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On January 1, 2017, the KHI News Service became part of KCUR public radio’s new initiative, the Kansas News Service. The Kansas News Service will continue to cover health policy news and broaden its scope to include education and politics. All stories produced by the former KHI News Service are archived here. Stories and photos may be republished at no cost with proper attribution and a link back to KHI.org.

Mental health an emerging issue for Kansas tribes

American Indian health officials see link between diabetes, depression

By Bryan Thompson | September 03, 2015

Mental health an emerging issue for Kansas tribes
A survey done by the Potawatomi Tribe last year identified mental health as a growing concern. Health officials see a link between diabetes and depression, and are working to find new treatment options for tribe members.

Members of the four American Indian tribes with northeast Kansas reservations recently gathered to talk about health. They discussed continuing the fight against diseases, such as diabetes, that have plagued Indians for generations. But the talk didn’t stop there.

“Native Americans are the most at risk for having diabetes. It’s just predispositioned that way. And so, because of that, I knew that that was going to be one of the most important things,” said Tiffany Buffalo, who heads the diabetes program for the Sac and Fox Tribe.

Buffalo and other certified trainers offer diabetes prevention classes on the Sac and Fox reservation. The tribes are working to help their members get more physical activity and improve their eating habits to fight diabetes.

If successful, that might help control another common health problem on the reservations in Kansas.

“We know, for example, that a third of all diabetics are depressed — but we do very little with that,” said Bill Thorne, who administers the health center on the Prairie Band Potawatomi Reservation.

Thorne said a survey done by the Potawatomi Tribe last year identified mental health as a growing concern. But prior to that, he said, there wasn’t much talk about it.

“It’s one of those areas that’s been kind of taboo,” Thorne said. “It’s out of the closet, but I don’t think it’s fully out yet. So, there’s going to be a lot of discussion about how to make sure that there’s no stigma attached with that when people seek help and care.”

Reservations, like small towns, are tight-knit communities where news and gossip travel quickly. As a result, Thorne said, American Indians — like others in rural areas — sometimes are reluctant to acknowledge that they’re struggling and to seek treatment.

“You can see it in their eyes and … their motions,” he said. “They will look around, and what they’re looking for when they come in to report for an appointment … they will look around to see if they know anybody, because some of them, they’re embarrassed or they don’t want people to know.”

“A lot of tribal members are embarrassed if they have mental health issues, and they don’t necessarily want to go into a doctor’s office and talk.”

- Kelly Cheek, who belongs to the Iowa Tribe of Kansas and Nebraska
      

But there are other deep-seated reasons, according to Grace Johnson, a mental health and substance abuse counselor at the Indian Center in Omaha. She said the losses the tribes suffered as the United States grew and developed still are taking a toll.

“A loss of culture, a loss of land, a loss of language,” Johnson said. “There’s a shorter lifespan for Native Americans that’s expected. A lot of death. We have high rates of suicide. We have high rates of addiction and high rates of accidental death. So, there’s a lot of grief that plays into this that, for some people, have not been able to be processed.”

Tribal health officials agree that the link between depression and diabetes is a clear indication that treating mental health needs to be a bigger priority in Indian communities. But mental health therapists are in short supply on reservations.

Johnson and her colleagues at the Indian Center recently started offering therapy through interactive video. At first, Johnson had concerns about how effective it would be. But she said results so far have been encouraging.

Kelly Cheek, who belongs to the Iowa Tribe of Kansas and Nebraska, said the video therapy offers some privacy for those seeking mental health treatment.

“A lot of tribal members are embarrassed if they have mental health issues, and they don’t necessarily want to go into a doctor’s office and talk,” Cheek said. “They don’t want everybody else knowing what the problem is, and I think the tele-mental health system that we just implemented is a good way for them to be kind of discreet about it.”

The effectiveness of video therapy is something that will have to be tracked and analyzed, as it’s just getting started on the Iowa reservation. Meanwhile, the Potawatomi Tribe is planning construction of a new behavioral health center. Both developments are indications that the tribes are taking the growing mental health needs of their people seriously.