25 U.S.C. § 1667 — Findings and purpose

(a) Findings. Congress finds: (1) American Indian and Alaska Native suicide is 1.9 times the national average, and youth ages 15–24 have a rate 3.5 times the average and the highest rate of any United States population group; (2) Indian country has more suicide risk factors, including prior attempts, family history, depression or other mental illness, alcohol or drug abuse, health disparities, stressful events and losses, easy access to lethal methods, exposure to others’ suicidal behavior, isolation, and incarceration; (3) in 2005 suicide was the second-leading cause of death for Indian and Alaska Native people of both sexes ages 10–34; (4) Indian and Alaska Native males ages 15–24 have suicide rates up to four times those of males of other racial groups and up to 11 times those of females of other racial groups, while females attempt suicide two to three times more often than males over their lifetimes; (5) some tribes, especially in the Great Plains, have rates up to ten times the national average and suicide clusters affect whole communities; (6) death rates are statistically underestimated because many areas lack resources to identify and monitor disease; (7) in 2007 the Service had physician vacancies of about 17% and nursing vacancies of about 18%, 90% of teens who die by suicide have a diagnosable mental illness, more than half had never seen a mental-health provider, and one-third of Indian-country health needs concern mental health; (8) tribal resource shortages and remote reservations often make federal-assistance requirements difficult to meet; (9) the Administration and Service have suicide initiatives, including the Service’s National Suicide Prevention Initiative, working with Service, tribal, and urban programs since 2003; (10) the National Strategy for Suicide Prevention was established in 2001 through a Department of Health and Human Services collaboration among SAMHSA, the Service, CDC, NIH, and HRSA; and (11) the Service and other Department agencies use information technology and other programs for Indian and Alaska Native suicide-prevention and mental-health needs. (b) Purposes. The part aims: (1) to authorize a demonstration project testing telemental health for Indian-youth suicide prevention, intervention, and treatment, including psychotherapy, psychiatric assessments, diagnostic interviews, therapies for suicide-related mental-health conditions, substance-abuse treatment, clinical expertise and consultation for frontline providers, training and support for community leaders, families, health and education workers, culturally relevant materials, and data collection and reporting; (2) to encourage tribes, organizations, and other providers serving Indian country to use predoctoral psychology and psychiatry interns; and (3) to improve Indian-youth mental-health services through existing SAMHSA grant programs.