A local treatment center with a focus on Native culture is expanding as they face increased needs from the community and a fentanyl crisis in the aftermath of the pandemic.
Now, the American Indian Community Center’s Goodheart Behavioral Health program is able to add mental health counseling, through a two-year, $150,000 grant from UnitedHealthcare.
With the funding, the center hired a full-time mental health provider, Nora Cornelius, who began July 1. She’s a cultural therapist licensed in mental health counseling.
Since 2017, Goodheart has offered drug and alcohol treatment programs and is licensed for adult intensive outpatient care, outpatient treatment and assessments. It also offers a two-year deferred prosecution treatment for potential dismissal of a driving-while-intoxicated charge.
Many of the program’s clients have experienced trauma, requiring mental health services, said Shelley Ethrington, Goodheart Behavioral Health clinical manager.
“It’s something we’ve needed since we started,” Ethrington said. “Before Nora’s coming on board, we’d have to refer out for mental health co-occurring. There are very few mental health counselors in the area who know how to deal with the Native American mental health problems.”
Ethrington, who does drug and alcohol treatment counseling, and office assistant Cassandra Andrew previously were the only two Goodheart employees.
The program serves about 80 clients a year. When mental health services are added in full, and with Cornelius on staff, Ethrington expects an increase to about 150 clients annually. The program doesn’t discriminate and serves both Native Americans and nontribal clients, she said.
“I think at one point, it was 90% Native and 10% non-Native,” she said. “It fluctuates. Most of our clients are on Medicaid.”
For elders on Medicare, that insurance doesn’t pay for treatment, so the program sometimes offers a monthly sliding fee, Ethrington said.
UnitedHealthcare recently awarded grants totaling $1 million, broken up among Washington nonprofits including Goodheart, with a focus on more access to care for underserved communities. Another recipient was the National Alliance on Mental Illness Yakima – for Yakima, Wapato and Toppenish – with $87,500 to expand the “Ending the Silence” mental health awareness program and ensure it is culturally relevant and responsive for Native American and Hispanic high school students.
Earlier this year, Ethrington said she got a call from someone at UnitedHealthcare who had heard positive recommendations about Goodheart’s services.
“She and I talked a lot about the problems going on, and how we take care of it,” Ethrington said. “I think she liked that we run things spiritually. We talked a lot about Native Americans and the fentanyl problems currently happening in Spokane, and how it’s killing our people. Left and right, they’re dying of overdoses.
“We talked about how almost every Native American has co-occurring trauma with PTSD because we are born with it. It’s generational, and they use a substance to cover that up. That’s brought on from colonization and boarding schools. It is in our DNA now.”
According to the U.S. Drug Enforcement Administration, fentanyl is a synthetic opioid 50 to 100 times stronger than morphine. Illegal fentanyl is primarily manufactured in Mexico, the agency said.
Fentanyl has emerged as a major regional problem in substance use, Ethrington said. Regarding past traumas, many Native American families haven’t received the help they’ve needed over the years, so there is intergenerational trauma, she said.
Cornelius plans to begin a culturally based sobriety support group, under the White Bison Wellbriety program.
Although Cornelius is licensed, the Goodheart program is awaiting licensing as a mental health counseling provider before she can offer those services.
“I’ve been helping with the substance use disorder groups and assessments for now,” Cornelius said. She also applies cultural education and some Native American holistic care. “We consider it a cultural, holistic mental health and substance use disorder treatment approach for healing.”
Both Cornelius and Ethrington said examples include uses for sage, cedar, red willow bark, sweetgrass and bear root that can offer natural remedies. The medicine wheel, sometimes depicted with the colors of black, white, yellow and red, has been used by generations of various Native American tribes for health and healing.
“I use the medicine wheel for groups’ and individuals’ treatment,” Cornelius said. “I use it as a counseling tool for the mental, emotional, physical and spiritual aspects of healing from drugs or trauma.”
The Goodheart counselors also use a talking circle, a traditional tribal ceremony when a group sits in a circle and usually leaves the east open. A leader uses smudge, a sacred ceremonial smoke that might include a small burn of sage or sweetgrass, as members pass around a sacred object such as a stone or talking stick.
“It’s passed around, and there is a lot of prayer,” Ethrington said.
The program’s intensive outpatient care includes clients attending three groups per week in two-hour sessions, and one individual session per month. The next level is outpatient treatment with one time per week in a two-hour group session, and one individual session per month. Clients are given random urinalysis tests.
In addition, clients must attend a sober support group. Cornelius’ start of a White Bison Wellbriety will be another option, or clients can choose either Alcoholics Anonymous or Narcotics Anonymous.
Ethrington and Cornelius also plan soon to visit city outdoor spaces where they know Native Americans are using fentanyl.
“We’ll bring food and meet them, maybe have hand drums and beat drums, and we’ll just sit around and be with them for a day – relaxed, just visiting back-and-forth with no judgment,” Ethrington said. After building relationships, they plan to give out coats and blankets, and eventually information on treatment.
Both counselors said mental health problems, domestic violence and drug abuse increased during COVID-19, and that in recent years, Colville and Spokane tribes called a state of emergency because of the number of suicides.
But among clients who get treatment and recover, there are many success stories, Ethrington said.
“On Monday, we had a kid come in to see us, and he’s been sober for a year,” she said. “Many people call us and tell us they’re doing great, which is awesome.”
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