Suicide among Native Americans in the United States
[8] Interpersonal relationships,[9] community environment,[1][8][9] spirituality,[10] mental healthcare,[8] and alcohol abuse interventions[1][9] are among subjects of studies about the effectiveness of suicide prevention efforts.
[11] Citing Devereux, Lester explains that "The modern Mohave seems to be more involved with lovers and spouses than was the case in the past, and there is an accompanying reduction in the affective commitment to and emotional dependence on the kin group and the tribe as a whole.
[8] Alcántara provides examples of this heterogeneity by contrasting links to suicidal ideation found in three different tribes: one in the Southwestern, one in the Northern Plains, and one in the Pueblo region.
[1] Alcántara and Gone cite a study showing that incidence of Native American youth suicide attempts is associated with unintentional injury, violence, risky sexual activity, and tobacco, alcohol, and drug use.
[16] In the sample of Northern Plains reservation residents mentioned by Alcántara and Gone, females and young people had comparatively higher suicidal thoughts, plans, and attempts.
[8] Dillard, et al. conducted a study of a tribally owned and operated health center in Anchorage, Alaska, where a majority 58% of suicide-related visits were by women.
[17] In a study of 212 Native youths (of the average age of 12) living on or near reservations in the upper Midwestern United States, Yoder et al. found that the girls were more than twice as likely to think of suicide than the boys.
[8] Reservation youth suicide was associated with depression, conduct disorder, cigarette smoking, family history of substance abuse, and perceived discrimination.
[8] Their report shows that healthy, supportive relationships and strong communication between the individual and friends, family, and tribal leaders are critically instrumental in protecting against suicide risk.
[8] In the American Journal of Public Health, Berman reports that lower rates of suicide among young rural Alaska Native men were associated with areas of higher incomes, more married couples, and presence of traditional elders.
[8] This information supports the use of prevention which targets the community's interaction with environmental factors as well as the environment itself, instead of person-focused interventions based on the suicide risk continuum model, in which ideation predicts attempt.
[8] Olson and Wahab endorsed targeted prevention of individuals with previous attempts or ideation, along with broad public health interventions involving community collaboration.
[1] A 2003 report by Garroutte found that among 1,456 Northern Plains tribal members, cultural spiritual orientation was associated with less suicide attempts after controlling for age, gender, education, psychological distress, and alcohol use.
[1] A combination of lower salaries offered by the IHS, isolated reservation locations, and seriousness and number of cases make it hard for Native American health providers to attract and retain workers.
[1] The mistaken belief that the IHS is sufficiently equipped to provide quality care endangers Native American communities to insufficient funding and protective policies.
[1] In 2013, Doll and Brady cited the Suicide Prevention Resource Center to explain that both professional health worker shortages and lack of cultural competence training contribute to these communities' systems' inefficacy.
However, academics such as Olson and Wahab, Alcántara and Gone, and Lester acknowledge that more and better data collection, research, and funding is needed to improve the response to both suicide and the problems underlying it.
[20] Research that focuses on Native Americans as if they are a homogeneous group can problematically obscure important information that may be specific to certain regions, communities, or sectors of the population.
