A Focus on Tribal Behavioral Health Providers: A Need to Advocate for the Wellbeing of Generations

May 17, 2024

By Sindy Bolaños-Sacoman, Owner & CEO, SBS Evaluation & Program Development Specialists, Director and Co-Founder, New Mexico Tribal Behavioral Health Providers Association

“…I can say that alcohol misuse has plagued our lives. Alcohol addiction has stunted the growth of my people for many generations. Culture and my people never reach the surface due to the cycle and social trauma contributed by this epidemic. My people have been targeted for so long by alcohol industries through cheap alcohol and accessibility within five miles from my dry reservation. With humility, I ask that you please help my people walk towards resiliency and healing.” Name withheld, Tribal Behavioral Heath Advocate

The New Mexico Tribal Behavioral Health Providers Association (NMTBHPA) was formed out of a need to provide a voice for Tribal behavioral health providers in our state and a need to bridge communication between the State departments and Tribal providers. Our mission statement is: Advocate as a united tribal voice for a quality behavioral health system accessible and responsive to tribal matters that affect the collective. Through engagement with state departments, the NMTBHPA seeks to amplify important behavioral health concerns faced by Tribal nations while fostering an environment where providers can positively impact the communities they serve. Indian Affairs Bureau Cabinet Secretary Lynn Trujillo endorsed the NMTBHPA, which held its first meeting in 2021 during the pandemic when the demand for behavioral health services was at an all-time high, regulations were changing due to pandemic restrictions- all while tribal shutdowns were in effect. 

Although Native Americans account for approximately 1.7% of the US population, they experience much higher rates of substance misuse compared to other racial and ethnic groups in the nation7. Alcohol use in tribes is so prevalent that nearly all native families have been affected directly or indirectly8. Thus, the voice of Tribal providers who treat those facing alcohol disorder, alcohol misuse, and alcohol related harms is crucial. But where are these voices and why are they not resonating in halls demanding change?

New Mexico is home to 23 separate and distinct Tribal nations which include 19 Pueblos; Jicarilla, Mescalero and Ft. Sill Apache Nations; and Navajo Nation. New Mexico has long suffered the nation’s highest rate of alcohol-related deaths and in 2021, reached an all-time high with 2,276 lives lost1,2 and in 2022, again, lost over 2,000 lives. Since 1981, NM has ranked 1st, 2nd, or 3rd in the nation for alcohol-related deaths3. Moreover, Native Americans in NM die of alcohol-induced causes at four times the state rate4,5,6. Thus, in a state that is home to many Tribal nations, it is vital to ensure, encourage, elicit, and listen to the needs and suggestions of those who provide mental health services. 

In 2022 and again in 2023, legislation was introduced to increase the liquor excise tax, which has not been increased in 30 years, by 25 cents generating approximately $250 million dollars in an Alcohol Harms Alleviation Fund to fund prevention, treatment, and recovery services9 statewide. The excise tax also included funding for Tribes to address the devastating impact of the alcohol crisis on tribal land. Although this evidence-based strategy is recommended by the Center for Disease Control10, the World Health Organization11, and the New Mexico Department of Health12, most tribal behavioral health providers were unaware of this effective strategy or that it was being proposed.

The NMTBHPA worked to build capacity amongst its membership around evidence-based strategies known to decrease alcohol-related harms, including liquor excise tax, and mobilized its membership to raise awareness about the alcohol initiatives proposed. Armed with information, knowledgeable about the proposed alcohol related initiatives, professional and life experiences, and years of seeing the negative impact alcohol has had on tribal communities, Association members verbalized their support for action to be taken. Several members stepped foot at the state capital for the first time, provided public comment, and participated in a process that had the potential to generate statewide change and address the alcohol epidemic that has plagued their communities and state for generations.

It is vital for Tribal behavioral health providers to understand the legislative initiatives proposed that could affect them or have a negative impact on Tribal Nations. Although it is rare for Tribal clinicians or preventionists to participate in a legislative process, especially when it comes to alcohol, many now have a heightened interest in increasing their capacity, educating the masses, actively participating during Behavioral Health Day, and raising awareness of the many tribal behavioral health needs across their state. Although behavioral health providers are extremely busy addressing community needs due to substance misuse, abuse and related harms, there has been an enormous increase in the willingness to learn, get involved and have their voices heard.

The accomplishments of the New Mexico Tribal Behavioral Health Providers Association have been many as they have brought awareness to the state behavioral health department, tribal liaisons, local behavioral health associations, law enforcement, and stakeholders statewide in order to reduce inequities.

Although the Association has not been funded for two years, the director and an active long-term core team have voluntarily guided and given direction to the group. If you are aware of funding sources for such initiatives, please contact [email protected]

You can learn more about the New Mexico Tribal Behavioral Health Providers Association at https://nmtribalbehavioralhealth.org

  1. https://www.nmhealth.org/publication/view/marketing/8331/ Centers for Disease Control and Prevention, National Center for Health Statistics.
  2. Underlying Cause of Death 1999-2020 on CDC WONDER Online Database, released in 2021. Multiple Causes of Death Files 1999-2020.
  3. https://ibis.doh.nm.gov/indicator/summary/AlcoholRelatedDth.html
  4. https://nmindepth.com/2022/an-emergency-hiding-in-plain-sight/
  5. https://ibis.doh.nm.gov/indicator/view/AlcoholRelatedDthInjury.RacEth.html
  6. https://www.lcsun-news.com/story/news/2022/07/27/new-mexico-nm-alcohol-residents-drinking-themselves-to-death-high-rate/65379663007/
  7. https://americanaddictioncenters.org/addiction-statistics/native-americans
  8. Hawkins EH, Cummins LH, & Marlatt GA (2004). Preventing substance abuse in American Indian and Alaska Native youth: Promising strategies for healthier communities. Psychological Bulletin, 130(2), 304–323. doi: 10.1037/0033-2909.130.2.304
  9. Alcohol Harms Alleviation https://www.ahacoalition.org/
  10. The Community Guide (2023). https://www.thecommunityguide.org/pages/about-community-preventive-services-task-force.html
  11. World Health Organization. Excise tax on alcoholic beverages (2024). https://www.who.int/data/gho/data/indicators/indicator-details/GHO/excise-tax-on-alcoholic-beverages
  12. https://www.nmhealth.org/publication/view/marketing/8331/
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