Native American/Indigenous Youth and Suicide

Suicide rates among Indigenous Native Americans and Indigenous individuals are significantly increasing. It is crucial to acknowledge that Indigenous populations are diverse, with unique characteristics and experiences. This understanding should guide school teams and mental health services aimed at promoting suicide-safe care in Native American and Indigenous communities. Screening, treatment, and follow-up interventions should be tailored to address the specific challenges faced by each group.

Importance of Language

The use of affirming language is crucial for all cultures, but it holds particular significance for Indigenous communities. Using language that promotes acceptance rather than stigma can make a significant difference in whether Indigenous individuals accept or reject care. It is important to note that this document does not reference the term "American Indian." While this term is used in certain government contexts, many Indigenous people do not view it positively. Instead, terms like Indigenous, Native, and Tribal are culturally resonant, affirming, and better represent the experiences of Indigenous peoples today. Additionally, based on a poll conducted among Indigenous people across the country, it was decided that the term "Indian Country" is preferred over "Native America" to refer to the lands where Indigenous people reside.

Efforts will be made to minimize the use of labels. People should not be identified as inherently suicidal; rather, they may be experiencing suicidal thoughts or behaviors. Similarly, individuals should be recognized as experiencing challenges, being in recovery from, or having symptoms of various conditions, rather than being defined solely by those challenges. Labeling individuals based on their challenges, regardless of the nature of those challenges (substance use, mental health issues, suicidality, etc.), diminishes their humanity and reduces them to their struggles. Therefore, terms such as patient, client, and consumer will not be used. Instead, more respectful and inclusive terms like people/families receiving services, people seeking services, individuals, and people with whom we partner on their journey to recovery will be employed.

Protective Factors within Indigenous Populations:

  • Sovereignty

  • Community control

  • Cultural identification

  • Language

  • Spirituality

  • Healing practices

  • Kinship models

  • Family connectedness

Amplifying Cultural Continuity

When addressing suicidality among Native American and Indigenous youth, research shows the importance of amplifying cultural continuity as a protective factor and its role in promoting resilience on the community level, particularly in preventing suicide among Indigenous communities. Here are some key points:

  1. Protective Factors and Local Resources: Protective factors on the community level involve local resources that address specific challenges faced by the community. These resources contribute to resilience and can help prevent suicide.

  2. Cultural Meaning and Values: The effectiveness of protective factors depends not only on their availability but also on the local meaning and value they hold within the community. Different cultural settings have diverse value systems and worldviews, which influence the protective factors' utility.

  3. Historical and Colonial Processes: Understanding suicide and health inequalities requires acknowledging the historical and ongoing processes of colonization. These processes have a significant impact on observed patterns of suicide rates and health disparities.

  4. Cultural Continuity Theory: Cultural continuity theory emphasizes the role of culture and the continuity of cultural transmission in developing interventions for preventing suicide in Indigenous communities. It proposes that a shared sense of a traditional past and present facilitates the building of a collective future, providing a framework for intervention development.

  5. Self-Continuity and Narrativist Implicit Theories: Self-continuity at the individual level refers to the perception of interconnections between one's past, present, and future functioning. Cultural continuity is described as the parallel concept at the community level, emphasizing a shared sense of a traditional past and present. The theory acknowledges the fluidity of self-construal and the potential for personal and personality change, but also highlights the vulnerability to disruptive social influence.

  6. Social Disruption and Suicide Risk: During cultural transitions and social disruptions, the self-continuity of young people in Indigenous communities is particularly vulnerable, leading to increased suicide risk. Cultural continuity serves as a protective factor by moderating the risk of social disruption and preserving self-continuity on the individual level.

  7. Systems Perspectives and Aspirations: Cultural continuity theory incorporates systems perspectives, highlighting how context and culture nurture aspirations and the capacity to aspire. It emphasizes that culture provides an organizing frame, and young people use communal values and purpose to make sense of their lives and their place within the world.

  8. Proxy Measures of Cultural Continuity: Research by Chandler and Lalonde explored the influence of community efforts to regain control over their cultural life on suicide rates. They hypothesized that proxy markers of cultural continuity, such as self-governance, access to traditional lands, and cultural facilities, would inversely predict suicide rates. Language use was found to enhance the predictive power.

  9. Components and Barriers to Cultural Continuity: Cultural continuity encompasses various components, including involvement in ceremonies, spirituality, healing practices, and knowledge transmission. Personal narratives often reflect efforts to combat cultural disconnection. The research also identifies barriers to the continuity of Indigenous cultures, highlighting areas for intervention development.

Overall, it is important to highlight the importance of cultural continuity as a protective factor in preventing suicide in Indigenous communities, emphasizing the role of culture, historical context, and community resources in promoting resilience and addressing health disparities.

Importance of cultural values and continuity in Indigenous suicide prevention efforts:

  1. Cultural Disruption and Acculturative Stress: Indigenous youth in the USA and Canada often experience a significant contrast between their cultural values and the influences of their immediate environment, including media and schooling. This social disruption, coupled with limited economic opportunities, places high acculturative stress on young men, who are at greater risk of suicide.

  2. Cultural Continuity as a Protective Factor: Cultural continuity research emphasizes the role of cultural transmission in buffering risk factors for suicide among Indigenous youth. Programs that integrate cultural practices and promote renewed cultural integration in the community can help protect at-risk youth.

  3. Importance of Protective Factors: The research suggests that increasing protective factors has a greater impact on reducing the probability of suicide attempts than focusing solely on reducing risk factors. A multi-level intervention that includes community-level protective mechanisms holds promise in addressing the crisis of Indigenous youth suicide.

  4. Advancing Risk Research: Protective frameworks have advanced risk research in Indigenous suicide prevention by identifying previously unrecognized risk factors, such as the social disruption caused by colonialism. Anti-racist perspectives are now being recognized as essential in understanding suicide disparities.

  5. Challenges and New Approaches: Implementing Indigenous suicide prevention efforts faces challenges, including limited community acceptance of deficit-based approaches and the potential for stigmatization. A protective factor framework offers a strength-based and culturally responsive approach, avoiding exclusive focus on problems and failures and producing more measurable effects within small populations.

  6. Culture as Central to Protective Factors: Culture is considered a fundamental defining characteristic in understanding protection and resilience processes. Culturally patterned expressions of efficacy and communal mastery are predictive of suicide protection among Indigenous youth. Incorporating the cultural logic of settings into implementation strategies enhances intervention change processes.

It is critical to emphasize the central role of culture within a protective factor framework for Indigenous suicide prevention. There is a significant need to integrate cultural practices, promote cultural continuity, and address social disruption to effectively support Indigenous youth and reduce suicide disparities.

Recommendations for Screening Indigenous Youth for Suicidality

  • Screening processes should be culturally relevant (e.g. language referring to one’s “spirit”). Factors such as attitudes toward death and suicide, mental health and substance use issues, and help-seeking behavior should be taken into account as well.

  • Involve community Elders, Traditional Healers, and other key individuals who could offer feedback and suggestions on how to discuss suicidality

  • Educate school personnel on protective factors within Indigenous populations. Explore these protective factors during screening and safety planning.

Decolonizing Data Collection

The process of decolonizing the collection of Native youth data involves implementing several approaches. These include:

  1. Respecting and reflecting the diverse cultures, traditions, and needs of Native communities in the data collection process.

  2. Empowering Native youth to have agency in determining which data points are relevant and should be collected.

  3. Ensuring that Native youth are actively involved in interpreting the collected data, taking into account their perspectives and insights.