Toward Understanding Suicide Among Youths: Results From the White Mountain Apache Tribally Mandated Suicide Surveillance System, 2001–2006

Abstract

Objectives. We examined suicide and suicide attempt rates, patterns, and risk factors among White Mountain Apache youths (aged < 25 years) from 2001 to 2006 as the first phase of a community-based participatory research process to design and evaluate suicide prevention interventions. Methods. Apache paraprofessionals gathered data as part of a tribally mandated suicide surveillance system. We compared findings to other North American populations. Results. Between 2001 and 2006, 61% of Apache suicides occurred among youths younger than 25 years. Annual rates among those aged 15 to 24 years were highest: 128.5 per 100 000, 13 times the US all-races rate and 7 times the American Indian and Alaska Native rate. The annual suicide attempt incidence rate in this age group was 3.5%. The male-to-female ratio was 5:1 for suicide and approximately 1:1 for suicide attempts. Hanging was the most common suicide method, and third most common attempt method. The most frequently cited attempt precipitants were family or intimate partner conflict. Conclusions. An innovative tribal surveillance system identified high suicide and attempt rates and unique patterns and risk factors of suicidal behavior among Apache youths. Findings are guiding targeted suicide prevention programs.

Spatial-temporal trends and risk of suicide in Central Brazil: an ecological study contrasting indigenous and non-indigenous populations

“…Evidence also points to ethnic inequality in suicide in Brazil, with notable excess suicide mortality in the indigenous population. This is similar to observations from around the world, notably in Canada, 3 Norway, 4 the United States, 5 Russia, 6 and Australia. 7 The state of Mato Grosso do Sul, Brazil, has the highest suicide mortality rate among indigenous people in the country.…”

“…This is an alarming nuance that has been little considered in the specialized literature, which usually directs its concerns to young indigenous males. 5,17,25 We therefore propose that research be undertaken to understand the influence of different factors on the high suicide mortality rate among indigenous girls in Mato Grosso do Sul. According to Hamlin & Brym, 12 ethnographic studies of Guarani women suggest that the alarming rates of suicide, especially among youths, could also be related to repercussions of the rearrangements of the Guarani family structure in the last few decades, expressed as work overload, exposure to new forms of sexual exploitation, and frustration with the requirement of traditional marriage at early ages.…”

“…Such findings are very similar to those observed among natives of Australia's Northern Territory, 7 but differs from what has been found in the young indigenous population of the United States and Alaska, where hanging and firearms were the most common methods and used equally frequently. 5 Various cultural factors have been pointed out in the literature as important for choosing the method of suicide. 37 In Guarani, the term jejuvy, which could be translated to squeezing the throat, is used to refer to hanging.…”

Desigualdades na mortalidade por suicídio entre indígenas e não indígenas no estado do Amazonas, Brasil

“…Há também registro de elevadas taxas de mortalidade por suicídio em grupos indígenas brasileiros específicos como no caso dos Guarani Kaiowá e Ñandeva 6 . Ademais têm sido reiteradamente encontradas elevadas taxas de mortalidade por suicídio em populações nativas do Canadá, Estados Unidos da América, Austrália e Noruega, para citar alguns exemplos [18][19][20] . Tais evidências em conjunto atestam que elevadas taxas de mortalidade por suicídio em indíge-nas, definitivamente, não são uma exclusividade do estado do Amazonas, nem do Brasil.…”

Understanding the Relationship between Substance Use and Self-Injury in American Indian Youth

“…The WMAT has approximately 15,500 enrolled tribal members who live on the Ft. Apache Reservation in rural eastcentral Arizona. The surveillance system was created by Tribal Resolution in 2001 following a cluster of youth suicide deaths, and it has been described in detail in previous publications (5,6). The original tribal mandate required community-based reporting of suicide deaths, attempts, and ideation by all health and human service agencies and tribal citizens to a centralized suicide prevention data management team.…”