The Impact of State Behavioral Health Reform on Native American Individuals, Families, and Communities

Bibliographic Data

ID4668280
AuthorsCathleen E Willging (0000-0001-6446-5083, Pacific Institute for Research and Evaluation, Behavioral Health Research of the Southwest, Albuquerque, New Mexico, USA), Jessica R Goodkind (0000-0002-2038-0878, University of New Mexico), Jessica Goodkind (University of New Mexico, Albuquerque, New Mexico, USA), Louise Lamphere (University of New Mexico, Albuquerque, New Mexico, USA), Gwendolyn Saul (University of New Mexico, Albuquerque, New Mexico, USA), Shannon Fluder (Pacific Institute for Research and Evaluation, Behavioral Health Research of the Southwest, Albuquerque, New Mexico, USA), Paula Seanez (Navajo Nation Office of Special Education and Rehabilitation Services, Window Rock, Arizona, USA)
Year2012
Volume22
Issue7
Pages880-896
Publication date2012-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueQualitative Health Research (JOURNAL)
Journal identifiersISSN: 1049-7323 • E-ISSN: 1552-7557
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/1049732312440329
PMID22427455
PMCIDPMC3515637
OpenAlexW2103472601
LanguageEN
Citations received2
References cited32

In 2005, the State of New Mexico undertook a sweeping transformation of all publicly funded behavioral health services. The reform was intended to enhance the cultural responsiveness and appropriateness of these services. To examine achievement of this objective, we conducted a qualitative study of the involvement of Native Americans in reform efforts and the subsequent impacts of reform on services for Native Americans. We found that the reform was relatively unsuccessful at creating mechanisms for genuine community input or improving behavioral health care for this population. These shortcomings were related to limited understandings of administrators concerning how tribal governments and health care systems operate, and the structural limitations of a managed care system that does not allow flexibility for culturally appropriate utilization review, screening, or treatment. However, interaction between the State and tribes increased, and we conclude that aspects of the reform could be strengthened to achieve more meaningful involvement and service improvements

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