APA Makes Case for Increased IHS Budget
APA and the Friends of Indian Health, a coalition of about 50 organizations of which APA is a member, are urging Congress to increase significantly the president's proposed Fiscal 2006 budget for the Indian Health Service (IHS).
IHS, an agency of the Department of Health and Human Services, is charged with improving the health of American Indians and Alaska Natives (AI/ANs).
“It is imperative that IHS first and foremost address the disparity in disease rates and access to care that exists in Indian neighborhoods,” stated psychiatrist Brian Benton, M.D., on behalf of the coalition to the House Appropriations Subcommittee on Interior, Environment, and Related Agencies in April.
A disproportionate number of AI/ANs suffer from alcoholism, substance abuse, and suicide compared with all other ethnic and racial groups in the United States, said Benton. He is of Cherokee descent and a member of APA's Committee of American Indian, Alaska Native, and Native Hawaiian Psychiatrists and the Assembly caucus representing these same groups.
The suicide rate for American Indians is 60 percent higher than that for the general population, and studies have shown that 70 percent of completed and attempted suicides on Indian reservations involved alcohol use, according to the testimony submitted by the Friends of Indian Health.
More than half of the American Indians who commit suicide have never seen a psychiatrist or mental health professional, said Benton. As medical director of psychiatric services at William W. Backus Hospital, a general community hospital in Norwich, Conn., Benton sees and treats a large number of American Indians for co-occurring depression and substance abuse.
“American Indians in New England have been mired in a culture of poverty, substance abuse, and domestic violence for centuries. This is a result of oppression, forced assimilation and loss of cultural identity, inadequate health care, and lack of educational opportunities,” Benton told Psychiatric News.
The IHS has lacked the resources it needs to meet the health care needs of Native Americans. “The IHS has been a low priority for the federal government,” said Benton.
Some Indian tribes own and operate casinos, which have become a source of significant income for them. Benton mentioned that tribes on two reservations in Connecticut near his hospital own successful casinos and have spent the income on establishing new health care services.
To improve the access of AI/ANs to general health care and mental health services, Congress needs to increase the Fiscal 2006 IHS Health Services and Health Facilities budget proposed by the president by $170 million, to bring it to a total of $3.22 billion, Benton testified.
The president requested an increase of $118 million in Fiscal 2006 for the health services program and a decrease of $85 million for the health facilities program for a total IHS budget request of $3.05 billion, according to the president's Fiscal 2006 IHS budget justification.
APA and the Friends of Indian Health requested that Congress appropriate the additional $170 million in the IHS Fiscal 2006 budget to accomplish the following:
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Fully fund the educational loans of health care professionals to retain more of the existing workforce and attract new health care professionals to careers in the IHS ($22 million).
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Increase prevention activities to decrease mortality rates and prevent diseases such as obesity, alcoholism, and HIV/AIDS ($8 million).
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Fully fund the recently established Tribal Epidemiology Centers so they can develop adequate surveillance and epidemiological systems to prevent and control diseases ($2 million).
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Increase funding for IHS to pay for specialized health care services that American Indians need but are not provided by IHS health care professionals, inflation-related increases, and salaries to support and maintain vital health programs ($53 million).
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Restore funding to IHS to maintain, improve, and replace outdated health care facilities on Indian reservations ($85 million).
The oral testimony presented on the IHS budget can be accessed online at<www.psych.org/advocacy_policy/leg_res/apa_testimony/testimonys.cfm> by clicking on “Testimony of Dr. Brian Benton before the House Appropriations Subcommittee....”▪
Brian Benton, M.D., in the House Rayburn Office Building of Congress after he testified on increasing the Fiscal 2006 budget of the Indian Health Service.
Photo: Alison Bondurant
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Published online: 3 June 2005
Published in print: June 3, 2005
Notes
American Indians and Alaska Natives need better access to mental health care to reduce their high rates of suicides and alcoholism, APA tells Congress.
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