Alaska
Behavioral Health Aides and the Alaska Tribal Health System: A Guide
By Dr. Stacey Forbes, DNP, APRN, PMHNP-BC
Key Takeaways
- The Behavioral Health Aide program grew out of Alaska’s “counselor-in-every-village” initiative to bring behavioral health prevention, treatment, and recovery services to rural communities.
- It was founded by the Alaska Native Tribal Health Consortium in 2009, modeled on the Community Health Aide Program, with certification overseen by the Community Health Aide Program Certification Board.
- ANTHC is a consortium of Tribal Health Organizations and works in partnership with the Alaska Native and American Indian people it serves.
- Outside specialists, including telehealth psychiatric providers, work best as partners to local and tribal care — with the patient’s permission, and never as a replacement.
For people outside Alaska, rural mental health care often conjures an image of long waitlists and distant clinics. In many Alaska communities the picture is different, and in some ways stronger: the person who answers when someone is struggling may be a Behavioral Health Aide who lives in the same community, speaks the same language, and knows the family. Understanding that system helps patients, families, and outside clinicians work with it rather than around it.
What a Behavioral Health Aide is
According to the Community Health Aide Program, the Behavioral Health Aide (BHA) program grew out of the statewide “counselor-in-every-village” initiative to provide behavioral health prevention, treatment, and recovery services in rural Alaska. The program was founded by the Alaska Native Tribal Health Consortium (ANTHC) in 2009 and was modeled on the Community Health Aide Program, which has long brought health care to remote communities.
BHAs complete training designed around a defined curriculum and core competencies, and their certification is overseen by the Community Health Aide Program Certification Board. The program addresses some of the hardest issues communities face, including domestic violence, sexual assault, substance use, suicide, and historical trauma.
The Alaska Tribal Health System
BHAs work within a larger network. ANTHC describes itself as providing health services in partnership with the Alaska Native and American Indian people it serves and with the Tribal health organizations of the Alaska Tribal Health System, through a system of care created as an act of self-determination. The Community Health Aide Program describes ANTHC as a consortium of 18 Tribal Health Organizations. ANTHC also offers behavioral health services, including through telehealth.
The Alaska Department of Health, for its part, says it works closely with Tribes and Tribal Health Organizations to support community-based health care, strengthen Tribal health systems, and improve access to Medicaid.
Why local care matters so much here
A clinician who flies in once a quarter cannot know a community the way someone who lives there does. Local behavioral health workers understand the context around a person’s distress — family, seasons, subsistence, grief that a whole village shares — and they are there between appointments and during crises, when an outside provider is not. Historical trauma is named directly in the BHA program for a reason: understanding it is part of understanding what someone is carrying.
- Someone who knows the family and the community
- Care in the person’s own language where that is available
- Presence between visits, not just during them
- A local safety plan that uses local people and resources
How an outside psychiatric provider can help
Some needs go beyond what a village clinic can provide on its own: a diagnostic evaluation for a complex presentation, or careful adjustment of psychiatric medication over time. Telehealth can bring that expertise in without anyone leaving home. The key is that it works alongside local and tribal care, not instead of it. With the patient’s written permission, a telehealth clinician can coordinate with a local behavioral health aide or clinic so that everyone is working from the same plan. See getting psychiatric care off the road system for the practical side of video appointments where connectivity is uneven.
If you receive care through a Tribal Health Organization, start there and ask what is available, including telehealth services. An outside practice should always respect the care relationships a patient already has.
In a crisis
Local plans matter most in an emergency, and it is worth knowing yours before you need it — who to call in the community, and where the nearest clinic or facility is. Statewide lines work anywhere with a signal.
- Careline: 877-266-4357, or text or chat 988 — free, confidential, and answered 24/7 by Alaskans.
- 988: call or text, 24/7.
- 911 for immediate danger. For how emergency evaluations work, see the Alaska involuntary commitment guide.
Common Questions
What is a Behavioral Health Aide in Alaska?
A Behavioral Health Aide is a trained and certified behavioral health worker in Alaska’s Community Health Aide Program system. The program grew out of the “counselor-in-every-village” initiative, was founded by ANTHC in 2009, and provides prevention, treatment, and recovery services in rural Alaska.
Who certifies Behavioral Health Aides?
Certification standards and procedures are overseen by the Community Health Aide Program Certification Board.
Can a telehealth psychiatric provider work with my village clinic?
Yes, with your written permission. Coordination means your local behavioral health aide or clinic and your telehealth clinician can work from the same plan. It should add to local care, not replace it.
What should I do in a mental health crisis in rural Alaska?
Call 911 for immediate danger. For crisis support, call Careline at 877-266-4357 or call or text 988. Know your community’s local plan ahead of time.
Sources & Further Reading
- Community Health Aide Program — About the BHA Program
- Alaska Native Tribal Health Consortium
- Alaska Department of Health — Medicaid Tribal Health Programs
- Careline Alaska
Care in Alaska
Dr. Stacey Forbes, DNP, PMHNP-BC, provides integrative telehealth psychiatry to patients throughout Alaska. See psychiatric care across Alaska, Alaska mental health resources, or book a consultation →
If you need help right now
Willow & Stone is an outpatient practice and is not an emergency service. If you or someone you care about is in immediate danger, call 911.
For urgent mental health support at any hour, call or text 988 to reach the Suicide & Crisis Lifeline, or text HOME to 741741 for the Crisis Text Line. Both are free, confidential, and available 24/7 nationwide.
Dr. Stacey Forbes, DNP, APRN, PMHNP-BC
Board-certified Psychiatric-Mental Health Nurse Practitioner and founder of Willow & Stone Integrative Mental Health. Nearly two decades of clinical experience; integrative, root-cause psychiatry via telehealth. Licensed in Texas, New Mexico, Florida, Alaska, Arizona & Colorado.
About Dr. Forbes →