Abuse tackled with traditional healing

FARMINGTON, N.M. (AP) - At Totah Behavioral Health Authority, alcoholics take weekly sweat lodges and Navajo language instruction instead of mandatory one-on-one counseling and Alcoholics Anonymous meetings.

Staff reports show the traditional techniques, often combined with standard substance abuse counseling, are working. The agency is reporting that more than 50 percent of its clients are finding employment after substance abuse treatment, according to six years' worth of the program's annual evaluation reports.

"We show consistent increases of relatives leaving and being housed, having less involvement in the legal system and their employment is increasing," said Kristine Carlson, the program and clinical administrator at Totah.

Totah was established in 2001. Staff treat San Juan County's homeless population for substance abuse and mental health issues. About 70 percent of the program's clients are court ordered to start therapy there.

The agency is unique because it takes standard substance abuse counseling and American Indian employees blend it with traditional Navajo cultural.

About 90 percent of the patients Totah staff refer to them as relatives are American Indian.

"On the Western-medicine side, our staff is well trained on evidence-based practices for substance and mental health issues," said Mike Renaud, the regional director of Presbyterian Medical Service, which operates the agency. "And then we rely on our native staff to bring their expertise to us."

Behind Totah's administrative building is a large yard with a fenced-in sweat lodge and a traditional hogan used for ceremonies.

Counselors approach recovery in creative ways. Men who arrive at the center from jail often go through sweat lodge ceremonies to purify their bodies. Patients are encouraged to speak in Navajo and search for their families and clans.

"A lot of them have abandonment issues," said Anna Holiday, the traditional services coordinator for Totah. "I tell them to reconnect with themselves and do research on their families."

David Johnson, one of the first clients to go through the Totah program, failed to recover from his alcohol addiction at court-ordered rehabilitation at places like the DWI treatment center in San Juan County.

He said the trust and respect incorporated into the Totah recovery program helped him to stop drinking.

"Some people can handle being told what to do and how to live their lives. I didn't like that," Johnson said. "These guys trusted me."

Though no longer receiving treatment for his alcohol addiction, Johnson still spends time at Totah, including attending weekly breakfasts at the facility.

After years living on Farmington streets, Johnson now has a home, a driver's license and a van. He works as a groundskeeper at Bethany Christian Church.

In addition to 50 percent of the clients finding employment after discharge, 30 percent have permanent homes and 75 percent report continuing to abstain from alcohol, according to patient surveys from the last six years.

"We're not a cookie-cutter program," Carlson said. "It makes us successful ... and it can make it harder to get funding."

Totah has about an $800,000 budget and treats between 300 and 400 people per year, Carlson said.

At Totah's request, county commissioners recently voted to add the agency to the list of providers that can access San Juan County's Indigent Health Care Fund. The fund consists primarily of gross receipts taxes and can be used by people without health insurance seeking medical treatment.

In 2011, San Juan County reduced the amount of funding it provided to Totah from $80,000 annually to $40,000. The agency has also seen a dip in funding from the state. By accessing the county's indigent fund, it can continue its services, Carlson said.

Questions remain about how Totah will gather the needed information to access county indigent funds. Liza Gomez, the indigent program director, said patients from other health agencies need to fill out forms that include social security numbers and addresses.

She was also unaware of how much money Totah will take from the indigent fund each year. It will likely draw between $40,000 and $80,000 annually, she said.

"It will be tricky," Renaud said. "It's fantastic the county was willing to (add Totah to the Indigent Health Care Fund). But it's going to be tough on our part to get the documentation people need to qualify. That population is not walking around with a lot of tax forms."