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Suicide Prevention Strategies for American Indian/ Alaska Native Youth: Understanding the Importance of Culture Teresa LaFromboise, PhD [email protected]


Community-Driven Approach: American Indian Life Skills

24 20 Pueblo of Zuni 16 12 8 4 0 Males Females

Risk Factors Intervention Mediating Factors

Outcome Variables

Acculturation Stress Historical Trauma Pervasive Poverty Avoidant Coping Community Violence Family Disruption Interpersonal Problems Depression Substance Abuse Psychological Disorder Age/Gender Stress AILS Intervention Approach Coping Ineffective Problem Solving Negative Thinking Suicide Effective Problem Solving Resilient Adaptation Positive Thinking

LaFromboise & Fatima, 2011

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 Skills Target Skills Positive thinking / Problem solving

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

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 Partnership Evaluation 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