NIH HEAL Initiative N CREW
Great Lakes Inter-Tribal Council
PERSON-CENTERED RESEARCH on CULTURE AS HEALTH (PERCH)
An Indigenous Model of Wellness
Abstract. Native American (NA) youth in the Bemidji area grapple with the opioid epidemic's harshest consequences, experiencing a devastating 68% rise in opioid-related deaths since 2019 (GLITEC, 2021). The COVID-19 pandemic further compounded this crisis, with opioid-related deaths spiking by 33.5% between 2019 and 2020. These alarming rates of substance use among NA youth stem from underlying mental health issues fueled by historical trauma, unresolved needs due to long-standing social inequalities, and the broader social determinants of health. In response to this urgent crisis, the Great Lakes Inter-Tribal Council (GLITC) has conducted extensive research and is pioneering the Adolescent Recovery Wellness Center (ARWC), a first-of-its-kind residential facility for youth aged 13-17 struggling with substance use disorder (SUD) and co-occurring mental health conditions. From the beginning, GLITC's focus has been on the development of a Person-Centered approach and integration of Tribal wellness practices. The N CREW HEAL initiative fuels this development of a research program named Person-centered Research on Culture as Health (PERCH). The three AIMS are to build capacity to engage in research: 1) Establish and register the GLITC Institutional Review Board (IRB); 2) Plan for long-term success and sustainability through development and demonstration of culturally appropriate and effective recovery and treatment services for NA youth; and 3) Establish a culturally specific Healthcare Model to sustainably support NA Youth with SUD and other co-occurring Mental Behavior Health conditions. GLITC’s plan is to operate the ARWC to address the unique health challenges faced by native youth, and stands as a symbol of resilience, strength, and the profound impact of integrating traditional and modern pathways to healing and wellness. Through this innovative approach & methodology, the ARWC’s operational plan will include a Cultural Competency Framework for treatment and an Indigenous Evaluation Framework that uses mixed methods statistical approaches to build a Convergence of Evidence Model demonstrating traditional wellness practices are effective and therefore should qualify as billable healthcare services. The Outcomes are integration of traditional health practices to strengthen cultural connectivity, improve mental behavioral wellness, and reduce risky behaviors in NA youth. Related wrap around services in tribal communities will integrate a compassionate Person-Centered healthcare model culturally defined and evidence-based to reduce SUD in NA youth.