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S. HRG. 109–66, PT. 1

YOUTH SUICIDE PREVENTION

HEARING

BEFORE THE

COMMITTEE ON INDIAN AFFAIRS

UNITED STATES SENATE

ONE HUNDRED NINTH CONGRESS

FIRST SESSION

ON

FIELD HEARING ON THE CONCERNS OF TEEN SUICIDE AMONG

AMERICAN INDIAN YOUTH

MAY 2, 2005

STATE CAPITOL BUILDING, ND

PART 1

(
COMMITTEE ON INDIAN AFFAIRS

JOHN McCAIN, Arizona, Chairman

BYRON L. DORGAN, North Dakota, Vice Chairman

PETE V. DOMENICI, New Mexico

CRAIG THOMAS, Wyoming

GORDON SMITH, Oregon

LISA MURKOWSKI, Alaska

MICHAEL D. CRAPO, Idaho

RICHARD BURR, North Carolina

TOM COBURN, M.D., Oklahoma

DANIEL K. INOUYE, Hawaii

KENT CONRAD, North Dakota

DANIEL K. AKAKA, Hawaii

TIM JOHNSON, South Dakota

MARIA CANTWELL, Washington

JEANNE BUMPUS, Majority Staff Director

SARA G. GARLAND, Minority Staff Director

(II)
(III)

C O N T E N T S

Page

Statements:

Dauphinais, Paul, school psychologist, Turtle Mountain Schools ................ 25

Dorgan, Hon. Byron L. U.S. Senator from North Dakota, vice chairman,

Committee on Indian Affairs ....................................................................... 1

Eagle Shield, Elena, freshman, Standing Rock Community School ............. 18

Fast Horse, Michelle, senior, Standing Rock Community School ................. 15

Grim, Charles, director, Indian Health Service ............................................. 3

Hines, Vaquita, junior, Standing Rock Community School .......................... 17

Lindquist-Mala, Cynthia, president, Cankdeska-Cikana Community College, Fort Totten ........................................................................................... 28

McDonald, Justin, director, Indians Into Psychology Program, University

of North Dakota ............................................................................................ 23

Middlebrook, Denise, public health analyst, Substance Abuse and Mental

Health Services Administration ................................................................... 6

Perez, Jon, director, Division of Behavorial Health Services, Indian

Health Service ............................................................................................... 3

Pomeroy, Hon. Earl, U.S. Representative from North Dakota ..................... 2

Shamwell, Ulonda, division director, Office of Policy, Planning Budget,

Substance Abuse and Mental Health Services Administration ................ 6

Yellow Bird, Doreen, journalist and family member, Arikara Nation ......... 14

APPENDIX

Prepared statements:

Forth, Dave (with attachment) ........................................................................ 35

Gipp, Brittany, Standing Rock Sioux Reservation ......................................... 39

Gipp, Robert, Standing Rock Sioux Reservation (with attachment) ............ 41

Hall, Tex G., chairman, Mandan, Hidatsa and Arikara Nation ................... 33

Murphy, Charles W., chairman, Standing Rock Sioux Tribe (with attachment) .............................................................................................................. 46

Shamwell, Ulonda ............................................................................................ 48

Two Eagle, Auntie Carol .................................................................................. 59

Additional material submitted for the record:

North Dakota Adolescent Suicide Prevention Project, Mark LoMurray,

Project Director ............................................................................................. 64

Plenty Chief-Brown, Minnie, enrolled member, Standing Rock Sioux

Tribe, letter ................................................................................................... 70

(1)

FIELD HEARING ON YOUTH SUICIDE

PREVENTION

MONDAY, MAY 2, 2005

U.S. SENATE, COMMITTEE ON INDIAN AFFAIRS, Washington, DC.

The committee met pursuant to notice, at the Brynhild Haugland

Room, North Dakota State Capitol Building, Hon. Byron Dorgan

(vice chairman of the committee) presiding.

Present: Senator Dorgan and Representative Pomeroy

STATEMENT OF HON. BYRON L. DORGAN, U.S. SENATOR FROM

NORTH DAKOTA, VICE CHAIRMAN, COMMITTEE ON INDIAN

AFFAIRS

Senator DORGAN. The hearing will come to order.

Ladies and gentlemen, thank you very much for being here. This

is a hearing of the U.S. Senate Committee on Indian Affairs, it is

an official hearing of the committee. My name is Byron Dorgan, I

am vice chairman of the committee. The chairman is Senator John

McCain from the State of Arizona. We are conducting this hearing

with the consent of Senator McCain and the rest of the committee.

I am joined today by the Chief of Staff of Senator McCain on the

Committee on Indian Affairs, Jeanne Bumpus, right over here, and

the Chief of Staff on the minority side is Sara Garland. I am also

joined by my colleague, Congressman Earl Pomeroy, who, although

not a member of the Committee on Indian Affairs, by consent of the

committee is going to sit in today and be a part of this. I am very

pleased that Congressman Pomeroy could join us, because he too

is concerned about this important issue.

I do want to make a couple of opening comments, and then we

have three panels of witnesses who will testify today. If there is

time following that, I would like to open it up for some additional

comments.

First, let me say that the topic of this hearing is teen suicide on

reservations. It is a difficult and very sensitive issue and frankly,

not easy to talk about. I suspect everyone in this room would prefer

that we not have to talk about it. But we find ourselves in the

midst of very serious problems that are not going to go away, and

I think we do a disservice by not confronting this, looking it in the

eye and trying to determine what can we do about it.

I am shocked by some of the statistics that one reads. Teen suicides on Indian reservations are double those in the rest of our

country. In the northern Great Plains, they are 10 times that of the
2

rest of the country. It is a very serious problem. And I think everyone who is in this room gathered for this hearing understands the

wrenching heartbreak and the senseless loss of these young boys

and girls who have their entire lives before them, but then decide

to take their lives.

I will make every effort at this hearing to be sensitive and responsible in how this information is conveyed to the public. I know

you will as well. But I must tell you, I am no longer comfortable

on a range of very sensitive and serious issues to be quiet and just

say, well, what’s happening is happening and we’re a little worried

about talking about it publicly. I am worried about not doing

enough to save the lives of these young boys and girls. I am worried that we do not devote the resources, we do not have the strategies that are necessary to save the lives of these young boys and

girls.

With the consent of the family, last year I spoke on the floor of

the Senate about a young girl named Avis Little Wind who took

her life. She was 14 years old. She lived on a reservation here in

North Dakota. I not only spoke about that on the floor of the Senate with their consent, I also went to that reservation and met with

school officials, this little girl’s classmates, people involved in mental health, people from the tribal authorities, to try to understand

what causes this sort of thing.

I discovered from that that there is a lot we don’t know. I also

discovered that some of the basic resources that need to be available to reach out to help these young people are not available. We

need to fix that. There is nothing more precious in this country

than our children.

So I am holding this hearing, we have a group of witnesses that

is pretty diverse, from a 15-year old high school student to the

head of the Indian Health Service in Washington, DC. And we hope

to receive guidance, expert advice, insight and from that try to develop some strategies that we think will work to save lives.

Let me now call upon my colleague, Congressman Pomeroy, and

again, thank him for being with us today.

STATEMENT OF HON. EARL POMEROY, U.S. REPRESENTATIVE

FROM NORTH DAKOTA

Mr. POMEROY. Thank you, Mr. Chairman.

I am very pleased that you are having this Indian Affairs hearing here in Bismarck, to elicit direct testimony on this extremely

troubling issue of teen suicides on our reservations. I could not

agree with you more strongly that although it is difficult to talk

about, we need to have a better understanding of what is happening, so that we can respond to it.

I believe that we need to look carefully at the funding of mental

health resources available to young people on our reservations, possibly there is some Federal culpability in this problem. We have to

understand it before we can figure out how to appropriately address it. That’s why this hearing is so important. I appreciate your

letting me participate this morning. I was able to rearrange my

schedule upon hearing that you would be here. I just think there

is nothing more important before us than the topic you have advanced today, and I look forward to the testimony.
3

Senator DORGAN. Congressman Pomeroy, thank you very much.

Prior to the first panel coming forward, I am going to ask Cecelia

Myreon with the Turtle Mountain Chippewa Tribe to offer the

opening prayer.

Ms. MYREON. I am going to be praying in Chippewa. The Creator

knows all languages, so you can just pray with me.

[Prayer offered in native tongue.]

Ms. MYREON. Megwich. Thank you.

Senator DORGAN. Cecelia, thank you very much.

Now we will ask the Two Nation Drummers to come forward.

[Drumming presentation.]

Senator DORGAN. That was Dave Ripley and Dennis Bursey.

Thank you very much.

Let me call panel 1 to the table, if I might. Charles Grim, director, Indian Health Service. He is accompanied by Jon Perez, director, Behavioral Health, Indian Health Service. We also have

Ulonda Shamwell, division director, Office of Policy Planning and

Budget and Substance Abuse and Mental Health Services Administration, accompanied by Dr. Denise Middelbrook, public health analyst in the same Substance Abuse and Mental Health Services Administration.

Let me thank all of you for coming to Bismarck, ND today, and

let me call first on Dr. Grim, the head of the Indian Health Service.

Dr. Grim, you may proceed.

STATEMENT OF CHARLES GRIM, DIRECTOR, INDIAN HEALTH

SERVICE; ACCOMPANIED BY JON PEREZ, DIRECTOR,

DIVISION OF BEHAVIORAL HEALTH SERVICES

Mr. GRIM. Thank you, Senator Dorgan. Good morning. I am

Charles Grim, director, Indian Health Service. Today I am accompanied by Jon Perez, our director for the Division of Behavioral

Health Services.

We thank you for giving us this opportunity to testify on teen

suicide among American Indian youth, and I do agree with you

that it is time that we began discussing this issue with all our communities and children become more aware about it and what we

can do to treat it.

I would ask that you enter my written statement for the record.

Senator DORGAN. Without objection.

Mr. GRIM. Suicide in Indian country, in contrast to most of the

rest of the U.S. population, is characterized by higher rates, and

from younger people, very often affecting entire communities as a

result of suicide clustering. We would also like to share with you

our concerns and efforts related to the recent tragic events at Red

Lake. Earlier last month, I visited the Red Lake Chippewa Reservation in Minnesota and witnessed first-hand the results of the

devastation brought about by the shootings at the Red Lake High

School.

I also saw the community uniting and drawing strength from the

support of mental health professionals and tribal spiritual leaders.

In the midst of the trauma and upheaval that was caused by the

shootings, there is still a sense of hope an a spirit of collaboration

among the community, the tribal leaders, and State and Federal

programs.
4

The IHS is working closely with the Substance Abuse and Mental Health Services Administration, the Administration for Children and Families, the Administration for Native Americans and

the Office of Minority Health to bring the resources of the Department to bear on that tribe and the tragedy that just recently occurred. The question that we need to ask is how do we prevent

such incidents from occurring in the first place. First, the Indian

Health Service is focusing on screening and primary prevention in

our mental health programs, especially for depression, which manifests itself in suicide, domestic violence and addictions.

Second, we focus on the effective utilization of treatment modalities that are available, and we are seeking to improve the documentation of mental health problems. IHS is currently utilizing effective tools for documentation to the behavioral health software

package. We work with communities who are focusing more on

these mental health needs. With about 80 percent of the mental

health budget and about 97 percent of our alcohol and substance

abuse budget from the Indian Health Service going directly to

tribes operating their own programs, now the tribes and communities themselves are taking responsibility for their own healing.

Suicide is not a single problem, but rather is a single response

to multiple problems. Neither is it strictly a clinical nor an individual problem, but one that affects and is affected by entire communities. Quoting from the Institute of Medicine’s landmark 2002

publication, Reducing Suicide:

Suicide may have a basis in depression or substance abuse, but it simultaneously

may relate to social factors like community breakdown, loss of key social relations,

economic depression or political violence.

This is particularly true in Indian country. To address it appropriately requires public health and community interventions as

much as direct clinical ones.

In late September 2003, I announced the IHS National Suicide

Prevention Initiative. It is designed to directly support the Indian

Health Service Tribal and Urban programs in three major areas associated with suicide in our communities. First, to mobilize tribes

and tribal programs to address suicide in a systematic, evidencebased manner; second, to expand and enrich research and program

bases; and third, to support and promote programmatic collaborations on suicide prevention.

Over the last 11⁄2 years, a substantial progress has been made

to developing plans and programs, but it is only the beginning of

what must be a long-term, concerted and coordinated effort among

Federal, tribal, State, and local community agencies to address the

crisis. The initiative addresses all 11 goals of the National Strategy

for Suicide Prevention. It also extends or enhances work between

tribal communities, local, State, and Federal agencies and now

even includes the greater tribal indigenous populations of North

American through our ongoing partnerships with Health Canada

and First Nations Inuit Health Branch.

Let me summarize briefly some of the efforts we have taken in

each of the three major areas. As over 80 percent of the IHS mental health budget goes directly to tribes, it is clear that tribes, not

IHS, are now primarily providing services to their communities.

IHS now seeks to support those direct services with programs and
5

program collaborations to bring resources and methodologies to the

communities themselves.

The IHS National Suicide Prevention Committee was empaneled

in February 2004 to help guide the overall IHS tribal effort. Composed of primarily tribal behavioral health professionals from

across the country, it served not only to assist in providing direction for efforts, but also to provide representative membership in

some of the specific programs that have been developed. IHS is currently working with our areas, our tribal communities and States

to establish area-wide suicide surveillance and prevention systems,

in collaboration with the BIA and States to collect information from

law enforcement and medical examiner data bases. This will supplement our IHS behavioral health management software, to be

able to gather information from tribal and IHS communities.

We are strengthening the partnerships between State and Federal representatives in the area of suicide prevention. We have IHS

representatives who are now members of State suicide prevention

teams and coalitions in many States throughout the country to ensure that American Indian and Alaska Natives are providing access

to State services. We have participated in work groups to improve

suicide prevention and intervention activities and provided outreach to attempters, families, and communities.

We have also begun to train laypersons from the community in

a program called QPR, Question, Persuade and Refer, to act as

gatekeepers. We have involved American Indian and Alaska Native

youth in suicide prevention efforts, primarily through school programs and curriculums and Boys and Girls Clubs. We have provided workshops and forums on suicide prevention and one IHS

area, the Aberdeen area, has a QPR initiative to assure competency

for non-mental health providers to identify and respond appropriately to suicidal behaviors.

Research into suicide in Indian country is limited, and what research is available suggests that suicide in our communities differs

in substantial ways from other racial and ethnic groups, suggesting

younger and more impulsive suicide attempts than other populations. To that end, IHS is collaborating with the National Institute of Mental Health, Health Canada, and the Canadian Institute

for Health Research on a multi-year effort to better understand suicide in Indian country and to develop evidence-based interventions

for prevention. Staff from those agencies have been working for

over 1 year to develop this initiative, and its first international

meeting will be held this September in Albuquerque, NM. The purpose is to bring together researchers, clinicians, program personnel,

wisdom keepers, and governmental representatives from North

America to begin a 5-year interagency, and indeed, international

effort, to develop a concrete research agenda and to develop specific

programs for our indigenous populations.

Finally, SAMHSA and Indian Health Service have created a national suicide prevention intervention team for Indian country.

Composed of one person from each IHS Area, these personnel are

currently being trained in community suicide prevention and mobilization. Once trained, they will be able to, in turn, train personnel

in tribal communities to provide suicide prevention programming,

including materials, techniques, and protocols. Training should be
6

completed by summer and the team members will be ready to

begin supporting communities at that time. This will also be a

multi-year collaboration which we hope to expand as resources

allow.

In summary, I think we are engaged in a battle for hope. For

those young people who see only poverty, social and physical isolation, lack of opportunity, or familial dissolution, hope can be lost

and self destructive behavior becomes a natural consequence. The

initiative and programs I have described are some of the methods

and means to restore that hope and engage youth and their communities to sustain and nurture. While they might not be sufficient

change many peoples’ living conditions, we can by working together, among Federal agencies, branches of government, tribes,

States, and the local communities, turn the tide to restore hope to

our youth. To that end, I commit to work with you and the committee, as well as others, to bring services and resources to that effort.

Mr. Chairman, this concludes my statement. Thank you for this

opportunity to discuss what the IHS and tribal programs are doing

to help the impact of suicide in our communities.

Senator DORGAN. Dr. Grim, thank you very much for your testimony.

Next we will hear from Ulonda Shamwell, of the Substance

Abuse and Mental Health Services Administration. Ulonda, why

don’t you proceed.

STATEMENT OF ULONDA SHAMWELL, M.S.W., DIVISION

DIRECTOR, OFFICE OF POLICY, PLANNING AND BUDGET,

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION; ACCOMPANIED BY DENISE MIDDLEBROOK,

PUBLIC HEALTH ANALYST

Ms. SHAMWELL. Good morning, Mr. Chairman and members of

the committee. I am Ulonda Shamwell, from the Office of Policy,

Planning and Budget at the Substance Abuse and Mental Health

Services Administration, within the Department of Health and

Human Services. I am pleased to offer testimony this morning on

behalf of A. Katharine Power, Director of SAMHSA’s Center for

Mental Health Services, CMHS. Ms. Power testified before this

committee on April 13, 2005, about suicide and violence among

American Indians and Alaska Natives. Unfortunately, she was unable to testify today, but sends her regards.

Accompanying me today is my colleague, Dr. Denise Middlebrook, Social Science Analyst, who is available to answer questions.

Mr. Chairman, before proceeding with my oral statement, I ask

that my written testimony be included in the record.

Thank you for the opportunity to describe how SAMSHA is working to provide effective mental health and substance abuse treatment services along with substance abuse prevention and mental

health promotion services in Indian country. It is also a privilege

to testify along with Dr. Charles Grim, Director of Indian Health

Service, this morning. SAMSHA and IHS have developed a strong

partnership, reflected in our current interagency agreement to

work efficiently and effectively together to help meet the public

health needs of American Indians and Alaska Natives.
7

My testimony will focus on two issues of great concern for the

public health of American Indian and Alaska Native youth. These

two issues are suicide and violence. Sorrowfully, there are real-life

examples to illustrate the impact of suicide and violence in Indian

country. Recently, a suicide cluster occurred on the Standing Rock

Reservation in North and South Dakota. Ten young people took

their own lives and dozens of other attempted to do so. More young

people are continuing to do so.

Tragically, many other reservations have similar stories to tell.

Suicide is now the second leading cause of death, behind unintentional injury and accidents, for American Indian and Alaska Native

youth ages 15–24. The suicide rate for this population is 21⁄2 times

higher than the national average. American Indians have the highest rate of suicide among all ethnic groups in the United States,

with a rate of 14.8 per 100,000, as reported in 1998. Rates are

highest in the northern plains, Pacific Northwest and Alaska areas,

five to seven times higher than the overall U.S. rate. More than

one-half of all persons who commit suicide in Indian country have

never been seen by a mental health provider.

In studies that examine risk factors among people who have completed suicide, substance abuse occurs more frequently among

youth and younger adults, compared to older adults. For particular

groups at risk, such as American Indians and Alaska Natives, depression and Substance abuse are the most common risk factors for

completed suicide. Mental health and substance abuse disorders

are also risk factors for violence.

According to the National Center for Injury and Prevention Control within the Centers for Disease Control and Prevention, injuries

and violence account for 75 percent of all deaths among Native

Americans ages 1–19. As I mentioned earlier, suicide is the second

leading cause of death for Indian youth ages 15–24, followed by

homicide, the third leading cause of death for the same age group.

A recent example of violence in Indian country is the tragedy at

Red Lake. A 16 year old junior at the Red Lake High School on

the Red Lake Reservation in Minnesota took the lives of 9 others

and then his own on March 21, 2005. The 16 year old shot and

killed his grandfather, his grandfather’s partner, 5 students, a

teacher, security office, and himself. Since this event, there have

been 2 more confirmed suicides and a number of attempts.

The statistical picture on the Red Lake Reservation, home to

about 5,000 tribal members, is well below the national average and

below that of many other reservations. Red Lake Nation is an impoverished community; 39 percent of the population lives below the

poverty line. Four out of five students at Red Lake High School

qualify for free or reduced fee lunch. One-third of the teenagers on

the reservation are not in school, not working and not looking for

work, compared to that of about 20 percent of all reservations.

A survey last year by the Minnesota Department of Health and

Education found that young people on the Red Lake Reservation

are far more likely to think about suicide, be depressed, worry

about drugs and be violent with one another than children across

the State. A State survey of 9th graders found that at Red Lake

High, 43 percent of the boys and 82 percent of the girls had

thoughts about suicide, with 20 percent of the boys and 48 percent
8

of the girls saying that they had tried it at least once. This event

has led to community trauma and turmoil. Unfortunately, this condition is repeated on reservations across the Nation.

SAMHSA focuses attention, programs and funding on improving

the lives of people with or at risk for mental and substance abuse

disorders. Consistent with President Bush’s new Freedom Initiative, SAMHSA’s vision is a life in the community for everyone. The

agency is achieving that vision through the mission, building resilience and facilitating recovery. SAMHSA’s direction and policy program and budget is guided by a matrix of priority programs and

cross-cutting principles that include the related issues of cultural

competency and eliminating disparities.

To achieve the agency’s vision and mission for all Americans,

SAMHSA-supported services are provided within the most relevant

and meaningful cultural, gender-sensitive and age-appropriate context for people being served. SAMSHA has put this understanding

into action for American Indian and Alaska Native communities

that it serves. It is important to note also that it is SAMSHA Administrator Charles Curry’s policy to level the playing field and to

ensure that tribal entities are eligible for all competitive grants for

which States are eligible, unless there is a compelling reason to the

contrary. In total, SAMHSA provides about $42 million to American Indian

and Alaska Natives annually. SAMHSA’s Center for Mental Health

Services is transferring $200,000 to IHS to support programming

and service contracts, technical assistance and related services for

suicide cluster response and suicide prevention among American

Indians and Alaska Natives. One example is the development of a

community suicide prevention tool kit. This tool kit will include information on suicide prevention, education, screening, intervention

and community mobilization, which could be readily available to

American Indian and Alaska Native communities via the web or

other digitally-based media for off-the-shelf use. To better assist tribal organizations, SAMSHA funded a $1-million grant that was awarded to the Oregon Health and Science

University to establish the One Sky Center, an American Indian

and Alaska Native national resource center. The One Sky Center

provides technical assistance, training, information dissemination

and communication to increase substance abuse prevention and

treatment knowledge and skills among service providers, policy

makers, tribal communities, funding organizations and consumers.

Today, the One Sky Center is a national resource center that, in

addition to its many other services, maintains a comprehensive list

of American Indian and Alaska Native programs that are currently

funded by SAMSHA. The One Sky Center is currently providing

technical assistance to Standing Rock community by providing

them with assistance and requesting SAMHSA’s emergency response grant for immediate and intermediate emergency funds.

SAMSHA also collaborates with IHS and the National Institute

of Mental Health within the National Institutes of Health on the

Circles of Care grant program. The Circles of Care grant program

supports the implementation of mental health service models designed by American Indian and Alaska Native tribal and urban Indian communities that utilize a system of care, community-based
9

approach to mental health and other supportive services for American Indian and Alaska Native children with serious emotional disturbances and their families.

SAMHSA’s Community Mental Health Services for Children and

Their Families grant program provides funding for direct Services

to improve systems of care for children and adolescents with serious emotional disturbances and their families. Seven tribal organizations are among the current 63 grantees.

Additionally, SAMSHA, under the authority of the Garrett Lee

Smith Memorial Act, has announced funding in 2005 for two programs. The first is the cooperative agreements for State-tribal

sponsored youth suicide prevention and early intervention programs, which will provide $5.5 million for 14 awards, with a minimum of one award that will be made to an American Indian or

Alaska Native Tribe, tribal organization or urban Indian organization. Second is the campus suicide prevention grants, that will provide $1.5 million for 20 awards. The receipt dates for both of these

awards is June 1.

SAMHSA also has an announcement for a cooperative agreement

for suicide prevention resource center grant that provides $2.6 million annually for up to 5 years. The receipt date is also June 1.

SAMHSA takes seriously the current challenge in Indian country, which includes few trained service providers, major transportation barriers and multi-generational poverty. SAMHSA is being

proactive in addressing these challenges that rob communities of

their most valuable resource: Their children and their future. The

vital treatment and prevention efforts that I have discussed today

are designed to address these problems and are improving services

for American Indian and Alaska Native children, youth and their

families.

Mr. Chairman and members of the committee, thank you for this

opportunity to appear today. I will be pleased to answer any questions you may have.

[Prepared statement of Ms. Shamwell appears in appendix.]

Senator DORGAN. Ms. Shamwell, thank you very much.

Let me ask a few questions. I do want to introduce tribal leaders

who are here, let me do that following this panel to introduce who

is with us, the elected tribal leaders. Let me ask Dr. Grim and Ms.

Shamwell, both of you are talking about grant programs and tool

kits and a wide range of issues. In addition, you describe intervention teams. Can you tell me the nature of these intervention teams,

the size of the teams, who is putting them together, when are they

available? What kinds of uses are being made of these intervention

teams?

Mr. GRIM. I’ll start out, and then I will ask if Dr. Perez has anything to add on. In the last several years, when we have had suicide clusters that occur in communities, what we have done is send

in a team of mental health specialists and/or social workers. They

come in and they essentially search capacity, give the community

search capacity in mental health for the current crisis that is occurring. They go in and work with the community in a variety of ways.

For example, they would set up centners in the hospital or the clinic in the town, they would set up centers, perhaps in other commu-
10

nities within the reservation, if there are multiple communities, to

allow people to just walk in and get that sort of assistance.

More recently, in the Red Lake crisis that occurred, we sent

teams out into the community, actually to go home to home, because people did not want to come out to the centers and speak,

but they wanted to speak at home with their families all present.

So we started doing that. One of the things that the QPR concept

works under, or one of the background philosophies, is that people

that need the counseling or need help that are considering suicide

will not often go to a place that is going to give them help and try

to talk them out of it if they are very seriously considering it.

So they worked with the Red Lake community members in that

concept, to help make more people aware of the signs and symptoms. The size of the team varies along with the size of the community. We try to put together a team of sufficient size to address the

issues. We will send them in for a couple of weeks to a couple of

months, depending on the nature of the crisis and how many people are using those teams. We try to leave behind any information

and any sorts of tool kits or other advice to the communities.

Senator DORGAN. Dr. Perez, do you have anything to add to that?

Mr. PEREZ. The only thing that I would add is, the teams are invited or requested. It is not something that we are going to immediately send in without being invited. There are lots of places, lots

of communities that really much prefer to respond to their crises

on their own. But it is a service that is available for them, at their

request.

Senator DORGAN. Isn’t it the case that we are pretty dramatically

underfunded in a lot of these areas? The reason I ask that question

is, and when I talked to you about the Avis Little Wind case, one

trained psychologist, I believe, and Ms. Shamwell, you mentioned

transportation at the end of your testimony. In the circumstances

where you go talk to these folks, they say, we are just dramatically

understaffed, we do not have the transportation capabilities to

move a child some place where they need to be moved to get the

help. So when you take a look at the whole system, it appears to

me that we just don’t have the resources out there.

I told you, Dr. Grim, during the testimony that you provided to

our committee in Washington, we have responsibilities for health

care for Federal prisoners. Then we have trust responsibility for

health care for American Indians. We are talking here about mental health. We spend exactly twice as much money per capita providing health care to Federal prisoners as we do meeting our trust

responsibility to provide health care for Native Americans.

Isn’t it the case that when you look at this with the transportation, trained professionals and so on, in most cases with most

reservations, we do not have the resources? Would you agree with

that, Dr. Grim?

Mr. GRIM. I think that over the last decade, that people have

come to accept mental health treatment more and more in this

country as a whole, not only in our population. So many of our

mental health programs, while they may have been satisfactory a

number of years ago, when mental health treatment was not

sought as often, I think now many of our programs are working at

full steam, they have having triaged care, they are dealing only
11

with some of the most urgent cases. And certainly when a suicide

cluster begins to appear in a community, I would hesitate to guess,

but I doubt any of our facilities are sufficiently staffed to deal with

a suicide cluster crisis when it occurs, which is why we have tried

to develop some team search capacity to allow a community to have

that help if they so desire.

Senator DORGAN. Ms. Shamwell.

Ms. SHAMWELL. I would defer to Dr. Middlebrook.

Senator DORGAN. Dr. Middlebrook.

Mr. MIDDLEBROOK. On the SAMHSA side of work that we have

been doing here with Standing Rock, we deployed myself and Dr.

Gale Walker from One Sky Center, it was a couple of months ago,

I think it was, 2 or 3 months ago, we came in and conducted needs

assessment with the community members. We identified key community members and worked with local IHS folks to determine the

extent of the problems, what the needs were for the community,

what types of follow-up were done following the suicides.

We clearly heard the issue of transportation as being one of

them, the issue of inability, with great distances between the eight

communities on the reservation, the inability to really provide adequate follow-up because of the extent of the crisis and the number

of people involved, with very few human resources in order to do

the follow-up.

We also heard needs around safe housing for kids, places for kids

to go when they felt that they could not go home, when they were

at risk. And so Dr. Walker developed a resource book and a complete report that he put together for us, that definitely outlines the

issues and has recommendations in it. We could certainly make

that available to you.

Senator DORGAN. What I would like to get from the Indian

Health Service and perhaps your organization, Ms. Shamwell, I

would like to get a description of the resources available on each

reservation. Because early prevention is what is going to save lives

here. If a young child is missing 90 days of school, lying in bed in

a fetal position, in desperate condition, somebody needs to be available to provide help. There needs to be early warning to deal with

these circumstances. At least my cursory observation is, the resources by and large on a day to day basis, forgetting about clusters here, on a day to day basis, the resources are horribly inadequate to deal with the problem.

So Dr. Grim, could I have your staff get for me some kind of

analysis of what kinds of mental health services are available reservation by reservation?

Mr. GRIM. Yes; I can do that, and I also want to thank you and

let the people here know that Senator Dorgan helped us get some

additional money to deal with the Standing Rock crisis. We very

much appreciated that.

Senator DORGAN. I think tool kits, intervention teams, all these

things are hopeful I think, and helpful in addressing what is the

problem. But I think I also need to understand, what are the larger

sets of resources available.

Mr. GRIM. We can do that.

Senator DORGAN. Let me call on Congressman Pomeroy.
12

Mr. POMEROY. Thank you for your testimony. One thing that disturbs me a little is that I’m not hearing the level of urgency that

I think the situation deserves. Maybe it is simply the form of testimony, but there are things in each of your statements that I find

a little troubling. Candid, but troubling.

I find Dr. Grim, on page 6 of your testimony, research into suicide in Indian Country is limited, but research is available to suggest suicide in our communities differs in substantial ways from

other racial and ethnic groups. Then you talk about a collaborative

effort that is leading to a 5-year study, the first conference to be

held in September. It seems as though, given the statistics that

show suicide is particularly problematic for this population, if we

don’t really understand it, we ought to have perhaps an accelerated

effort beyond what the statement would reflect.

And as to SAMHSA’s response, Ms. Shamwell, I am trying to fig- ure out from the statistics you provided here: You provide $42 million to American Indians and Alaska Natives generally, but you

then indicate $200,000 has been provided in support of programming and services to deal with suicide cluster response and suicide

prevention. This also seems perhaps not proportionate to the problem, as revealed in the statistics. I want to make sure I am fair

here, so I would like to hear from each of you concerning what the

urgency is within your agency in responding to this crisis, and

whether or not there is more Congress needs to do? I don’t care

what the Administration’s budget calls for. What else does Congress need to do to get you the resources you need to make the response you would like to make?

Dr. Grim.

Mr. GRIM. I think that any of our people that work on the ground

in our hospitals and clinics realize the crisis level of the situation.

There has been substantial progress in the last 11⁄2 years to 2

years of dealing within our programs and tribal programs on a

community-wide basis. But also, some of the things we talked

about in the testimonies are also looking at a long-term concerted

effort and we are trying to coordinate multiple groups of agencies.

The Indian Health Service and SAMSHA are working closely already, but our National Institutes of Mental Health and our counterparts in Canada are working with us also. So we are looking at

a more long-term research based program.

We are already beginning to put through the One Sky Center,

through our Division of Behavioral Health and in concert with

SAMSHA a lot of effort into suicide prevention in Indian country.

We are trying to address goals that have been laid out in the national strategy for suicide prevention for our communities, and we

have tried to make sure that each one of those issues are being addressed. So it is going to take a little bit of a long-term effort, because as I said, it is not really just a clinical problem with an individual. That is the end point of a whole host of multi-factorial

issues that are not really just health related within the community.

There are social and economic issues, educational issues and things

like that. Getting all those groups to work together within one community sometimes is difficult. That is why we are looking at it, we

realize there is a crisis, but we are looking at it as a long-term effort that we are going to have to systematically approach.
13

Ms. SHAMWELL. Actually, the $42 million represents all of the activities that we have in Indian country and in tribal communities.

Some of them are treatment, some of them are prevention, some

of them are mental health focused, some of them are substance

abuse focused.

But really, we see all of them as part of the continuum. The $200,000 that you mentioned is just one activity that addresses suicide. We have several others that I talked about also that are

brand new, that we actually have announced on the street right

now, which we are very excited about.

What we are hoping to do, though, pretty much along the lines

that Dr. Middlebrook spoke about, we are trying to assess what is

hampering so that we have a long-term plan, but we also have

short-term response where we not only send people directly when

there is a tragedy, but we also have these new funds that are available that we are very excited about and eager to get out into the

communities.

Mr. POMEROY. Thank you both.

Senator DORGAN. I want to thank both of you for testifying. I

hope and expect that you are going to be able to stay for the remainder of the hearing. I want you to hear the remaining testimony.

But I appreciate the fact that both of you have traveled some distance. I think Congressman Pomeroy’s question is a question that

we continue to ask: Does everyone understand the urgency.

So thank you very much for being here, Dr. Middlebrook, Dr.

Perez, Dr. Grim, and Ms. Shamwell.

Let me say that when we began to put this hearing together, we

contacted Gene LaFrambois, who is the Superintendent of the

school in Fort Yates. He indicated that he really felt we should

have some students testify. Tim Krehler, the vice principal at the

Standing Rock School, helped us arrange that. I am going to invert

the second and third panels. Let me just say to you, we have Dr.

Doug McDonald, director of the Indians Into Psychology Program

from the University of North Dakota with us; Dr. Paul Dauphinais,

the school psychologist at Turtle Mountain Schools; and Cynthia

Lindquest-Mala, the president of the Community College in Fort

Totten. They are going to be our third panel. I am going to invert

the panels and ask the second panel to come forward, which is

Michelle Fast Horse, who is a senior at the Standing Rock Community Schools; Vaquita Hines, a junior at the Standing Rock Community Schools; and Elena Eagle Shield, a freshman at the Standing

Rock Community Schools. They have all expressed an interest in

testifying, and let me thank again the recommendation from Superintendent LaFrambois, and also Mr. Krehler. Thank you for making them available as well, and helping them attend.

Also on this panel Doreen Yellow Bird. Doreen Yellow Bird is a

journalist and a family member and a member of the Arikara Nation. Doreen has written on this subject in her professional life.

Before I ask the panel to present, I would like to acknowledge

some tribal leaders who are among us today. Charles Murphy, the

chairman of the Standing Rock Tribe. Chairman Ken Davis, Turtle

Mountain Band of Chippewa. Dontino White, chairman of the Spirit Lake Tribe. Thank you.
14

Mike Peters, Secretary of the Sisseton-Wapeton Sioux Tribe.

Mike is in the back over there. We have Cheryl Coulas, executive

director of the North Dakota Indian Affairs Commission with us.

And finally, we have Deborah Hall Thompson, who is here representing Chairman Hall of the Three Affiliated Tribes. Deborah,

thank you very much for being here.

I want to thank all of you for participating and thank you for

your leadership with the respective tribes.

Let me thank this panel for being here, thanks to the students

especially. And let me begin by calling on Doreen Yellow Bird. Doreen, if you would begin and then we will hear from the students.

Thank you very much for the work that you do, Doreen.

STATEMENT OF DOREEN YELLOW BIRD, JOURNALIST AND

FAMILY MEMBER, MEMBER, ARIKARA NATION

Ms. YELLOW BIRD. Thank you very much, Senator Dorgan and

Congressman Pomeroy for being here. My name is Doreen Yellow

Bird. I am Sahnish from the Three Affiliated Tribes and in White

Shield. I am also a journalist and a writer with the Grand Forks

Herald, and I am also the aunt of two nephews who have committed suicide and a niece who has made an attempt.

A couple of months ago, I was at the Standing Rock Reservation

doing interviews with students and people who were parents of or

as students who were involved in suicide. It was an experience that

just breaks your heart, to see the young people, our children, leaving us in this manner. I spoke to a woman who had lost her son,

and I could see the sorrow on her face that again was heartbreaking, as she told me that she would never, ever get over the

loss of her child, and that she would take this loss to her death.

She said she would always remember that.

I talked to some of the students who were affected and who felt

what was going on. They were frightened by it. I talked to people

on the reservation who said that they are also frightened, because

there didn’t seem to be a pattern, it was not a certain group of children, it was not young people, it was not teens who did poorly in

school or who used drugs and alcohol. There was a whole list of

children, there were more women, more young women than young

men, which was a pattern years ago. So there was a fear among

the people.

So 2 or 3 weeks later, I was working at the Grand Forks Herald.

About 3:30, we got a call from Red Lake and we were up to Red

Lake within 11⁄2 hours. I was there for the next 2 days and involved in the killing and the suicide there. The awful sorrow and

sadness and fright that you feel is almost, it was almost overwhelming to see some of the women wailing for their children. I

could only take it so long and I had to come back to the Herald

and I did my work from there.

But more tragic to me was the loss just recently of my nephew.

I talked with my aunt, who is one of the bundle keepers of the

Sahnish, our people. This is her grandchild. The children’s mother

is her sister, and she passed away, so my aunt is now her mother

and this is her grandchild. She was really stunned by the suicide,

because this was the second one in that family. She told me to tell

them that in our way, in the Sahnish way, that they should not
15

have the wake and the giveaway kind of thing, that they should

bury the child in a good way, but that they should not give praise

to it, because she said that she is in her eighties and she has lived

with diabetes for 49 years. She has had several heart attacks, she

has ulcers, she has a whole gamut of diseases that go along with

diabetes. And she now has arthritis, so she lives in pain and that

kind of thing continuously. But she said that our Creator says that

life is a precious gift, and she said we must make sure that our

children understand that, that they know that life is a gift that you

don’t let it go so easily.

She said that, Doreen, I don’t think that these kids, these children, my grandchildren understand what dead is. That is our role,

she said, as elders and as parents, to teach them. She said, we’re

not doing that, we need to go back and we need to help them. She

cried.

I know that she does not understand all of what is going on. My

aunt does not know that methamphetamine is a powerful thing on

the reservation. She does not know that some of her other grandchildren are involved with that. Their mother said that they were

afraid that they were at risk, because they have real highs from

meth, and then when they come off meth, they’re suicidal. So they

are concerned, meth is a huge problem in North Dakota and on reservations. As I talked to some of the people about suicide, they also

mentioned that their children were involved with meth.

Alcohol is also a depressant. So if you are using alcohol, you are

also at risk, as the people from IHS also said.

So I tried to explain some of these things to her, and she said

that, Doreen, one of the things you need to do is when you get out

and you talk to people, when you talk to elders, when you talk to

spiritual leaders, she said, ask them to pray for our children. She

said, they are our most precious thing. They carry the vessel of our

ancestors in them. We need to continue on.

So she said, tell them that. She said, tell them to take care of

their children and ask they to pray, pray for their children, pray

for our children.

Thank you for allowing me to speak.

Senator DORGAN. Doreen, thank you very much. I appreciate

your being here.

Michelle Fast Horse, Vaquita Hines, and Elena Eagle Shield, at

your age I had great difficulty speaking to three people at once, let

alone a crowded room. But I really appreciate your school recommending you and your willingness to share with us today. Let

me ask you to begin, Michelle. You are a senior in high school. Why

don’t you provide us whatever thoughts you have? If you would pull

that microphone close while you speak, we would appreciate it. And

again, thank you very much for being with us, Michelle.

STATEMENT OF MICHELLE FAST HORSE, SENIOR, STANDING

ROCK COMMUNITY SCHOOL

Ms. FAST HORSE. Honorable Vice Chairman Dorgan and other

members of the Committee on Indian Affairs, [greeting in native

tongue]. My name is Michelle Fast Horse. I am a senior in the

Standing Rock Community School. I will be graduating May 29.
16

I live in Cannonball, ND, and I have for my entire life. I have

been asked to testify to your committee regarding the suicides on

the Standing Rock Reservation.

I am humbled to represent the youth of Standing Rock. I do not

speak for all youth, but I am only expressing my personal opinions.

I believe suicide is a great mystery. There is no way suicide can

be predicted. The only way to tell if someone is going to commit

suicide is when they actually tell you that they are. Teenagers and

young adults make up a majority of the Nation’s suicides. I think

because we teens are very confused about life and have a lot of

stress on pressure on us, we become depressed. Some teenagers

have absolutely no trust in anyone, due to the fact that no one is

there for them to talk to. That is probably why they don’t talk to

counselors and get help.

Something that can be hard in a teen’s life are boyfriends or

girlfriends that break up with them, because sometimes that’s

practically their only friend or the only person they trust. Many

teens go through physical or emotional abuse at home and they

often don’t know how to cope with all those bad feelings, so they

possibly turn to suicide. Sometimes teens tend to suicide because

of drugs and alcohol or while they are under the influence of drugs

and alcohol.

I personally lost a friend to suicide while she was under the influence and she had, after she had died, we found out that she was

being abused. Two of my other friends came to me while they were

under the influence of alcohol and they wanted me to help them,

because they did not want to live any more, they wanted to commit

suicide. They believed that nobody loved them.

Depression among teenagers can be a cause for many things that

happen, from early childhood, being either neglected or abused, because of living in poverty or having parents that abuse drugs or alcohol.

There are many ways that adults can help teens. Creating more

community awareness on suicide I think is really needed, especially

in my community. Teenagers need places where they can hang out,

such as arcades and gyms and skate parks, because where I live

there really is nothing. Some teens should be able to have like a

safe house, in case something, if something is going on at home and

they want to go somewhere and they have nowhere to go, they can

go to a safe house, if there was one.

Teenagers become depressed because they, some of them do not

know what to do after high school. There are people that can help

in our schools. They can help them apply for college and help them

with their financial aid. That would really work. That would help

them so they can become more educated and get greater jobs and

prevent the poverty in our communities.

In closing, I believe suicide is very controversial, and I believe

there are many ways to prevent it, starting with people that are

just wiling to volunteer and listen. Thank you.

Senator DORGAN. Michelle, thank you very much. We appreciate

your being here and sharing with us.

Next, Vaquita Hines is a junior at the Standing Rock School.

Vaquita?
17

STATEMENT OF VAQUITA HINES, JUNIOR, STANDING ROCK

COMMUNITY SCHOOL

Ms. HINES. Honorable Chairman McCain, Honorable Vice Chairman Dorgan and Honorable Senators of the Committee on Indian

Affairs, hello, my name is Vaquita Hines. I am a junior at the

Standing Rock Community School. I live in rural Fort Yates.

I recently returned to live in the Fort Yates community and this

is my second year of attending Standing Rock High School.

I am also humbled to represent the youth of Standing Rock. As

Michelle said, I am only here to express my opinions and how I

feel. I cannot speak for the rest of the youth on Standing Rock.

When someone commits suicide, the questions that first come to

mind are why, what, how. There are many questions and they all

can’t be answered. No one knows the real reason why someone

chooses to commit suicide. It could be stress, financial problems,

sexual or physical abuse, emotional abuse, school, peers. A big factor is drugs and alcohol. There are several factors that lead to suicide, and I could go on and on with a list of things.

I really don’t understand why anyone would want to take their

life. Yes, there are going to be times in your life that are going to

be bad, and you are going to have your troubles. But you will get

over them. I guarantee you things will become better. Everyone

goes through it all at one time in their life.

I think the reason for some of the suicides on the Standing Rock

Reservation is because there is nothing for the kids to do. There

isn’t very much school programs and activities to keep the kids occupied and out of trouble. Also, it is not very difficult or hard to

get alcohol in the hands of a teen, so there is an extremely high

rate for underage drinking.

Sometimes teens live in a rough household with no one to talk

to or turn to, no mother, no father, no parental figure. They might

even feel alone, as if no one loves or cares for them. The majority

of Standing Rock’s population is kids and teenagers, so there needs

to be something for them to do.

There has been a lot of talk about having dorms. Of course, there

are benefits and downfalls of having dorms. For one, there could

be more kids attending school. Many kids leave Standing Rock to

go to other boarding schools around the country. By having dorms,

some would stay and other kids from different places could come

and stay in them, too.

There could probably be a decrease in tardies and absences in

school because the students would be close by. Dorms would make

the students feel safer and free from alcohol and drugs. There

would also be qualified people around for them to talk to and kids

for them to learn from and relate with. Some downfalls are, they

wouldn’t be with their immediate family members and they

wouldn’t have a parental figure to teach them their family history

and family values. There could be more after school programs. We

do have some at Standing Rock, but there could be more school

dances, movie nights, game nights, plays, talkers, and even small

clubs such as a girls’ group, guys’ group, chess clubs. There are

many ideas that come to mind.
18

Another idea is having a local teen crisis hot line that would be

readily available by answering questions and listening to what you

have to tell them.

Basically what I am trying to say is Standing Rock needs to get

the youth involved. In some situations, the parents should be held

responsible for some children’s actions. For example, the parents

should be involved as much as possible in the kid’s life. They

should know what they’re doing, when they are doing it and who

they are going to do what with. I myself grew up in many different

places, I am an Army brat. I have been everywhere. And I wasn’t

exposed to suicide until I moved to Standing Rock Reservation. I

never even thought about it, heard about anybody doing it, I never

even witnessed it.

Those are some of the things I feel could be done about the situation, the action that needs to be taken. Don’t just say you want to

do something and never get it done. Don’t give a bunch of, like suggestions, and never do it.

Those are some of the things that could be done about this situation. I would like to leave you with two notes. Why not love and

live life and make it better and make it happen? Thank you for listening. Michelle and I will be more than happy to try and answer

any of the questions you may have.

Senator DORGAN. Thank you very much, Vaquita.

Next is Elena Eagle Shield. Elena is a freshman at the Standing

Rock Community School. Elena, why don’t you proceed?

STATEMENT OF ELENA EAGLE SHIELD, FRESHMAN, STANDING

ROCK COMMUNITY SCHOOL

Ms. EAGLE SHIELD. Good morning. My name is Elena Eagle

Shield, and I would like to thank you, Senator Dorgan and honored

guests, for offering me this opportunity to voice my opinion.

Children need a system of well-rounded support. Children cry for

help and need attention. Family and friends from far away, other

places, forgo events such as weddings, graduations, birthdays, anniversaries, et cetera, but come running when there is a death. I

don’t think it should have to be like that. We shouldn’t have to

gather for grief or hard times. We should gather for celebrations

and happiness.

Family plays a big role in children’s outlook on life. We need

someone to love us, to care enough to push us toward our goals and

say we can get a Ph.D or be a Senator or be the President of the

United States. We need support for the big things.

We need to rekindle cultural values, also, such as prayer, honesty, respect, generosity, wisdom and courage, which in return improves and strengthens family dynamics. Even simple things such

as having supper together, watching movies, doing homework, just

letting children know that they are special and they are loved.

I am confident that if parents were there and involved, teens

would have that well-rounded support and not have to look for an

activity in alcohol and drugs, which plays a major part in suicide

and fatalities and attempts. Therefore, we need extracurricular activities such as dance classes, cultural activities, karate lessons,

gymnastics, other things like swimming pools, arcades and skate

parks. We are so isolated, we just need diversional activities,
19

things to look forward to, like trips to different places. We need to

know that there is a big world out there, and there is a wide variety of our outlook on life.

Incentives for certain deeds, regardless of grade point averages

or attendance. Because some kids do not have someone to push

them toward getting good grades or wake them up in the morning

to get them to school on time. Most of the time, the ones who need

these things, these incentives and trips the most, can’t do it.

We need more conferences, youth gatherings, not just one annual

a year. We need to get the chance to speak amongst each other and

listen as well.

Teens are already intervening with friends around a lot of issues

as well as suicide, drugs and alcohol, sex, without adult knowledge

and support. We need to be able to talk to who we feel comfortable

with, regardless of whether they are a certified counselor or it’s

their job. If not, we need to get more certified counselors.

We are learning more and getting involved, because we do understand that these issues are not only facing us now, but all over the

world, facing all kinds of teens and races.

When there are problems with drugs and alcohol or an attempt

or a gesture of suicide, we need help right now, not put it off until

next week or even the next day. It needs to be dealt with right

away, not put off because there is a waiting list or no money. One

thing is we need more treatment centers. We have one treatment

center in our area, which holds a bed for one of our youth, the Aberdeen Area Regional Youth Treatment Center. Don’t worry about

what happened or what could have happened, worry about what

could happen now, what we all could do to help, by working together.

We need more law enforcement officers who can come by and are

truly interested in what is going on on the reservation and about

the youths’ future. We also need to be our own support system. We

can start off with positive friends, positive activities, caring adults

who really listen and want to have a say and listen to what we

have to say also. And again, values and beliefs.

You say there is a shrine of suicide commiters and attempters.

Don’t you think that blanket is a sign that look, here are all these

suiciders and look at all the empty spaces that need to be filled in?

Why not a survivor’s blanket for the ones who are helping and

want to help others get through things like this?

I would like to say thank you for listening to us, to us youth. I

know you want to hear what we have to say, but most adults won’t

listen, because that’s all we are is youth, we don’t have a Ph.D or

other credentials behind our name. I believe you have already decided what you want to hear.

In closing, another thought that came to me was if you are really

concerned about the issues going on, on behalf of the youth I extend an invitation to come to the Standing Rock Reservation and

personally meet with and hear testimony with other youth, heart

to heart, without any publicity.

I would be pleased to answer any questions to the best of my

ability. Thank you very much.

Senator DORGAN. Thank you very much.
20

The three of you are very inspiring, and we appreciate your being

here. Who are the folks who are standing? Parents? All right.

Thank you very much for being here as well.

Let me ask, and I will certainly accept your invitation, Elena, to

come back to Standing Rock as well and have some meetings with

the youth at Standing Rock. I have met with classmates of those

who have committed suicide. One of the things that some have said

is sometimes there is an early warning, sometimes there are signals, sometimes it’s clear who is having trouble. Then other times

it is not clear at all, it is just a complete surprise, just out of the

blue. And you think, well, this is not someone who I ever would

have thought would have attempted suicide.

Some say it goes to alcohol and drugs, among other things. There

is a wide range of causes, as Dr. Grim suggested. But I think all

of you mentioned alcohol. In a school system, at least the site you

are familiar with, is it pretty obvious to students where you can

obtain alcohol or where you can obtain drugs or from whom you

can obtain alcohol and drugs?

Ms. EAGLE SHIELD. Yes; I think it’s really easy. Anybody can just

walk up to, even a cousin or auntie or uncle, who just wants

money, they’ll help you get it, whenever you need it.

Ms. HINES. There’s also people that hang out outside the bars,

and like young, 21 years old. A lot of people hang out with older

people and it is very easy. All you have to do is ask, and I guess

you’ll receive.

Senator DORGAN. What kinds of resources exist at school for

somebody who is troubled, let’s say someone who is having a lot of

difficulties in a lot of different areas and needs to reach out and

talk to somebody? What kind of counseling service is available at

your school?

Ms. HINES. I think there are a lot of counselors, but a big problem is that we had an issue in our school where someone talked

to a counselor and it wasn’t confidential. Their information wasn’t

just with the counselor, and that kind of made a big old thing, people just don’t feel safe by telling their business and just letting

their guts out to someone that they don’t trust.

But there are a lot of counselors that we can talk to, and a lot

of our teachers. There are a lot of supporters, but there just needs

to be more.

Senator DORGAN. You heard Doreen Yellow Bird talk about

methamphetamine. As students, do you hear about methamphetamine, hear people addicted to methamphetamine in the community? Is that a subject you’re acquainted with at all? I don’t mean

personally.

Ms. HINES. I don’t hear a lot around the school. I don’t really

think there is a lot of students that use it around the school. But

of course, they are not going to say they use it. But I don’t really

hear a lot about methamphetamine users. I’m sure there are some.

Senator DORGAN. Doreen, let me ask, you were up at Red Lake

and you have two nephews, you said, that took their own lives.

Ms. YELLOW BIRD. Yes.

Senator DORGAN. Were both of the nephews involved with methamphetamine?
21

Ms. YELLOW BIRD. No; not the one, the latest one actually was

a big surprise. Most of the people, all the relatives were astounded

that he committed suicide. There didn’t seem to be any reason. He

was doing well, and he just didn’t seem to be a candidate for a suicide. It was a big surprise.

And the other one was back in 1993. I am not sure if alcohol was

involved.

Senator DORGAN. Congressman Pomeroy.

Mr. POMEROY. I want to thank this panel. I have heard a lot of

panels at a lot of hearings, but I don’t recall any being more riveting than the words you brought us this morning. You were so articulate, so insightful, really very, very good.

Doreen, you said something that is going to stick with me for a

long time. You were quoting your friend when she said, ‘‘I don’t

think our children understand what dead is.’’ Would you elaborate

on what your friend was trying to communicate? I have wondered

about this relative to teen suicide, both on and off the reservations.

Ms. YELLOW BIRD. It was my aunt, and she is the grandmother

of the children who committed suicide. She was basing that on her

many years of experience and her experience with her many, many

grandchildren who are teens. It is a cultural thing, also, that when

you are this age, you go through a point where you think you are

immune from death. You are not, you don’t really understand that

death is forever and there is no turning around, that once you’re

gone, you’re gone. There is also a cultural aspect of taking your

own life that’s also Lakota-Dakota and that’s also Sahnish, that I

don’t know whether the young people know those things either.

Mr. POMEROY. I don’t know if the students would have a comment on this one or not. Do you think it is fully appreciated by

those who consider suicide how completely irreversible, how forever

a successful suicide is?

Ms. EAGLE SHIELD. Yes; I recently had a cousin who committed

suicide. Me and my family were talking and we don’t think that

any temporary situation is such a, for a permanent cause—I don’t

know how to put it.

Ms. FAST HORSE. When there was a suicide, maybe before the

last one, there was like a big commotion going on in the whole

school where everybody was like, bring in these speakers, bring in

these speakers, talk about suicide and all that. They wanted to do

so many things, they had all these ideas and I haven’t seen anything happen so far. It was like, maybe March or so. And everybody was, why don’t people do anything if they feel so strongly

about it? It just dies out, all the activities they have in mind just

dies out.

Ms. HINES. I’d like to add something, it’s just something that was

really interesting that my tribal government class was talking

about. When someone commits suicide, it’s like they have, it’s kind

of like it’s a big old, how can I explain this? When someone commits suicide, they celebrate it differently, they have memorials and

tournaments and all that stuff for them. That’s all good and stuff,

but I’m just saying, who wouldn’t want to have all that when you

pass away?

It’s just that it shouldn’t be celebrated so much when someone

commits suicide, like that was the thing, we all in our school had
22

to sign a big card when one of our peers had passed away and I

heard someone say, oh, I wish someone, they all do this when I

pass away, I heard a sophomore say that. I was like, whoa, that’s

not the message that we are trying to send. When someone passes

away, everyone comes, a lot of people celebrate it and stuff like

that. It shouldn’t be celebrated. A lot of people look at it different

like that. It shouldn’t be celebrated, I don’t think.

Mr. POMEROY. Thank you. Very interesting answers.

Senator DORGAN. You raised the question that I think Ms. Eagle

Shield raised a bit, about is it appropriate to talk about this publicly even. Part of my passion is, I lost a wonderful daughter, to

heart surgery, not to suicide. But I know the tragedy of losing a

child. That tragedy is simply magnified by suicide for those parents

and those families who have experienced that. It is happening far

too often. It is just such an enormous tragedy.

Elena, at the end of your testimony you raised the question that

I have thought a lot about. I held a meeting at the United Tribes

Technical Center with about 40 or 50 people, a non-public meeting,

we didn’t exclude anybody, we just didn’t invite anybody except

those that we wanted there to talk about this. The question is always, for those of us on this committee, for example, not just on

suicide but other issues as well, what is the appropriateness of

having a hearing that will obviously generate attention? Is that

positive or is it negative?

The alterative to that is to simply allow what is happening to

continue and say nothing, because we are worried that saying

something will generate publicity. The fact is, I think the only way

we are going to address this issue of teen suicide is to look it

square in the eyes and say, here’s what’s happening, it is a tragedy

of enormous proportions and we must address it honestly. And yes,

that is hard to do. And yes, it will cause some people some pain,

just to address it.

But we really don’t have any choice. When young people whose

souls are tormented sufficiently that they believe they have to take

their life, there is something dreadfully wrong. We must try in

every way possible, as parents, as citizens, as loved ones of those

who are taking their lives, we must find a way to address it.

So I think your testimony is really very helpful to us. I appreciate very much, Mr. Krehler, thank you for bringing your students. It was very important, when Sara Garland was helping put

this hearing together, I said, I don’t want to push students into testifying at a hearing like this. But my understanding was that you

wanted to come and talk about this issue. I think it is helpful to

have you here.

So we thank the three of you, and Doreen, thank you for what

you write and what you think and what you share with us on these

and many issues. Thank you for being with us today. We appreciate it very much.

The next panel that we will hear from is Dr. Doug McDonald,

who is the director of Indians Into Psychology at the University of

North Dakota; Dr. Paul Dauphinais, a School Psychologist at the

Turtle Mountain Schools; and Cynthia Lindquest-Mala, the president at the Community College at Fort Totten. If you would please
23

come forward, we would very much appreciate your testimony as

well.

Mr. POMEROY. Senator Dorgan, as we had previously discussed,

I do have a prior commitment, a speaking engagement. So I have

to leave before the third panel can present. Because I know the

third panel, I want to express my appreciation for them bringing

their experience forward, and adding their comments into the

record.

Again, I want to thank you, Senator, for allowing me to participate. I appreciate very much your being here.

Senator DORGAN. Congressman Pomeroy has been a very strong

voice in the U.S. House of Representatives on many, many issues,

including issues affecting Native Americans. We appreciate your

interest and willingness to be here. Thank you very much.

[Applause.]

Senator DORGAN. Let us start with Doug McDonald. Doug is the

director of the Indians Into Psychology program at the University

of North Dakota.

Dr. McDonald.

STATEMENT OF JUSTIN [DOUG] MCDONALD, DIRECTOR, INDIANS INTO PSYCHOLOGY PROGRAM, UNIVERSITY OF NORTH

DAKOTA

Mr. MCDONALD. Thank you, Senator Dorgan and Representative

Pomeroy, distinguished tribal leaders with us here today. I want to

send an apology out to my elders, I am uncomfortable with my

back to you. So I ask for your forgiveness.

I am honored to be among this panel today, yet deeply regret its

necessity. My name is Doug McDonald, I am a professor of psychology at the University of North Dakota and director of our Indians

Into Psychology program, which is funded by the Indian Health

Service. I would like to extend a very heart-felt and public acknowledgment and thank you to you, Senator Dorgan, for your unswerving support of the program over the years.

I am a member of the Oglala Lakota Nation of Pine Ridge, SD,

and grew up on my family’s quarter horse ranch on the Northern

Cheyenne Reservation of southeastern Montana. I am a licensed

psychologist and have supervised over 100 Indian graduate and undergraduate psychology students. Our program and department

has produced over 30 post-graduate graduations for our Native students.

I currently supervise three practicum sites in which our doctoral

clinical students work exclusively with troubled American Indian

youth on our surrounding reservations. I myself have consulted in

Indian Health Service clinics, group homes and reservation school

systems since 1992. I also recently led a team of graduate students

in responding to the crisis at Red Lake.

With all of that said, I only wish that all of these efforts were

enough to do more than dent the surface of the huge and complex

problem that brings us here today. Today, a male American Indian

adolescent in North Dakota is just as likely to die by his own hand

than any other means by the time he turns 25. Although youth suicide prevalence rates across our region vary, they still run from

two to five times higher than for their non-Indian counterparts.
24

Although these numbers are alarming, yet they represent only

the tip of a more frightening iceberg, in my opinion. Our reservation youth are being seen and in many cases hospitalized for suicidal behavior, which may range from ideations or threats to an actual attempt at a rate that far exceeds those for any age cohort of

any cultural and racial group. In my unique position, I have been

able to observe this scenario on seven of our regional reservations

over the past two decades.

While I am typically a very optimistic person, which hopefully a

psychologist should be, I must say that I see this tide rising with

tsunami force, with precious little defenses to stem its might. I do

not fear what we know. We know Indian youth suicide in our region is a serious problem. I fear what we do not know. I, along with

my colleagues, have spent the greater portion of my professional

life trying to help folks realize that American Indians are the least

represented American ethnic minority group for which appropriate

and reliable mental health research exists, as has been discussed

somewhat today.

I have spent the remainder of it trying to contribute to that still

inadequate body of literature. We do not know why the problem is

so large. We don’t even really know how large it is. We may speculate as to the relative contributions of poverty, substance abuse,

child abuse and neglect, inter-generational trauma, boarding

schools, insufficient health care and education, and certainly these

variables are all factors. But we can only guess as to the relative

size of their impact and the degree to which they interact with

such obviously brutal synergy.

For some reason, or constellation of reasons, our Native youth

have come to a place, as we just heard, where the most basic

human social skill and interaction, talking about their problems, is

not seen as either productive or viable. It is my opinion that this

phenomenon forms the Rosetta Stone by which all these other relevant variables may be better understood.

So in simple terms, what needs to be done? I believe the answers, just as the questions, must be complex and powerful. In essence, three components are key. First, clearly, we need more answers. And answers may only be achieved through methodologically sound, yet culturally appropriate and competent research and

professional training.

Research requires resources. These resources include time,

money, expertise and logistics. Any effort that Federal, State, tribal, or even private entities can produce can be considered in order

to increase the knowledge base regarding Indian youth suicide.

The second component is treatment, as again we have heard several times. And this treatment must take many forms and be holistic and as creative as it is consistent. For example, local tribal and

community customs must be recognized and followed if there is any

hope that they will be embraced and effective. Elders and old ways

must be respected to the same degree as evidence-based protocol.

Finally, tribes and communities themselves must embolden

themselves toward taking monumental leaps of faith and not only

allowing but participating in data gathering and healing. Too often,

tribes have been exploited by outside researchers swooping in and

out of town, never to be seen or heard from again.
25

Reopening those doors will not be easy. Yet it may become necessary in order to gain a greater understanding of this monstrous

problem that is causing our children to believe that a gun or handful of pills is a more worthwhile option than asking someone to

talk.

Thank you.

Senator DORGAN. Dr. McDonald, thank you.

Relative to your comment about respecting the culture and so on,

we did, as would be a custom, invite a Hidatsa elder and spiritual

leader, Sadie Mann, to testify this morning. She was intending to

do that, but called this morning and said she was not able to be

here. I just wanted everyone here to know that we had made that

invitation, so she was on the list of those who would testify.

Dr. Paul Dauphinais is the school psychologist at Turtle Mountain Schools. Dr. Dauphinais, thank you very much for being here.

STATEMENT OF PAUL DAUPHINAIS, SCHOOL PSYCHOLOGIST,

TURTLE MOUNTAIN SCHOOLS

Mr. DAUPHINAIS. Thank you for having me.

I want to express my sorrow, first of all, for all the children who

have died tragically and in hopelessness. The pain and loss of a

loved one is very real and very great, as we have heard. That pain

is unimaginable.

My heart goes out to all those who have lost loved ones so tragically and to the communities who struggle with trying to find answers of why children, especially children, are taken from us. I

want to thank you, Senator Dorgan, for affording me the opportunity to let Congress know, to let the public know about the severity of the problem and to provide the impetus to do something to

prevent these tragedies.

When invited by my tribal chairman, Mr. Davis, I accepted the

responsibility, because I feel I live on the borrowed time of my

grandchildren, time that I cannot waste, the time that has been

given to me as a gift and I have a responsibility to respect the gift

or the gift could be taken back. My grandparents, in the same way,

accepted my gift and provided me the opportunities that I have had

and hopefully will continue to experience. These experiences do not

always bring the things that I would want, but all the experiences

have given me new and important information and I would like to

think that they have made me wiser.

I have experienced calls in the night telling me that one of my

children has attempted suicide. I have experienced depression, I

have seen my children in depression and states of hopelessness. I

am thankful my child did not, was not successful in committing

suicide and continues to live, although continues to battle the demons of mental illness.

I am raising one of my grandsons, and I enjoy him very much.

But I know the love he has for his mother and she for him.

My story unfortunately is not unlike that of many parents and

grandparents living in our Native American communities. Like

many others, the story is not totally one of endless tragedies. We

are blessed with children who have weathered their life with less

depression and hopelessness and have come to use their borrowed
26

time well. One has recently birthed a child, and another is awaiting fatherhood this month. These are very joyous occasions.

I was born on Turtle Mountain Chippewa Reservation, grew up

in the Yankton Sioux Reservation and have worked on other reservation communities and now work on the Turtle Mountain Reservation as a school psychologist. I worked as a school counselor,

human service administrator and I am a licensed psychologist in

North Dakota. I am also pathologically optimistic.

I am hopeful we can make our grandchildren’s time one that will

facilitate their potential and that one will give them the support

and strength to have hope. I know that if we really ask our children about themselves and their experiences, they will respond.

The science of psychology tell us that we can and should ask children if they need help and they will respond to us. I think the children that were in the panel before us expressed that very clearly.

My first wish is that we need to ask our children about themselves. As a community, we need to support the positive development of all our children. This includes supporting parents’ efforts

at providing nurturance and safety to their children and supporting

teachers to provide the best educational experience possible.

Between 7 and 10 million teenagers suffer from mental health

conditions; 90 percent of teens who die by suicide suffer from a

diagnosable mental illness at their time of death. In fact, in 63 percent of completed suicides, psychiatric symptoms developed more

than 1 year prior to death. It is ironic that by the time they reach

adolescence, most young people have been immunized against a

wide array of threats to their health and well-being, including measles and mumps, hearing, speech, and vision impairments, but few

are screened for depression.

If we screen, we will have children that we must attend to. At

the same time, can we ignore asking our children about themselves

because we don’t want to hear what they have to say? We are also

blessed with highly skilled professionals who are native to our community in the Turtle Mountain. We have young professionals that

have been part of Dr. McDonald’s INPSYDE, psychologist training

program, who now want to remain in their community. We have

MSW social workers and masters level counselors, school psychologists and a psychiatrist even who want to remain in their community to contribute to a better future, to respect their borrowed time

and gift.

We have begun to use the Teen Screen program researched and

designed at Columbia University by Dr. Shaffer. Teen Screen is a

screening program that uses scientifically designed tools to help

identify youth who are suffering from undiagnosed mental illness

and who are at risk for suicide.

In our Turtle Mountain Schools, we have identified over one-half

of our older children who have used alcohol or drugs and who have

used meth; over one-half who could be considered clinically depressed; and one-fourth could meet the criteria for PTSD. PTSD is

a very destroying mental illness that just piles on and on and on

every time a person is traumatized. Dr. Manson from the Mental

Health Research Center in Colorado recently published an article

including American Indians living in adverse environments that
27

placed them at high risk for exposure to trauma and harmful

health sequlae.

We have screened those middle school students whose parents

gave us permission and who themselves volunteer to take the

screening. The percentage of children with possible mental health

disorders was higher than the average of the other Teen Screen

sites throughout the United States. We also found that when we

screened our 1st grade through 5th grade children, 500 or so children, using the dominic computer interactive program, there was

an extraordinary number of children at risk there, too.

We have learned from this that we need the collaboration of Indian Health Service mental health teams in our particular community. They have been very, very supportive in that way.

Another wish I have is to provide support and a place for new

Native professionals. Many want to stay at home, the ones that I

have had experience with, that I supervise in their practicum in

our school system are very well trained and express the willingness

to stay home. We need to find a place for them.

We need to support efforts to allow mental health in schools. We

can do this through third party reimbursement for services within

schools, and through relaxing of policies that prohibit such practice

by IHS and BIA. We need to support training programs that expand the mentorships of Native psychologists and training, paired

with the best in the field of helping those who have been traumatized, the best in the field of helping children with depression and

other mental health disorders.

The schools have children for 8 hours a day. We have found

through our efforts in Turtle Mountain that having psychologists

and social workers and psychiatrists, as well as the established

school counselors, nurses, and social workers in the school, it

makes a big difference in terms of grade improvement and lessening office referrals and providing prevention programs and life skill

development for our children. We have found that by providing

skills to children to learn to cope with angry, fearful, worrisome

feelings they respond well in using these skills appropriately.

We have available to us Dr. LaFromboise’s ‘‘American Indian

Life Skills Development Curriculum.’’ She is a member of our community and a tenured professor at Stanford University. So there

are programs that exist for Native children. We need to find them,

they need to be allowed they need support. These kinds of programs need the Government stamp of approval, so we need to have

more research in those areas. Some of them are very, very good.

We need to support those prevention programs designed and researched for Native children. We need to support efforts in Native

communities with teams of professionals that can respond to tragedies. We need to support efforts for Native communities to have national teams of Native professionals who can provide the expertise

in prevention efforts.

Again, I want to thank you, Senator Dorgan. My wish list I suppose has grown with the years I have worked in my Indian communities. But I am hopeful and I know there’s a pony in there somewhere. [Laughter.]

I want to thank you personally for the many times you have responded to my family, also. I know you are quite informed about
28

the issues that plague the youth in our Native communities and

issues that create despondency and hopelessness. I am hopeful you

will continue to support our efforts in our Indian communities. I

want to thank you again.

Senator DORGAN. Dr. Dauphinais, thank you, and thanks for

what you do as well. We appreciate very much your being here.

The final witness will be Cynthia Lindquest-Mala. She is the

president of the Community College at Fort Totten, but previously

executive director of the North Dakota Indian Affairs Commission,

director of the Indian Health program at the University of North

Dakota Medical School. Ms. Lindquest, thank you very much.

It says you are a Ph.D candidate. Have you received your Ph.D?

Okay. If you will turn that microphone on, thank you. Please proceed.

STATEMENT OF CYNTHIA LINDQUIST-MALA, PRESIDENT,

CANKDESKA-CIKANA COMMUNITY COLLEGE, FORT TOTTEN

Ms. LINDQUIST-MALA. Thank you, Senator, and thank you very

much to the U.S. Senate Committee on Indian Affairs, Ms.

Bumpas, Ms. Garland, and Senator Dorgan.

I do appreciate the opportunity to be here. I do not have prepared testimony and I will begin by saying [greeting in native

tongue]. My friends, I am called Star Horse Woman, and I come

from the Spirit Lake Nation. My professional role is president of

Cankdeska-Cikana Community College, Spirit Lake Lakota, Fort

Totten, ND.

I need to share with you, in sharing with you my Indian name,

that I have a responsibility. I have come to understand in carrying

my Indian name, my Dakota name, is to speak from my heart. I

speak the truth as I understand it, as I have come to learn. I need

to share with you that I have come up through the ranks professionally as my tribe’s health director/planner in the early 1980’s, a

position I held for about 7 years. I have worked for the Indian

Health Service at the regional and national level. I am an adjunct

assistant professor of community health and rural health for the

University of North Dakota School of Medicine and Health

Sciences.

Why I share that with you, and I am going to come back to my

personal story, because I did grow up on the reservation, the Mission District, St. Michael, ND. When my parents went through a

bitter divorce, I was a teenager. I went through what professional

people called culture shock. I did not understand it at the time. But

one of my reactions and responses to going through culture shock

and not understanding my identity in being Dakota and Scandinavian, was that I took to alcohol and subsequently attempted suicide

myself two or three times as a child.

In my healing and learning journey, and especially my years as

the tribe’s health director/planner, the permeation of alcohol and

substance abuse on the reservation was just unbelievable. So I

made a conscious decision at that point in my life to set that aside.

I couldn’t be a hypocrite and be my tribe’s health director/planner

and have that lifestyle.

But alcohol and substance abuse affected everything in our lives

and still does. I have been back home as the tribal college presi-
29

dent for about 18 months. I have been truly blessed in my healing

and learning journey and coming to terms with my identity and

identifying as Dakota. But coming home after having national experience and getting to see Indian country from a national perspective, it is disheartening because of what is happening to our children.

I had a friend visit with me one time from England. We went to

a couple of different reservations here in the Dakotas. After the

end of the visit, we were just talking about the visit and getting

her impressions. Her impressions were, she loved to be around the

children, but at the same time, she was saddened, because our children did not have that spark of life in their eyes. There was almost

a sense of despair in young, young kids. And I had never looked

at it that way, especially having come off of being a tribal health

director/planner and being so enmeshed in dealing with health and

health issues. At that point in time, Spirit Lake Nation was dealing with four to five suicide attempts a week. We had one bachelor’s level social worker.

The program was a tribal health program. We retroceded it back

to the Indian Health Service, and it is still with the Indian Health

Service. We had contract psychologists and psychiatrists coming

into the reservation. It is still that way. It hasn’t changed, in all

the years. That’s what hurts, that’s what breaks my heart.

I love being home, I love being a tribal college president. Because

I am seeing optimism and hope in the student body at my college

and the changes there.

What I need to share with you all is that this is a very complex

and serious issue, as you so eloquently stated in your opening, Senator Dorgan. It is rooted in history. We can never forget that. It

reflects broken treaties, broken promises. It is linked to what they

call post-traumatic stress, that is so, for me, obvious now in Indian

Country. It is linked to how and why we live the way we live.

There are many policies passed with good intentions, but that did

not work, that tried to change how we live. The essence of those

policies was the dismantling of our families and the breakup of the

structure of how our families lived and the way we lived.

To me, this suicide epidemic happening in Indian country is just

a manifestation of all its history and reflects our community’s historical oppression, the assimilationist policies meant to deal with

Native people. Our people are wounded. Our people have wounded

souls and wounded spirits.

The data from the deaths reflect communities and families in crisis. The healing has to begin by understanding, and understanding

means different things to different people. We must understand

and perpetuate a public understanding of Indian people in this

country and its history. The dynamics of what is going on right

now does in fact reflect this history. We need to create learning environments so non-Indian people understand better that history

and the trauma that we are dealing with. We must create learning

environments so our people have a better understanding also of

this trauma and what we need to do to deal with it.

As these young people so eloquently stated, this issue of trust,

this personal thing with trust, while most teenagers, it doesn’t

matter what culture or community you come from, most teenagers
30

have this issue of trust. But for Native people and Native youth,

it is especially compounded, because you have this historical trauma. We are fearful and we are mistrustful because of these broken

promises, these broken histories.

At the same time, you look around, you look at the healing that

is occurring, the wonderful resilience, survivability of the indigenous people of this country, our compassion, our ability to forgive,

our ability to continue to give and to give back. That is the essence

of what is helping our people survive and looking forward until tomorrow, for all tomorrows, for the future.

So what can the U.S. Senate Committee on Indian Affairs do to

address teen suicide in Indian country? Do what you are doing,

Senator Dorgan. Have public forums, official and unofficial. We

need to talk about it. We need to have mechanisms to do that in

whatever way, whatever level, at different levels of Government,

public, private, homes, churches, pow-wows, wherever. Gather that

information and data, share it, disseminate it. Demand that the

Federal Government, that Congress appropriate adequate resources

for our health, our education of our people.

Off the top of my head, the Indian Health Service is funded at

about 60, 65 percent of need. That gap is growing. It is not getting

smaller. It is not diminishing. When I used to know these numbers,

the mental health services and programs of the Indian Health

Service were only funded at 20 to 25 percent of need. I don’t think

that’s changed since I used to do Indian Health work. I think those

numbers are probably comparable today. Likewise for education

and education systems.

As the vice chairman of this committee, Senator, you could go

forward and request that all the other Federal agencies open their

doors for Indian programming, Indian services, Indian resources.

Demand that based on this relationship, this unique relationship

our people have with this country, that those promises be fulfilled.

Assist in creating learning environments through education, health

care programming. Have the faith-based organizations come to the

table, be with us, and let’s endeavor.

Create better training programs for our youth, for peer counselors, for our people to become mental health, behavioral health

aides under the CHR model that is so wonderful relative to being

a liaison for health care and health care services. There needs to

be setasides marked for tribal governments, tribal colleges, for each

and every one of the Federal agencies to address this. It has to be

a collaborative partnership. It cannot just be the Indian Health

Service or SAMHSA. It has to be all of HHS, the Department of

Education, the Department of Justice, Department of Commence,

Department of the Interior, again, working together from a Federal, Congressional level down to the local level so it reaches our

people.

We do have models. There are many wonderful models out there

of community-based partnerships that are culturally appropriate,

that are working. One I can just cite off the top of my head is Don

Coyhis’ Wellbriety program in the White Bison non-profit organization out of Colorado, grass-roots movement addressing alcohol and

substance abuse issues. Really literally working in each individual
31

district and community to bring national momentum toward addressing alcohol substance problems in Indian country.

Overall, there needs to be a sustained infusion of resources, both

financial and human, to address this issue, and in a concerted and

a partnership way. In closing, the word dakota, hopefully you understand or know it means friend or ally, it comes from a bigger

word, wodakota, which means to be in harmony or balance. Indigenous culture has great beauty and understanding in this relationship we have with each other as human beings, the relationships

we have with mother earth, and the things that we can bring forward relative to our knowledge of our healing powers, our resiliency that we do have here. It is working in many, many of our

communities. It needs to be supported, it needs to be expanded.

We need to do what these young ladies asked us to do. We need

to have activities for them, every day, 24/7. And a variety, youth

centers, whatever. It is happening, it could happen more.

I thank you very much for having this today, Senator, and for

your courage in taking the lead. [Phrase in native tongue.] We are

all related.

[Applause.]

Senator DORGAN. Thank you very much.

You talk about areas of despair, there are of course areas of inspiration as well. I mentioned that the three high schoolers who

appeared today were very inspiring. You are not nearly as young,

the three of you, but in many ways your individual stories are

equally inspiring, in so many ways.

I want to thank you very much for your testimony and say to

Cynthia, based on what you finished with, this is the first of two

hearings. We will hold a second hearing in Washington, DC on

June 15. Senator McCain and I have agreed to hold this field hearing and then hold a second hearing. What we are attempting to do

is provide some significant focus on a very serious problem.

We will ask anyone who attends today or your acquaintances,

anyone who wishes to submit formal testimony for the formal

record which will be published of this committee, I would invite all

of you to submit that testimony. You can submit it through my office and it will be made a part of this formal hearing record. I want

to encourage you and urge you to do that, if you wish to.

I am going to submit questions for this panel. What I would like

to do is submit a list of questions to you to solicit from you the

complete list of suggestions that you have of how you think our actions ought to address these sets of issues. You all have talked, and

so have other witnesses, talked about the larger challenges. And

there are many—health care, education, you name it, there are

many challenges, no question about that.

But at least providing focus on this issue, what are the specific

lists of recommendations you would have for Senator McCain, myself and other members of the committee? I too think that we do

not have nearly the funding we need in these areas, and that is a

part of it. Then organizing the resources the right way to address

these issues is another part.

Let me ask for a show of hands, if I might, of those who have

attended this hearing, how many in this room have either had a
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relative or an acquaintance of theirs commit or attempt suicide?

Let me see some hands.

[Show of hands.]

Senator DORGAN. I think that, perhaps more than anything any

of us can say, describes the severity of this and the urgency of this

issue. I too have an Indian name, I was honored about 10 years ago

by the Standing Rock Sioux Tribe, in a very inspiring ceremony,

and they gave me the name Shantay Unweaka, which means

Thinks With His Heart. I think that my passion is with all my

heart and I hope yours and Senator McCain’s and the members of

our committee, we have to reach out to those young people whose

lives are full of despair and hopelessness and say to them, you are

not alone. You are just not alone. There are people who love you

and care about you. We want to make the kinds of resources and

assistance and help available to you.

So that’s what this is all about. Again, I am going to submit

questions to this panel. I want to thank all those who have appeared today.

I want to thank Jeanne Bumpus for coming out, representing

Senator McCain. She is the Chief of Staff for the Majority and Sara

Garland the Chief of Staff for the Minority. But there really isn’t

much of a majority or a minority in our committee. This is a committee in which all the members take seriously some very significant problems, and we want to work together to solve them.

You have all been very, very patient today. You have sat through

a rather lengthy hearing, and this young man is the most patient,

what a wonderful way to start the life of a 2-hour hearing and be

quite as good as he has been. Let me thank all of you for being

here in this hearing is officially adjourned.

[Whereupon, the hearing was adjourned.]
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APPENDIX

ADDITIONAL MATERIAL SUBMITTED FOR THE RECORD

PREPARED STATEMENT OF TEX G. HALL, CHAIRMAN, MANDAN, HIDATSA AND ARIKARA

NATION

Vice Chairman Dorgan and other members of the committee, thank you for the

opportunity to provide testimony today on behalf of the Mandan, Hidatsa and

Arikara Nation on a very important issue that continues to plague Indian country,

and in particular, youth on the several reservations in the State of North Dakota.

I apologize that I cannot be present today to testify personally; unfortunately I have

preexisting commitment that would not allow me to be here today. However, I appreciate the invitation to provide my comments and more importantly, I appreciate

the efforts that are being made by this committee and Senator Dorgan to address

the problem with teen suicide among Native American Youth. I also appreciate and

thank you for bringing this hearing here to North Dakota so that our tribal members are able to participate in this important process.

I believe the recent tragedy on the Red Lake Reservation and the rash of suicides

on the Standing Rock Reservation have caused all of us to open our eyes and realize

that our youth are suffering and are at risk. First and foremost, it is absolutely essential that a comprehensive assessment/survey be conducted to determine why our

children would even consider suicide an option. That could then be used to identify

our youth who are at risk and develop strategies to address the problems our children are facing.

I would like to begin by providing some background and statistics on suicide in

general on the Fort Berthold Indian Reservation. I will also provide you with information regarding the lack of resources which hamper our ability to effectively address this issue and would like to conclude with my recommendations to the committee on how we can better serve the needs of our youth and prevent these tragic

events from occurring.

Members of the committee, I do not need to restate the stunning statistic rates

for teen suicide among Native youth; you are very aware of these alarming numbers. I will present to you our most recent data regarding suicide on the Fort

Berthold Reservation. Fortunately for my reservation, we have not had a successful

suicide since 2003; we have however, had increasing numbers of attempts.

1. November 2004 through December 2004: 9 gestures, ideations or attempts

reported;

2. January 2005 through April 2005: 18 gestures, ideations or attempts reported;

3. Law enforcement responds to an average of 2–3 attempts per month

Of course, as the case usually is in Indian country, the lack of resources is the

major obstacle in preventing teen suicides and attempts. Two of the major components that are directly responsible for the intervention and prevention of suicide,

mental health and law enforcement services, continue to face decreased funding.

The following data represents a synopsis of those services as they are available on

the Fort Berthold Reservation:

1. Mental Health Services:
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• $242,565 annual budget for I.H.S. to service a population of approximately

7,000 individuals (roughly $354 per person annually)

• 1 full-time licensed therapist (Director of Mental Health)—approximately 40

percent of time is spent providing direct patient care other time is spent on administration and management

• Full-time Social Services representative—does not provide direct patient care or

therapy

• Full-time Clinical Social Worker position was eliminated from the fiscal year

2005 budget due to lack of funding

• 1 Contract Psychiatrist—1 day every other week (6-hour day—sees average of

25 patients—approximately 10 minutes per patient)—primarily provides medication management

• 1 Contract Psychologist—1 day per week (6 hour-day—sees an average of 5–6

patients per day)

• Suicide attempts are referred for hospitalization for up to 72 hours off reservation—patient followup is minimal due to lack of mental health services available locally

2. Law Enforcement:

• Serves 6 tribal communities and over 980,000 acres of land

• 1BIA Chief of Police and 1 lieutenant—primarily administrators

• 6 BIA patrol officers

• 8 tribal polices officers employed under COPS Fast Program

• Since fiscal year 2003 Tribe has experienced loss of 7 tribal police officers due

to COPS Fast budget cuts

• Facing continued threat of elimination of COPS Fast funding which would result in a loss of 8 officers and leave a total of 8 officers servicing the entire Reservation to provide 24 hour coverage

It cannot be denied that this lack of essential services has a direct impact on the

ability to prevent and intervene in suicides. Another valuable resource for Indian

country in the area of health care and mental health care needs that is facing elimination due to budget cuts is the Indians into Medicine (INMED), the Recruitment

and Retention of Indian Nurses Program (RAIN) and the Indians into Psychology

Program. These program are vital to improving the delivery of health and mental

health care services in Indian country. We cannot afford to loose these programs.

With those matters in mind, I make the following recommendations for immediate

action:

1. Increase Indian Health Service Budget to provide additional funding for mental

health services with emphasis on funds for youth mental health services;

2. Support the Tribal COPS Fast Program;

3. Support continued funding for the INMED, RAIN, and INPSYCH programs;

and

4. Assess how public and tribal schools can better serve the mental health needs

of children and identify at risk youth.

3. More long range recommendations include:

1. An immediate study/assessment must to be completed to determine why our

children are taking or attempting to take their own lives and to provide tools to

identify at risk youth;

2. Use the information from the assessment to address youth needs.

Again, I thank you for this opportunity to provide information and hope that you

will continue forward with finding solutions to address this problem.
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