Indians need more access to behavioral medicine

Psychologist urges Congress to use APA?s Indians into Psychology program as model for providing health care on Indian reservations.

By Lisa Rabasca
Monitor staff

Four of the leading causes of death among American Indians?accidents, substance abuse, heart disease and diabetes?all have roots in behavioral health and could be curtailed dramatically if Native Americans received more behavioral medicine and prevention services?the type of interventions psychologists are well equipped to provide, according to APA?s testimony to Congress on May 21.

Speaking for APA was Arthur McDonald, PhD, who urged Congress to develop a program modeled after APA?s Indians into Psychology program, which encourages American Indians to pursue careers in psychology and supports undergraduate and graduate programs for American Indians in Psychology.

Accidents, including suicide, alcohol and drug use, stress-related cardiovascular disease, and diabetes are the four major causes of death on Indian reservations. Many studies show that behavioral medicine and health psychology can prevent substance abuse, diabetes and cardiovascular disease, said McDonald, who is chief executive officer, Morning Star Memorial Foundation, Lame Deer, Mont.

Studies also show that medical costs are significantly reduced when patients are offered programs that help them modify their diets or stop smoking and are prevention oriented. However, to provide such programs, there is a need to train psychologists in primary care. The agency currently does not include a substantial training component for its psychologists.

'The Indian Health Service is not staffed in a way conducive to approaching a behavioral model in prevention, but that should not prohibit them from developing this new direction,' McDonald said.

There are approximately 103 psychologists who are American Indian, according to the 1996 APA registry. Only 53 are enrolled in the clinical/counseling field with just 11 working for the Indian Health Services.

APA?s Indians into Psychology program could help train psychologists in primary health care, McDonald said. Through the program, APA works with the Department of Veterans Affairs, Indian Health Services and the Appropriate Tribal Colleges to entice American Indians to study psychology. The program currently receives $600,000 annually from the federal government to provide services to the entire United States.

'That is a very, very weak statement of intent or belief in efficacy, if anyone believes a problem of this magnitude can be touched with $600,000,' McDonald said.

Accidents, alcohol and drug use, stress-related cardiovascular disease, and diabetes are the four major causes of death on Indian reservations.

Although APA?s Indians into Psychology program provides funding to the University of North Dakota and the University of Montana to attract more American Indian students to graduate psychology programs, McDonald believes these two programs will hardly touch the need.