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History of Advocacy for Epidemiological and Services Research in Alaska

History of this issue:
   About ten years ago the state legislature appropriated $500,000 to the University of Alaska, Anchorage as seed money so that they could start a research program using the money available from the National Institute of Mental Health (NIMH) as a continuing source of funds. Nothing happened. So we asked why, and were told that the University does not have properly credentialed people to carry out national levels of research. The University spent the seed money for travel to Siberia in their Circumpolar Health program.
   In the early 1990's NIMH sent Ann Hohmann, Ph.D., the current director for their epidemiological and services research grants branch, to the Tri-Discipline Conference in Anchorage. Her goal was to encourage someone in Alaska to use the available research funds. She also contacted the University of Alaska, Anchorage. She told us that there was enough money to fund a full-time research manager position and contract out the actual research to qualified professionals. She received some follow-up requests for information, but did not receive any applications for the research grants.
   Since we were working on suicide issues at that time, we contacted the Institute of Social and Economic Research (ISER). We had a number of questions that we felt were researchable: e.g., risk factors that may be contributing to the high rates of suicide in western Alaska and the reason that state surveys of those schools found a general sense of hopelessness among high school students. We were informed that ISER has its own research program into these issues to prove that the problems were caused by the Native's loss of a subsistence life style. We feel that a research project could find risk factors that may be modified to help reduce the suicide rates.
   We had worked with the Alaska Mental Health Board on the research issues and the use of federal grants for service demonstrations. However, the board felt that the money was too small to be bothered with (some grants were multimillion dollar grants and probably too big for Alaska to handle adequately), and several people felt that they knew enough about the needs without further research or demonstrations. Fortunately, Margaret Lowe, the Director of the Division of Mental Health Developmental Disabilities, felt that they needed more information about the children mental disorders.
   Director Lowe contracted with the University of Alaska, Fairbanks for a survey of schools. That study was completed in 1993 by Norman Dingus, Ph.D., and reported on in "1993 Alaska Youth Mental Health Needs Assessment." One of Dr. Dingus' recommendations is, "There is a serious need for child and adolescent psychiatric epidemiology research in Alaska. More complete and accurate data would help both plan programmatically for allocation of increasingly scarce mental health resources and to determine treatment efficacy over time. … More comprehensive baseline data on SED would also be useful in determining if treatment and preventive intervention efforts are producing the desired outcomes."
   Because of the University of Alaska's concern that Alaska does not have the trained professionals to conduct a epidemiological and services research program, we held a teleconference that included Holly Galbraith, Ph.D., a child psychologist and director of the DMHDD children's program; Eric Trupin, Ph.D., director of the Division of Community Psychiatry at the University of Washington School of Medicine; and Dick Wilson, Chair of the NAMI Alaska Children's Committee. According to Dr. Trupin the University of Washington is the regional university research center for the WAMI area (Washington, Alaska, Montana, and Idaho). They have a research responsibility throughout that area and are available to help Alaska.
    If requested to do so, they can have someone write the grant proposals, supply the trained interviewers, conduct the research, do the statistical analysis, and prepare the reports. In other words they can do any or all of the research activities, but they need someone in Alaska to ask for their help and to provide logistical support within Alaska. No action came out of that teleconference.
   We heard that Dr. Dingus had transferred to the ISER to head up a research program in mental disorders. While he did some surveys for "Kids Count," no research programs were undertaken. When we inquired, we were told that no money was available for such research. We then telephoned the NIMH epidemiological and services research grants division, they reported that they had received increased funding and that funds were available for all of their grant announcements listed on their web page.
   The Department of Health and Social Services has a Division of Epidemiology, but they do not list any programs concerning the brain or mental disorders.

Currently, NIMH has a number of research announcements that specifically mention Alaska Natives. We believe that Alaska is a natural place for research to help Alaska Natives.
   There is a demonstrated need for the research, the money is available, and trained research people are available. We need to find an agency that will develop a continuing research program.

&emdash; Prepared 9/24/98 by Dick Wilson