Tribally Based Suicide Prevention Programs: A Review of Current Approaches

Suicide is a major health challenge in American Indian/Alaska Native (AI/AN) communities, particularly among the youth. In 2004, suicide was the second leading cause of death for AI/ANs of all age groups. Among individuals between ten and fourteen years old, 13.5% of deaths were from suicide, which is nearly twice the national rate of 7.2%.1 Many factors contribute to the high prevalence of suicide in AI/AN communities, including individual factors (mental illness, substance abuse, feelings of hopelessness or isolation, impulsive behavior, and a history of violence, substance abuse, or family history of mental illness) and group factors (historical trauma, poverty, unemployment, and geographic isolation).2 Actions are needed at both the federal and tribal levels to prevent suicide, and some initial important steps have been taken. To address the challenges of youth suicide in Indian Country, a bill titled 7th Generation Promise: Indian Youth Suicide Prevention Act of 2009 was incorporated into health care reform legislation enacted in March 2010 (Patient Protection and Affordable Care Act, 2010).3 This legislation authorizes two demonstration projects aimed at preventing youth suicide in AI/AN communities. 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 tribally Based suicide Prevention Programs a review of Current approaches