Tai Paquin, LADAC

Last month, we held a webinar dedicated to the topic of tribal community partnerships. This presentation emphasized the importance of seeking out community partners to provide support and resources for the integration of mental health services. This webinar also coincided with Suicide Prevention Month, a month-long observance aimed at encouraging open dialogues, reducing stigma associated with mental health issues, and encouraging individuals to seek assistance. Throughout the month, some BH2I grantees participated in their own initiatives designed to raise awareness about this issue. However, discussing the topic of suicide in Native Communities presents significant challenges.

To address the rates of suicide in American Indian and Alaska Native (AI/AN) communities involves navigating the complexities of historical trauma, cultural disconnection, and limited access to mental health resources. The remote location of some communities complicates the issue by making it challenging to access timely and culturally sensitive mental health services, which can hinder effective intervention and support. AI/AN communities require multi-level targeted interventions, with each level playing a crucial role in preventing suicide and promoting mental health and well-being. Moving forward, I will delve deeper into some strategies for community interventions.

  • Routine Risk Assessment & Screening. It is important to strive to target common risk factors, including mental health conditions, substance abuse, prior suicide attempts, family history of suicide, and/or recent life stressors or losses. As well as implementing screening tools such as the Columbia-Suicide Severity Rating Scale (C-SSRS) or the Patient Health Questionnaire (PHQ-9) to assess patients for suicidal ideation and behaviors. These actions can be taken regularly, especially for individuals with risk factors such as depression, substance abuse, or trauma history.
  • Crisis Intervention and Hotlines. Establishing Native-focused suicide prevention hotlines and crisis intervention services that offer immediate support and understanding of Native cultural contexts. This could be an adjunct to a “warm hand off” phone, or also a dedicated phone for on-call support to public safety departments.
  • School Programs. Introducing mental health and wellness education in tribal schools, alongside programs that promote cultural identity, self-esteem, and resilience. These can support youth in developing protective factors such as healthy relationships, problem-solving, and emotional regulation skills and can also help reduce the risk of future suicidal behaviors. Initiatives such as these include psychoeducational groups, mobile crisis units, teen centers, and mindfulness spaces.
  • Peer Support Networks. Training community members, especially youth and elders, to serve as peer mentors or suicide prevention advocates. These individuals can provide direct support to those struggling with mental health issues and help connect them to necessary resources.
  • Incorporating Spiritual and Community Resources. Providing access to mental health professionals who are trained in or sensitive to AI/AN cultural practices, including traditional healing methods. This might include integrating counseling with tribal ceremonies or spiritual practices. These may include talking circles, sweat lodges, or communal ceremonies to address grief, trauma, and emotional health.
  • Crisis Response Protocols. Assisting schools and/or first responders in establishing clear and consistent protocols for responding to suicide threats or behaviors. This includes immediate intervention steps, such as contacting school counselors, local mental health professionals, and families, and ensuring individuals receive immediate and necessary support.
  • Suicide Prevention Training. Encourage community, school staff, tribal departments, and public safety providers to receive regular training in suicide prevention, crisis intervention, and mental health first aid. This training equips them with the skills to recognize and respond appropriately to signs of suicide risk and refer individuals to appropriate resources. As IHS collaborators, you are welcome to utilize the Sister Sky team in QPR (Question, Persuade, Refer) Training for free. If you would like more information please contact your Sister Sky, Inc. team.
  • Social Marketing & Language Access. Developing media campaigns that promote mental health awareness, cultural pride, and positive role modeling in Native communities. These efforts could be made to ensure that suicide prevention materials and mental health resources are culturally sensitive and available to be translated into the local Native language(s). Such strategies can utilize cultural liaisons or community leaders that are trusted within the community.
  • Collaborative Partnerships. Forming partnerships between tribal governments, non-profit organizations, healthcare providers, and federal agencies to create sustainable mental health and suicide prevention programs. For some BH2I sites, collaborative efforts such as partnerships with university or state clinical programs ensure resources are pooled into their communities.
  • Post-Hospitalization Support. Clients hospitalized for suicide risk should be discharged with plans that include comprehensive follow-up care. These plans could include a detailed safety plan and assured access to essential support services, such as outpatient therapy, community-based programs, and other mental health resources. Additionally, integrating care coordination programs into this process to ensure continuity of care and support.

In summary, key strategies for addressing suicide in AI/AN communities include regular risk assessments, incorporating spiritual and community resources, crisis intervention, school-based programs, youth leadership, peer support networks, and the sharing of cultural knowledge. Equally important are training community members in crisis management, promoting mental health awareness through social marketing, building collaborative partnerships, and offering structured support after hospitalization. These approaches can all play a role in fostering mental well-being and preventing suicide in AI/AN communities.