(PS7-C68) An Adaptation of the Assertive Community Treatment Model for Native American Populations

Native Americans face disproportionally high rates of unemployment, poverty, and homelessness compared to the general population, and are at high risk for co-occurring psychiatric and substance use disorders. Compounding the risks faced by Native Americans is the loss of connection with the cultural and spiritual practices that have historically facilitated healing. Due to the impact of multiple health disparities on Native American communities it is imperative for this population to receive evidence-based interventions that adapt for and encourage engagement in traditional practices. The Rocky Boy Reservation is the home of the Chippewa and Cree Tribes (CCT) that was formed in 1916 and gained federal recognition in 1934 (Chippewa Cree Tribe, 2018). Rocky Boy Reservation is one of two reservations in the state that compacted their federal funds which allows the tribe to make decisions and improve delivery systems based on community health needs. Data from community health assessments consistently indicate mental health and substance use as top concerns among residents. To improve the access to and quality of care for those with Serious Mental Illness (SMI) the Tribal Assertive Community Treatment (TACT) program has been implemented through the reservation’s healthcare clinic. The program has been implemented through SAMHSA COVID-19 relief funds to address the increased mental health and substance use needs associated with the pandemic.  Assertive Community Treatment is an evidenced-based model found to effectively support those with SMI with or without co-occurring substance use disorders to stabilize in their own communities. With its value on individualized care and empowerment, reduced reliance on formal supports like hospitals and detention centers, and success through integrating and educating supports from the natural ecology, ACT is well-suited for rural populations and those that emphasize family and community ties. The TACT program is an adaptation of the ACT model to account for cultural factors including traditional practices, factors related to rural settings, and historical trauma.  Data will be provided regarding program fidelity, specific adaptations, and outcomes. Due to the small sample size of participants, qualitative data from the community regarding outcomes, benefits, and drawbacks to the program will be presented in lieu of participant data to protect confidentiality and privacy. A focus on improved health and wellbeing for those with SMI who live on Native American reservations is important for the overall health of the community, and the implementation of EBPs that are relevant and aligned with traditional ways is essential.