The misuse and dependence of alcohol and drugs are related to theft, domestic violence, child abuse, disabling accidents, and occasional suicides. The results are broken families, deception, mistrust, neglect, separation from community and loved ones, isolation, resignation, and despair. Discussions between Alaskan tribal leaders and officials from the U.S. Department of Justice on sovereignty and criminal justice issues led to a desire for a village program that would directly confront alcoholism, drug abuse, mental illness, and criminal behavior. This study funded by the U.S. Department of Justice, Bureau of Justice Assistance and the Substance Abuse and Mental Health Services Administration examined the feasibility of developing a mental health and substance abuse center in a village that would offer both care and preventive services. The report is divided into three main chapters. The first chapter looks at the population of Native peoples and the dimensions of substance abuse and mental illness in Alaska. The next chapter describes the mental health programs that are available in Alaska and evaluates the care that is offered to individuals and families in rural and urban communities. The third and final chapter summarizes what was learned from extended visits to three villages: (1) the patterns of alcohol and drug use and related problems; (2) local opinions, through interviews, about existing mental health and other counseling services; and (3) community recommendations for the development of a family and residential treatment program. Tables and appendices