Yurok Circles of Care Project

YUROK CIRCLES OF CARE PROJECT

COMMUNITY STRENGTHS AND RESOURCES ANALYSIS

Chad Keith Olson

A Project Presented to

The Faculty of Humboldt State University

In Partial Fulfillment of the Requirements for the Degree

Master of Social Work

Committee Membership

Ronald Swartz PhD., Major Professor

Margaret Waller PhD., Committee Member

Allyson McCovey CoC Project Director, Committee Member

Michael Yellow Bird PhD., Graduate Coordinator

May 2013

ABSTRACT

YUROK CIRCLES OF CARE PROJECT

COMMUNITY STRENGTHS AND RESOURCES ANALYSIS

Chad Keith Olson

The Yurok Circles of Care project seeks to develop a behavioral/mental health service

model for Yurok children, youth and transition age adults 0-25 and their families. System

improvement is being sought in this community because of the disproportionate number of Yurok children being served by the juvenile justice, child welfare, mental health, and alcohol and other drug systems. There are also high rates of trauma exposure, depression, anxiety, suicide, substance use, teen pregnancy, and accidental death in the community.

For this project 15 semi-formal interviews were conducted with service providers in three

identified service areas. Information was gathered on services provided, service system

strengths, identified gaps in services, barriers to participation and traditional, informal

and natural supports that are currently used. A variety of services were found to be

present in each service area. Geographic barriers, transportation issues, intra-system

communication issues and system navigation issues were seen as significant barriers for

families seeking funded services. The renewal of traditional Yurok practices, values and

beliefs was presented as a sustainable model for improving, promoting and supporting

health and wellness in the Yurok community.

ACKNOWLEDGEMENTS

This project would not have become a reality without the assistance of numerous dedicated and inspirational people. My first thank you goes to the Yurok Circles of Care

Project Director Allyson McCovey for her assistance, support, encouragement and direction throughout this project. I also give thanks to Dr. Michael Yellow Bird for being willing to share his knowledge and insights regarding decolonization and for challenging me to think at a higher level. Thanks also need to be given to the service providers that agreed to be interviewed, the committee members that took me in and shared of themselves during the Circles of Care conference in Denver and to the Yurok community and people for sharing their experience, insights and many gifts. A special thank you is given to Patti Gibbens, teacher at Jack Norton School, and to my mom, Pam Olson, who was a past administrator of the River Schools. Lastly, I want to thank my daughter,

Kaylee, for mentally challenging me on a daily basis with her fierce debates and quick

mind. Thank you one and all.

iii

TABLE OF CONTENTS

ABSTRACT ...... ii

ACKNOWLEDGEMENTS ...... iii

TABLE OF CONTENTS ...... iv

INTRODUCTION ...... 1

REVIEW OF LITERATURE ...... 5

METHOD ...... 15

RESULTS ...... 20

Eureka/Arcata/McKinleyville ...... 22

Crescent City/Klamath ...... 32

Hoopa/Weitchpec ...... 37

DISCUSSION ...... 46

REFERENCES ...... 50

INTRODUCTION

There are almost 5,000 enrolled Yurok tribal members, making it California’s largest indigenous group (Yurok Tribe, 2012). The current tribal lands consist of an area extending one mile on either side of the mouth of the Klamath River and 44 miles upriver, covering 63,035 acres. There is limited access to basic services for tribal members living on the reservation, with the majority living in areas that do not receive electricity or phone service (Yurok Tribe, 2012). In addition, 80% of tribal members have incomes below the poverty line and limited access to employment opportunities, healthcare and educational services due to what is considered a grossly substandard transportation system. (Yurok Tribe, 2012)

The Tribal council, Tribal members, and employees of the Tribe have worked hard to improve this infrastructure. Improvements have been made to roads in the area and electrical service is being extended into areas that did not previously receive it.

Various tribal entities, under the direction of the tribal council, have sought and acquired grant funding for a number of projects to improve infrastructure, manage tribal resources and improve the quality and availability of services on the reservation. Yurok Social

Services received a Substance Abuse and Mental Health Services Administration

(SAMHSA) grant in 2011 to design a system of care that will meet the mental health needs of Yurok tribal members 0-25 years old.

The Circles of Care SAMHSA grant provides funding for three years for the research and design of a program model. Circles of Care seeks to improve access to

culturally appropriate, timely, behavioral health supports and services for individuals,

children, youth and families living on the Yurok reservation (A. McCovey, personal

communication, September 21, 2012). Formal and informal supports that encourage

overall community health and wellness will be identified and assessed through this grant.

The current service system’s components will be described and mapped. System

strengths, barriers and gaps will be identified through this process. A relational paradigm

that incorporates mind, body, spirit and environment will inform the process.

Circles of Care is a research and design grant and does not provide funding for the

implementation of the model that is developed. The sustainability of the services and

supports that are included in the model will also need to be assessed to insure that the

program model is a good fit for the community over time.

Between 1999 and 2004, statistics placed suicide as the second leading cause of death for Indigenous people in the United States 10 to 34 years of age (The Suicide

Protection Action Network, 2012). The rate of anxiety, depression and substance abuse

among indigenous peoples was identified as a contributing factor to the high rate of

suicide (SPAA, 2012). High levels of poverty, a substandard infrastructure, negative

experiences with unresponsive, culturally inappropriate or ineffective Euro-American service providers has made it difficult for individuals and families to seek or access supports and services they may need or want. The disruption of cultural life-ways and past experiences of trauma, coupled with assessments and funding sources that emphasize

Euro-American beliefs, values and concepts of health, has left many communities with few options for families and individuals needing assistance.

Behavioral health services and supports for people that identify as Indigenous

are increasingly combining Euro-American treatment models with Indigenous traditional

models of health and wellness. This trend toward more holistic models of care that

incorporate Indigenous beliefs, values and practices has been driven by the lack of

improvement in health statistics for these groups.

Indigenous communities in North America consistently had the highest rates of

suicide among their youth aged 15 to 29 from 2003 to 2007 and an overall rate that was

matched only by whites at 18.1% during those years (Crosby, Ortega & Stevens, 2011).

These statistics may have been significantly underreported as they depend on correct

identification of a person’s ethnicity and the reporting agencies’ identification of the death as a suicide. The figures for Indigenous youth are believed to reflect an underreporting of 25% to 35% (Crosby, Ortega &Stevens, 2011). Deaths from motor vehicle accidents, the leading cause of death for people 5 – 34 years of age, were also seen at higher rates for Indigenous people. The rate for whites was less than 2% while the rate for people who were identified as Indigenous was 7% during the period from 2003 to

2007 (West & Naumann, 2011). Indigenous females had higher drug induced death rates than any other ethnic or racial group from 2003 - 2007 reaching a peak of 11.5% in 2007

(Paulozzi, 2011).

The preceding statistics clearly reveal the need for a reassessment of the service systems currently used to promote the mental health and wellness of Indigenous people in

the United States. Describing the elements that make up the current service system for the

Yurok community has been identified as the first step toward development of a system

4 model that meets the needs of the community. Identifying the strengths, gaps, redundancies and barriers that exist in the current system will enable the Yurok Circles of

Care effort to be focused on meaningful changes and improvements in the service system.

These changes have the potential to significantly improve the mental health and wellness of children, youth and transition age adults in the community and decrease the suicide, alcohol and drug use, and accidental death rates of these populations.

REVIEW OF LITERATURE

Numerous studies have been conducted with Indigenous peoples and communities over the past 20 years which focus on health disparities. Many of these studies highlight the physical and behavioral health problems found in Indigenous communities or seek to describe programs that are being developed for those communities. Some recent studies have used a multi-method approach to identify the causes of health disparities and to develop community and culturally based services and interventions.

Studies that assessed the effectiveness of traditional Indigenous health and wellness practices for mental health issues in children and adolescents were rare. Clinical studies of evidence-based practices in mental health with Indigenous children and adolescents in rural populations were almost non-existent. Substance use issues were the most common subject for study but are just one factor of interest. Studies that focused on strengths, resiliency and natural/informal supports were seen as having more relevance to the current topic of interest and were given more attention in this review. Those studies that focused on children and youth generally examined factors affecting resiliency, ethnic identity and education. No studies were identified that examined the connection between improved behavioral health and wellness and the incorporation of traditional Indigenous values, beliefs and practices in treatment delivery.

In the 32 studies examined for this literature review, 10 examined programs that combined traditional values and practices with Euro-western practice models, 12 focused

on traditional indigenous values, beliefs and practices, and 10 looked at resilience and

natural supports. A wide variety of data collection and analysis methods were used

including both qualitative and quantitative techniques. All studies examined people,

communities and programs within the United States. They varied widely in regard to

participant characteristics however all of the studies focused on Indigenous people and

programs. None of the identified studies utilized Indigenous people or communities in

Humboldt County as participants.

Recognizing and addressing the effects of historical trauma with families is vital.

in developing behavioral health supports and services for Indigenous youth and families .

Interventions which help parents recognize the effects of historical trauma and provide an

opportunity to learn traditional Indigenous parenting skills increased positive parental

involvement with youth. (Goodkind, Lanoue, Freeland & Freund, 2012). Mmari, Blum,

& Teufel-Shone (2010)identified positive parental involvement as a significant protective factor for Indigenous youth.. This is consistent with the Circle of Care philosophy which seeks to improve mental health and wellness for youth by encouraging family and community engagement. The renewal of traditional models of child rearing and family systems would be consistent with the findings of these studies as well.

According to LeFromboise, Hoyt, Oliver & Whitbeck (2006) having a supportive

mother, believing that the community is supportive of you and having a strong

indigenous identity improve behavioral and social functioning for children and youth.

Participation in traditional Indigenous cultural activities is shown to increase the

connection urban Indigenous youth have to their Indigenous heritage. This appears to

have less of an effect on youth that have been raised on a reservation (Schweigman, Soto,

Wright & Unger, 2011).

Positive social support was identified as a key protective factor in preventing

alcohol, substance use and mental health disorders in Indigenous women. . Conversely,

negative social supports, wherein individuals are criticized or isolated in order to promote

behavioral change, were shown to increase the likelihood of those disorders (Oetzel,

Duran, Jiang & Lucero, 2007). This supports the need for more research into the role of

extended family and community in promoting behavioral health and wellness.

The importance placed on extended family and community is a defining

characteristic of many Indigenous peoples. Interventions designed to fit the Euro-

American concept of treatment which emphasizes personal responsibility, problem

awareness, and the separation of the ill from those who are well, is in direct opposition of

traditional Indigenous models of health and wellness. According to Grandbois (2005),

Indigenous people frequently use Euro-American biomedical treatment models to address acute symptoms but seek traditional health practices and practitioners to restore balance in their lives and deal with the causes of an illness.

Caution must be exercised at this point as it would be erroneous to assume that all

Indigenous people in North America have the same beliefs, values, experiences or practices. Grandbois (2005) asserts that, “The differences in the backgrounds of two

AIAN individuals might be greater than the differences between two Europeans from dissimilar countries.” Likewise, views of mental illness differ widely from person to person and group to group as do the interventions that fit those people and groups. This

understanding makes it difficult to generalize findings from one Indigenous group to

another and emphasizes the need for the development of community-defined interventions and supports.

Studies show that the degree to which a person attaches stigma to mental illness is related to how strongly they are connected to traditional values, beliefs and practices

(Grandbois, 2005). Individuals that are well connected to traditional belief systems are less likely to stigmatize the mentally ill than those who have accepted the Euro-American

view of illness. An individual that attaches a high degree of stigma to mental illness may

not seek out the supports or services that they need for fear of being labeled. This may

also be complicated by the reality that they may feel disconnected from their culture and

their heritage and be less likely to use the natural supports found in their communities.

The realities of navigating a society that identifies you as “at risk” and is

constantly looking for signs of dysfunction only exacerbate the problems faced by

Indigenous youth. Strickland & Cooper (2011) detail the struggles faced by young males,

15 to 19 years of age, as they attempt to avoid “getting into trouble” at school, with the

police, and with their parents. Stress, alcohol, drugs, and family issues were identified as

substantial risk factors for suicide . Depression, hopelessness, experiences with prejudice and negative contact with societal structures like schools and law enforcement also increased the risk of suicide. For the males that participated in the study cultural traditions, prayer and family support were identified as significant protective factors

(Strickland & Cooper, 2011). The study used a community based participatory planning team to support and provide direction to the researchers which is similar to the research

philosophy advocated by the Circle of Care. The study has a narrow focus, male youth 15

to 19 years of age from one community. Its findings support the hypothesis that cultural

factors and natural/informal supports play an important role in promoting Indigenous

health and wellness.

Traditional models of care and traditional Indigenous practices that promote

health and wellness are also prevelent in the literature. Most of the research in this area

focuses on the importance of ceremony and ritual in traditional Indigenous models of

treatment. The conflict between Euro-American and Indigenous practices is also a

common theme identified in these studies (Gone, 2007, 2008; Hodge, Limb & Cross,

2009; King, 2011; Lucero, 2011) .

Various factors have made it difficult to assess the effectiveness of Indigenous

treatment models using Euro-American assessment methods. Policies of the United States

government which have sought to outlaw traditional Indigenous life ways and practices

have promoted a strong distrust of Euro-American systems. The sacred nature of

Indigenous health and wellness practices also makes it difficult to systematically assess treatment interventions. The invasion of Indigenous communities by anthropologists and other researchers, which have tended to benefit the researchers but not the Indigenous

people being studied, has also led to resistance of research. There is wide variation in the

cultural practices of Indigenous people and this makes it difficult to generalize findings.

The small sample sizes found in many of the studies of traditional practices also affect

their validity and generalizability when viewed from a Euro-American research

paradigm.

The push for outcomes driven mental health services that rely on evidence-based practices (EBP) and models in Euro-American society has made it difficult for traditional

Indigenous health and wellness models to gain support. This has led to the development of decolonized research methods that utilize practice based evidence in assessing traditional practices. This reframing is essential to the process as it recognizes the validity of centuries of experience. As Lucero (2011) states, “traditional practices are more than complementary forms of healing. They are stand-alone methods, developed and used by tribal people long before the concept of EBPs existed.”

Whereas much of the emphasis in Euro-American treatment models focuses on individual, biology and personal insight, traditional Indigenous models emphasize community, spirituality and holistic balance. Gone (2007) utilized ethnographic field methods to perform an in depth interview of a 50+ year old tribal member who grew up on the Fort Belknap reservation. This individual described himself as a traditionalist.

Gone (2008) expanded on this research in a second paper by examining the role of “space and place”. This second study also built on prior interviews he had conducted with

“conventional” health services employees on the Fort Belknap reservation.

Differences in the analysis and interpretation of behavioral anomalies observed in individuals were explored in both of these papers as well as the differences in interventions proposed. Euro-American interventions were identified as systems of colonization that continue the erosion of traditional beliefs, values and practices.

Dysfunction, according to Gone (2007), was seen as a direct result of the socio-historical context of European colonization and a more subtle form of genocide. Culturally based

spiritual and ceremonial practices based on pre-colonial traditions are seen to promote

recovery and community healing from the traumas of the past. The use of fasting, sweat

lodges, dances and rituals are shown to be empowering.

Space and place are identified as key concepts by Gone (2008). Traditional

Indigenous healing practices embrace the role of the natural world as a nurturing and healing force. Human culture is intimately and inseparably connected with environment according to Gone (2008) and Colombi (2012). Traditional healing practices recognize and emphasize this connection. Dine’ healing ceremonies that utilize sand paintings are an example of this concept.

Euro-American therapeutic practices generally take place in an office setting.

Buildings are placed in locations of convenience and little thought is generally given to the potential healing qualities of that location. The environment is less important, in

Euro-American thought, than the intervention that is to be used. Traditional Indigenous healing practices require that the healer take great care in identifying the environment where the healing intervention will take place. Place is no less important than any other element within the framework of the healing.

Coming of age ceremonies and rites of passage were another area that was covered in a limited way within the current body of research. These types of ceremonies are seen as a way to encourage a strong sense of identity while preparing individuals for the adult roles that they are expected to assume (Markstrom & Iborra, 2003). Coming of age rituals are often used to convey traditional knowledge, skills, values and expectations to those in the next generation. While not seen as healing ceremonies per se they play a

significant role in promoting mental and physical health through a connection to

community and strong identity formation. Both of these are seen as important protective

factors for individuals and communities (Waller, Okomoto & Hankerson, 2002;

Markstrom & Iborra, 2003; Brokenleg, 2010)

The third theme that was identified through a search of the literature included

studies that focused on the effectiveness of programs that incorporated Indigenous

practices. Several studies in this area also looked at how programs that combined

traditional Indigenous practices and Euro-American practices were developed. The methods used to analyze and evaluate the findings within this area varied widely from study to study. Goodkind et al. (2011) utilized an extensive review of the literature, focus groups, consultations with traditional providers and a survey of providers that is similar to what has been proposed for the Circle of Care.

As stated earlier in this review the largest body of research on collaborative

models has been conducted within the context of substance abuse treatment programs.

Novins et al. (2012) described the use of community-centered participatory action research methods to develop a comprehensive substance abuse program for adolescents that combined traditional Cherokee beliefs, traditions and practices with Euro-American evidence based practice methods. Many of the programs that combined Indigenous and

Euro-American practices prominently featured the medicine wheel concept and is used to represent the inter-relational nature of health and wellness. The importance of individuals and communities balancing mind, body, spirit and emotion is one key concept of this model.

Educational and behavioral health programs that reflected a paradigm shift toward

community participation in the development of community based services and supports

were also found. The use of traditional Indigenous beliefs, values and practices in

behavioral health and substance abuse treatment were also identified as effective by

Novins et al (2012). The need to recognize and address the effects of current and past

trauma was a repeated theme in all of the studies. There was importance placed on peer

support and the use of Indigenous service providers in the identified studies as well.

Programs frequently identified suicide, drug abuse, alcohol use and violence as

the issues to be addressed by services. This problem-centered approach appears to be

more closely associated with Euro-American concepts than Indigenous beliefs and values. Providing parenting skills classes for parents that worked on the development of traditional parenting values and techniques was shown to improve outcomes for children

(Bigfoot & Funderburk, 2011). Holistic approaches that combined mind, body, culture, spirituality and environment were also supported in the literature (Nebelkopf, E. &

Wright, S., 2011; Goodkind et al, 2011; Goodkind et al, 2012).

Overall, studies support the development of community generated supports and

services for Indigenous children and youth that emphasize traditional beliefs, values and

practices. While few clinical studies have been performed in Indigenous communities

with regard to the effectiveness of specific treatment modalities (Gone & Alcantara,

2007) the efficacy of traditional Indigenous practices appears to be supported by the

literature. The great diversity of environments, beliefs, practices and values makes it

imperative that services and supports be designed by and tailored to the community in

14 which they are to be offered. The program model development methods proposed by the

Circle of Care appear to be well supported by this literature.

METHOD

A participatory action research (PAR) model (Van de Sande & Schwartz, 2011) that

emphasizes decolonized research methods was used as the foundation for this project.

PAR emphasizes the need to include the community in all aspects of the research process.

The Circles of Care project as a whole is composed of three interlocking components that will be completed concurrently but only the first was completed for this Masters Project.

Interviews with community agencies and community service providers were used

to map out the mental/behavioral health service systems in three regions identified as key

service areas for Yurok tribal members. Five areas of inquiry were identified by Circles

of Care Project staff and were used to focus the interviews. A snowball technique was

used to identify agencies, community leaders and community members to be interviewed.

The interviews were semi-structured using questions generated by the Circles of Care

staff.

The first area of inquiry focused on the types of services that the agency or

service provider being interviewed provided to Yurok children, youth and transition age

adults 0 to 25 years old and their families. Specific questions were asked about the

physical regions that the agency or provider covered, the population served, the

requirements for participation, the specific services that were being provided and the

services that were designed specifically for indigenous or Yurok peoples.

The second area of inquiry focused on the strengths that agencies and service

providers could identify in the current system. This area looked at what service providers

and agencies believed to be working well in the current service system. Questions were

asked about other agencies and service providers that the agency or service provider

identified as part of the current service system. The level of contact and collaboration

between those agencies and service providers that were identified and the agency or

provider being interviewed was also explored. Questions then focused on what services

the provider believed to be effectively supporting and promoting the mental health and

wellness of Yurok children, youth and transition age adults and their families. What

characteristics enabled those services to be effective with these populations was also

explored.

A third area of inquiry focused on the gaps and overlaps that the agencies and

service providers believe exist in the current system. Service providers were asked to

identify supports and/or services that they felt were missing or limited. Questions focused

on the types of services that providers believe the community needs, services that are

working well and that need to be expanded and services and supports that are provided by

multiple agencies in the same region.

The fourth area of inquiry focused on the barriers that families and individuals face in accessing the services and supports that they need. Within this area of inquiry providers were asked to examine the barriers that individuals may face in accessing their specific services as well as services and supports in general within the community. Non- specific questions were used to elicit information regarding the existing barriers in order to limit the influence of the interviewer’s perception regarding the existing barriers.

The fifth and final area of inquiry pursued for this project focused on the informal and natural supports that service providers and agencies were aware of in the three regions covered by this project. Traditional practices that support mental and behavioral health were explored in this area as well as informal support systems that providers and agencies observed families and individuals utilizing. The specific role that community, family and tradition play in supporting the mental and behavioral health and wellness of

Yurok tribal members was explored with providers in this area. Opportunities for Yurok children, youth and transition age adults to engage in and learn about Yurok culture and traditions that providers were aware of were identified.

Ethnographic analysis and mapping techniques were used to identify the dominant themes generated through the interviews with agency staff and service providers. These themes were used to create a master list of community identified strengths, systems supporting health and wellness for youth and young adults, gaps in the system and barriers that families face in seeking services and support.

Emphasis was placed on identifying the community’s strengths, recognizing the natural and informal support systems that are part of the Yurok community and culture, and on the community’s readiness to implement changes in its system of care. The sustainability of the model developed through the Circles of Care project is of significant concern and issues regarding component sustainability were also closely examined.

The Circles of Care Committee served as an advisory committee for this project.

The committee provided guidance regarding the specific questions that would be asked

18 and approved the process that was followed. Progress reports were provided to committee members on a bi-weekly basis to insure consistent communication.

The protection of Yurok cultural knowledge, the Yurok community and the Yurok people is considered to be of paramount importance in this process. To insure the privacy and confidentiality of the Yurok Tribe all primary documents presented by the tribe for use in the data collection phase of this project were examined on site. No copies were made of any reports, research projects, documents or raw data during the project.

Information gathered from the interviews with service providers and agencies were stringently protected following strict protocols to protect individual and group identity and privacy. No information was collected regarding individual or group identities and all thematic data was presented in aggregate form to protect the anonymity of the participants.

As the majority of these interviews were conducted at the agencies where participants worked it was not possible to fully conceal the identities of those choosing to participate from the community at large. Participants were provided a verbal description of the Yurok Circles of Care Project, informed of the potential consequences of participation in verbal and written form and provided an opportunity to ask questions and have potential issues clarified. Only information from providers and agencies that consented to participate following these written and verbal disclosures were included in this project. Participants were informed that they had the right to withdraw their consent at any time without consequence and that the information gathered during their interview could be withdrawn any time prior to April 10th.

No identifying information was gathered from community members, key

informants or groups that choose to participate. Data collected from groups and agencies

was coded and pooled with similar data to protect the identities of those choosing to

participate. Paper based and computerized notes were maintained in a locked safe at a

secure location. Computer based notes were stored on a stand-alone hard drive with a

USB drive used as a backup.

The Circles of Care grant coordinator supervised all phases of the project, read all

reports generated and procured approval of the information that was to be released. All information that addressed culturally protected or private information, as identified by the

Yurok Tribe, was deleted from any and all reports. Dr. Michael Yellow Bird, Chair of the

Master of Social Work program at Humboldt State University, provided guidance and supervision to the project and received copies of all emails and reports generated during for this project.. Margaret Waller PhD, Humboldt State University Social Work faculty, and Ronnie Swartz, Humboldt State Social Work faculty member, also provided support, guidance and oversight for the project.

At the conclusion of the project all paper based notes were shredded and burned.

Computerized notes were wiped from the primary stand-alone drive and the back-up USB

drive according to DoD 5220-22.M standards to prevent re-creation of the data collected.

The collection methods utilized for this study are similar to those used for other Circles

of Care grant funded projects. Study results are limited to the Yurok reservation

communities and specific findings may not be generalizable to other communities or

groups.

RESULTS

Fifteen semi-formal interviews were completed with individuals working in programs or agencies providing services to Yurok children, youth, and transition aged adults 16-25 and their families. Interviews averaged one to two hours in length and were

recorded using written notes taken during each interview. Information regarding services

that were identified by individuals participating in the interviews but who were not

contacted directly was collected from program flyers, pamphlets and agency websites.

Three service regions were identified by service providers during the initial interviews conducted for this project: 1) Eureka/Arcata/McKinleyville. 2) Crescent

City/Klamath and 3) Hoopa/Weitchpec. Five service provider interviews were conducted

in each of these three areas. Two interviews were conducted via telephone with the

remainder conducted face to face at the agency or service provider’s location. Two of the

interviews were conducted with multiple staff concurrently participating from the

identified agency.

The interviews focused on five areas identified in discussions with Yurok Circles

of Care program staff. Areas covered included: 1) Services provided by that agency. 2)

Other agencies which provide services that support or promote mental and/or behavioral

health and wellness in Yurok children, youth and transition age adults 0-25 years old and

their families. 3) System strengths: What is working well? 4) Gaps and barriers that

currently exist in the service system. 5) Informal and natural supports that Yurok families

21 currently utilize which may support or promote mental/behavioral health and wellness in

Yurok children, youth, transition age adults 0-25 and their families.

Three interview participants provided information on three or fewer of the identified focus areas while the remainder of the participants were able to discuss all five focus areas. The service providers interviewed for this project included individuals from educational, mental health, alcohol and other drug, family resource and social service agencies. They included a mix of government and non-profit agencies.

A few of the agencies and organizations identified through this project provide services in more than one of the three regions identified in this report. United Indian

Health Services (UIHS) is the primary medical, dental and behavioral health provider for tribal members and their families in all three regions. Yurok Social Services also has offices in all three regions and provides a variety of services including: youth prevention services, domestic violence services, Temporary Assistance to Needy Families (Tribal

TANF), General Relief and Indian Child Welfare Act (ICWA) social workers.

The Redwood Coast Regional Center (RCRC) provides case management and contract services to children and adults with developmental disabilities in all three regions. The Hoopa/Weitchpec region is served though the Eureka RCRC office which covers all of Humboldt County.

Headstart, early Headstart and the Headstart home based programs are also found in all three regions. Each of these programs provides educational and school readiness services to children 0 – 5 years old. Slots for each program are limited and families must meet eligibility guidelines to participate.

First 5 offers school readiness programs in all three regions, sponsors playgroups and play centers for children 0-5 years of age and their parents or caregivers, and provides funding, information, training and other supports to organizations providing services to children 0–5 years of age. First 5 also provide support to the Family Resource

Centers that are found in each of the regions. These Family Resource Centers provide a range of services to families, tailored to fit the needs of the community in which they are located. Services often include food and transportation assistance, assistance completing application forms for various programs and services, parenting groups and classes, computer and internet access, and referrals for services.

The school systems in each of the three regions provide a central point of contact for families. Assessment, special education and counseling services are legally required services provided at every educational level. Individual Educational Plans (IEPs) are required for children who require specialized services for school success. IEPs identify specific services that a child will be provided.

School staff in each of the regions are often the first to identify developmental, behavioral and mental health issues in children. They are also frequently the first to recognize when a family is struggling.

Eureka/Arcata/McKinleyville

The Eureka/Arcata/McKinleyville area was identified as having the greatest number of service providers, agencies and organizations providing mental/behavioral

health services. United Indian Health Services was identified as an important resource for

mental/behavioral health services for all members of federally recognized Tribes in the

region by all 14 service providers that responded to questions regarding the current

service system. Two Feathers Native American Family Services was also identified as a

resource for members of federally recognized tribes and their families by all five service

providers in the Eureka/Arcata/McKinleyville region.

Two Feathers is a non- profit organization that provides services to Native

Americans of federally recognized tribes and individuals living in their household, who

reside in Humboldt County and have been the victims of domestic violence, sexual

assault or child abuse/neglect. The majority of the people that they serve have already

exited the abusive relationship. They are chartered by the Big Lagoon Rancheria.

Services are funded using a variety of grants and contracts for services with all services

free to clients. They currently serve approximately 150 people.

Organizations and programs in the Eureka/Arcata/McKinleyville region that were

identified by more than three service providers as primarily providing services to tribal

communities and tribal members included: 1) California Indian Legal Services (CILS). 2)

The North Coast Indian Development Council (NCIDC). 3) California American Indian

Recovery Services (CAIRS).

In addition to UIHS, Humboldt County Mental Health (HCMH) and Humboldt

County Mental Health – Child Youth and Family Services (HCMH – CYFS) provide

behavioral/mental health services to Yurok Tribal members in the

Eureka/Arcata/Mckinleyville region. HCMH operates Sempervirens, the only Psychiatric

Health Facility (PHF) in the three identified regions, and provides crisis services to individuals with mental health issues that have been identified as a danger to themselves or others. Sempervirens provides psychiatric services, medication support, psychiatric nursing services, social work services, peer support services and groups.

HCMH also provides psychiatric services, counseling, assessment, advocacy, case management and referral services to individuals and families. CYFS provides services to children who are in need of specialized mental health services such as counseling and/or medication and to their families. HCMH also operates Same Day Services which provides assessment and brief counseling services, the Psychiatric Emergency Services unit (PES) which provides brief stabilization services for individuals with psychiatric emergencies that may lead to hospitalization, the Hope Center which is a peer drop in center for adults with a mental illness, a transition age youth program (TAY) and with case management and peer support services to individuals identified as high need.

HCMH contracts with Remi Vista, a non-profit organization, to provide additional behavioral supports and counseling to children and youth with Serious Emotional

Disorders (SED).

HCMH contracts with other agencies and programs for long term psychiatric care including several programs and hospitals outside of Humboldt County, Crestwood

Behavioral Health Center in Eureka, Transitional Residential Treatment Facilities

(TRTF) in Eureka and several mental health board and care operators. The Children’s

Center, HCMH’s short term residential program for children, was closed in April 2013. It was the only program providing residential mental health services specifically to children

25 within the three identified regions. Children that require specialty residential mental health services may be sent out of the area for services, be placed in the Humboldt

County Regional Facility, in therapeutic foster homes or in Sempervirens.

HCMH was awarded a Systems of Care SAMHSA grant and is currently working to develop a mental health system model for the county of Humboldt. Through this grant they have identified several Evidence Based Practices (EBP’s) that they are seeking to implement and have expressed interest in identifying practices that have been modified to fit the needs of Indigenous communities and people. These EBP’s include: 1) Trauma

Focused Cognitive Behavioral Therapy (TF-CBT). 2) Functional Family Therapy (FFT)

3) Parent Child Interactive Therapy (PCIT). 4) Incredible Years (IY) 5) SafeCare. 6)

Wraparound and Aggression Replacement Therapy (ART).

UIHS also provides alcohol and drug services to members of federally recognized tribes and their families in Humboldt County. They employ several substance abuse counselors that work with individuals who have substance use issues and also engage the services of traditional healers at their Potawat site in Arcata. Sweats are also conducted on site. Youth receiving alcohol or drug services at UIHS that require residential drug or alcohol treatment are referred to one of three out of county treatment facilities identified by Indian Health Services: 1) Cinnamon Hills – Utah. 2) Yuki Trails –

Santa Rosa. 3) Nevada Skies - Nevada.

Humboldt County Alcohol and Other Drug Services (AOD) provides group and individual counseling, assessment, drug and alcohol testing and case management services. AOD also operates a residential detoxification program in Eureka. Residential

drug and alcohol services are provided through several non-profit agencies including: 1)

Crossroads, 2) The Bonnie and Lee Brown programs, and 3) Humboldt Recovery Center

(HRC). HRC participates in weekly sweats conducted at the county’s detox center and

also provides opportunities for people in their programs to participate in community

service activities such as the yearly Elder’s Dinner held at Redwood Acres in Eureka.

A variety of clean and sober houses provide long term housing for individuals

needing ongoing support to remain clean and sober. They often require residents to

remain drug and alcohol free while living in the house and require daily attendance at

Alcoholics Anonymous (AA), Narcotics Anonymous (NA) or AOD treatment groups.

Most require individuals to submit to drug testing as requested.

AA and NA groups occur throughout the Eureka/Arcata/McKinleyville region

and were identified as an important support for individual with addictions. Three service

providers that were interviewed also stated that Wellbriety and Red Road to Recovery

groups were available in Humboldt County but this was not verified due to time

constraints. The Wellbriety Movement and the Red Road to Recovery are based on

Native American concepts of health and wellness. Wellbriety is defined on the Red Road

to Wellbriety (2013) website as a concept that seeks to go beyond the ideas of sobriety

and wellness to define what is best for the whole, naturally-balanced person each of us seeks to become. The Red Road to Recovery is an alcohol and substance abuse program based on Native American beliefs and values. Walking the Red Road is about taking the spiritual and mental journey toward right living, toward living in concert with the earth and not just on it (The Red Road to Wellbriety, 2013).

Humboldt County Child Welfare Services (CWS) is the Humboldt County Health and Human Services (HSS) agency responsible for investigating reports of child abuse and neglect in the Eureka/Arcata/Mckinleyville region. CWS works with children and families in which abuse and/or neglect has occurred on an ongoing basis by providing voluntary family maintenance services, court ordered family maintenance services, family reunification services, foster placement, guardianship home evaluations, adoption services, transition age youth services, mental health assessments, referrals to support services and organizations, and through advocacy work.

CWS is currently working on a grant funded project that is focused on changing the manner in which the children of federally recognized tribes are provided services through CWS. The California Partnership for Permanency (CAPP) grant provides funding to develop services and supports, in collaboration with local tribes, which will decrease the number of tribal children experiencing abuse and neglect and improve outcomes for those children that do come into contact with the CWS system. A model for services has been developed over the last year with tribal participation and training of

CWS social workers has begun.

CWS provides a variety of case planning and case management services to families and also coordinates services with various other agencies and organizations. The department directly contracts with foster families that they investigate an license. They also contract with Environmental Alternatives Foster Family Agency (EA) for foster placements.

A mental health clinician is assigned to CWS. Referrals for counseling services are also made to CYFS and AOD when they are deemed appropriate. RCRC is another key partner, providing services to children and parents with developmental disabilities.

CWS uses a differential response system to identify families that do not meet the criteria for opening a CWS case but who could benefit from services or appear to be in danger of requiring CWS services in the future.

Families that meet this criteria may be referred to a Family Resource Center

(FRC) for services or to Public health (PH). PH has an Alternative Response Team

(A.R.T.) that families are referred to by CWS for issues of general neglect that do not

require CWS intervention. A.R.T. provides intensive case management services to

families for six months. PH has a number of other programs that promote and support

mental/behavioral health for children, youth and their families such as the High Risk

Infant Visitation and Education Program, the Childhood Lead Poisoning Education and

Follow-up program and the SafeCare program.

The School Attendance Review Board (SARB) receives referrals from schools

regarding children who are having school attendance issues. The SARB meets with the

student and their parent or caregiver to discuss the school absences and to develop a plan

for addressing the problem. The Community Schools provide educational and support services to youth that have been expelled from school for a variety of reasons, have significant attendance problems that could not get addressed or that are failing in the traditional school environment.

The Humboldt County Regional Facility is used to incarcerate youth that have engaged in criminal activity. It is also occasionally used to house youth that have entered the CWS system. UIHS and Two Feathers provide individual and group counseling services to tribal youth that are incarcerated at juvenile hall. Probation officers provide case management services to youth that are placed on probation by the courts.

College of the Redwoods (CR) and Humboldt State University (HSU) are also included in the list of programs providing support and services to members of the Yurok

Tribe in the Eureka/Arcata/McKinleyville region. College of the Redwoods has a comprehensive disabled student services program, counseling services and an Equal

Opportunity Program (EOPS) for low income and minority students. Humboldt State

University provides these services and also provides specialty services to members of federally recognized tribes through their ITEPP and programs. HSU has a Native

American Studies major and also focuses on Indigenous people and rural communities in its Master of Social Work program.

The greatest strengths identified by the service providers in this region were the variety of services available and the presence of programs dedicated to serving tribal members and their families. UIHS, Two Feathers and the Tribal TANF program in particular were identified as important components of the system in this region.

Employment opportunities were seen as more varied in this region than in the other two. Specific program components like Positive Indian Parenting classes, domestic violence counseling, sweats, Native American talking circles, and drumming circles were also identified by service providers as positive elements in the system.

A strong connection to place and extended family, a positive cultural identity, participation in ceremonies and cultural practices were some of the factors that service providers identified as helping to facilitate mental/behavioral health in Yurok youth. One provider told the story of a female rite of passage ceremony that she and her family were able to hold for her daughter. This rite of passage provided the family with an opportunity to convey important culture knowledge about what it means to be a Yurok woman and to

instruct this young woman in the expectations of an adult woman of the community. The

service provider also saw this as an important ceremony for providing her daughter with a

sense of connection to community, family, culture and history.

Transportation was identified as the most significant barrier for families seeking

to engage in services in all three regions. Several of the programs identified attempt to address this issue through the use of vans, by having some workers operate in the field or by providing bus tickets or transportation funds. Even in the Eureka/Arcata/Mckinleyville area this was identified as an issue for families. A public transportation system operates in this region but it is not accessible in most rural areas, can be expensive for families on

limited incomes to use, and it can require a substantial investment of time.

Transportation to important ceremonies in the Klamath or Weichpec areas can be

very problematic. Families living in the Eureka/Arcata/Mckinleyville region often rely on

getting rides from people if they do not have a working vehicle as public transportation to

these two locations is very limited and can be expensive. Families may feel disconnected

from the community living in this region because of the difficulty with engaging in

important cultural activities, events and ceremonies.

Families or individuals that are late for appointments or miss appointments

because of transportation issues may have to reschedule for another day or may be seen

as non-compliant and placed on a waiting list for services. Many services are offered

during business hours when children are in school. Appointments with these providers

can place families in a difficult position, having to decide between the educational needs

of their child and their need for services.

Service providers identified a number of prevention-focused programs and services in the Eureka/Arcata/ Mckinleyville region but also identified the need for more prevention services. A distrust of mainstream services in the area was identified as a significant issue by several of the service providers interviewed. Some of this distrust was seen as being due to past experiences in which local tribes participated in discussions and meetings where new services were being designed but were left feeling that their perspective was not really considered in the final product. The limited number of Native

American service providers in many of the mainstream agencies was also seen as a barrier for families seeking services.

Returning to the reservation communities after receiving services in a residential program was another area that service providers identified as problematic. Individuals who receive drug and alcohol treatment were seen as being at particular risk when returning to the environment in which they had previously become addicted. It was noted that many of these returning individuals had expressed a commitment to remaining clean prior to returning to the reservation community and attempted to give back to the community what they had learned while in treatment. Most of these individuals were said

to have met significant resistance in their efforts and either returned to using drugs and/or

alcohol or decided to move out of the community.

Crescent City/Klamath

Services in the Crescent City/Klamath region are significantly more limited than

those in the Eureka/Arcata/McKinleyville region. UIHS has several offices in this region

including two in Crescent City and one in Klamath that provide mental/behavioral health

services to members of federally recognized tribes and their families. They are the

primary provider of mental health services to Yurok children, youth, transition age adults

0-25 and their families.

Del Norte County Mental Health (DNMH) provides walk-in or referral services to adults and families facing mental health issues. DNMH also has a transition aged youth

(TAY) program and operates a youth peer center called Coastal Connections. Mental health specialists work daily with youth in juvenile hall and provide life skills training and a dual diagnosis group. DNMH works with the Healthy Families program for families receiving Medi-Cal services and has a Full Service Partnership program that assists families and individuals lacking support and provides assistance with accessing mental health services.

DNMH contracts with Remi Vista for services to children 0 -18 years old. Remi

Vista is a non-profit organization that provides services to children who receive Medi-Cal benefits. Remi Vista’s services include: 1) individual, family and group counseling. 2)

Therapeutic behavioral services (TBS). 3) Trauma Focused Cognitive Behavioral

Therapy (TF-CBT). 4) Parent Child Interactive Therapy (PCIT). 5) Positive Parenting

Practices (PPP). 6) Foster care services. 7) Post adoption services. 8) Services for individuals diagnosed with autism. 8) The Transitional Housing Placement – Plus program (THPP). Services are delivered in the community, in school settings and at designated sites.

Coastal Connections is DNMH’s peer drop in center for youth. A youth council provides direction to the center’s paid staff and insures that programs and services are youth driven and meet the needs of the youth that participate. The center has a full kitchen and provides snacks for activities and dinner for participants in the center’s art class. The center provides a space for youth drug and alcohol groups including “Friday

Night Live”, a drug and alcohol prevention group. Cultural activities for Native youth are also an important component of the centers activities.

Domestic violence services in this region are provided by Yurok Social Services

(YSS). Sexual assault and domestic violence prevention, services for victims of sexual assault, one on one counseling, a peer to peer program and groups facilitated by Licensed

Clinical Social Workers (LCSW’s) are included in the range of services provided by

YSS. MEND/WEND was identified by one service provider as an organization that also provides domestic violence services in the Crescent City/Klamath and

Eureka/Arcata/Mckinleyville regions.

Youth prevention services, mental health evaluations, child welfare services and the TANF program are also provided through the YSS program. YSS was not identified

as a component of the mental/behavioral health system by the Euro-American service providers that were interviewed in this region.

Del Norte Child Welfare Services (DN-CWS) responds to and investigates reports of child abuse and neglect in this area. They are mandated to provide family maintenance, family reunification, placement and related services to families and children that are the perpetrators or victims of child abuse and/or neglect. Social workers provide a variety of supports and services to children and families engaged by the CWS system. YSS ICWA social workers advocate for Yurok children and families and provide additional assistance and support designed to support the goals of the ICWA.

The Del Norte Family Resource Center (DN-FRC) provides an indoor and outdoor space for CWS family visitations supervised by DN-CWS social services aides.

The DN-FRC also houses several programs that provide support services to families of young children and to families who have children with disabilities. A monthly meeting of

Del Norte service programs is also held at the DN-FRC and provides an opportunity for organizations to collaborate with one another and to share information regarding services.

Remi Vista provides foster care and counseling services to children that are the

victims of child abuse/neglect. Redwood Coast Regional Center serves children and

adults with developmental disabilities in the region and is an important resource for

developmentally disabled children that are the victims of abuse/neglect .

The Early College of the Redwoods charter school in Klamath closed shortly after

staff was interviewed for this project. The main campus of the school is located in

Crescent City and continues to provide 6th to 12th grade students the opportunity to

35 participate in self-directed educational programs and earn college credit in a school designed to meet the needs of Yurok youth.

Alcohol and other drug services are provided by DN – HHS Alcohol and other

Drug Services agency. Counseling, residential services, groups and testing are provided by this agency. The Jordan House was also identified by providers as a residential treatment program for adults with addictions in Del Norte County. Coastal Connections also has drug and alcohol prevention services for youth and offers support groups weekly.

Yurok Social Services also provides a variety of drug and alcohol prevention services to youth in the Crescent City/Klamath region.

The schools in Crescent City/Klamath also offer special education, counseling and cultural activities to students. The Early Headstart, Headstart and home based

Headstart program were identified as important points of connection for families in the area and provide early detection of developmental and mental health problems in children. The Early College of the Redwoods program was also identified as an important educational and cultural resource for Yurok children.

There were a variety of strengths identified for this area. Crescent City and

Klamath are small communities. Program staff are integrated into the community and have an intimate understanding of the community. They also see a genuine desire in the community and in the various agencies to improve and expand mental health services.

This region is also seen as having a strong sense of connectedness to Yurok traditional lands and practices. Individuals and small groups in this region have promoted traditional customs and practices through basketmaking, beading, fishing, eeling, dance

36 preparation and hiking/backpacking activities. Yurok language instruction and community service projects are also promoted as important for renewing traditional values, practices and roles within the community.

Once more transportation was an issue identified as a significant barrier to families in this region. Children in the Klamath area were identified as having few recreational or educational opportunities by service providers. Children in Klamath are required to travel to Crescent City for middle/high school. They also have to travel to

Crescent City to participate in sports or other recreational activities at this time.

It was stated that there is a need for an after school drop-in center in the Klamath area as there are currently no gathering spaces or activities for children after school or on weekends. It was also stated that it would be important to have a counselor or some other person that children could talk to about problems at this center. The opportunity for youth to interact with healthy, young, Yurok adults was also identified as being of high importance.

Intergenerational poverty and historical trauma were seen as significant problems in the community, limiting the ability of families to participate in services. Families also express some resentment toward the tribe because of a perceived lack of follow through according to service providers. Communication between programs and providers, even within the same departments, are often limited. Services were seen as lacking clarity regarding their services, goals or mission.

A few families utilize a high number of services and there is a much higher demand for services than some agencies have the resources to provide. For some

37 individuals it can be problematic to seek services in a small community like Klamath where confidentiality, dual roles and anonymity can be issues. As one provider stated,

“seeking assistance from law enforcement for a domestic violence issue when you know that the perpetrator is related to a person on the force is a problem.”

There are sometimes issues with explaining the difference between Yurok Social

Services (YSS) and Humboldt or Del Norte county services to members of the community. The type of services and range of services by each entity is not always easily discerned by families interacting with these systems. Communication between the

County of Del Norte and YSS is not always consistent or timely and was seen as an issue that makes it difficult for families to receive the services they need.

Hoopa/Weitchpec

Mental health services in the Weitchpec area are provided by United Indian

Health Services (UIHS), Humboldt County Mental Health (HCMH) and the Hoopa

Health and Social Services department. Counseling services through UIHS are offered one time per week, on Mondays. UIHS also operates a large van in the Weitchpec area that provides transportation services to people with UIHS appointments. This van transports UIHS clients to the Potawat site in Arcata as well as to the Weitchpec health center.

UIHS provides individual, couples, family and children’s counseling service through their behavioral/ mental health section. They also provide counseling for Indian

youth incarcerated at juvenile hall, provide parent education and Positive Indian

Parenting (PIP) classes, conduct behavioral assessments, and provide psychiatric services

and medication support. They do outreach to the Headstart programs and have

successfully implemented a plan to integrate behavioral/mental health services with their

medical services section. They currently have 3 mental health counselors that provide

services in the Humboldt County area which includes Weitchpec and Hoopa, employ 3

grant funded mental health counselors and have 2 interns.

They have a traditional healer that provides services on site one time per month

and conduct men’s, women’s and coed sweats one time per week. They also provide case

management services to their clients. They currently have grant funding for outreach,

education, direct services and community training on suicide prevention and sexual

assault.

Hoopa Health and Social Services is also a key provider of mental/behavioral health services in this service region. Yurok youth in this region attend Hoopa High

School and are often referred to Hoopa Health and Social Services when needs are

identified. Hoopa Health and Social Services currently employs 4 counselors that provide

a range of mental health services. Most of their referrals are from the local schools and

from the Hoopa Tribal Court.

They provide domestic violence counseling for adults, have Anger Management

classes, provide case management services, serve as a client ally with the court, provide

family advocacy services and operate Friendship house. Sweats and Ceremonies are also

used to promote mental/behavioral health and wellness.

Weitchpec is in Humboldt County but is approximately two hours’ drive from

Eureka, the central location for Humboldt County Health and Human Services. Two

HCMH counselors were identified as providing services in the Hoopa/Weitchpec area.

Individuals requiring crisis services are served through Semper Virens in Eureka.

Crestwood Behavioral health provides long term mental health rehabilitation services to adults but is also located in the Eureka area.

The schools in this region provide counseling and special education services to children at each of the school sites. A mental health assessment is conducted on each of the children in the Early Headstart and Headstart programs in Weitchpec one time during the school year. A school counselor splits time in each of the schools in the district.

Domestic violence services are provided by UIHS, Hoopa Health and Social

Services and Yurok Social Services to the Yurok families living in this region. Some individuals and families affected by domestic violence also seek services at Two Feathers in McKinleyville.

Child welfare services are provided by Humboldt County Child Welfare Services

(CWS) which is headquartered in Eureka. Families also receive support and assistance from YSS Indian Child Welfare Act social workers. All services that are provided by

CWS in the Eureka/Arcata/Mckinleyville region are also provided to families in this region.

Alcohol and other drug services are provided by UIHS, Hoopa Health and Social

Services and by Humboldt County Alcohol and Other Drugs program. UIHS provides intensive outpatient treatment, outpatient services, individual support, individual and

group counseling, aftercare services and referrals to residential treatment facilities

identified by Indian Health Services.

Hoopa Health and Social Services employs three AOD counselors. They provide

one-on-one counseling, outpatient services, offer prevention programs in Jack Norton,

Orleans and Hoopa Elementary schools, make referrals to residential treatment programs

out of the county and conduct urine tests. Hoopa Health and Social Services staff also

take youth on safe and sober field trips including: 1) Trips to gather rocks for sweats. 2)

basketball trips. 3) A trip to Mt. Shasta. Services are also provided as part of the Meth

and Suicide Prevention Initiative including the “Be the Change Club” at Hoopa High

School and “Challenge Day” with Teen Challenge.

Some of the other programs that were identified as being important components of the behavioral/mental health system in the Hoopa/Weitchpec region were the Family

Resource Centers in Hoopa and Willow Creek, the Building Healthy Communities program, College of the Redwoods Hoopa branch campus, the Klamath Basin Tribal

Youth Program, the Redwood Coast Regional Center, 7th Generation, the New

Beginnings Program through Public Health, the Dreamquest youth and teen center in

Willow Creek and the Hoopa Vocational Rehabilitation program. Several short summer

camps and activities were also identified by service providers as valuable resources to the

community.

Service providers in this area were able to identify a wide array of services,

supports and activities that are working well in this service region. The KT Net bus and

UIHS health van were both identified as important transportation resources for the

41 community. The Ke-Pel head start program, Jack Norton Elementary and Weitchpec magnet school were also identified as important programs in the community. The

Weitchpec magnet school was identified as having a cultural immersion program that includes Yurok language instruction and cultural education 4 days per week after lunch.

Jack Norton Elementary uses a traditional “settle up” model of discipline and is an important resource and point of contact for families in the Wautec community. In the

“settle up” model of discipline students incur a debt to the community or individual that is harmed by their action and is expected to repay that debt by performing an action that is of benefit to those harmed. Buckley (1983) discusses the use of this system of justice in traditional Yurok society and its role in maintaining balance and harmony between families in the community. He states that a mediator was often used to assist with the negotiation of a reasonable price for the harm that had been done. Payment was often in the form of goods or labor. Jack Norton Elementary has also engaged students in Yurok language instruction and has received grants to incorporate Yurok cultural activities into the school.

Tribal TANF was also identified as a program that was working well by providers in this area. They help provide clothes for kids, provide transportation to appointments and are an important connection between the tribe and people in their homes. The Tribal office in Weitchpec is a central location for communication in the Weitchpec area since phone service is not available along the river between Weitchpec and Wautec. People in that office were described as friendly and helpful and as having knowledge about what is happening with people in the community.

Getting back to traditions, “Indian Day”, drum groups, ceremonies, identity strengthening/building activities, field trips to dances, summer camps, net hanging, drum making, learning the stages of tanning a deer, Indian cards, making drum sticks and providing men in recovery with the opportunity to introduce youth to recovery concepts were a few of the activities that appeared to successfully promote and support the mental/behavioral health and wellness of Yurok children, youth, transition age adults and their families. A letting go ceremony for girls and opportunities for girls to make medicine pouches and learn the process for making basket was also seen as particularly effective. Talking circles, sharing food, potlucks and reminding people that you are there if they need to talk were also identified as important for promoting community and individual connectedness.

The service providers in this area identified a range of gaps, barriers and needs that exist in this region and some specific suggestions on what is needed. Many Yurok children and families receive services from the Hoopa tribe but it was stated that deep wounds continue to exist between the Yurok and Hoop tribes because of the

Hoopa/Yurok Settlement Act. It was felt that healing these wounds and reestablishing the traditional relationships that existed between the tribes would strengthen both communities and make services more accessible and appropriate for Yurok youth and their families.

Increasing Yurok cultural education and recreational activities was identified as a very high priority by the service providers in this region. Some of the specific suggestions included: 1) More day camps throughout the year. 2) Afterschool programs.

3) Year round cultural training that includes instruction on Yurok values, beliefs and expectations. 4) Traditional food: gathering, processing, preparing and eating. 5)

Community service with elders. 6) A mentorship program. 7) Gatherings with food to bring families and community together. 8) Instruction on survival skills. 9) Classes on native plants. 10) Traditional Basketmaking and beading. 11) Drumming circles. 12)

Bike/hiking trails. 13) Surrogate grandparents.

An interest in more contact with Humboldt State University (HSU) students in the area was also expressed. It was stated that students from a variety of HSU programs would be able to make valuable contributions to the community and would benefit from their contact with the community. Developing a closer relationship and collaboration between the school and the community could be of benefit to both.

Transportation was consistently identified as a significant barrier for parents in this region as services frequently require 1 to 2 hours or more of travel one way. It was suggested that a van be located at Wautec and scheduled from that location for community members that are living in the more remote locations on the reservation.

People in this area do not have phone service and it is difficult for some individuals to get to the tribal office to access their phone service.

The need for children to have greater access to positive male role models was expressed. It was stated that fathers are often working away from the family or absent.

Reestablishing the important role of Yurok women as the centers of community and family life was associated with the need for positive male role models.

Several service related needs were also identified in this process including: 1) The need for more family education related to addiction. 2) Services for families to prepare them and the community for the return of youth placed in residential treatment programs out of the area. 3) Evening counseling. 4) Increased domestic violence education and services. The Head Start and Early Head Start programs were identified as being services that are working well in the community but they have a limited number of slots available and it was stated that children from Hoopa sometimes get into the Weitchpec program before Yurok children because of the scale that is used. Since there are no other preschool programs in the area this was identified as a significant barrier for families.

There was a perception that families that are healthy and are doing well are often penalized in the current system. Meetings are generally scheduled during work hours which make it difficult for individuals to have a voice in the community. For families in which all of the adult caregivers are working this can mean that time off will need to be taken to attend a meeting or that the family’s perspective is not heard. Families in which two parents are working do not qualify for some services, like Head Start, and may not have access to similar services in the community. The importance of maintaining healthy families and insuring that they have access to the supports and resources they need was stressed.

Some of the other barriers that were seen as significantly impacting the ability of the community and families to improve the mental/behavioral health of the people identified by the Yurok Circles of Care grant included: 1) Politics, at every level. 2) The distractions that come from popular society and from the capitalist system. 3) The walls

that are put up between people and groups by the worldviews of dominant society. 4) The promotion of new drugs. 5) Modern music and media.

The Hoopa/Weitchpec region is the more remote of the three regions covered in this report. Its distance from mainstream Euro-American based services and supports have provided the community with an opportunity to focus on the development of services and supports that are culturally based and culturally relevant. Services in this area are required to be more flexible and creative in the way that they interact with and provide services to the community. The service providers interviewed in this area also appeared to have the most insight into the changes that are needed to promote and support the mental/behavioral health and wellness of children, youth and transition age adults 0-25 and their families.

DISCUSSION

All three of the identified service regions were shown to have a wide variety of programs providing mental/behavioral health services and supports to Yurok children, youth, transition age adults and their families. Many of the service providers interviewed were aware of many of the programs identified in their region but were often unaware of

the range of services provided and there was limited contact between most of the

programs.

This lack of coordination and communication between providers appears to make

it difficult for families to receive the information and services they need, particularly

when in a crisis. It was suggested that the use of a family service coordinator could be

beneficial in assisting families with navigating the complex system and accessing the

resources that they need in a timely manner. The use of a cultural broker, a person that understands Yurok cultural values and beliefs and is also comfortable navigating the systems currently providing services to Yurok tribal members, would be of benefit.

Throughout this process the need to emphasize and renew Yurok cultural beliefs, values and practices within the community was expressed as the primary priority. While there have been strong efforts in all three regions to promote use of the Yurok language and ceremonies many of the other cultural practices and values are applied sporadically, if at all. It is likely that this is the result of the genocidal practices, and resulting historical trauma, experienced by the Yurok people.

Life ways that served to promote health and wellness for all Yurok people since

time beyond memory was disrupted over the last 150 years but may hold the key to many

of the physical, mental, emotional, spiritual and environmental problems that the

community currently faces. These Yurok life ways evolved to fit the internal and external

environments of the Yurok people.

Thinking, a Yurok meditative practice (Buckley, 1982), is a tool that could easily be re-established in the community and fits the goals of the Yurok Circles of Care Project

by promoting the behavioral/mental health of those who engage in this practice.

Mindfulness activities activate regions of the brain associated with hope, well-being and

critical thinking and strengthen the brains neural pathways (Yellow Bird, 2012).

Traditional life skills that educate Yurok youth for life could be offered through school and afterschool cultural education programs and as immersive experiences during school breaks. Both the Crescent City/Klamath and Hoopa/Weitchpec regions expressed an interest in these types of activities. Community service work, knowledge of traditional food practices, traditional training activities and traditional spiritual activities would serve to promote a sense of connection to the community and promote a strong cultural identity. This could also have a positive impact on the way that youth are viewed in the community.

Community events and activities that promote social cohesion, that build community connectedness, were a major part of what community members expressed an interest in during the course of this project. Renewing traditional supportive relationships

and ties within the community was seen by many as the most important factor for

improving the mental/behavioral health of the community.

It seems evident that any meaningful solutions to the mental/behavioral health

problems in the Yurok community will need to come from the community itself. It is only

through the will of the community that any meaningful change is likely to occur. The

desire to improve the lives of the children in the community was evident in all of the

contacts that were made with community members and service providers for this project.

Clearly, there are numerous community leaders that have already begun to work on

improving community cohesion and on renewing the traditions that promote and support

community and individual health and wellness.

This service system evaluation is the first of three interlocking projects that seek

to engage the Yurok community in the development of a mental/behavioral health system

model that truly fits their community. Representative focus groups will be used in the

next phase to gather input from the community on what that model should look like. A

pilot project has been included in the Yurok Circles of Care grant and will be developed

out of the service system analysis/focus group process.

The Yurok Circles of Care project will also seek to build community cohesion

and capacity through the projects activities in the community. Information regarding

community services will continue to be gathered so that the descriptions of services in each of the three regions covered by this report can be clarified and expanded. Several key agencies were not interviewed for this project which will need to be remedied prior to a report being submitted to SAMHSA. The interview process has proven to be an

49 excellent vehicle for introducing service providers to the Yurok Circle of Care project as well as a way to connect providers to the process.

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