Black Feathers 2: Mental Health Within Native Families with Disabilities

Black Feathers’ hosts Crystal and Shauna discuss the importance of mental health with Johnna James, citizen of Chickasaw Nation, who will talk about her family’s journey with disability, mental health and suicide. If you are having a mental health crisis please visit 988 Crisis Lifeline or call 988.  For additional resources visit blackfeathers.org

Transcript

Crystal Hernandez: 0:00

Welcome to Black Feathers podcast, a true and honest conversation about disabilities for all. I'm your host, Dr. Crystal Hernandez from the Cherokee Nation,

Shauna Humphreys: 0:09

and I am Shawna Humphreys from Choctaw Nation.

Crystal Hernandez: 0:12

Today we will discuss the importance of mental health at the intersections of disability within our tribal nations. We will hear from Johnna James and her personal journey with mental health, suicide, as well as disabilities within her family. Johnna, I know you have an incredible story. And we are so thrilled to have you here, being able to share this with our listeners, as well as Shauna and myself.

Joanna James: 1:10

Thank you guys for having me. So I do have a lot of stories that narrate my life. And one of the reasons I'm excited to share is because to me, it's a roadmap that I've been given. So I'm going to start with my name is Jonna James, Chickasa Saya, I am a citizen of the Chickasaw Nation. And I do a lot of things I worked in behavioral health, I've worked in suicide prevention. I've been an Indian Child Welfare caseworker. Currently, I work at a tribal serving institution where I do student recruitment serve on the executive team for the college, as well as teach in American Indian Studies course. So again, lots of work in Indian country. But my most favorite purposes are being and Ishki and Iposi, see, so I get to be a mom and I get to be a grandma. I am a mom to six children, five I gave birth to and one that I adopted. So my five children by birth are Chickasaw, my adopted child is a Choctaw member. And that's what I really want to talk about today. Because, like so many that work in the behavioral health field, you know, there's a story for my family and, and the path that we have been on and, and how that has played out for us. And I want to start with, I was married to my high school sweetheart. We got married when we were 20 years old, I did go to college, and I had planned the perfect college plan and and we had this roadmap that we created, we started having children younger than we'd expected due to some health problems. And that I didn't want to miss my chance of being a mom. So we made the decision to go ahead start having children when I was 21 years old. And then from there, we had three children in the following. Our children were all two years apart. So I noticed with my third child, there was some developmental delays. And I was thinking there cannot possibly be something wrong with all of my children, we've all they all had some sort of struggles. The middle child at the time had a speech impediment. And so I got their doctor's records. And I went through all of them. And I went to their pediatrician, I said, explain all of this. And so he ran some tests and found out that my children had lead poisoning. And we had built a brand new home. So we couldn't really figure out where the lead poisoning came from. The government got involved at that point, of course, because that's what they do when when lead poisoned children happened in the state of Oklahoma. And through that investigation, we found that my husband's employee at the time, there was a lead base coolant that he was working with. And we did not know that and then our home had become contaminated. There were a lot of people involved in our life from there. And in that journey, we found out that the lead poisoning had led to our children's developmental delays. They were seen at a young Child Study Center, and all three of them received autism diagnosis. So at that time, it was called pervasive development disorder, not others, but not otherwise specified. And our third child, the one that was struggling so much, how to IQ that made her borderline. And so she was going to have lifelong struggles. We were devastated, of course, but we got intervention. We got therapists, we did pet parent child interaction therapy, we did everything that was available that child's at now. They just turned 18 Actually August 2 And so, um, but we got all the interventions and services that was available, you know, 15 years ago to help these kids and, and help us and I want to say right off the bat, with the children receiving their diagnosis early on. My thought process was not that these diagnosis were about what was wrong with my children. I Um, it was for me an explanation of how my children navigate this world and my job going forward as their mom was going to be to learn their navigation maps, they just see the world in a different and what I have learned beautiful way than I, and most people do. So went on to have we adopted a child and then had two more children, we just went on as the normal family trying to navigate life as you do. But then in 2013, we lost my mother to suicide. And so again, we sought out behavioral health services we had were members of the Chickasaw Nation, who did an amazing job coming in and helping our family. We had coordinated services for the children to help them navigate all things school. Because you know, when when a trauma like that, it really rocks every area of your life is what we learned. I noticed that my youngest child continued to have struggles continue to have outbursts continue to have behavioral health struggles, continue to have at school struggles. And the more they struggle, the more behavioral health services read, we reached out for one of the things about this, this, my youngest is, they were always super smart. And and so to me, I didn't understand. You know, everything that we were trying, nothing seemed to be working. And then last December, we went to a psychologist, and I was devastated. When my 14 year old, she's 14, at the time, was diagnosed with Level Two autism. What had happened was because I was a mom to three other autistic children. I had just intervened in my youngest child's every time I saw them struggle, I would, you know, adjust and do the things that I learned early on. And what happened is between my child masking and my own personal interventions, we just went undiagnosed. One of the things that that they had, that was really a struggle was they would always tell me, they would get upset and overwhelmed, and they couldn't tell me what's going on. And they would say, Mom, I want to tell you, I just can't talk. They said that so many times. And what I was hearing was, I don't know how to share my emotions. Or maybe I'm an introvert. That's what I thought for the longest time that this sixth child out of this family of extroverts was an introvert. These were the things I was thinking all of this time and, and what we found out during their diagnosis is when they are in overwhelm, they go nonverbal, they literally are not able to talk. This explains so much it explained why in therapy, when we would get to the heart things, they would not be able to talk and what we were saying was, well, they're shutting down, they're shutting down their emotions, they're not able to share with us, we didn't realize that they in that moment, were nonverbal and unable to communicate with us. And this is the story I want to share, I want to share because I feel like especially in my interactions with Crystal, we have talked about or Dr. Hernandez My apologies. What we've talked about is the intersection of autism and behavioral health services. And what does that mean. And that was one of the things a psychologist helped us navigate in December was to find a therapist that knows how to navigate autism, because people with autism need different approaches sometimes, so that their therapy will work. Sometimes regular talk Therapy or CBT therapy is not what's appropriate for for them. And that's another thing I learned with all of my children, even though they have these, these autism diagnosis, they each still operate and navigate life differently. Like just because there's five children with autism diagnosis does not mean I have five children that all act the same way. They each have different behaviors, and and again, different roadmaps and how they learn and how they communicate. And so that's that's just where we're at today. And, you know, I had to work through a lot of guilt as a mom not recognizing what was going on with my youngest child until they were 14 years old. And now I've had others also share their experience of not being diagnosed with autism until later in life. And I'm not there yet. I will be in October. But what I learned through my children also is some of the things that I do are also traits of autism. And so I do have that evaluation in October and that has taken a year to get to that because there's just not enough services out there. And and even for adults, those services were out set out for a year a year. and a half. And so learning if if some of these things are also kind of what's going on or or maybe there were some things that made more sense in my childhood, that that didn't make sense then. And so we're exploring that path as well, but, but I've had to reconcile with myself as a mom. What I didn't know. And I have a friend that Choctaw that works in behavioral health, and she had told me many years ago, when I was working, first working as suicide prevention grant, I met her. And there were some things I was going to be learning that I did not know. And I had already lost my mom to suicide, and she shared with me, you're gonna hear some things that you did not know when you lost your mom. And it may make you feel some kind of way, like, Oh, why didn't I see that like, one of the things was, maybe that people that are struggling with suicidal ideation may start giving their belongings away. And that was the case with my mom, she had given away some of her jewelry. But the advice my friend had given me at the time was, as you're learning these things, there's a Maya Angelou quote, she wanted me to remember and it was we do the best we can until we know better. And then when we know better, we just do better. And I hang on to that, quote, I have through this journey of the last 10 years, working with my family, as we have tried to find balance and healing. We can't go back to the past and change some things that we can. As we learn to do better, we can do better. And, and that is also what has inspired me to share our story because I learned better by those that were willing to share with me, and, and so if it can help somebody else that's struggling with autism and struggling with healing, however, you're seeking those services, to just know not to give up, we just have to find the roadmap to how we navigate and how our children navigate things. Until we find what works.

Crystal Hernandez: 12:05

Thank you for sharing that Gianna. It was it was very insightful and brave. And I know we've shared you and I together a lot of pieces of our children's stories. And and we have worked in those cross sections of mental health, as well as intellectual developmental disability spaces, you know, so I do have a question for you. So you talked about how you navigated those those interventions early on? Did you find any gaps or any opportunities within your tribe that really understood developmental disabilities or screenings? Or any of those things? Or, or do you think that we've evolved and grown over the the two decades,

Joanna James: 12:45

we have certainly grown and unfortunately, it was not on my I didn't think to reach out to my tribe at that time. So we went through local services, and I feel like the local services were great, but back then it was very, it was mostly parent child interaction therapy. And and I think that, that that's important, because the difference in those from my experience in difference in those is, when we did parent child interaction therapy, it was we would all sit in a room and I would sit in there with my children, and they would behave a certain way. And then they would teach me how to react to them, or interact with them based on their different behaviors. And, for example, the the child that had the speech impediment, so she has autism, but also has a diagnosis of apraxia. And so, you know, navigating how to communicate with that child, teaching them some sign languages. And so those were some of the things I was taught then, what I see now it's more of a person centered approach where they're working with the person with autism. And I think that that's more appropriate, because you can't go through life with my children, like I can't always be there to hold my hold their hand and navigate for them. They deserve to know how to navigate situations themselves more, working directly with the autistic person, and teaching them social interactions, how to cope. We're doing that with my 14 year old right now. You know, when they go into overwhelm, and both how they're interacting with the people around them when they're in overwhelm, and how they are interacting inside themselves, because their narrative in the past towards themselves when they couldn't interact. Was there something wrong with me and I must be worthless, and now they're learning. I'm in overwhelm right now. And I deserve to be calm, and I deserve to take my time and do whatever it takes to be calm. I can remove myself from the situation, all of the things they're learning to be to be easier on themselves. And so I feel like we've come a long ways I feel like the approach does need to be aimed at helping the autistic person I take care of themselves, and also not to change them, my children will always be autistic, there's not a cure for autism. And so to teach them to be successful in this world, as they are, I think is just one of the best things that has changed and could have happened.

Crystal Hernandez: 15:19

Absolutely. So you said two things I just want to circle back on, you talked about being becoming nonverbal. And so we look at a lot of the the research and the data, specifically related to the autistic population, and that 50% On average, are nonverbal. And, and really non speaking, right. And then during times of distress or stress, they an additional portion of them lose that ability to verbalize. And so when I say that, it doesn't take away all the other methods of communication that they do have at their disposal, and that they do often use. And so what I'm talking about is traditional expected verbal ability. And, and so we do know that, and you mentioned that, and so I just wanted to kind of, you know, chime in on that. And the other thing that we, that you mentioned was the intersection of mental illness, and autism. And so again, looking at a lot of that statistic, in that research, it talks about the presence of 78% co occurring rate among those two populations. And so a lot of our traditional mental health systems do not account for autistic individuals, meaning that they don't understand they lack the training, they lack the sophistication and policy to really have equity, and to understand that they should could and, and it's imperative that they serve this population

Joanna James: 16:48

Absolutely in and we have dealt with a wide range of behavioral health issues among all of the children. So I don't want to talk about any of them specifically, that's their own story. But for some of the things that we have seen are include depression, they have included self harm, they have included anxiety. And I feel like there is a direct correlation between the traumatic experience of being autistic in a world that doesn't make space for autistic people. The dialogue that they have shared with me, based on interactions like they've had at school, and even how maybe some of their own educators have talked to them, or treated them, or use the wrong word in front of them. And then they've internalized that story. And that is one thing about children is they they will make up a narrative if we're if we're not helping them. And sometimes that can be a very negative narrative, and that that's traumatic it. You know, when you go through life thinking, I'm worthless, or I'm weird, or I'm not accepted, or I don't have any friends, or one of my children really struggled with making friends. And they, they say, Mom, I just want one friend. And that broke my heart. So yes, I feel like so many of their struggles, on the behavioral health side and mental illness. They're locked in, in their own world trying to navigate. And we just have to do better, I think, to help them. So it's not so traumatic for them. That's something we can do is take some of that on for them.

Crystal Hernandez: 18:33

Absolutely, absolutely. And you mentioned a few times some of the work that you've done in the field of suicide in the area of suicide, and also some personal experience with that. And so our autistic community as a as at a massively higher rate of suicidal ideation and contemplation, as well as completed suicides. And again, oftentimes, they're left out of prevention efforts, they're left out of any kind of marketing campaign, any sort of, you know, place within the suicide prevention world. And so that's another area we can definitely do better and should do better. So I just want to bring it back to real quick the the tribal systems because I know, you didn't use them with your kiddos. But moving forward, you definitely work among tribal nations routinely. And so do you see, what do you see in terms of the behavioral health space and the mental health space? Even the artistic space within the tribal nations that you're, you're have, you know, work with and have knowledge of?

Joanna James: 19:42

So I will say in the last 10 years, we have accessed our behavioral health resources through our tribe and they have been amazing. They're the ones that stepped in to help the kids after my mom's suicide loss and and what I see with all of our tribes, I see that Um, well, I'll say on a federal level starting with there's we have these Native Connections grants I was I was in that field working with the tribe, when the Native Connections grants were created back in, I want to say that would probably have been 2015 or 16. And we have more funding services and sources, and our tribes are really able to reach their community members, especially through the Native Connections grant, which is a really hot community center grant. And so I, I see our tribes being innovative. I, I brag on them all of the time, especially in Oklahoma, because those are the ones that I do see their stories. I there's one tribe that is using stick balls prevention. And in the way that they explain that to me is they're teaching their children how to be part of their indigenous community, by playing stickball with them. They're teaching them what a leader looks like what a team player looks like. So they're using a game, but at the same time, being intentional to teach that child how to be included in community and how to include others. And I think that's just beautiful. We know that our culture is prevention. You know, I, I have heard, I was told that, you know, culture is like a fish in water. You don't the fish doesn't realize it lives in water until you take it out. And I feel like culture is that way for our people, you know, you don't realize how important it is until you're not in it. And so that's what I, what I mostly appreciate with the tribes and how they are reacting to, to all things behavioral health right now is that focus on community and belonging and taking part in your indigenous ways. So I'm grateful to both all our tribes that were at those consultations, as well as the agencies within the state of Oklahoma that that made that possible so that our autistic children have access to services. So I see our tribes out there, constantly trying to make it better.

Crystal Hernandez: 22:03

Perfect. So I know Shauna does a tremendous amount of work within her tribal, mental health systems. And so I'm just curious, Shauna, what are your thoughts about the stories that we just heard? And kind of, you know, how we've evolved as tribal nations and the focus and emphasis that we have now moving forward on on wellness and how we perceive mental health and those intersections?

Shauna Humphreys: 22:29

Yeah, so a couple of things come to mind. First of all, Johnna, it's, it's a pleasure to have you and I know we've done work together in suicide prevention in the past. And that's kind of where part of my journey started with suicide prevention was working alongside Johnna and at that time, I believe it was the Wichita affiliated tribes that Johnna was working for. And we were both doing the SAMSA GLS, the Garrett Lee Smith, suicide initiative. But one thing that, to me, culturally, culture is prevention. I love how you said that Johnna in Choctaw Nation is one of those that is using stickball as prevention, to give that sense of belonging, but also the storytelling. So what you just did right now, you know, culturally, this is how we learn. This is how we spread awareness. And this is how we carry our traditions is by storytelling. I feel like the tribes have really come a long way, just like John has said, in as our work both in mental health and with autism, we're still a long way to go. But I feel like when I first started back with behavioral health, I guess it's been about eight years ago, always been in the mental health field. But back with the actual department, you know, behavioral with Choctaw Nation, we didn't really have a whole lot of, we had some programs going out into the community kind of helping spread awareness. But really, with the tomorrow's wholegrain is where I noticed some systems change, like occurring, like we started screening people that come into the clinic, using PHQ9 in the Columbia, because we knew that not everyone would set foot at the behavioral health buildings. And so it's like, how do we truly, you know, help people and meet them where they are. And so it's like, well, let's just let's go to them and provide that holistic care. And so now we've seen integrated starting to occur, then that kind of happened through part of the Native Connections grant that John was talking about. And we just, I just continue to see the vision for our tribes grow and grow and tap into that culture as prevention. Because like I just said, whenever you're an integrated, you're treating not just the physical piece, but now that we're screening for suicide and for depression, you're treating the mental health piece. And so you know, Mind Body Soul, we're kind of getting that that connection and, and truly meeting people where they're at. creating harmony is also kind of what I say. But yeah, but that's kind of it what I've been noticing and what I've encountered over the years, and I just hope to see it continue to grow.

Crystal Hernandez: 25:07

So you both have mentioned connectedness and kind of that connectivity. And you know, as we embrace a connected view, as people, you know, we draw on our ancestors, our community, our stories, our customs, our history, you know, in, in all of this can and does shape our world, right, our perceptions and our people as a whole. And it's these very elements that often serve as protective factors. And that's what people oftentimes don't talk about, you know, among among our tribes, is that we have a tremendous amount of protective factors, which explain and highlight our resiliency as people in our strength. And this really does shine the light on the incredible strides we have seen among our tribal nations. As we have grown and placed a strong emphasis on mental health, you see tribal nation stepping forward, saying we are going to allocate we are going to build, we want to be at the table, and we want our people to thrive and be healthy. And that's fantastic.

Joanna James: 26:08

So I want to tell another story, and I should have invited her with me, she's not here today, but my 20 year old, she was 13 at the time, she lost her grandmother, so a real significant age and she was close to my mother and Chickasaw Nation helped her through her behavioral health journey. And they did a commercial with her, you know, after I mean, she worked hard at her healing and she also has an autism diagnosis and, and then she went on to become a mentor for we are native, which is a national organization for Native youth and she was an ambassador, so they choose 30 ambassadors in the United States, and she was chosen to be one of them. And, and then she went on to college last year. It was her first year in college. And you know, she knows she's autistic she she's always done whatever help has been provided she she takes it for, for all it's worth and does everything she can to implement those coping skills in. So going through the Chickasaw Nation behavioral health she was taught a lot she was taught about beading, she was she was doing her therapy and she was taught the connection to our ancestors and and just real connected to her culture. And so she remains connected to her culture today and and still now she's out speaking to others about generational trauma and so super proud of her journey. But last year, she was struggling at college and she called me and she said, Mom, I went outside and I saw the Te Ata statue. So Te Ata Fisher was a storyteller for the Chickasaw Nation. And you can watch the movie over Te Ata, she was an amazing role model. And she went to USAO, when it was Oklahoma College for Women, and that was, that is the college my daughter goes to and she said, Mom, it was hard. And I just was ready to quit. And I walked outside, and I saw take out a statue today. And I remember that if she can do this, so can I. And I said, Alyssa, this is exactly why we do why we get to do what we do. And and I'm like I said, I'm so proud of her. She, she does the children's conference every year for the Oklahoma Department of Mental Health, she has definitely gone on to share her story in so many spaces, but I just want to share that. Because it goes to talk about that connection and how empowering and healing it can be when it's just give it to them. I mean, somebody took the time to give all of this to her. And she has just run with it. And now she's getting to impact others. And so yeah, there's definitely a connection there. And the more connected we are, I feel like the better chance our children have at succeeding.

Crystal Hernandez: 28:50

That's beautiful. Thank you for sharing that she sounds like such a tremendously strong woman. And I bet you're so happy as a mom to see that in her.

Joanna James: 29:01

I am and in not just as a mom, but I think one of my favorite things about being a mom is learning. Like the journey of being a parent is to watch your children find who they are. And so I have some kids that, you know, their native identity is not right at the top. They all know they're Chickasaw, but that's not but for this one it is but I see that, you know, especially with autistic children, helping them each find their own thing once into astronomy. One has become a is a stagehand on a dramatic drama production at school, helping them each plug into their thing and watching them just bloom and I've seen that with her and I'm excited and honored to get to watch the rest of them grow up and and I think that's just also been key to their successes is finding where their passion is at and just encouraging that I was thinking after Crystal had said about the high suicide rates with autistic people. So very gently, I want to say about autism. And my experience with working with youth with autism is the literal nature of how they process. And so also having that suicide prevention background. And so having I've had a youth tell me when we were having a conversation about suicide, them saying, I can suicide if I want to, it's my body. And I think that that's something we have to take into consideration with our youth that are autistic. And I think this is why the cams model is so important, we have to understand that, yes, suicide can happen. And when you are a person that processes everything literal.

Crystal Hernandez: 31:08

So what we see a lot of times is is you know, individuals who are artistic, yes, they're all very different from one another, but some of the commonalities that we see is the way that they that they do process, the literal nature of the world. And and, you know, I talk about this quite often that we have a world that was created by people with so many vast differences, including individuals who, who were autistic, that that really shaped our sciences, or arts or music or philosophies. But yet our world doesn't embrace them, and doesn't include them. And so there's a lot of pressure on on folks. And you know, so you have differences. So you have some people who have the anxiety have the depression, who have you know, that exhaustion from masking constantly of trying to be what the world wants. And then you have the other that you just mentioned about, you know, that literal nature of process that I, I make these decisions because I can, and, you know, I was at a meeting for autism at the state capitol. And it was really about raising action and awareness and inclusion. And it was a virtual one due to COVID. That year, and we had a tremendous amount of representation of autistic adults on that virtual meeting. And the topic of suicide was brought up. And it was one of those moments where they were referencing having an autistic adult meeting with various members from various places. And that overwhelmingly, the number of hands that went up, when they were asked, How many of you contemplated taking your life was overwhelming and frightening. But again, it goes back to, we are not learning and we are not growing, and we are not evolving the way that we do suicide prevention. And we have to,

Joanna James: 32:57

I think that you said that, so very well and completely, we have to look at how others process things, and make sure that we're developing goals and initiatives that are adjusted to their way of life. Because they my experience with my autistic children is they have beautiful navigation systems, but they're different. And so therefore, they they require some different services and different approaches. And they deserve that. And so I'm with you on that, I think that we have a long way to go. And it starts with this awareness that we need more services that are appropriate to those that just navigate life differently than the rest of us.

Crystal Hernandez: 33:42

And imagine all of that what we just discussed with those different roadmaps, those different systems, those different navigation systems, and throw in the fact that some of us are within tribal nations navigating trying through that system, when we're getting roadblocked in addition to those roadblocks. And so it's it's a double it's a double walk, you know,

Joanna James: 34:06

I agree and I think on the other side of that is for those that are indigenous that maybe don't have access to their tribal behavior health or not close by are those services aren't available. So there have not operate within systems where they're not getting the most culturally appropriate services that that can recognize historical trauma. So yeah, there's lots of layers to that. And I think it's just time to start becoming aware of some of those so we can address them.

Crystal Hernandez: 34:29

Fantastic. Well, thank you Johnna, for sharing all of your stories and for having an open and honest conversation with us, about your family and yourself really. And I think that everything that you do, personally and professionally just shapes and helps so many people. So thank you so much for everything that you do. I am who I was created to be, if I was meant to be someone or something else, the Great Creator would have made me such. He put within me certain gifts such as my heart, my mind, my senses, and my soul. I am who I was created to be. This is an unknown native chief. We talked a lot about mental health and navigating some some systems today. And I want to talk about some barriers. And again, when we talk about tribal nation, some are very different from others. And some have different geographical barriers, some have funding barriers, some have more opportunities. And so we're just going to talk about some generalized kind of barriers, you know, that are often mentioned in any publication, any sort of presentation. And it talks about, you know, those inadequate funding and coverage issues, as well as a traditional mistrust related to that historical trauma. And the big one I want to talk about is the lack of cultural respect and true inclusion, sometimes you'll hear them talk about cultural competency. But really, what it boils down to is a lack of, of inclusion and a lack of representation. And so we don't have a lot of mental health providers who are representing our tribal nations as people and then subsequently as professionals. And we do see that oftentimes mentioned as a substantial barrier that kind of lends to all the things the lack of understanding the mistrust, and kind of that dismissive sometimes nature. What do you

Shauna Humphreys: 36:45

So you're spot on there, like just thinking think about that, about behavioral health, with my tribe, which is Choctaw Nation, you know, there's some of us that are tribal, proud Choctaw tribal members that did go to school to become, you know, counselors and be in the profession, but we still have quite a few that are not. The beautiful thing I've noticed, with my tribe, though, is that they're all willing to learn. And so it starts kind of with providing that education to them. The you know, how a historical trauma is still in play today. And those kinds of things. To me, one of the biggest barriers, besides making sure we provide that education is the roll nature of the Choctaw Nation. So we're the southeastern, you know, didn't have counties of Oklahoma, very rural often joke, like where I live, it's an hour in either direction, just to your nearest Walmart. And so, like, being able to get to your nearest clinic isn't always just right down the road, like a lot of people picture. And so that role area definitely plays a factor, both with getting to care. And then, you know, being rural, there's also limited Wi Fi service, and those kinds of things in our area. I go to my grandma's this day. And she lives in Smithville, Oklahoma, which most people may not even heard of, but there is no cell phone service, like I get to her house, and I just don't expect to get a call or text until I'm back in their range of, of cell service. So there's just a lot of different factors that come into play with living in a rural area. And that, to me, is probably one of the biggest things.

Crystal Hernandez: 38:24

Absolutely. I know, a lot of colleagues throughout the different tribal nations, and they talk about that, you know, rural nature, or the lack of transportation or connectivity, you know, a lot of us take for granted, picking up a smartphone or jumping on our computers or tablets. And that's not what everybody you know, wakes up to, a lot of folks don't have that capability, you know, especially during the COVID, 19. You know, when the world really went to telehealth when we went to tele evaluations and teletherapy. And we seem to forget that not everybody has that opportunity. And what we see is a huge gap and divide and you know, in that accessibility and that service level, and, you know, we know what COVID did to the world, you know, the isolation, the cut off the trauma, the collective trauma, the anxiety and depression, the suicidal rates that we've, you know, witnessed, and in just some of the domestic violence and abuse and in all sorts of things and then factor in being cut off from, you know, traditional therapeutic, you know, services that some folks might have relied on or, or even medications. And, and then we wonder why, why we're why tribal nations have stepped forward and said, No one's going to help us we're going to help ourselves. And so we've seen a tremendous amount of initiatives going forward, not just with implementing, you know, their own behavioral health and mental health services, but also trying to figure out how to connect are folks that live out in areas that don't have connectivity with Wi Fi and so you see a lot of infrastructure emphasis on both sides of that equation.

Shauna Humphreys: 40:03

Absolutely. And, yeah, COVID really did highlight that. And, you know, as tribes, we're very collective culture. So, you know, we get together as families, any chance we get, and it's not just close, immediate family, like, you know, extended family, you know, we all get together at great grandma's house, you know, for instance, and it a lot of it centered around food and laughter. And during COVID, you know, nobody could meet with their families, but for, for tribes, we're, we're collective, and we're always used to having several people around us, it definitely highlighted that. And, you know, one thing I was going to add on the piece about, about food, you know, in my experience with grants, you know, and everything, that's one thing that always is kind of hard for me to wrap my mind around, like, I understand federal funding, and, and things like that. But when you're provide federal funding for a tribe, like one, one way that we show love and respect to each other is by feeding one another, or at least my family does that. But most grants do not allow the purchase of food, and things like that. And so I'm not once again, not necessarily complaining about that, and I do understand how federal funds work. But at the same time, it's like, if we're wanting to be a little more culturally appropriate with different things, and, and have that awareness, you know, food is a big part of who we are as well.

Crystal Hernandez: 41:30

You know, that's, it's interesting that you mentioned that shadow, because that's a constant area of concern that is raised when I talk to to various tribal nations, is that the funding is available, but there's so many gaps in their understanding of how our culture actually works. And the things that would actually work to get to the heart of the information needed to build systems for folks to use appropriately, you know, and so it kind of goes back to the things that are built, and then they get mad or expect us to use, but they're not built with us for us in mind, you know, and so there's barriers, automatic barriers that kind of go up instead of realizing that our people are uniquely different sometimes, and, and what might work for one group might not work for the other. And so that flexibility in that understanding that you mentioned, is so important, and I'm hoping that we are moving towards shifting that understanding, and really creating meaningful systems that work. So I do want to talk, Shawn, if we can about stigma, you know, because we know, when people are going to access services, specifically related to mental health, a lot of times we still have that stigma of of going through those doors, and I know that you were, you were mentioning that earlier, you know, they might not want to go to behavioral health, they might not want to be seen and behavioral buildings and those types of things. And so stigma, you know, has been a heavy focus for everyone. And kind of combating that and really moving us towards a place where we can see mental health, the same way that we see physical health, you know, we go to doctors for checkups, when we have a cold or or flu, we go to the doctor, when we need vaccination, we go to the doctor, whatever. And so that is still not the same for mental health service, we still have that stigma of I'm going to be seen, I'm going to be judged they won't understand or that embarrassment or fear, or whatever, you know, tacked on to that historical trauma that, you know, gap in service that, you know, transportation issue, the lack of representation, or whatever. And so that compounding stigma for our people, among tribal nations that are seeking mental health services is real. And it's really large and deep

Shauna Humphreys: 43:49

it is it's very real. And sometimes I think some of the thinking behind it is to is that, oh, I'm having to reach out for help. You know, because our culture is kind of based on strength and like you said, taking care of things ourself. And so I think for some, it's also just the fact that they're having to reach out for help. They don't, they don't want to have to do that, even though it's so necessary, you know, sometimes in life. But yes, the stigma is, is is very real. And one thing that I will say that seems to be helping break that stigma is that integrated care service that I talked about earlier, it's where a counselor comes into the visit with you when you go to the doctor. You know, we have a lot more people open about that and talking to a counselor while they're at the doctor kind of treating, you know, all three in one place. But it still doesn't take you know, make up for the fact of like going to the behavioral health clinic for other services. You know, there you're being screened, kind of giving some really brief solution focused coping skills and tools, but really that long term care and treatment still occurs in the behavioral health building, but reaching out for help is never a sign for weakness. Yes, but for so many especially for our culture, in some ways it is seen that way If you or someone you know is experiencing a mental health crisis call the 988 suicide and crisis lifeline, which provides confidential 24/7 support by dialing 988.

Crystal Hernandez: 45:28

Join us next time for a discussion of developmental disabilities and hear stories from our wonderful guest. So Black Feathers podcast is a podcast that will occur on a monthly basis. We hope that you will listen subscribe and follow us on social media. Thank you to Cherokee National Treasure Tommy Wildcat for the use of your flute music on this podcast.

Shauna Humphreys: 45:51

I want to thank Lukas Fraser and tha Boys for letting us use their drumming music. Please subscribe to black feathers podcast. You can find us wherever podcasts are found.

Crystal Hernandez: 46:00

We would love to hear from you and invite you to submit your stories and questions. Until next time.

Shauna Humphreys: 46:06

Thank you for joining us on this month's journey. Remember none of us walk this alone. Together. We are stronger and it is the roots that bind us. Follow us on black feathers.org