This brief summarizes current research around those Americans most at risk for falling into deep poverty. It also examines the role of the safety net in preventing and solving deep poverty. It proposes three potential areas of research, including: 1) measurement of food insecurity and other material hardships, 2) work and the effect of the labor markets on those experiencing poverty, and 3) policy – approaches that have worked, and those that have not (for example, looking at what policies can help those most at risk for poverty, such as SNAP, TANF, and child support enforcement).

From the Office of the Assistant Secretary for Planning and Evaluation, these three briefs address issues associated with prolonged youth homelessness, the role of mental health, as well as interventions that have been attempted to prevent and stop youth homelessness. Factors include history of childhood maltreatment, involvement in the justice system, and higher high school dropout rates, among others. Mental illness is also prevalent among the chronically homeless, including youth. Supportive housing interventions can provide safe and stable housing for these populations. Other interventions include programs to support education and employment, as well as those that reduce substance abuse. However, none of these interventions have been rigorously tested and merit further investigation.

Adverse childhood experiences (ACEs) are associated with numerous risk behaviors and mental health outcomes among youth. This study examines the relationship between the number of types of exposures to ACEs and risk behaviors and mental health outcomes among reservation-based Native Americans. In 2011, data were collected from Native American (N = 288; 15-24 years of age) tribal members from a remote plains reservation using an anonymous web-based questionnaire. We analyzed the relationship between six ACEs, emotional, physical, and sexual abuse, physical and emotional neglect, witness to intimate partner violence, for those <18 years, and included historical loss associated symptoms, and perceived discrimination for those <19 years; and four risk behavior/mental health outcomes: post-traumatic stress disorder (PTSD) symptoms, depression symptoms, poly-drug use, and suicide attempt. Seventy-eight percent of the sample reported at least one ACE and 40% reported at least two. The cumulative impact of the ACEs were significant (p < .001) for the four outcomes with each additional ACE increasing the odds of suicide attempt (37%), poly-drug use (51%), PTSD symptoms (55%), and depression symptoms (57%). To address these findings culturally appropriate childhood and adolescent interventions for reservation-based populations must be developed, tested and evaluated longitudinally. (author abstract)

This toolkit from the U.S. Department of Health and Human Services, Administration for Children and Families provides resources on trauma-informed care that are tailored to the needs of AI/AN communities. The resources are divided into sections based on the different stages of the process of implementing trauma-informed human services. For example, an agency in the beginning phases could use the resources in the “What do we mean by trauma-informed services and why is such an approach important?” section. An agency that has already started implementing trauma-informed services could find resources in the “We’ve begun working on theses, issues, but are trying to decide what to tackle next. How can I figure out next steps?” section. The toolkit also includes examples of treatments for trauma that have been adapted specifically for AI/AN communities.

These webinar slides from the Indian Health Service provide an overview of historical trauma and trauma-informed care in health and behavioral health systems. Historical trauma is prevalent among AI/AN individuals, and it can be transferred across generations. The webinar provides case examples of historical trauma, and discusses the secondary trauma or compassion fatigue that providers can experience when working with clients who have experienced trauma. The presenters also included examples of trauma-informed interventions specifically targeted to AI/AN populations.

American Indian and Alaska Native youth are 2.5 times more likely to experience trauma than their non-native peers, and this trauma can result in mental health disorders, substance abuse, violence, and suicide if not treated. This Mathematica Policy Research report, sponsored by the U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, contains the results of an environmental scan of trauma-informed programs for AI/AN youth. The authors summarize three interventions that help AI/AN youth address traumatic stress and behavioral health concerns: Cognitive Behavioral Intervention for Trauma in Schools; Honoring Children, Mending the Circle; and Pathway to Hope. The report concludes with a discussion of the challenges of conducting research in tribal communities, including the need to bridge the gap between mainstream and Native conceptions of mental health and wellness.

This report presents a first-of-its-kind collaborative tribal-federal blueprint for improving the behavioral health of American Indians and Alaska Natives. This was developed in response to calls from tribal leaders for improved collaboration with federal agencies to address the behavioral health of their communities.

Some AI/AN communities have experienced suicide clusters, in which a group of suicides or suicide attempts happen close together in time and space. These suicide clusters are rare and occur almost exclusively among teenagers. This report from the Substance Abuse and Mental Health Services Administration provides information about suicide clusters and responses in tribal communities and identifies strength-based approaches to prevention and response. The authors begin with background information on the prevalence of suicide among AI/AN populations, a description of suicide clusters, and a discussion of the risk and protective factors for suicide. Next, the authors describe the results of a qualitative study of two communities that experienced suicide clusters: a tribal reservation near Albuquerque, New Mexico and three villages on the Bering Sea coast of Western Alaska. Those communities also provide their perspectives on the resources necessary to prevent and respond to suicide clusters and the barriers to effective response.

This newsletter from the National Indian Child Welfare Association describes the secondary traumatic stress that may occur among providers who work with AI/AN youth and adults. Also known as vicarious trauma, compassion fatigue, or burnout, secondary traumatic stress is the emotional duress that comes from hearing another person’s traumatic experiences firsthand. Left unchecked, this secondary trauma can lead to burnout and turnover among social workers. To combat secondary trauma, the authors suggest a strategy of relationship-based prevention. Building trust and safety among coworkers and allowing staff members to practice self-care will help prevent secondary trauma symptoms from escalating to burnout. The newsletter also provides self-care tips and resources for social services professionals who are concerned about secondary traumatic stress.

This WorkforceGPS desk reference on the Workforce Innovation and Opportunity Act (WIOA) provides information for state and local boards on serving priority populations using WIOA Adult funds. Those priority populations include recipients of public assistance, low-income individuals, individuals who are basic skills deficient, and veterans. The desk reference also includes definitions of each priority population and provides links to additional guidance and resources on WIOA.