanges. As some of you know American Indian Health and Family services has played an important role in enrolling both tribal members and non-tribal members through the Marketplace and Healthy Michigan. If the Supreme Court had not upheld the subsidies, most of the individuals that we enrolled in the marketplace would no longer be able to afford coverage and would become uninsured again.

If you would like to read the filing please visit here

Day 5: Building On 20 Years of Success

We started off the week talking about the health care disparities that exist in the United States, and while they paint an ugly picture, the last 20 years have shown us that there have been improvements and that we will continue to see improvements. In order to see those improvements, we need to continue to fight for change and to play an active role in change.

For those of you reading these posts this week, how do you think you can be a part of the changing landscape of health care? What is the number one change that you would like to see and what do we need to make that change?

Excerpt from the American Public Health Association:

Let’s celebrate our accomplishments and talk about what it will take to become the Healthiest Nation in One Generation!

2015 marks the 20th anniversary of APHA coordinating National Public Health Week! The accomplishments of the public health community over the last two decades are significant. To become the Healthiest Nation in One Generation: experts need to support the integration of public health and primary care; policy decision makers need to understand and support funding for both a strong public health workforce and prevention programs proven to advance health; both national and local policy decision makers need to expand the consideration of health implications in all the policies they create; and the general public needs to make healthy choices for themselves and demand that everyone has an equal opportunity to make those same choices.

Facts & Stats:

Some of the greatest public health achievements of the 20th Century – according to the CDC (and we agree!) include:

Healthier Mothers & Babies – Infant and maternal mortality rates have decreased in the U.S. Environmental interventions, improvements in nutrition, advances in clinical medicine, improvements in access to health care, improvements in surveillance and monitoring of disease, increases in education levels, and improvements in standards of living contributed to this remarkable decline.
Immunizations – Today, U.S. vaccination coverage is at record high levels! National efforts to promote vaccine use among all children has helped eradicate Smallpox and dramatically decrease the number of cases of Polio, Measles, Hib and other diseases in the U.S.
Motor Vehicle Safety – We’ve seen a huge reduction in the rate of death attributable to motor vehicle crashes in the United States, which represents the successful public health response to a great technologic advancement (the motorization of America). The response has spanned government, public health and driver and passenger behavior.
Family Planning – Increased contraception use, public health education and other factors mean that, today, Americans face fewer unintended pregnancies and are far more likely to achieve desired birth spacing and family size.
Tobacco as a Health Hazard – During 1964-1992, approximately 1.6 million deaths caused by smoking were prevented thanks to substantial public health efforts.
Decline in Deaths from Heart Attack & Stroke – Still the country’s top killers, the public health community has helped achieve remarkable declines in deaths from both diseases: since 1950, deaths from cardiovascular disease have declined 60 percent, and stroke rates have declined 70 percent.

(For more visit http://www.cdc.gov/about/history/tengpha.htm)

What’s next? Together we can create the healthiest nation in one generation.

We have a lot of challenges to overcome, but it all starts with a simple first step:

Sign the pledge to show your commitment. Ask others to sign as well because the more people who sign, the more influence we have to drive change.

Sign the petition to ask our leaders to do their part. It will take change at both the local and national level to ensure our communities make a positive impact on our health.

See below

Day 4: Building Broader Communities

Public Health involves us coming together as a community to create change. Very little happens when we do work as an individual, but when we come together in coalitions we can impact the health of our communities. When looking to build these coalitions, think outside of the box and go beyond your normal partners. Sometimes the unlikeliest partner will actually be the best partner that you could have.

The examples below show how partners that cross many sectors can create wonderful change