The state's role in suicide prevention programs for Alaska Native youth.

This paper is presented from the viewpoint of a regional state administrator for mental health services who has observed the implementation of Alaska's suicide prevention programs for several years. Other observers, or participants in those programs, might see their strengths and weaknesses in a different light. The region observed, Region Ill , is the most rural of the three mental health regions and has the highest percentage of Alaska Natives. It covers roughly three fourths of the state and includes only one urban area, Fairbanks. Although many Alaska Natives, like Indians in the "lower 48, " have migrated to urban areas, the majority still live in rural areas (about half live in communities with less than 1,000 population). These villages are extremely isolated by the standards of the contiguous United States; however, they have been massively influenced by Western technological society in the past 50 years. particularly so in the past 20. In the 1940s the Natives of Alaska still were the majority popu lation; less than 50 years later, in 1988, the estimated 81 ,200 Natives made up only 15% of the state's residents. In spite of a high birth rate and a decreasing infant death rate, they have been overwhelmed by a tide of white immigrants. With this tide came the many mixed blessings of the technological society, among them snow machines, television, schools, welfare checks, and the cash economy. Also considered a mixed blessing by some was the 1972 Alaska Native Claims Settlement Act (ANCSA), which created 12 regional Native corporations and many village corporations. These corporations were to manage the lands and resources to which the Native claims were now recognized. They also generated sister corporations that manage health and social services funded by state and federal governments through a variety of agencies. Three fourths of Region Ill's Community Mental Health Centers (CMHCs) are funded through a Native corporation. The Native population's relative political and economic impact was enhanced by ANCSA, which brought 11% of the state's land under the control of Native corporations. ANCSA was expected to raise Native standard of living and wellbeing. Native family incomes rose almost 40% between 1970 and 1980, educational levels rose, and the quality and quantity of housing stocks also rose. However, while the proportion of Native women working increased to equal that of Native men, the employment profile of Native Am er ic an I nd ia n an d Al as ka N at iv e M en ta l H ea lth R es ea rc h