Systems of mental health care for American Indian and Alaska Native children and adolescents.

As described elsewhere in this book, the burden of mental health and related problems on American Indian and Alaska Native children and adolescents and their families is considerable. Because many American Indian/Alaska Native community members see the struggles of their children, adolescents, and families as intricately tied to their history of genocide, forced assimilation, the failure of the federal government to meet its treaty obligations, and the failure of local and regional governmental and nongovernmental entities to respect each tribe's sovereign status, facing these struggles is often filled with pain and anger. This also likely compounds the child and family's perspective on stigma associated with mental health problems and treatment that is all too common among all. The systems of care movement and its related federal programs have offered a unique opportunity to address these problems in ways that are more consistent with tribal worldviews than has heretofore been possible. And while the federal programs built upon systems of care principles have not always been as supportive of American Indian/Alaska Native communities as they could have been—particularly in the early years of these programs—they have evolved into transferable models for federal support of tribal efforts that address their needs in ways that fit with American Indian/Alaska Native community values and preferences. In this chapter, we will provide a brief overview of the history of the systems of care movement and its underlying values and beliefs. We will next discuss the involvement of American Indian/Alaska Native communities in them system of care movement and related federal programs, with particular attention to the Center for Mental Health Services' (CMHS) Circles of Care program and the Comprehensive Community Mental Health Services for Children and Their Families program (often referred to as the Children's Mental Health Initiative, or CMHI). We will conclude this chapter with an analysis of strengths and challenges of the systems of care movement for addressing the needs of American Indian/Alaska Native children, adolescents, and their families. (PsycINFO Database Record (c) 2016 APA, all rights reserved)