Report to Congress on the Indian Health Service about the feasibility study of the possible merger of Indian Health Service's alcohol/substance abuse and mental health programs.


In response to Senate appropriations report 101-85 of fiscal year 1990. The Senate Appropriations Committee requested (Report No. 101-85) that the Indian Health Service (IHS) conduct a feasibility study to examine the possibility of merging the IHS Alcohol/Substance Abuse (A/SA) and Mental Health (MH) Programs. IHS formed an Oversight Committee consisting of staff affiliated with the MH and A/SA Programs, tribal representatives, and Alaska Natives to guide the Study. The modified Delphic method of interviewing was utilized and its application explained. Data collected from interviews were coded, automated, verified and analyzed. The merger was evaluated for likely impact of specific aspects of program operations, personnel, and program effectiveness, distribution of programs and program components, and changes in costs. The analyses of the interviews revealed that an overlap of issues and treatment is not a sound basis for merging A/SA and MH Programs. Separation of programs gave each program a better chance of funding. Current procedures for data collection and reporting resulted in reports of limited reliability and use and, therefore created a need to improve the collection and management of data regarding the prevalence, prevention, and treatment of mental health and alcohol and substance abuse problems. Consistent with the principles of self-determination, all reorganization efforts done in consultation with the tribes, and should include specific plans to enhance all aspects of health care delivery, promote comprehensive health care centers offering a full range of outpatient services and community health representatives.