Suicide Prevention in American Indian and Alaska Native Communities: A Critical Review of Programs

Middlebrook, Denise; LeMaster, Pamela L.; Beals, Janette; Novins, Douglas K.; Manson, Spero M.

doi:10.1521/suli.31.1.5.132.24225

Cited by 89 publications

(78 citation statements)

References 44 publications

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“…First, our results support close attention to the many tribal health programs that have begun to encourage cultural spiritual orientations. These programs are becoming increasingly common but few (if any) have been systematically and empirically evaluated (Manson et al, 1989;Middlebrook et al, 2001). Our results suggest that the effort may be worthwhile.…”

Section: Discussionmentioning

confidence: 99%

“…On the one hand, some researchers have suggested that cultural spiritual commitments contribute to American Indian ''resiliency'' (Long & Nelson, 1999;see further Hill, Solomon, Tiger, & Fortenberry, 1993). Intervention and prevention programs aimed at suicide (and other social ills) among American Indians increasingly assume a positive association between cultural spirituality/culture and health, and their administrators report anecdotal evidence to support the assumption (Brave Heart & DeBruyn, 1998;Middlebrook, LeMaster, Beals, Novins, & Manson, 2001).…”

Section: Introductionmentioning

confidence: 99%

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Spirituality and attempted suicide among American Indians

Garroutte

Goldberg

Beals

et al. 2003

Social Science & Medicine

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139

110

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American Indians exhibit suicide-related behaviors at rates much higher than the general population. This study examines the relation of spirituality to the lifetime prevalence of attempted suicide in a probability sample of American Indians. Data were derived from a cross-sectional sample of 1456 American Indian tribal members (age range 15-57 yr) who were living on or near their Northern Plains reservations between 1997 and 1999. Data were collected by personal interviews. Commitment to Christianity was assessed using a measure of beliefs. Commitment to tribal cultural spirituality (or forms of spirituality deriving from traditions that predate European contact) was assessed using separate measures for beliefs and spiritual orientations. Results indicated that neither commitment to Christianity nor to cultural spirituality, as measured by beliefs, was significantly associated with suicide attempts (p trend for Christianity=0.22 and p trend for cultural spirituality=0.85). Conversely, commitment to cultural spirituality, as measured by an index of spiritual orientations, was significantly associated with a reduction in attempted suicide (p trend ¼ 0:01). Those with a high level of cultural spiritual orientation had a reduced prevalence of suicide compared with those with low level of cultural spiritual orientation. (OR=0.5, 95% CI=0.3, 0.9). This result persisted after simultaneous adjustment for age, gender, education, heavy alcohol use, substance abuse and psychological distress. These results are consistent with anecdotal reports suggesting the effectiveness of American Indian suicide-prevention programs emphasizing orientations related to cultural spirituality. r

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spirituality and attempted suicide among American Indians

Garroutte

Goldberg

Beals

et al. 2003

Social Science & Medicine

Self Cite

139

110

View full text Add to dashboard Cite

show abstract

“…In one review, Middlebrook, LeMaster, Beals, Novins, and Manson (2001) identified nine prevention programs that met Institute of Medicine criteria for evaluating preventive interventions (Mrazek & Haggerty, 1994). Of these, five targeted AI/ AN suicide among youths: the Zuni Life-Skills Development Curriculum (LaFromboise & Howard-Pitney, 1994), the Wind River Behavioral Program (Tower, 1989), the Tohono O'odham Psychology Service (Kahn, Lejero, Antone, Francisco, & Manuel, 1988), the Western Athabaskan Natural Helpers Program (May, Serna, Hurt, & DeBruyn, 2005), and the Indian Suicide Prevention Center (Shore, Bopp, Waller, & Dawes, 1972).…”

Section: Suicide Prevention and Treatment For American Indian And Alamentioning

confidence: 99%

Cultural considerations in adolescent suicide prevention and psychosocial treatment.

Goldston

Molock

Whitbeck

et al. 2008

American Psychologist

411

318

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Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community-based interventions are discussed, along with future opportunities for research in intervention development and evaluation.

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“…Although often taken for granted, sending this simple message could spark personal and community changes capable of preventing Inupiat youth suicide. Building relationships between healthy adults and young people has been found to be a deterrent to youth suicide in other Native populations (30,31), and has been touted as an essential element for positive youth development (32).…”

Section: Original Researchmentioning

confidence: 99%

Youth and adult community member beliefs about Inupiat youth suicide and its prevention.

Wexler¹,

Goodwin²

2006

International Journal of Circumpolar Health

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Objectives. To better understand youth and adult community members' perceived causes and possible preventative steps to address the high Inupiat youth suicide rates in Northwest Alaska. Study Design. A five-item, open-ended survey focusing on community members' perceptions of suicide causes, warning signs, and protective factors was administered in the twelve Native villages served by the Maniilaq Association, a native non-profit organization. Methods. A total of 382 surveys were completed. Qualitative answers were assigned to categories by two reviewers. Main categories are described reflecting the percentages of all response categories and those of youth and adult respondents. To discern whether the difference in proportion between adult and youth respondents was significant, a two-tailed z test was used to compare the two category proportions with their respective sample sizes. Results. The results showed that villagers believe that a community-based approach is most beneficial. Many risk factors for suicide were associated with alienation, and prevention strategies were linked to increased communication and connection with others, their culture and spirituality. The results also show that different perspectives are held by adults and youth. Adult respondents identified boredom as the primary reason for suicide. This-according to adult survey responses-can be addressed through programs offering young people activities, education, and a sense of culture. In contrast, the majority of young people attribute suicide to stress. The young respondents answers highlight the need for adults to talk to them about their everyday lives and their futures so that they receive the guidance and support they need to navigate difficulties that arise. Conclusions. These differing adult and youth conceptions of youth suicide prevention need to be aligned in order to create effective youth suicide prevention strategies for Inupiat and other Native populations. (Int J Circumpolar Health 2006;65(5):448-458.)

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Suicide Prevention in American Indian and Alaska Native Communities: A Critical Review of Programs

Cited by 89 publications

References 44 publications

Spirituality and attempted suicide among American Indians

Spirituality and attempted suicide among American Indians

Cultural considerations in adolescent suicide prevention and psychosocial treatment.

Youth and adult community member beliefs about Inupiat youth suicide and its prevention.

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