Tribal Affairs

Commitment to Tribal Communities

SAMHSA develops, coordinates, and funds programs and resources that address mental and substance use disorders among American Indians and Alaska Natives. SAMHSA’s tribal agenda reflects SAMHSA’s commitment to helping Native Americans access behavioral health systems that meet their needs.

SAMHSA’s efforts reflect a commitment to upholding the federal government’s historical and unique legal relationship with Indian tribes through consultation, outreach, education, and engagement. SAMHSA's mission is to provide efficient and effective delivery of resources and services to ensure that American Indians and Alaska Natives have access to prevention, treatment, and recovery support services that reflect the best of modern science and traditional cultural practices.

Office of Tribal Affairs and Policy (OTAP)

The Office of Tribal Affairs and Policy (OTAP) serves as the agency’s primary point of contact for tribal governments, tribal organizations, and federal agencies on behavioral health issues that impact tribal communities. OTAP supports SAMHSA’s efforts to develop and implement innovative practices and policies driven by data.

OTAP also supports SAMHSA’s efforts to implement the Tribal Law and Order Act (TLOA). This work is carried out in partnership with tribal nations and in collaboration with other SAMHSA offices and centers, and other federal agencies. For more information, email OTAP at otap@samhsa.hhs.gov.

Office of Indian Alcohol and Substance Abuse (OIASA)

The Office of Indian Alcohol and Substance Abuse (OIASA) is an organizational component of OTAP. Under TLOA guidelines, OIASA coordinates federal partners and provides tribes with technical assistance and resources to develop and enhance prevention and treatment programs for substance use disorders, including the misuse of alcohol.

Access contact information for OIASA.

National Tribal Behavioral Health Agenda

Tribal leaders have consistently called for more coordination and collaboration among federal agencies whose efforts contribute to the health and well-being of American Indian and Alaska Native communities. In response, tribal leaders and various federal agencies developed the National Tribal Behavioral Health Agenda for enhanced coordination.

This national agenda is framed by four cross-cutting tribal issues: youth, culture, identity, and individual self-sufficiency. It also includes the following five foundational elements:

• Historical and intergenerational trauma. Historical trauma is the impact of chronic stress and trauma that negatively affects health. These impacts are magnified when entire communities experience and re-experience past and present trauma. The intent of this element is not to further assess historical trauma but rather to support the development of priorities and evidence- and practice-based actions that support healing. Learn more about how SAMHSA addresses trauma and violence.
• National awareness and visibility. There is general awareness that Native Americans experience higher rates of alcohol and substance use. However, the scope of these behavioral health problems is not fully understood. The intent of this element is to support the development of priorities and actions that help to improve understanding of American Indian and Alaska Native behavioral health disparities, as well as their consequent impacts on physical health and well-being. Learn more about how SAMHSA addresses mental and substance use disorders among American Indians and Alaska Natives.
• Social-ecological approach. There are a number of cross-cutting factors that influence health outcomes. For Native Americans, these factors include historical trauma (and other contexts) and a range of social, policy, and economic conditions such as poverty, under-employment, lack of access to health care, lower educational attainment, housing problems, and violence. The intent of this element is to support the development of priorities, interventions, and other actions that capture the larger context within which American Indian and Alaska Native behavioral health issues are rooted. The aim is to develop priorities that tribal, federal, state, and local governments and private groups can take that collectively contribute to positive outcomes. Learn more about SAMHSA’s efforts to develop tribal priorities and policies.
• Prevention and recovery support. Traditionally, Native Americans have understood that the mind, body, and spirit are inseparable. Despite traditional practices and beliefs, attitudinal barriers exist for people with behavioral health disorders. The intent of this element is to support the development of priorities and actions that identify and address the barriers to early intervention for American Indians and Alaska Natives. Early intervention is required to sustain positive emotional health. Learn more about SAMHSA’s efforts to ensure effective delivery of prevention, treatment, and recovery support services for all Americans.
• Behavioral health services and systems improvement. Native communities face service delivery issues that are complicated by personnel shortages, limited health care resources, and distances to obtain services. There also are other issues that inhibit access to appropriate behavioral health services. These include referrals from school, detention, court, housing, primary care, child welfare, and other systems. The intent of this element is to support the development of priorities and actions to improve coordination, linkages, and access to behavioral health-related services. Learn more about SAMHSA’s efforts to improve the delivery and financing of health care.

SAMHSA addresses a range of issues affecting American Indians and Alaska Natives, including the misuse of marijuana and the behavioral health impacts of HIV, AIDS, and Viral Hepatitis on Native communities. Access information about these and other behavioral health topics that highlight SAMHSA’s efforts to prevent and reduce the impact of mental illness and substance use among communities nationwide.

Learn more about how SAMHSA works to improve the behavioral health of American Indians and Alaska Natives:

• SAMHSA’s Efforts
• Grants Related to Tribal Affairs
• Publications and Resources on Tribal Affairs