10 March 27th-april 2nd, 2025 phoenixnewtimes.com PHOENIX NEW TIMES | NEWS | FEATURE | FOOD & DRINK | ARTS & CULTURE | MUSIC | CONCERTS | CANNABIS | speak only Native languages often see doctors who speak only English. Explaining complex medical information becomes a slog. “We’re very much a tight- knit community,” said Payestewa-Picazo, “and if you don’t know these outsiders, it can be very, very uncomfortable.” Sometimes, doctors give medical advice that betrays their cultural ignorance. When Andrews sought professional help for her mental health issues, she was told to “eat healthier” — good advice in general, but impractical for Andrews. Only a handful of grocery stores serve the Tohono O’odham Nation, where Andrews lives. Some villages don’t have regular access to clean water. “You’re telling me I need to have fruits and vegetables,” Andrews said. “I don’t even have a refrigerator. What are you talking about? I’m lucky to get nonperish- able foods.” There have been efforts to bridge this cultural divide. Last October, the Biden administration expanded both Medicaid coverage and the Children’s Health Insurance Program to allow funding for traditional Native American healing prac- tices like smudging, which involves burning sacred herbs to cleanse and heal the body, mind and spirit. Native health advocates feel strongly that such a step will make going to the doctor a bit less fraught for people in their communities. But with Donald Trump in the White House, it’s unclear if that change is here to stay. In his first few weeks in office, Trump has reversed many Biden-era directives, including those that promote lower drug costs and expand coverage under the Affordable Care Act and Medicaid. A new Trump-backed budget passed by the Republican-controlled House of Representatives calls for massive cuts to Medicaid and 30-60% cuts to IHS. All six Arizona Republican representa- tives — including Eli Crane, whose district encompasses the entirety of the Navajo Nation — voted in favor of the spending cut. Combatting stigma Native communities could use more mental health resources. They need clinics that are closer and better staffed, doctors who better understand their patients, and lawmakers who don’t view crucial services as a line item to be deleted in the name of cost savings. But, like many demographics, Native people who struggle with mental health need to feel more comfortable admitting it. That’s what Jalen Harvey is trying to make happen. As the Western area repre- sentative and secretary of the National Unity Council Executive Committee, Harvey works with Native youth to empower them to become community leaders. Each year, NUCEC conducts a survey to determine the top issues Native teens face. Suicide is often at the top of the list. In response, the organization hosts healing circles, inviting Native kids to talk with one another and share their emotions. Another campaign, called “I Will Live,” encourages Native teens to persevere through mental health hardships. It involves kids posting photos of themselves doing everyday things to highlight their resilience in a chaotic world. It might feel like a small step, but it can make a difference. “We’re taught to be strong all the time,” Harvey said. “But it’s okay to talk about these issues. These are the topics that should be talked about.” These efforts matter, Harvey said, yet more can and should be done by the state and federal government to lower Native suicide rates. ADHS isn’t ignoring the issue. Thanks to a grant from the Substance Abuse and Mental Health Services Administration in partnership with the Department of Education, Inter Tribal Council and Cochise County Office of the Superintendent, the state health depart- ment has been able to boost the number of Cochise County school staff members trained in suicide prevention, said Joshua Stegemeyer, the suicide prevention coordi- nator at ADHS. But the Trump administration has been slashing federal grants left and right and has targeted the entire Department of Education for dismantling, leaving such life-saving programs in limbo. Advocates also fear that programs meant to improve Native health outcomes could be axed amid Trump’s purge of diversity, equity and inclusion initiatives. Anti-DEI rhetoric turns the purpose of such initiatives on its head. DEI programs are meant to give a fair shake to minority groups who have historically faced more barriers in hiring, college admission, receiving quality health care and more. By casting DEI programs as racist — mostly against white people — Trump and his allies inherently insist those barriers for other demographics do not exist. The Native suicide rate is stark evidence that those barriers are real. Addressing it requires specialized atten- tion, which appears less likely over the next four years. What comes next for Indigenous communities is unclear. If outside help evaporates — if IHS is gutted, if important funding is clawed back — Native advocates will do their best to confront their community’s suicide crisis alone. “I am nervous for the future of public health for these next four years. It’s not an easy time to be in public health,” Fuller said. “But I think that with the knowledge we have built, we have the resilience and the tools we need.” If you or a loved one are struggling, help is available. The 988 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week, across the U.S. and its territo- ries. The Arizona statewide number is 1-844-534-HOPE. Or text “HOPE” to 4HOPE. Lives at Stake from p 6
