Q & A with Sr. Donna Stevens, mental health on a reservation

Sr. Donna Stevens, right, at the Butterfly Drop-In Center with an Apache woman. Stevens said clients are usually at least 17 and out of school, but mainly consist of young adults, middle-aged or elderly. Kids, she said, are only treated "in the context of a family." (Courtesy of the Franciscan Sisters of Perpetual Adoration)

The White Mountain Apache tribe in Whiteriver, Arizona, a town about three hours east of Phoenix, has roughly a 92 percent unemployment rate. Few adults there can read above the sixth-grade level, as 60 percent of the town's people drop out of school by the 10th grade.

Statistically, the tribe's annual average rate of suicides and homicides dwarfs those found in the rest of the country: While 1 in 100,000 people commits suicide or homicide nationally, this community of about 15,000 sees roughly 23 suicides and anywhere from 15 to 25 homicides a year.

This is the community where Franciscan Sr. Donna Stevens practices psychotherapy at the Rainbow Treatment Center, the tribe's substance abuse treatment facility. What began in the 1980s as a small center with three staff members has grown into an operation with five buildings and 150 professionals.

Stevens spoke with Global Sisters Report about the ministerial challenges and cultural differences that affect those seeking drug rehabilitation.

GSR: What drew you to drug treatment?

Stevens: The devastation it was causing. At the time I went to school for my doctorate, we didn't get a whole lot of education in substance-use treatment — it's only been in the last 15 years that substance use has come into its own as a treatment field. Before that, my education was standard psycho-dynamic and cognitive behavioral. For the past 20 years of being here, I've sort of developed my own model of thinking in terms of what's causing disruption in happiness and peacefulness in the human spirit. . . .

We deal with the spiritual, the physical, the way people think, the way they communicate, and how people understand their emotions. Oftentimes, when people first come into counseling, they can identify three feelings — mad, sad, and glad — and 'somehow' — and that 'somehow' captures everything. There is no equivalent in Western language for 'somehow,' but their behavior comes from that, so we have to explore what 'somehow' means and turn that into peacefulness.

Sr. Donna Stevens in Whiteriver, Ariz., with some members of the White Mountain Apache tribe. While the town has had a Catholic church for more than 100 years, the tribe also includes Lutherans, Baptists, roughly 30 different Pentecostal groups, and Mormons. (Courtesy of the Franciscan Sisters of Perpetual Adoration)

Tell me about some of the cultural differences that might affect the rehabilitation process.

Western society is very goal-oriented. But native people here live for today, and it's more immediate. We have to deal with today; we can't look at tomorrow or set goals for tomorrow because tomorrow isn't here yet. They tend to be more immediate-focused, whether that's wanting to go fishing rather than going to work, or if that's in drinking rather than staying sober because who knows what tomorrow is going to bring. It's more present-orientated and situation-oriented rather than goal-centered, so that's something that we try to address.

I learn every day. As people who are well-educated as we women religious are, as white professionals are, we come in and we think we know stuff. When you really start working in the grass roots, you find out that you really don't know much at all, and you can never assume things.

I think if there's anything I've learned, it's humility and that I don't really know what's good for people. They have to know what's good for them. I think I've worked through a lot of my professional arrogance when I first was educated and I thought, 'Well, boy, I have something to offer now.' Then I come to a community like this and I realize they have more to offer me than I have to offer them, and that's in terms of understanding humanity, and the human condition, and kindness and humility and patience and courage. Our people are survivors, and most cultures would crumble under the pressures.

What are some misconceptions you've learned firsthand about drug treatment?

It's not a matter of, like Nancy Reagan said, 'Just say no.' There ain't no easy fix; there ain't no easy answer, especially when you don't have alternatives for people. Most people don't have transportation — they're on foot, they hitchhike 30 miles to Wal-Mart, Grandma is pushing strollers — and there are no jobs here on the reservation, but they don't have the job skills to go elsewhere. They're used to living with very little.

But you can't 'just say no.' It isn't that easy. You have to provide people the alternative, and when your resources are extremely limited, those alternatives are hard to come by. You're fighting uphill all the time.

I just lost two clients last week who died from substance use, two clients I was very fond of, and that happens every week to me. And they're young, in their 30s or 40s, and shouldn't be passing away. We have 20-year-olds dying here of cirrhosis of liver because by the time they're 13, they're alcoholics.

If you think you can come in and tell people not to drink anymore, it's just silly. And I can't just talk about it. That's not the Apache way: You don't talk about people who passed away. You hold it in, and it builds up and up. You don't talk about feelings. It's a matter of teaching people how to adapt so that the human suffering doesn't eat them up and consume them. That's exactly what happens with substance abuse — it consumes the individual, and that's mostly because of unresolved historical trauma and personal trauma.

Pictured with two women of the Apache tribe, Sr. Donna said women "tend to come in to treatment sooner than men do. They're more concerned or sensitive about relationship issues than men are, and I think that gender bias is true in the white, Western community, too." (Courtesy of the Franciscan Sisters of Perpetual Adoration)

Any lessons you've gathered through your work that you think could benefit others working in rehabilitation ministries?

Leave your arrogance hanging on the wall with your diploma. Get down on your knees, pray for humility, strength, positive thinking and encouragement. The biggest thing is the relationship you establish with every individual you work with. I get swamped here because everybody I deal with becomes a precious person to me, and they know that because of the way I talk with them, listen to them, empathize, express my understanding of what they are trying to tell me and share with me — that's what you have to do.

There are many models out there that have their benefits, but when it comes down to it, each person is a unique model, a human being, and you have to meet them where they're at: What does this woman need from me, or what's going to nourish her soul, what's going to give her hope, what's going to allow her to pull up her own unrecognized resources to create a life for herself and her children? What's going to help him realize that he's worthwhile and has dignity and can respect himself again?

When I first came here 20 years ago, one of the things people asked me was how long I was going to stay. They said, 'Everyone else leaves in two years,' and that's because of the loan repayment program of the government — if you stay two years in an unserved area, then you get your loans repaid. So after two years, a lot of the professionals leave for greener, easier pastures.

But I said I was going to be here 'as long as you want me. I go where you go.' It's taken about 20 years for people to trust that; now, people see me as steady and trustworthy, and I'm starting to see the grandkids now. I've been through three generations of people — it's turned into, 'OK, Donna helped me when I was your age, so we'll go see Donna.'

People have learned to trust. But you can't create that trust without dedication and without persistence in being there every day, regardless of how it is when you're there. I think that's in terms of other people in substance-use rehab: It's not a short-term commitment. It's a long-term commitment, particularly with culturally diverse people. They've learned not to trust commitments, and I think there's plenty of commitments made out there to indigenous people to bear that out.

[Soli Salgado is a staff writer for Global Sisters Report. Follow her on Twitter: @soli_salgado.]