---
kind: "section"
citation: "25 U.S.C. § 1665a"
title: "25"
title_heading: "Indians"
number: "1665a"
heading: "Behavioral health prevention and treatment services"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/25/1665a"
units:
  - "Chapter 18 — Indian Health Care"
  - "Subchapter V–A — Behavioral Health Programs"
  - "Part A — General Programs"
---

# §1665a. Behavioral health prevention and treatment services

- (a) **Purposes—** The purposes of this section are as follows:
  - (1) To authorize and direct the [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), [Indian tribes](/usc/25/1603.md?p=14), and [tribal organizations](/usc/25/1603.md?p=26), to develop a comprehensive [behavioral health](/usc/25/1603.md?p=2-A) prevention and treatment program which emphasizes collaboration among alcohol and [substance abuse](/usc/25/1603.md?p=21), social [services](/usc/25/1603.md?p=18), and mental health programs.
  - (2) To provide information, direction, and guidance relating to mental illness and dysfunction and self-destructive behavior, including child abuse and family violence, to those Federal, tribal, State, and local agencies responsible for programs in [Indian](/usc/25/1603.md?p=13) communities in areas of health care, education, social [services](/usc/25/1603.md?p=18), child and family welfare, alcohol and [substance abuse](/usc/25/1603.md?p=21), law enforcement, and judicial [services](/usc/25/1603.md?p=18).
  - (3) To assist [Indian tribes](/usc/25/1603.md?p=14) to identify [services](/usc/25/1603.md?p=18) and resources available to address mental illness and dysfunctional and self-destructive behavior.
  - (4) To provide authority and opportunities for [Indian tribes](/usc/25/1603.md?p=14) and [tribal organizations](/usc/25/1603.md?p=26) to develop, implement, and coordinate with community-based programs which include identification, prevention, education, referral, and treatment [services](/usc/25/1603.md?p=18), including through multidisciplinary resource teams.
  - (5) To ensure that [Indians](/usc/25/1603.md?p=13), as citizens of the United States and of the States in which they reside, have the same access to [behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) to which all citizens have access.
  - (6) To modify or supplement existing programs and authorities in the areas identified in [paragraph (2)](#a-2).
- (b) **Plans—**
  - (1) **Development—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), [Indian tribes](/usc/25/1603.md?p=14), and [tribal organizations](/usc/25/1603.md?p=26), shall encourage [Indian tribes](/usc/25/1603.md?p=14) and [tribal organizations](/usc/25/1603.md?p=26) to develop tribal plans, and [urban Indian organizations](/usc/25/1603.md?p=29) to develop local plans, and for all such groups to participate in developing areawide plans for [Indian](/usc/25/1603.md?p=13) [Behavioral Health](/usc/25/1603.md?p=2-A) [Services](/usc/25/1603.md?p=18). The plans shall include, to the extent feasible, the following components:
    - (A) An [assessment](/usc/25/1665.md?p=2) of the scope of alcohol or other [substance abuse](/usc/25/1603.md?p=21), mental illness, and dysfunctional and self-destructive behavior, including suicide, child abuse, and family violence, among [Indians](/usc/25/1603.md?p=13), including—
      - (i) the number of [Indians](/usc/25/1603.md?p=13) served who are directly or indirectly affected by such illness or behavior; or
      - (ii) an estimate of the financial and human cost attributable to such illness or behavior.
    - (B) An [assessment](/usc/25/1665.md?p=2) of the existing and additional resources necessary for the prevention and treatment of such illness and behavior, including an [assessment](/usc/25/1665.md?p=2) of the progress toward achieving the availability of the full continuum of care described in [subsection (c)](#c).
    - (C) An estimate of the additional funding needed by the [Service](/usc/25/1603.md?p=18), [Indian tribes](/usc/25/1603.md?p=14), [tribal organizations](/usc/25/1603.md?p=26), and [urban Indian organizations](/usc/25/1603.md?p=29) to meet their responsibilities under the plans.
  - (2) **National clearinghouse—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall coordinate with existing national clearinghouses and information centers to include at the clearinghouses and centers plans and reports on the outcomes of such plans developed by [Indian tribes](/usc/25/1603.md?p=14), [tribal organizations](/usc/25/1603.md?p=26), [urban Indian organizations](/usc/25/1603.md?p=29), and [Service areas](/usc/25/1603.md?p=19) relating to [behavioral health](/usc/25/1603.md?p=2-A). The [Secretary](/usc/25/1603.md?p=17) shall ensure access to these plans and outcomes by any [Indian tribe](/usc/25/1603.md?p=14), [tribal organization](/usc/25/1603.md?p=26), [urban Indian organization](/usc/25/1603.md?p=29), or the [Service](/usc/25/1603.md?p=18).
  - (3) **Technical assistance—** The [Secretary](/usc/25/1603.md?p=17) shall provide technical assistance to [Indian tribes](/usc/25/1603.md?p=14), [tribal organizations](/usc/25/1603.md?p=26), and [urban Indian organizations](/usc/25/1603.md?p=29) in preparation of plans under this section and in developing standards of care that may be used and adopted locally.
- (c) **Programs—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall provide, to the extent feasible and if funding is available, programs including the following:
  - (1) **Comprehensive care—** A comprehensive continuum of [behavioral health](/usc/25/1603.md?p=2-A) care which provides—
    - (A) community-based prevention, intervention, outpatient, and [behavioral health aftercare](/usc/25/1665.md?p=3);
    - (B) detoxification (social and medical);
    - (C) acute hospitalization;
    - (D) intensive outpatient/day treatment;
    - (E) residential treatment;
    - (F) transitional living for those needing a temporary, stable living environment that is supportive of treatment and recovery goals;
    - (G) emergency shelter;
    - (H) intensive case management;
    - (I) diagnostic [services](/usc/25/1603.md?p=18); and
    - (J) promotion of healthy approaches to risk and safety issues, including injury prevention.
  - (2) **Child care—** [Behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) for [Indians](/usc/25/1603.md?p=13) from birth through age 17, including—
    - (A) preschool and school age fetal alcohol spectrum disorder [services](/usc/25/1603.md?p=18), including [assessment](/usc/25/1665.md?p=2) and behavioral intervention;
    - (B) mental health and [substance abuse](/usc/25/1603.md?p=21) [services](/usc/25/1603.md?p=18) (emotional, organic, alcohol, drug, inhalant, and tobacco);
    - (C) identification and treatment of co-occurring disorders and comorbidity;
    - (D) prevention of alcohol, drug, inhalant, and tobacco use;
    - (E) early intervention, treatment, and aftercare;
    - (F) promotion of healthy approaches to risk and safety issues; and
    - (G) identification and treatment of neglect and physical, mental, and sexual abuse.
  - (3) **Adult care—** [Behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) for [Indians](/usc/25/1603.md?p=13) from age 18 through 55, including—
    - (A) early intervention, treatment, and aftercare;
    - (B) mental health and [substance abuse](/usc/25/1603.md?p=21) [services](/usc/25/1603.md?p=18) (emotional, alcohol, drug, inhalant, and tobacco), including sex specific [services](/usc/25/1603.md?p=18);
    - (C) identification and treatment of co-occurring disorders ([dual diagnosis](/usc/25/1665.md?p=4)) and comorbidity;
    - (D) promotion of healthy approaches for risk-related behavior;
    - (E) treatment [services](/usc/25/1603.md?p=18) for women at risk of giving birth to a child with a fetal alcohol spectrum disorder; and
    - (F) sex specific treatment for sexual assault and domestic violence.
  - (4) **Family care—** [Behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) for families, including—
    - (A) early intervention, treatment, and aftercare for affected families;
    - (B) treatment for sexual assault and domestic violence; and
    - (C) promotion of healthy approaches relating to parenting, domestic violence, and other abuse issues.
  - (5) **Elder care—** [Behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) for [Indians](/usc/25/1603.md?p=13) 56 years of age and older, including—
    - (A) early intervention, treatment, and aftercare;
    - (B) mental health and [substance abuse](/usc/25/1603.md?p=21) [services](/usc/25/1603.md?p=18) (emotional, alcohol, drug, inhalant, and tobacco), including sex specific [services](/usc/25/1603.md?p=18);
    - (C) identification and treatment of co-occurring disorders ([dual diagnosis](/usc/25/1665.md?p=4)) and comorbidity;
    - (D) promotion of healthy approaches to managing conditions related to aging;
    - (E) sex specific treatment for sexual assault, domestic violence, neglect, physical and mental abuse and exploitation; and
    - (F) identification and treatment of dementias regardless of cause.
- (d) **Community behavioral health plan—**
  - (1) **Establishment—** The governing body of any [Indian tribe](/usc/25/1603.md?p=14), [tribal organization](/usc/25/1603.md?p=26), or [urban Indian organization](/usc/25/1603.md?p=29) may adopt a resolution for the establishment of a community [behavioral health](/usc/25/1603.md?p=2-A) plan providing for the identification and coordination of available resources and programs to identify, prevent, or treat [substance abuse](/usc/25/1603.md?p=21), mental illness, or dysfunctional and self-destructive behavior, including child abuse and family violence, among its members or its [service](/usc/25/1603.md?p=18) population. This plan should include [behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18), social [services](/usc/25/1603.md?p=18), intensive outpatient [services](/usc/25/1603.md?p=18), and continuing aftercare.
  - (2) **Technical assistance—** At the request of an [Indian tribe](/usc/25/1603.md?p=14), [tribal organization](/usc/25/1603.md?p=26), or [urban Indian organization](/usc/25/1603.md?p=29), the Bureau of [Indian](/usc/25/1603.md?p=13) Affairs and the [Service](/usc/25/1603.md?p=18) shall cooperate with and provide technical assistance to the [Indian tribe](/usc/25/1603.md?p=14), [tribal organization](/usc/25/1603.md?p=26), or [urban Indian organization](/usc/25/1603.md?p=29) in the development and implementation of such plan.
  - (3) **Funding—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), [Indian tribes](/usc/25/1603.md?p=14), and [tribal organizations](/usc/25/1603.md?p=26), may make funding available to [Indian tribes](/usc/25/1603.md?p=14) and [tribal organizations](/usc/25/1603.md?p=26) which adopt a resolution pursuant to [paragraph (1)](#d-1) to obtain technical assistance for the development of a community [behavioral health](/usc/25/1603.md?p=2-A) plan and to provide administrative support in the implementation of such plan.
- (e) **Coordination for availability of services—** The [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall coordinate [behavioral health](/usc/25/1603.md?p=2-A) planning, to the extent feasible, with other Federal agencies and with State agencies, to encourage comprehensive [behavioral health](/usc/25/1603.md?p=2-A) [services](/usc/25/1603.md?p=18) for [Indians](/usc/25/1603.md?p=13) regardless of their place of residence.
- (f) **Mental health care need assessment—** Not later than 1 year after March 23, 2010, the [Secretary](/usc/25/1603.md?p=17), acting through the [Service](/usc/25/1603.md?p=18), shall make an [assessment](/usc/25/1665.md?p=2) of the need for inpatient mental health care among [Indians](/usc/25/1603.md?p=13) and the availability and cost of inpatient mental health facilities which can meet such need. In making such [assessment](/usc/25/1665.md?p=2), the [Secretary](/usc/25/1603.md?p=17) shall consider the possible conversion of existing, underused [Service](/usc/25/1603.md?p=18) hospital beds into psychiatric units to meet such need.

## Source credit

(Pub. L. 94–437, title VII, § 702, as added Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.)

## Notes

### Editorial Notes

### Codification

Section 702 of Pub. L. 94–437 is based on section 181 of title I of S. 1790, One Hundred Eleventh Congress, as reported by the Committee on Indian Affairs of the Senate in Dec. 2009, which was enacted into law by section 10221(a) of Pub. L. 111–148.

### Prior Provisions

A prior section 1665a, Pub. L. 94–437, title VII, § 702, as added Pub. L. 102–573, title VII, § 702(a), Oct. 29, 1992, 106 Stat. 4573, provided for Indian Health Service program, prior to the general amendment of this subchapter by Pub. L. 111–148.