Indian Health Service is building a $1.8-million outpatient therapy center on the Sioux San Hospital campus in Rapid City to tackle high demand for behavioral health services among American Indians in West River. Specifically, the new facility responds to the epidemic of youth suicide on the reservations.
Wait—Rapid City isn’t on a reservation….
High rates of suicide and suicide attempts are not exclusive to Pine Ridge, which is home to the Oglala Sioux Tribe. Reservations across the state, including Rosebud and Cheyenne River, have grappled with mental-health crises over the years. Federal experts say that some reservation children experience a form of post-traumatic stress from exposure to family turmoil.
The plans for the 7,900-square-foot modular building call for space to provide behavioral health services and a duplex with two, three-bedroom compartments to host overnight stays for families and transitional patients. The existing staff at the Sioux San Hospital will provide the aftercare to patients, and IHS officials assert it “is centrally located” among the three reservations [“Tribe Says Behavioral Health Unit Being Built Too Far from Reservation,” AP via Rapid City Journal, 2016.03.22].
If I were centrally locating myself among the tribal headquarters of the Pine Ridge, Rosebud, and Cheyenne River reservations, I wouldn’t put myself in Rapid City. I’d draw the triangle connecting Pine Ridge, Rosebud, and Eagle Butte and look for someplace with water and a gas station inside that triangle…
…like Kadoka. Kadoka may not be the friendliest place for our Lakota sisters and brothers, but find me any off-reservation town in South Dakota where Indians don’t get looked at crosswise, and I’ll buy you a lottery ticket.
The average distance to Kadoka from the three tribal headquarters listed is 94 miles. To Rapid City, the tri-HQ average is 157 miles. If tribal members from Lower Brule and Fort Thompson want to avail themselves of the new services, the trip to Kadoka would be 96 miles less, an hour and a half shorter, than the trip to Rapid.
IHS says building a new facility outside of Rapid could increase costs by half a million, but Rosebud Sioux Tribe Health Board member O.J. Semans says IHS chose Rapid City for its own convenience, not that of the tribal members it serves. Even Senator John Thune apparently thinks better service closer to more tribal members is worth the extra cost:
“There are already a litany of well-known problems facing the Great Plains Area IHS, which is why I don’t believe building a new counseling facility nearly 100 miles away from Pine Ridge will help fulfill our commitment to our tribal citizens in South Dakota or mitigate the damage that’s already been done,” Thune said in a statement Tuesday [AP, 2016.03.22].
Naturally, the optimal solution would be a quality behavioral health facility fighting youth suicides on each reservation, as close to the tiospaye as possible. But if IHS can only afford one new facility (and tell us again why IHS is short on cash, Senator Thune?), then IHS should strongly consider placing it in a genuinely central location to the tribes.