Many years ago, when I was a new mother, a public health nurse came to my home to check on my newborn daughter. She took one look at my four-month baby and then promptly reprimanded me. My baby, she said, was failing to thrive. I had been nursing my baby, as was tradition in my family, but apparently it wasn’t enough. The nurse told me to give my baby expensive store-bought formula and that if I couldn’t take care of her properly, then the county would remove her from my custody. In a daze, I called my mother, herself a mother of thirteen children. She was, of course, concerned for my baby’s well-being. My experience, though, triggered something else for her: memories of experiences on the Standing Rock Reservation where hundreds of children were removed from their families.
Many, including two generations of my family, were sent to federally-operated boarding schools the Carlisle Indian Industrial School in Pennsylvania, and hundreds more were placed into state-sponsored care and adoption for causes related to poverty, such as housing and food insecurity. Thankfully, my baby did thrive and she’s now a mother caring for her own infant. My mother’s story, far more complex than I first realized, became the impetus for my work with Native people and supporting their efforts to become self-determined, thriving communities. Along this journey, I’ve come to better appreciate the weight of our family’s cultural inheritance and the responsibility of tenderly tending to our children and to our children’s children with utmost care.
For most of us, this journey starts in early childhood, a critical period that determines a person’s ability to reach his or her lifelong potential. Children attain their fullest potential when their families and community create holistic systems geared toward early childhood wellness, long-term health, and social and economic well-being.
This progress can be disrupted when a child experiences adversity, stress, or trauma. Exposure to abuse, neglect, discrimination, violence, and other adverse experiences increase a person’s lifelong potential for serious health problems and engaging in risky behaviors, as documented by the landmark Adverse Childhood Experiences (ACE) study.[i] Moreover, childhood trauma is far more pervasive, injurious, and costly than many people realize. The impact of trauma can be subtle, insidious, or outright destructive. As we become more aware of the extent of trauma’s toxic impact on children and society, care providers also are realizing the exceptional value of trauma-informed approaches to treatment and recovery.
Trauma-informed care involves a broad understanding of trauma-inducing events, the wide range of stress reactions, as well as the social and economic factors that influence trauma and stress. Trauma can occur in a single event, or in multiple, repetitive, long-lasting, and collective events; it also affects everyone differently, including the particular expression of trauma. Trauma-informed care acknowledges and considers the pervasive nature of trauma, seeks to understand a person’s life experiences, and promotes environments of healing rather than practices that may inadvertently re-traumatize and cause stress.
A type of trauma particularly pernicious to Native people is historical trauma. According to Maria Yellow Horse Brave Heart, Ph.D., “Indigenous peoples of the Americas have experienced devastating collective, intergenerational massive group trauma and compounding discrimination, racism, and oppression.” This collective phenomenon stems from centuries of disastrous federal policies focused on wresting lands and destroying native cultural bonds. From the colonizing forces of Manifest Destiny to the destruction of family bonds wrought by boarding schools, Native people collectively and cumulatively have endured staggering losses of lives, lands, and lifeways.[ii] Brave Heart further finds that as a collective phenomenon, even those who never experienced the traumatic stressor, such as children and descendants, can still exhibit signs and symptoms of trauma. Importantly, many positive aspects arise from historical trauma and these, such as resilience, posttraumatic growth, and adaptive survival behaviors, deserve equal attention.
The National Native Children’s Trauma Center (NNCTC) at the University of Montana, a program within the National Child Traumatic Stress Network,[iii] is solely focused on improving the ability of service providers to respond to the trauma-related needs of Native American children who, as a general population, are at increased risk of depression, anxiety, low self-esteem, post-traumatic stress disorder (PTSD).[iv] Addressing these impacts requires developing a deep understanding of root causes of the trauma and disrupting influences on Native children and families and finding adaptive ways to cope with, respond to, and heal from trauma, while also creating more supportive and caring communities.
With these promising models in mind, the NNCTC has launched series of webinars on the topic of “Trauma-Informed Tribal Community Development.” This first webinar, held on July 29, 2021, featured Senior Director of Policy and Programs, Marilyn Zimmerman, in conversation with Miriam Jorgensen, Research Director at the University of Arizona’s Native Nations Institute, and Patrice Kunesh, Director of Peȟiŋ Haha Consulting and Development Officer at the Native American Rights Fund. Three themes emerged from this initial discussion: (1) the importance of recognizing the trauma and resiliency of Native people; (2) the critical role of Native self-determination in sustaining community development; (3) a community’s built environment and systems of care together enhance wellness and prospects for a healthy future.
Theme I: Four Rs plus Resiliency
Marilyn set up the discussion describing the four R’s in trauma-centered care: realization, recognition, response, and re-traumatization. Realization involves understanding that trauma is experienced through multiple pathways. For Native people and their communities, within these pathways flow an undulating current of stress stemming from centuries of massive loss, unresolved grief, scarcity, and continual deprivation. Current manifestations of these complex conditions range from chronic hunger, poor or inadequate housing, and lack of health care, all of which require some form of individual intervention as well as an institutional or systems-level response. Recovery from intergenerational trauma will be most effective when community support systems are interwoven with tribal values and culture.
In responding to trauma, Marilyn cautions that more harm and re-traumatization can be inflicted when pathologizing the victims of adversity or stereotyping children and families who live in poverty – shaming and blaming are other forms of trauma and could lead to grave consequences.[v] Equally important is the harm done in equating adversity to destiny – that poverty in itself curtails all hope of positive progress and development. Such a dooming construct of trauma overlooks the whole growth focus of trauma-informed care and the powerful force of resilience, both of the brain and body to manage and recover from severe stress and of the community to overcome its collective adversity. According to Marilyn, “When Tribes are walking in sovereignty, good things happen in the tribal community – suicide reduction, improved housing conditions, and child welfare is directly impacted.”
Theme II. Native Self-Determination Is Necessary for Sustained Development
Miriam Jorgensen picked up the theme of resilience to expand on the trauma-centered concepts to include narratives and strategies deeply rooted in community assets. For Native nations, this means increasing their capacity to heal and restore community well-being through a larger strategic vision embedded in Native nation building, sometimes known as a Seven Generation approach.
Miriam illustrated how many tribes have overcome more than two hundred years of paternalistic federal oversight and severe funding deficiencies[vi] through nation-building practices. This approach to tribal governance promotes the exercise of inherent tribal sovereignty, interrelates traditions and culture, and fosters public-spirited leadership. In recent decades, Native people themselves have redefined the federal role by determining their own priorities, allocating their own resources and directing their own programs. Moreover, cultural values are instilled into every decision and action.[vii] The benefits of nation-building inspired are profound – tribally-driven community investments have resulted in stronger tribal economies and more resilient tribal societies. Most importantly, tribal self-determination is the only federal policy that has ever succeeded in improving the health and wellbeing of Native people.[viii]
Theme III. A Built Environment Trauma-Informed Principles
Extensive evidence demonstrates trauma’s harmful effects on physical and psychosocial functioning. Trauma-informed care acknowledges trauma’s widespread impacts and delivers care in a manner to promote healing and avoid re-traumatization. A unique opportunity arises when Native nations adopt the trauma-informed care approach in planning infrastructure, such as houses, neighborhoods, and work spaces. The concept of creating trauma-informed physical spaces deserves attention for two reasons. First, it prioritizes important social values such as safety and collaboration. Second, physical aspects of the built environment, such as lighting, housing density, and green space, may either trigger trauma or promote healing and well-being for individuals and communities.
The Cheyenne River Sioux Tribe is a prime example of self-determination in action to address the dire need for safe and affordable housing for its large and growing population.[ix] The Tribe’s housing department is planning and designing a 265-unit subdivision in Eagle Butte, South Dakota, and is using, albeit inadvertently, principles of trauma-informed care to create homes, a neighborhood, and public spaces that promote individual and community well-being.
The Cheyenne River Housing Authority (CRHA) administers the Tribe’s housing programs and federal funds on the reservation. Sharon Vogel, the Housing director, has extraordinary knowledge of the CRST community and culture, having raised her family on the reservation and served in several tribal government positions. Sharon has a vision to transform her community: every reservation family would live in safe, sanitary, and affordable housing in a community with a central social and cultural gathering place. Her current mission is to create an affordable housing community called Badger Park, a 160-acre subdivision nestled in rolling grassland plains in Eagle Butte, that will create 265 family units, housing a total of 1,000 - 1,500 people. The site will also include park and recreation areas as well as a business center.
The hallmarks of Sharon’s success are her inspired leadership and determination to persevere on behalf of her family and community. Her work exemplifies four principles of affordable housing development: self-governance and capacity building; community planning; financial partnerships; and design and sustainability. Throughout this process, she is creating a more agile and responsive government, employing leading edge technology, and working across boundaries in multiple sectors. What makes this work of building homes truly remarkable is that it is being done in a cultural context and on Native homelands in rural South Dakota.[x]
From its conception, the Badger Park subdivision epitomizes a well-planned, intentionally designed, affordable, and sustainable housing development project. Its essential elements include a comprehensive assessment of the community’s actual needs, a community vision that reimagines shelter and shared spaces, and a modernized infrastructure that supports a community network of roads, water systems, and internet service. The potential of this approach cannot be overstated. First, it unifies the place with the people by reconnecting them to their homelands and empowering them to rebuild a community based on their own cultural narrative. Second, it prioritizes people by emphasizing their health, safety, and well-being. Further, it also instills a sincere sense of respect and dignity, qualities rarely considered in the legacy of reservation housing development. Indeed, what Sharon and the CRHA team have accomplished is much more than an affordable housing project. They have inspired pride and worthiness and the possibility of transformational social and economic change for the Cheyenne River Sioux community. It is a vision that sees what ought to be through the lens of what is and endeavors to remove the contradiction between the two.
Conclusion
Indian Country should more intentionally consider trauma-informed approaches in designing and planning its built environment. Trauma-informed approaches have achieved positive outcomes in social programs and community settings. However, trauma-informed approaches have not been widely applied to the built environment. The Cheyenne River Sioux Tribe has demonstrated that the concept of a trauma-informed neighborhood may promote healing for individuals and communities. Evidence of such positive outcomes might derive from using geospatial, population health, and community-engaged approaches, and would have direct implications for public policy and tribal planning, particularly for communities in which residents bear a disproportionate trauma burden. Thus, the built environment is a key setting to influence Indian Country trauma recovery, health, and well-being.
[i] The Centers for Disease Control and Prevention (CDC) defines ACEs as “all types of abuse, neglect, and other potentially traumatic experiences that occur to people under the age of 18.” The concept originated from a large CDC-Kaiser Permanente study from 1995-1997 in which participants received questions about exposure to forms of household dysfunction prior to turning 18. The study found that the more ACEs an individual experienced before 18, the more likely she or he would likely suffer from substance abuse, depression, health problems, or attempt suicide. The more recent 2018 Child Trends’ study found that 45 percent of children in the U.S. have experienced at least one ACE, and one in nine children nationally has experienced three or more ACEs.
A similar study of ACEs in Native children (defined in the scientific literature as American Indian and Alaska Native (AI/AN) in South Dakota found that Native children, as compared to non-Native, displayed higher prevalence of ACEs including abuse, neglect, and household dysfunction. The National Indian Health Board has published a resource hub on ACEs in Indian Country.
[ii] The Meriam Report: The Problem of Indian Administration (1928) was the first government study to demonstrate with extensive data that federal Indian policy in the 19th century had resulted in a travesty of social justice to Native Americans, https://www.narf.org/nill/resources/meriam.html.
[iii] The National Child Traumatic Stress Network (NCTSN) is a federal government-based research within the U.S. Department of Health and Human Services-Substance Abuse and Mental Health Services Administration (SAMHSA), whose mission is straightforward: to facilitate the safety and recovery of every child and family so they can thrive. SAMHSA has been an influential and effective champion of trauma-informed programs and systems that “infuse and sustain trauma awareness, knowledge, and skills into their organizational cultures, practices, and policies.”
[iv] Post-traumatic stress disorder (PTSD) among many Native families was triggered again recently upon the discovery of mass graves at boarding schools in Canada and the U.S. In an attempt to assimilate Native children and break up families, the government forcibly sent them to boarding schools where they often faced brutal abuse, neglect and sometimes death. Those who died are largely believed to have suffered malnutrition, disease or neglect.
[v] A 2018 Child Trends’ study found that 45 percent of children in the U.S. have experienced at least one ACE, and one in nine children nationally has experienced three or more ACEs. Knowing that a child is in a family where there is divorce or in a low-income community often leads people to make negative assumptions and these stereotypes can harm children, lead to discrimination, and even become self-fulfilling prophecies.
[vi] The U.S. Commission on Civil Rights report Broken Promises: Continuing Federal Funding Shortfall for Native Americans (December 2018), https://www.usccr.gov/pubs/2018/12-20-Broken-Promises.pdf.
[vii] The Indian Self-Determination and Education Assistance Act of 1975 (Public Law 93-638), 88 Stat. 2203 (codified as amended at U.S.C. §§ 450-450m, re-codified at §5301 (Jan. 4, 1975) (ISDEAA). The Act was the result of 15 years of change, influenced by American Indian activism, the Civil Rights Movement, and community development based on grassroots political participation. At its core, self-governance inherently respects tribal institutions, particularly tribal laws and courts, and honors the uniqueness of each tribe’s cultures and histories, especially language and ceremony.
[viii] Joseph P. Kalt and Joseph William Singer, MYTHS AND REALITIES OF TRIBAL SOVEREIGNTY: THE LAW AND ECONOMICS OF INDIAN SELF-RULE, Native Issues Research Symposium, Harvard University December 4-5, 2003 (revised January 2004), https://scholar.harvard.edu/files/jsinger/files/myths_realities.pdf.
[ix] The Tribe’s current enrollment is 22,000, with approximately 8,500 members living on the Reservation. Many of the 16 small communities on CRIR are geographically remote and spread across its reservation, the fourth-largest in the United States. U.S. Department of Interior, Bureau of Indian Affairs, Cheyenne River Agency, https://www.bia.gov/regional-offices/great-plains/south-dakota/cheyenne-river-agency.
[x] For a more detailed examination of the Cheyenne River Sioux Tribe’s housing project and Sharon Vogel’s approach to community and economic development, see Patrice H. Kunesh, The Power of Place and People–Creating a Vision for Community in Indian Country through Self-Governance and Self-Determination, Journal of Affordable Housing and Community Development Law 2021 (30:1), https://www.americanbar.org/groups/affordable_housing/publications/journal_of_affordable_housing_home/.
