Dale Walker - "Native People Need to Ferret Their Way Through the System"




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Feb 06, 2015
by Stuart Milne and Jonathan Elbaz
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Dale Walker - "Native People Need to Ferret Their Way Through the System"

Director of the One Sky Center: The American Indian/Alaska Native National Resource Center for Health, Education and Research speaks to Salzburg Global about the health care challenges facing indigenous communities in the United States Dale Walker speaking at session 536

Roger Dale Walker had never heard of psychiatry before going to medical school, but by the end of his fourth year he had found his calling and has never looked back. A member of the Cherokee people in the United States, Walker spoke to Salzburg Global during the session New Paradigms for Behavioral and Mental Health Care to share his thoughts on the challenges and possible solutions of improving mental health care for indigenous peoples.

“It has been a delightful process and a wonderful field to work in,” he said. “You are able to work with individual patients, communities, and political community issues.

"I am also an addiction psychiatrist, which has been a great addition because it brings me a breath from my ordinary work and allows me to work across systems and individual communities with multiple problems.”

He said the 1999 report by the US surgeon general best summed up the health care situation facing the 5.2 million Americans identifying themselves as natives.

“The American Indian and Alaska native people have the same disorders, the same problems, as the general population.

“However, they are much more severe: The rate of morbidity and mortality is higher, the ability to work with these populations is harder, and there is an access-to-health problem,” he explains.

“The issues become shocking and very difficult to deal with because there is a lack of health care person-power in these communities.”

Walker said the disparate sources of federal funding made for a complex and confusing process for those requiring access to health care resources or money. 

“Native people need to ferret their way through the system. They need to figure out where to get help for what.”

Walker is the founder and director of the One Sky Center, the first National Resource Center for American Indians and Alaska Natives specializing in substance abuse and mental illness in native populations.

He attended the session as part of a dedicated US native team. Their final recommendations highlighted the importance of integrating mental health care at the federal level, calling for the establishment of a single agency or cabinet post to implement solutions more effectively and efficiently than they are at present.

“For instance, if there is a cluster suicide or a domestic violence problem out in the community, you cannot muster the resources quickly.

“They come down in pipelines, and it is very hard to move money from one pipeline to another. That is the big issue.

“But now, there is also local and state funding that can be made available. We are just now able to develop these resources, and we’re hoping they will become resources for native people.”

The challenges of native health care extend far beyond the borders of the US, with an estimated 370 million indigenous people living in more than 70 countries.

Their needs are beginning to be addressed on a global scale, demonstrated by the convening of the first World Conference on Indigenous Peoples in New York in September 2014. However, the resolution adopted by the United Nations General Assembly as a result of the gathering did not cover health care or education in its 40 points.

Walker’s team saw a chance to correct this oversight, and were encouraged by their experiences at Salzburg Global to propose a future session exploring the relationships between governments and indigenous communicates in order to improve access to health care.

“I will take back with me the excitement of the people here. We have made wonderful contacts and will share information with one another. That is always the reason to have a meeting like this.

“Salzburg Global Seminar lives up to its reputation, and it has been a great opportunity.”

Dale Walker was a participant at the Salzburg Global program New Paradigms for Behavioral and Mental Health Care, which is part of the multi-year series Health and Health Care Innovation in the 21st Century. The session was hosted in partnership with the Dartmouth Center for Health Care Delivery Science. More information on the session can be found here: www.salzburgglobal.org/go/536.