SEATTLE — Roxanne White was in a “very desperate and very broken place” when she first came to Thunderbird Treatment Center in 2002.
White, who is Nez Perce, Yakama, A’aninin (Gros Ventre) and Nooksack, was grappling with addiction and a history of trauma she had not yet confronted. Thunderbird was the first place White heard a story that paralleled her own, told by women attending one of the center’s open Alcoholics Anonymous meetings.
The treatment center became a foundation for her recovery, and today, White uses her own story of human trafficking, sexual assault and domestic violence to advocate for families of Missing and Murdered Indigenous Women and People (MMIWP).
“It was amazing, changed my life,” she said.
But in February, after 33 years helping Native American people like White address substance use disorders in its current location, Thunderbird will shut its doors. The Seattle Indian Health Board (SIHB) owns and operates Thunderbird, and plans to sell the Rainier Beach property and use the revenue to build what officials say will be a more modern facility, with more amenities and more treatment beds.
However, exactly when that new facility will open remains unclear. That means on the day Thunderbird closes, there will be no inpatient facility to take its place, leaving the community without a critical resource treating addiction for low-income and primarily Alaska Native and American Indian patients (Thunderbird also serves non-Natives).
Thunderbird’s 65 inpatient treatment beds represent almost 20% of all state-licensed inpatient treatment beds in Seattle, places that provide wraparound support for people dealing with substance use crises.
SIHB has tapered off its 45-day treatment intakes and has transition plans for its three remaining patients in long-term treatment. Leaders also plan to expand the facility’s outpatient treatment program to mitigate the temporary closure’s impact.
But some fear what the facility’s closure means in the short-term.
“I think it’s poorly planned because the impact it’s going to have on individuals who are struggling with the disease of alcoholism or narcotic drugs,” said David Northover, a member of the Yakama Nation Housing Authority Board of Commissioners. “It’s a catastrophe to all of these people who have no place to go like Thunderbird.”
Northover himself is a graduate of Thunderbird Treatment Center after four stints as a patient. He was homeless for years on the Yakama Reservation, sleeping in alleys and struggling with chronic alcoholism. Thunderbird eventually got him into sober housing. He went on to become an advocate for families experiencing poverty and served as board chair for the Statewide Poverty Action Network.
SIHB’s board had been discussing selling the property for six years, said SIHB CEO Esther Lucero, Dine. The building was old, and not able to easily accommodate people the health board wanted to serve, like pregnant women and people with disabilities. The cost of repair or rebuilding was too high, and interest from a buyer prompted an opportunity. The health board did not identify who the buyer is because the sale has yet to be finalized.
“We kind of hit a dead end,” SIHB board president Chris Stearns, the first Native American (Navajo) elected to the Auburn City Council, said. The board’s feeling was, “We’ve got to do it now.”
The plans for the new facility include 92 beds, and what Lucero says will be “the premier treatment program for Native people in the country.”
That means treating “traditional Indian medicine with the same respect we do Western medicine, and that our people can access the recovery services they need regardless of what substance they’re trying to overcome,” Lucero said. “Where families can be part of recovery, and where we can offer reentry into their communities in a really mindful way.”
Billie Jo Kipp, former behavioral health director at SIHB and Thunderbird and current senior fellow at the Aspen Institute, said cultural interventions like those at Thunderbird are critical to Native American health and recovery.
“What happens in Native American addiction is we are often cast into a treatment program that doesn’t honor our ways of getting well,” said Kipp, a member of the Blackfeet Nation.
If walls could talk
The Thunderbird Treatment Center property was originally built for unwed mothers in 1926. The facility today still bears traces of that history: a door to a staff bathroom that’s too narrow for a wheelchair, a defunct dumbwaiter that’s been painted over.
What the building lacks in modern amenities, it has in views. The wide windows look out onto a serene Lake Washington.
“A lot of healing occurred on these lands,” said Shannon Jackson (Nez Perce), the center’s community relations manager, as she walked along the grounds on a recent Friday.
Thunderbird’s talking circles were an important part of that healing, Northover said. He described sitting in a circle around burning sage with fellow residents, praying and sharing experiences. That talking circle process, in addition to the traditional arts and crafts instruction, where people could share experiences about their culture and teach others, made Thunderbird unique.
“If those walls could talk,” Northover said, “that would be so powerful.”
Thunderbird is one of just a handful of treatment centers offering services for urban Indians in the Pacific Northwest. SIHB, its parent organization, is primarily funded through federal Indian Health Service (IHS) grants.
Tribes, urban Indians, advocates and the U.S. Commission on Civil Rights have long contended that the IHS is chronically underfunded. In fiscal-year 2017, IHS spent $3,332 per person on medical care, whereas Medicaid spent $8,109. A U.S. Commission on Civil Rights Report published in winter of 2018 argued that “the budget for urban Indian health care has failed to keep pace with inflation and the growing urban Indian population.”
Another issue: Funding to stanch the overdose crisis has increasingly focused more on medication-assisted treatment and less on inpatient care, Lucero said. Thunderbird does not currently offer medication-assisted treatment, but plans to when it opens its future facility.
Dr. Walt Hollow, one of the founding members of SIHB and current assistant director of the family medicine residency program at the Puyallup Tribal Health Authority, said there’s already a critical shortage of beds for tribal members who need inpatient treatment. Thunderbird’s temporary closure means even fewer beds for patient referrals, and likely more people who return to drinking or using drugs if they’re unable to access care.
“That will affect us,” said Hollow, who is Assiniboine and Sioux. “I hope it gets restarted as soon as possible.”
Thunderbird’s 45-day treatment program was rare, said Dana Francis, program manager for recovery organization Peer Seattle. Most treatment programs only last 15 days, Francis said, and people who need longer treatment already face wait lists that can last three to six weeks.
“Access on demand is critical,” Francis said. “You have to capture people when they’re in that place of, ‘Yes, I want to do this.'”
To meet that demand, Lucero said the organization is returning to the original vision the community had for Thunderbird – to build a beautiful space. When the facility opened in 1987, it started with 95 beds before whittling down to 65.
“In the for-profit world, when you go to recovery, it’s like going to a retreat,” Lucero said. “Why shouldn’t our people have that?”
