Suicide Prevention Strategies for American Indian/

Alaska Native Youth:

Understanding the Importance of Culture

Teresa LaFromboise, PhD lafrom@stanford.edu

Community-Driven Approach: American Indian Life Skills

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Pueblo of Zuni

24

20

16

12

8

4

0

Males Females

Acculturation

Stress

Historical Trauma

Pervasive Poverty

 Community

Violence 

Family Disruption 

Interpersonal Problems

 

Depression

Substance Abuse

Psychological Disorder

Age/Gender

Indi

vidu

al F

acto

rsSo

cial

Fac

tors

Ecol

ogic

al F

acto

rs

AILS Intervention

ResilientAdaptation

Effective Problem Solving

Positive Thinking

Ineffective Problem Solving

Negative Thinking

Suicide

ApproachCoping

AvoidantCoping

Stress

LaFromboise & Fatima, 2011

Risk Factors Intervention Mediating Factors Outcome Variables

Historical Trauma

Loss stemming from HT (daily or more thoughts about their tribe’s loss of land) is often on the minds of 20.5% of Native adolescents in the 11 to 13-yr. old age group . Whitbeck et al., 2009

Acculturation Stress

Vulnerable negative mental health outcomes: anxiety, depression, feelings of marginality, heightened psychosomatic symptom levels, and identity confusion

Suicide rates were positively associated with acculturation stress and negatively associated with traditional integration in 18 tribes (Lester, 1999).

Substance Abuse

Of the 10 leading causes of death among Native adolescents, at least 3 are related to heavy alcohol use: Accidents, suicide, and homicide (Indian Health Service, 2002).

Community Violence

• Meichenbaum reported on 85 Inuit youth sexually abused by a teacher: suicide rate of Inuit males was 119/100,000. Suicide rate among the cohort of sexually abused Inuit male youth: 200/100,000.

American Indian Life SkillsTarget Skills

• Open communication • Handling depression • Stress management• Anger regulation• Suicide prevention• Goal setting

Positive thinking / Problem solving

Effectiveness of the American Indian Life Skills (N=128)

Student Posttest Survey• Hopelessness • Confidence in ability to manage anger Behavioral Role Play Study • Peer suicide intervention skills• Peer problem solving skills

Effectiveness of Public Health Approach for Suicide Prevention

May et al., 2005

San Juan County PartnershipEvaluation of AILS (N=90)

Effect of Time on Outcomes at Post-Test Controlling for Pretest Scores

Hopelessness* Suicide Risk * Public Collective Esteem* (What participants believe others think

about their race/ethnicity) Self-Efficacy**Self-Awareness*** *p<.05, **p<.01. ***p<.001

Thank You