Name of Area: Nashville

The Nashville Area's forum was held June 27-29, 2006 in Nashville, and
was attended by a number of Behavioral Health expert presenters and
Tribal Representatives. As a result of this forum, the participants
identified best practices of how to integrate behavioral health with the
other two Director's Initiatives (chronic disease and health
promotion/disease prevention). These best practice(s) included:

a\) The integration of health care services via a multidisciplinary team
(medical providers, behavioral health providers, nutritionists, and
fitness experts, community health representatives and injury prevention
specialists).The inclusion of a spiritual advisor as a team member also
will be considered.

b\) The integration of routine behavioral health screening in primary
care.

c\) The use of evidence-based practices for the treatment of depression.

d\) The use of holistic psychotherapy for the healing of PTSD.

e\) The assessment of community resources toward the development and
implementation of community-based wellness plans.

The behavioral health/chronic disease/health promotion/disease
prevention best practices that came out of this forum were shared with
Nashville Area forum participants and will be shared with other IHS
Areas and I/T/U programs upon request. The following information has
been shared with forum participants to date:

a\) Oral and written guidance on the rationale for utilizing a
multidisciplinary team approach in primary care.

b\) Tools for performing depression, alcohol, and domestic violence
screening in primary care.

c\) Written guidance on 1) conducting a community needs assessment
survey and a community readiness assessment and 2) developing and
implementing a community wellness/action plan.

A compendium of resources relative to 1) utilizing the
multidisiciplinary team and 2) conducting behavioral health screening in
primary care (and documenting results in RPMS specifically) will be
developed for dissemination to and use by all Nashville Area Tribes and
interested parties.

Outcomes, as a result of this forum, were:

a\) The initiation of an open and ongoing dialogue between Nashville
Area Tribal Leaders, Health Directors, and Healthcare Providers for
Health Promotion/Disease Prevention, Behavioral Health, and Chronic Care
regarding the development and implementation of reasonable and
attainable community-based wellness plans.

b\) A Nashville Area commitment to provide:

-   Ongoing efforts toward educating/encouraging Nashville Area I/T/Us
    regarding the use of best or promising best practices in the
    delivery of Behavioral Health and Chronic Health Care services.

-   Ongoing assistance to Area I/T/Us in the development and
    implementation of health care strategic plans that are inclusive of
    Dr. Grim's 3 initiatives.

c\) Plans to develop and implement the above-reference compendium of
resources, in order to 1) improve patient care and 2) increase the
Nashville Area's behavioral health screening rates and documentation in
RPMS for data analysis purposes.

d\) Plans to enhance and expand this year's forum in the next fiscal
year to further improve the overall well-being of Nashville Area
recipients of health care services. A possible focus on *Obesity as a
Family Problem* has been discussed.

[Nashville Area Participating Tribes]{.underline}

Alabama-Coushatta Tribe of Texas

Catawba Indian Nation of South Carolina

Coushatta Tribe of Louisiana

Eastern Band of Cherokee Indians

Houlton Band of Maliseet Indians

Aroostook Band of Micmac Indians

Mississippi Band of Choctaw Indians

Oneida Indian Nation of New York

St. Regis Regis Mohawk Tribe

Penobscot Indian Nation

Wampanoag Tribe of Gay Head (Aquinnah)

Unity Healing Center

North American Indian Center of Boston, Inc.

Lifelines Inc. of Baltimore

[Forum Behavioral Health Topics and Expert Presenters]{.underline}

Dr. Winona Simms, Stanford University

*Culture in the Provision of Care*

Jane Root-Sylvain and Simone Carter, RN, Houlton Band of Maliseet
Indians

*Domestic Violence Prevention and Intervention*

Mose Herne, MPH, MS

Use *of the Multidisciplinary Team Approach in Primary Care*

Dr. Ken Kindya, Houlton Band of Maliseet Indians

*Routine Behavioral Health Screening: Improving the Health of the
Overall Community*

Dr. Jane R. McGoldrick, Independent Practice, Burtonsville, MD

*Back from the Abyss: A Holistic Path to Healing PTSD*

Dr. Steven D. Hollon, Vanderbilt University

*Cognitive-Behavioral Therapy for Depression: Evidenced-Based
Strategies*

Dr. John Fite, Independent Practice, Nashville, TN

*Strengthening Resiliency in Youth*

[Forum Planning Committee Members]{.underline}

Michelle Ruslavage, RN, HPDP/Nursing Coordinator, *Chair*

Brenda Bordogna, Seminole Tribe

Christy Duke, USET

Dr. Roy S. Kennon, Chief Medical Officer

Lisa Martin, Catawba Tribe

Meg Parsons, Oneida Tribe

Dianna Richter, USET

Dr. Palmeda D. Taylor, Area Psychologist/Acting Director, Office of
Public Health

Sandra Yarmal, Passamaquoddy Pleasant Point Tribe