“Report: A chronic state of crisis...a lack of quality health care provided to Native Americans"

– Byron Dorgan Investigative Report


Native Youth Struggle Due To Failed Federal Healthcare

Know the Facts:

  • The U.S. government is responsible for providing adequate mental healthcare for Native Americans, through signed treaty agreements. However, the U.S. spends twice as much money on healthcare for convicted criminals in prison, than it does for Native Americans. (4, 5)

  • Indigenous communities across the US & Canada are currently declaring suicide State-of-Emergency proclamations in hopes of spurring the government into providing adequate mental health resources. (7)

  • Statistically, Native American youth are 3x more likely to die by suicide, with some reservations at 10x the national average. However, mental health service utilization among Native Americans remains the lowest, partly due to inadequate or limited availability in Native communities. (2, 3)

  • The Indian Health Service (IHS), the federal agency responsible for overseeing healthcare services for Native Americans, operates medical facilities on tribal lands that are extremely understaffed and have been sanctioned for dangerous, faulty care, leaving patients without services required by law. (6)

  • In Pine Ridge, despite an ongoing suicide crisis, the IHS hospital only allows 4 patients per MONTH to visit with a psychiatrist. (NOTE: The average psychiatrist in the U.S. sees roughly 20 patients per DAY.) (8, 9)

Investigative Report Exposes "Gross Incompetence"

WASHINGTON—Chairman of the Senate Committee on Indian Affairs Byron Dorgan, after a year of investigating horror-filled findings about the federal government’s responsibilities to provide healthcare services to Native Americans, released their report. The senator’s office reviewed 140,000 pages of Indian Health Service (IHS) documents, visited three IHS facilities in the Aberdeen area, and met with tribal members and individual IHS employees. At the same time, more than 200 individuals contacted the committee to share their concerns.

“Our investigation found a chronic state of crisis at the Indian Health Service” Dorgan said. “It requires urgent and immediate corrective action across a broad front.”

"The federal government has treaty and trust obligations to provide quality health care to Native Americans"

Among the investigation’s major findings:

  • Five IHS hospitals in the Aberdeen Area are at risk of losing their accreditation or certification from the Centers for Medicare and Medicaid Services (CMS)
  • Several facilities have been cited as having health care providers on staff who lacked proper licensing or credentialing with chronic mismanagement, lack of employee accountability and financial integrity.
  • Several service units experienced substantial and recurring diversions of reduced health care services, due to lack of qualified providers or funds.
  • Key senior staff positions remained vacant for long periods of time, contributing to the lack of proper management.
  • Employees with criminal records, a record of misconduct, or poor performance being transferred to different health facilities within the Indian health system.

Our Investigation:

(Above) Director of Behavioral Health at IHS Pine Ridge Hospital, Charlie Sitting Bull, holds up four fingers, signifying the amount of youth who can receive psychiatric services each month. [Photo from documentary, ‘The Bears on Pine Ridge’]

"IHS Headquarters told me not to talk to the Tribe...I couldn't tell them our suicide rates were higher"

– Charlie Sitting Bull, IHS Director of Behavioral Health

During a comprehensive three-day interview with Charlie Sitting Bull, the former director of Behavioral Health at Pine Ridge Hospital (2015-2019), a startling expose unfolded, shedding light on a culture of suppression within the Indian Health Service (IHS) hospital and an alarming issue with funding.

Sitting Bull courageously unveiled a disconcerting reality where voices were silenced within the IHS hospital, highlighting the pervasive nature of this problem. Most notably, he revealed a staggering revelation about the lack of mental health professionals. Despite his persistent efforts to secure a psychiatrist for the department, the position remained vacant for an astonishing four years. Consequently, only a meager four patients per month were able to access psychotropic medication, severely limiting the scope of mental health support provided.

In a truly shocking admission, Sitting Bull disclosed that IHS headquarters in Washington DC explicitly instructed him to cease sending suicide data and reports. Furthermore, he was prohibited from engaging in discussions with Tribal representatives regarding the vital data he had collected. This revelation underscores a concerning trend of suppressing critical information and hindering necessary dialogue within the IHS system.

''People ARE DYING HERE": Federal Hospitals Fail Tribes'

– Christopher Weaver, Wall Street Journal

Our film production team conducted interviews with several journalists who have dedicated years to researching healthcare issues pertaining to Native American communities. One notable journalist, Christopher Weaver from The Wall Street Journal, shared his experiences and findings regarding the Indian Health Service (IHS) and the significant problems plaguing this federal agency.

Weaver shed light on how the IHS agency knowingly sent unqualified and problematic employees to Pine Ridge hospital. In one shocking case, the agency knowingly transferred a pedophile pediatrician to Pine Ridge Hospital, where he was later convicted of multiple counts of child abuse. Shockingly, the IHS went to great lengths to silence whistleblowers and hide their records from public scrutiny.

During the filming of ‘The Bears on Pine Ridge,’ the IHS was hesitant to engage with journalists and our film crew due to the intense backlash following the incident. Consequently, we reached out to journalists like Weaver for research.

(Above) Dana Fergusson, reporter for the Argus Leader in South Dakota reveals some investigative details about the IHS hospital in Pine Ridge. [Photo taken during filmming, ‘The Bears on Pine Ridge’]

''Dozens of patients died needlessly due to errors made in South Dakota IHS hospitals."

– Christopher Weaver, Wall Street Journal

During a six-month investigation, Argus Leader (USA Today) reporter Dana Fergusson gathered personal stories from Tribal residents about the insufficient health services being provided to the community through the federal hospital. Fergusson’s revelations were equally alarming, including instances of suicidal patients left unattended at the hospital. In one disturbing case, a young patient attempted to hang herself in the emergency room using a call cord, after being left unattended.

The documentary’s producers also interviewed several IHS employees, who wished to remain anonymous, who confirmed Fergusson’s findings and detailed other shocking incidents within the hospital, further highlighting to our film team the deeply troubling state of healthcare for youth on the reservation.


  • Indian Health Service (IHS), the federal agency responsible for providing Native Americans with health care, is failing to uphold treaty responsibilities.
  • Widespread issues at IHS hospitals have taken up resources necessary to help care for youth with mental health struggles.
  • It’s been reported that up to 80% of youth will not be able to see a counselor.
  • In Pine Ridge, suicidal youth are often shipped away to hospitals up to 300 miles away, due to a lack of resources at their local IHS hospital.
  • Due to a lack of resources, residents in Pine Ridge have formed their own prevention programs to try to save lives, as featured in ‘The Bears on Pine Ridge’ documentary. However, these programs struggle to stay operational, as they rely on inconsistent federal assistance.


Raising awareness about critical issues such as Native mental healthcare and Indigenous suicide rates holds significant importance. Why? Without concerted efforts to bring knowledge and exert pressure on Congressional representatives, government-run agencies like the Indian Health Service (IHS) will persist in being underfunded, neglecting Native communities like Pine Ridge.

Despite the escalating crisis, government policies and federal funding allocated to address these pressing issues have remained woefully inadequate.

It falls upon all of us to persist in spreading awareness, amplifying the collective voice that demands action. State and Federal Governments, lacking motivation, have failed to implement comprehensive, long-term plans or allocate sufficient funding toward Native mental health initiatives. By continuing to shine a spotlight on these issues, we can foster a broader dialogue and inspire the necessary changes that these communities urgently require.