Indigenous communities in the United States experience elevated risk for suicide for a number of reasons, including unredressed historical and cultural trauma. The presumed scientific rigor provided by randomized controlled designs has been described as culturally unacceptable and perhaps unethical in some tribal contexts. Community desire to address emerging health issues often takes precedence over the methodological demands of formal evaluation procedures. We describe two examples of suicide prevention efforts in indigenous communities.
Many communities have responded to the need for suicide prevention — particularly among young people — with:
Cultural Adaptation for Rural Native Hawaiian Communities
The Connect Suicide Prevention Program developed by National Alliance on Mental Illness - New Hampshire (NAMI-NH) is recognized as a National Best Practice Program. Using a combination of PowerPoint slides, interactive exercises, and case scenarios, the Connect Suicide Prevention Program uses a public health model to enhance participants’ abilities to recognize warning signs of suicide risk, increase their comfort level in connecting with youth who may be at risk, promote knowledge of risk and protective factors, and reduce stigma around mental health issues. Through Hawaii’s Caring Communities Initiative, the program was adapted to be more culturally appropriate for Native Hawaiian and Pacific Islander communities. For example, local experts identified the importance of time to build trust and connections between trainers and participants through extended introductions and time to “talk story.” Quick introductions that did not include all participants were not culturally acceptable. The program was also adapted to include more local images and examples, and to include more hands-on learning activities.
Locally-Developed Intervention for Alaskan Native Youth
The Village Wellness Team Program is a locally-developed, strength-based initiative of rural Athabascan Alaska Native villages to promote community resilience and wellness as a community-level universal suicide prevention effort. Central to the program is a local Village Wellness Team in each participating community, which is an independently functioning team of local volunteers who meet together to discuss village health issues and to plan activities to promote wellness in ways that respond to the unique needs of their particular village. The program model addresses community-determined suicide risk factors including language loss and loss of traditional cultural activities by sponsoring community wide events that preserve and teach traditional cultural practices.
What existing suicide prevention strategies in your community could be culturally adapted to support marginalized communities?
What locally-developed suicide prevention strategies support groups with marginalized identities in your community? How can these locally-developed strategies inform your community’s overall strategy?