C4 Innovations

Community & Behavioral Health | Recovery | Social Change

Equitable Paths to Recovery for Indigenous Peoples

Several states and cities across the U.S. have abandoned the Columbus Day holiday in favor of Indigenous Peoples’ Day. What was once a day in October to celebrate the person who “found the new world” is now a time to honor the people who originally inhabited North America—the Indigenous peoples who faced incredible adversity as their culture and way of life was violently impacted by the masses who followed behind the European newcomer.

C4 honors and celebrates Indigenous peoples, communities, cultures, and traditions. In our work to increase access to substance use, mental health, and housing supports, we are partnering with Native peoples and tribal communities to address inequities in services and systems.

Over many centuries, Indigenous peoples have experienced genocide, forced removal from their homelands, repeated attempts to breakdown their culture and languages, and forced assimilation. Reactions to historical trauma—emotional harm caused to an ethnic group by a traumatic experience—often manifest in poor physical and emotional health, including low self-esteem, depression, substance use, and suicide, even many generations later (NCAI, SAMHSA). The National Congress of American Indians reports that suicide is the second-leading cause of death for Native youth aged 15–24 (NCAI). According to SAMHSA’s National Survey on Drug Use and Health, American Indian and Alaska Natives currently experience the highest rate of alcohol, marijuana, cocaine, inhalant, and hallucinogen use disorders and have the second highest rate of opioid overdoses when compared to other ethnicities (NSDUH).

Individual experiences of trauma and behavioral health challenges among Indigenous peoples are compounded by structural barriers to care. For example, the most recent data from SAMHSA indicate that of the 13% of American Indian and Alaska Natives who need treatment for substance use disorder, only 3.5% receive services (SAMSHA). Barriers to care may include discrimination, poverty, lack of health insurance, stigma around having a substance use disorder, low levels of education, and distrust of the westernized treatment system (Dickerson et al).

In response, substance use and mental health supports specifically developed and delivered by, in partnership with, and for Indigenous communities are critical. For providers working in regions with Indigenous peoples and communities, expanding partnerships with Indigenous peoples to develop culturally sensitive and inclusive practices in programs can help bridge treatment gaps. For more information, read The National Tribal Behavioral Health Agenda.

Though Indigenous communities have endured great challenges, they maintain resilience and strengths which support recovery—including persistence, resilience, courage, and strong familial ties. The recovery community must support Indigenous families and communities in creating new, equitable paths towards recovery, expanding culturally relevant services, and creating inclusive programming.