They were building the young man’s coffin in the front yard when we arrived. Portable construction lights harshly illuminated the scene as men worked in the shadowy dawn that lasts almost until noon out here on the tundra. The men worked steadily and quietly in a manner that suggested front-yard coffin construction was a routine task. I soon learned that it was.

We arrived about 30 minutes earlier via a shaky nine-seat bush plane, the only way in and out of most villages here on the Yukon Kuskokwim Delta east of Bethel, Alaska. There are over 50 Yup’ik villages on this great frozen sponge of a place, where the great flat expanse of land leading to the Bering Sea is actually just permafrost and thus, constantly shifting.

Ray Daw, Navajo, director of Behavioral Health for the tribally owned Yukon Kuskokwim Health Corporation (YKHC) and Rose Domenic, Yup’ik Director of the corporation’s Behavioral Health Prevention Department and leader of Calricaraq invited me along to observe this unique rapid response trauma intervention in action. Calricaraq means (Healthy Living) in Yup’ik and is unlike any other mental health professional intervention team. In addition to those trained in traditional western behavioral health, it includes a group of Yup’ik elders with extensive knowledge of their language and culture. Daw, the first Native director for Behavioral Health describes the expertise of the Calricaraq team as heart skills that can’t be learned from books. “Western interventions are built primarily from books and depend on certification and a system that manages individual behavior by relying on an expert,“ he said. “That system is shunned by our elders and seen as a way to mask issues that individuals may have, issues that need to be addressed and cared for.”