Culturally Appropriate Evaluation of Tribally Based Suicide Prevention Programs: A Review of Current Approaches

f A l l 2 0 1 2 W I C A Z O S A R E V I E W Suicide is a major health challenge in American Indian/Alaska Native (AI/AN) communities, particularly among youth. In 2004, suicide was the second leading cause of death for AI/ANs of all age groups, and the rate was higher than that for the general population. Among 10–14 year olds, 13.5 percent of deaths were from suicide, which is nearly twice the national rate of 7.2 percent.1 Rates of suicide attempt are highest for AI/AN young women, while young men are the most likely to complete suicide. In 2004, among 15–19 year old AI/ AN males, 32.2 percent of deaths were from suicide, which was 2.5 times the rate for males of all races in this age range (12.6 percent).2 Many factors contribute to the high prevalence of suicide in AI/AN communities, including mental illness, substance abuse, feelings of hopelessness or isolation, impulsive behavior, and a history of violence, substance abuse, or mental illness in their families. AI/ANs as a group also have specific risk factors for suicide, including historical trauma, such as boarding school experiences, high rates of poverty, unemployment, and geographic isolation.3 To assist tribes in preventing youth suicide, the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS) published a detailed resource guide in 2010.4 The guide is titled To Live to See the Great Day That Dawns: Preventing Suicide by American Indian and Alaska Native Youth and Young Adults, and provides a comprehensive review of research studies and programs related Culturally Appropriate evaluation of tribally based suicide Prevention Programs A review of Current Approaches