This article explores the problems that tribal communities confront when forced to select from menus of evidence-based practice that were not developed with their unique challenges and opportunities in mind. The authors discuss the possibility for adapting or enhancing existing approaches but also point out the need for much more research and…

Opens with a brief discussion of the epidemiology of suicide among American Indians and Alaska natives. Next comes a critical review of selective suicide preventive intervention programs identified in the literature and considers methods used to evaluate each program. Discussion then shifts to practices and policies. Concludes with recommendations…

Circles of Care grantees were provided the opportunity to develop a locally relevant definition of serious emotional disturbance (SED) that would be used to define what type of emotional, behavioral, and mental disability would be required to receive services. After conducting detailed assessments of the definition in the guidance for applicants…

The Circles of Care initiative emphasized the importance of developing an outcomes measurement plan that was consonant with the model system of care as well as community values and priorities. This analysis suggests that the Circles of Care grantees achieved this key programmatic objective, but that a major constraint was the tendency of funders,…

This introduction to the evaluation component of the Circles of Care initiative includes background on the nature of the initiative, Center for Mental Health Services support for developing systems of care for youth with emotional disturbances, and an overview of the systems of care approach. The prevalence, unique challenges, and the historical,…