On the Blackfeet Reservation, social worker Erika MadPlume uses horses to teach children skills like patience, boundaries, and emotional control.
One of her clients, diagnosed with attention deficit hyperactivity disorder, is what she calls a “really wired kid.” He’s constantly moving and always testing limits, challenges that often spill over into life at home and at school.
Horses, MadPlume says, will quickly mirror that energy. Their muscles tighten, eyes widen, and nostrils flare. Sometimes they even bolt at sudden movements.
“He’s usually this big ball of energy, and the horse will give him immediate feedback on that,” she said. “They have a calming effect that teaches him to be aware of how he’s acting and how his actions influence their behavior — lessons that translate to human interactions too.”
These equine-assisted services are one form of care offered at Sukapi Lodge, the first tribally run mental health center in the country. Located two miles west of Browning, the Lodge officially opened its doors in October, providing mental health services rooted in Blackfeet culture and tailored to the community’s needs.
Sukapi Lodge serves all ages, offering everything from equine programs and youth mentorships to cognitive behavioral therapy and substance use disorder treatment. All enrolled members of the tribe and descendants are eligible to receive care at the center.
Sukapi means “good” or “well” in the Blackfoot language. For MadPlume, this approach to wellness is “holistic,” addressing spiritual, mental, emotional, and physical health. She works to bring this “native way of wellness” into all aspects of care.
“Using a cultural approach allows clients to identify who they are and explore their background,” MadPlume said. “It can help them form their own cultural identity — which can be a really important part of healing.”
Land surrounding the Sukapi Lodge in Browning. Courtesy image
At Sukapi Lodge, this cultural approach is combined with modern therapeutic practices in what MadPlume calls “two-eyed seeing” — a way of looking at mental health care through both Indigenous and scientific lenses to create a more dynamic treatment.
A key part of this approach involves gathering the data needed to understand the community’s needs. While suicide and substance use rates are higher among Native Americans than any other racial or ethnic group in the U.S., there is currently no behavioral health data collection specific to the Blackfeet Nation.
“We carry oral tradition; we weren’t pen to paper and don’t think of data in the same way as Western society,” MadPlume said. “But it’s important to acknowledge that Western perspective as well because it can be crucial in building programs that can best help our people.”
MadPlume considers herself lucky to have grown up immersed in Blackfeet culture, something she knows is increasingly rare.
As a child, she was surrounded by the Blackfoot language, having been raised by her grandmothers who are both fluent speakers. Her grandfather is one of the last surviving speakers of the Blackfeet dialect of “Hand Talk,” also known as Plains Indian Sign Language. Before colonization, the language connected tribes across the Plains, enabling communication during trade and conflict.
That grounding in tradition helped her see the value of equine-assisted mental health care.
Horses have been at the heart of Blackfeet life for centuries, revolutionizing the buffalo hunt, shaping warfare, and holding significant spiritual value. That legacy continues in MadPlume’s family, who run a ranch. She says she’s been around horses for as long as she can remember. In her family, it’s tradition to “lead people home” on horseback during a funeral.
“I’ll always remember when a little kid came up to me, and he was just ecstatic to even just pet the horse, to hold the horse,” she said. “It was really eye-opening to see the impact they can have for kids who don’t get to be exposed to them every day.”
For some people, horses offer what words can’t. MadPlume explained that many of her clients, especially men, struggle to open up in traditional talk therapy. With animals, however, they are often able to connect more naturally, creating a bridge that builds trust with their practitioner.
As MadPlume brings equine programming to life at Sukapi Lodge, her work reflects a vision first imagined by Executive Director Karrilyn Monroe, who has seen the gaps in social services on the reservation firsthand.
Monroe has been involved with the tribe’s social work services for more than a decade. She had held positions with the tribe’s Temporary Assistance For Needy Families program and the Blackfeet Child & Family Services office when she first envisioned the Sukapi Lodge nearly five years ago.
Initially, she planned to create a homeless shelter for the 36 high school students on the reservation who had been identified as couch surfing during the COVID-19 pandemic. She submitted a proposal and was awarded $1.4 million in American Rescue Plan Act funding to get the center off the ground.
But the CEO of Tribal Health at the time wanted all programs to be self-sustaining. Monroe explored every possibility but couldn’t find a way to make a homeless shelter viable without outside assistance.
After extensive communication with the state of Montana, the tribe pivoted to a mental health center, a model which could be billable under the state. Monroe spent two years immersing herself in the world of mental health, determined to make the center a reality.
Her time working for the tribe greatly informed her approach to building the center’s services.
While working as a case manager for Child and Family Services, she discovered that many in her community lacked the knowledge and resources to get essential forms of identification, such as social security cards or birth certificates.
She explained that it’s common on the reservation for many family members to live together in one house or for young people to move frequently between houses, making it easy for documents to be lost or misplaced. As a result, the center is launching programs to teach young people how to secure the identification they need to access education, employment, and other services.
“Meeting people where they are,” is another key pillar of the Sukapi Lodge approach, Monroe said. The Blackfeet Reservation spans 1.5 million acres, meaning that travel can take hours, which is particularly challenging for clients who may be struggling to even get out of bed. To address this, the Lodge offers telehealth services and makes visits to care centers, schools, and jails.
Privacy was another top concern for Monroe, particularly given that mental health care remains stigmatized.
“Because we’re a small community, people are so afraid of telling their secrets or having somebody know they receive services,” she said.
To make clients feel safe, the center is tucked outside of downtown Browning, away from prying eyes. Appointments are staggered so that clients don’t cross paths in the hallways, while wall panels and noise machines ensure confidentiality. Other Blackfeet social service organizations have toured the building, learning firsthand how the Lodge prioritizes privacy so they can reassure their own clients.
Staffing at the Lodge further supports this culturally safe environment. Two out of the three providers are tribal members with dual certification in mental health treatment and addiction counseling. In a community disproportionately affected by alcohol and drug addiction, this allows clients to receive comprehensive care while only having to build trust with one provider.
Erika MadPlume and Karilyn Monroe of Sukapi Lodge, a mental health therapeutic service center in Browning. Courtesy image
Indigenous providers also bring a sense of “cultural humility” to their work, MadPlume said. This approach can make a significant difference for clients who have previous poor experiences receiving mental health or substance use treatment elsewhere.
“I’ve heard it from clients who don’t want to see a non-native practitioner and seen that cultural barrier myself in the school settings I’ve worked,” she added. “When you’re not aware of the setting you’re in, you can cause real harm.”
MadPlume recalled working at a school on the reservation that had recently brought in a number of non-Indigenous and international teachers, shortly before a cluster of students died by suicide. The teachers who had not grown up in the Blackfeet culture struggled to understand how the deaths rippled through the entire school and the broader community.
“We grieve through humor; we tend to laugh in serious situations,” she said. “And our family systems don’t fit in within Western norms — sometimes our cousins are [like] siblings, or we have family members with no blood relation at all.”
MadPlume said that understanding these cultural nuances makes it impossible not to bring a personal approach to care.
“It goes back to the way most of us were raised, which is to be community minded,” she added.
Her family’s own experiences with loss, particularly the death of her brother, give her that ability to connect with her clients.
Her brother first developed depression, compounded by grief after multiple family losses. Over time, that depression deepened, and he developed a substance use disorder. The concurrent disorder — simultaneous mental health and substance use conditions — eventually led to a drug-induced psychosis. MadPlume lost her brother to suicide in July 2024.
A few weeks ago, she assessed a client at a local jail who reminded her deeply of her brother. They faced similar challenges, and the client had even known her brother — they once worked together. The client had connected with Sukapi Lodge through Facebook, where his mother had been posting desperately, seeking help for him, just as MadPlume’s mother had done years earlier.
As part of the assessment, MadPlume asked the man what his strengths were. He quickly dismissed himself as not good at anything. She pushed back, reminding him that he had lit up just minutes ago while talking about his commitment to fitness and the outdoors.
The man thanked her. No one had ever told him that before. He then broke down into tears.
“It was a really grounding moment to see someone open up because they felt safe,” she said. “It reminded me why I’m here, to prevent more people from falling through the cracks.”
Interactions like this one inspire the Sukapi Lodge team as they work to expand and fill care gaps on the Blackfeet Reservation.
They hope to expand mental health services in Heart Butte, Babb, and other isolated Blackfeet communities that are currently under resourced.
Reaching these areas can be challenging, MadPlume noted, because many of their communities are “clannish.” She doesn’t see this as a negative trait, but rather as a reflection of their deep roots, interdependence, and protective nature.
“Although we were one Blackfeet tribe, we did have our own singular clans that lived in different places and took care of their own, and it’s cool that they’re carrying that tradition forward,” she added. “It’s tough to navigate the breakthrough when you’re not from those areas, but once they know you they’ll let you in.”
Monroe emphasized that the team will continue to “think outside the box,” an approach she believes is essential to meeting people where they are.
One of their top priorities is creating a crisis response space where people experiencing suicidal thoughts can receive immediate, supportive care. MadPlume hopes it will offer a “homier” alternative to the clinical, often intimidating settings currently available through Indian Health Service (IHS) or local hospitals.
“My brother would sometimes just get thrown into a concrete room at IHS, where he’d sit waiting for hours for a provider to come and see him,” MadPlume said. “If you’re thinking about taking your own life, or you’re having delusions or psychosis, that’s no place you want to be. It’ll only make it worse.”
Sustaining this work also means investing in the next generation of Blackfeet social workers.
Hundreds of students have completed two-year degrees in addiction studies or social work at Blackfeet Community College (BCC). Through a partnership with the University of Montana, BCC graduates can continue on to earn a bachelor’s or master’s degree remotely, without leaving the reservation.
But many students hit a roadblock when it comes to earning required practicum hours. There are currently no local sites or supervisors available to oversee them. MadPlume herself had to find a supervisor outside the community while completing her degree.
As a result, Monroe is now working to make Sukapi Lodge an approved practicum site, allowing Blackfeet students to train within their own community.
In the meantime, Sukapi Lodge will embrace its mission to provide care to its community.
“Our community needs a place like this, and we want people to see it as a resource and a place they can turn to,” Monroe said. “We want this to continue to be a place of healing for everybody.”