Dianne Vendiola, A.A., M.M.H.Sp.

Diane Vendiola, a member of the Swinomish Tribe, is an Indian culturally-oriented educator and trainer. For this article, she draws upon the book in which she collaborated, A Gathering of Wisdoms: Tribal Mental Health – A Cultural Perspective. The book was published as a Swinomish Tribal Mental Health Project and is being hailed as a landmark publication among Tribal mental health professionals.

The Skagit Tribal Mental Health Program began as a cooperative effort between Skagit Community Mental Health Services (CMHS) and the Swinomish Tribe. Services, provided at tribal sites, are closely coordinated with tribal programs. We have two Indian Tribal Support Counselors, supervised by a psychiatric director, a clinical therapist, and a project administrator and counselor. Thus we combine direct services with ongoing staff training. 

We look for staff among those members of the tribal community who are seen as natural helpers, and train them. We cooperate with traditional healing systems. We’ve developed a culture-specific model of service delivery, direct to traditionally oriented, "hard-to-reach" Indian clients. We’re establishing links with other mental health and social services programs in other tribal and mainstream communities

Program Goals

Specifically, our goals are these:

1. Provide culturally oriented mental health services for 25 Indian clients per year on the Swinomish Reservation.

2. Make mainstream mental health and social services more accessible and culturally sensitive to the needs of Indian people through referral, support, advocacy, consultation, and education.

3. Develop a theoretically coherent, specific, and replicable model for culturally effective mental health services on Indian reservations.

4. Increase cooperation between traditional Indian healing and mental health systems to meet the unique psycho-social-spiritual needs of Indian clients.

5. Provide ongoing, accredited training to Tribal Support Counselors, increasing their skills as effective mental health providers for Indian clients.

Cultural Factors

Our experience and observations have deepened our conviction that cultural factors are vital to the treatment and recovery of our Indian clients. These most certainly include cultural identity, extended family, Indian healing ways, variations of the English language in Coast Salish Indian community usage, patterns of alcohol use and their significance for mental health work, and the grieving process.

Accomplishments

For 11 years now, our Program has provided culturally oriented mental health services to Indian people. Most treatment is slanted toward suicide intervention, domestic violence, social withdrawal, family crisis related to substance abuse, child abuse, runaway teens, grief support, and conduct and somatoform disorders. We intervene in crises. We provide individual and family counseling, as well as case management. We refer as many clients for traditional spiritual "work" as for other kinds of consultation. We even meet clients in their own homes—and on their schedules, not ours. To help our people help each other we’ve fostered these support groups:

• Parent Education 

• Caregivers 

• Young Children

• Women

• Elder Issues and Consultation

We’re great believers in education and prevention. We make presentations to increase mainstream agency awareness about Indian people. We publish a monthly health column in the community newspaper. Every year we conduct a major outreach effort, and we’ve just applied for funds to help increase its impact. With an eye to the future, we’re putting a talented Support Counselor—one of our own—through school. 

We’re fully committed to adapting mental health services to Indian ways—not vice versa. I’m happy to report that it’s working, 

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North Sound Mental Health Administration