An Indian-controlled mental health program

The control of health care programs for American Indians is shifting slowly from the federal government to the tribes. In 1971 the Apaches began operating a community mental health center on a reservation in northeastern Arizona. The tribal council appointed a 14-member board to administer the center; a majority of the members were Apaches. The board then hired an executive director who was not an Indian. There were 15 professional and paraprofessional staff members; 12 were Apaches or other Indians. In January 1976 the tribal council fired the director and disbanded the board of directors, although the clinic continued operation. The authors discuss sociocultural factors that influenced the center's development and give several reasons for the center's problems, including the general expectation that agencies run by Indians will not be successful.