Suicide Prevention in Australian Aboriginal Communities: A Review of Past and Present Programs

A review of Aboriginal suicide prevention programs were conducted to highlight promising projects and strategies. A content analysis of gray literature was conducted to identify interventions reported to have an impact in reducing suicidal rates and behaviors. Most programs targeted the whole community and were delivered through workshops, cultural activities, or creative outlets. Curriculums included suicide risk and protective factors, warning signs, and mental health. Many programs were poorly documented and evaluations did not include suicidal outcomes. Most evaluations considered process variables. Results from available outcome evaluations suggest that employing a whole of community approach and focusing on connectedness, belongingness and cultural heritage may be of benefit. Despite the challenges, there is a clear need to evaluate outcomes if prevention is to be progressed.     

A Protective Factors Model for Alcohol Abuse and Suicide Prevention Among Alaska Native Youth

This study provides an empirical test of a culturally grounded theoretical model for prevention of alcohol abuse and suicide risk with Alaska Native youth, using a promising set of culturally appropriate measures for the study of the process of change and outcome. This model is derived from qualitative work that generated an heuristic model of protective factors from alcohol (Allen et al. in J Prev Interv Commun 32:41–59, 2006; Mohatt et al. in Am J Commun Psychol 33:263–273, 2004a; Harm Reduct 1, 2004b). Participants included 413 rural Alaska Native youth ages 12–18 who assisted in testing a predictive model of Reasons for Life and Reflective Processes about alcohol abuse consequences as co-occurring outcomes. Specific individual, family, peer, and community level protective factor variables predicted these outcomes. Results suggest prominent roles for these predictor variables as intermediate prevention strategy target variables in a theoretical model for a multilevel intervention. The model guides understanding of underlying change processes in an intervention to increase the ultimate outcome variables of Reasons for Life and Reflective Processes regarding the consequences of alcohol abuse.     

A Systematic Review of Suicide Prevention Programs for Military or Veterans

Military personnel and veterans have important suicide risk factors. After a systematic review of the literature on suicide prevention, seven (five in the U.S.) studies of military personnel were identified containing interventions that may reduce the risk of suicide. The effectiveness of the individual components was not assessed, and problems in methodology or reporting of data were common. Overall, multifaceted interventions for active duty military personnel are supported by consistent evidence, although of very mixed quality, and in some cases during intervals of declines in suicide rates in the general population. There were insufficient studies of U.S. Veterans to reach conclusions.     

Centering culture in the treatment of opioid use disorder with American Indian and Alaska Native Communities: Contributions from a National Collaborative Board

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation oversight provided by the CB. These proceedings provided a foundation for ongoing CB work and a frame for developing the program-level implementation intervention using a strength-based and holistic model of OUD recovery and wellbeing. Topics of discussion posed to the CB included engagement and recovery strategies, integration of extended family traditions, and addressing stigma and building trust with providers and clients. Integration of traditional healing practices, ceremonies, and other cultural practices was recommended. The importance of centering AI/AN culture and involving family were highlighted as priorities for the intervention.     

Substance Use Among Native American Indian Youth: A Selected Review of Causality

The author presents a selected review of substance use causality among Native American Indian youth. A review of selected empirical research relative to substance use is given. In addition, selected examples of research-oriented implications and practical suggestions are offered.     

Project HOPE: Implementing Sensory Experiences for Suicide Prevention in a Native American Community

Suicide remains a significant problem for Native American populations; however, culturally appropriate interventions are lacking (Suicide Prevention Resource Center, 2011 Suicide Prevention Resource Center . ( 2011 ). Suicide Among American Indians/Alaska Natives. Retrieved from http://www.sprc.org/library/ai.an.facts.pdf  [Google Scholar]). Occupational therapy practitioners can aid in suicide prevention and intervention (American Occupational Therapy Association, 2005). This study presents a culturally appropriate program and research project following a community-based participatory research design that explores the impact of a sensory curriculum for suicide prevention on Native American youth. The perceptions of the young peoples' sensory experiences are explored. Evidence from the study demonstrates the value of exploring the use of occupational therapy intervention in Native American communities to address significant health concerns.     

7 Suicide: The Scourge of Native American People

Reportedly, Native Americans have a rate of suicide that is greater than any other ethnic group in the United States, especially in the age range of 15–24. Many who are concerned as to why this is the case offer a variety of theories. Most of the theories have yet to be tested. This particular presentation focuses on the traditional tribal structure of most Native Americans and events of history that have impacted the cultures of Native American Tribes. The particular events covered refer to Western education, various religions, and legislation as playing a most significant role in impacting the cultures of Native Americans. With the hope that we can all work together to diminish the scourge of Native American people, I repeat the words of Chief Seattle, “… be just and deal kindly with my people.”     

A Systematic Review of Trauma Interventions in Native Communities

American Indian/Alaska Native and First Nations communities suffer from health disparities associated with multiple forms of trauma exposure. Culturally appropriate interventions are needed to heal current and historical trauma wounds. Although there are evidence-based trauma interventions for other populations, few have been implemented or evaluated with Native communities. Understanding the extant research on trauma interventions in Native communities is crucial for advancing science and filling gaps in the evidence base, and for meeting the needs of underserved people. In this systematic review of the literature on trauma interventions in Native communities in the United States, Canada, Australia, and New Zealand, we identified 15 studies representing 10 interventions for historical and/or current trauma. These studies involved the community to some extent in developing or culturally adapting the interventions and suggested positive outcomes with regard to historical and interpersonal trauma symptoms. However, notable limitations in study design and research methods limit both internal validity and external validity of these conclusions. Only one study attempted (but did not achieve) a quasi-experimental design, and small sample sizes were persistent limitations across studies. Recommendations for researchers include working in partnership with Native communities to overcome barriers to trauma intervention research and to increase the rigor of the studies so that ongoing efforts to treat trauma can yield publishable data and communities can secure funding for intervention research.     

Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention

American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre‐existing interview data from 15 self‐identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community's knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models.     

The Effectiveness of Suicide Prevention Centers: A Review

This article reviews 14 studies examining whether suicide prevention centers have a preventive effect on suicide rates. Seven studies were identified that provide some support for a preventive effect, one found an increase in the suicide rates, and six failed to find any significant effects (either preventive or facilitative). The studies' different methodologies are reviewed, and limitations on the authors' conclusions pointed out. The conclusion of this article is that the evidence provides support for a preventive effect from suicide prevention centers, albeit small and inconsistently found.     

Suicide among American Indian adolescents: an overview

Suicide has become a major concern of many Indian tribes and pueblos, as the rates in these tribes have increased dramatically in the last decade. One of the critical research questions is how to explain the vastly different rates of adolescent suicide among tribes. Research has identified some common patterns in experience and behavior among Indian adolescent suicides; these patterns are similar in many ways to those found in Los Angeles suicide research of Teicher (1979). Chronic versus acute stress factors in suicide are examined. Recent research has also identified a number of factors characterizing tribes with high suicide rates; these include failure to adhere to traditional ways of living, to traditional religion, and to clans and societies, and the resulting chaotic family structure and adult alcoholism. The roles of adoption of Indian children, boarding schools, and high unemployment in many tribes are also discussed. Suicide prevention and intervention programs are briefly described.     

Beyond the Belmont Principles: A Community‐Based Approach to Developing an Indigenous Ethics Model and Curriculum for Training Health Researchers Working with American Indian and Alaska Native Communities

Individuals responsible for carrying out research within their diverse communities experience a critical need for research ethics training materials that align with community values. To improve the capacity to meet local human subject protections, we created the research Ethics Training for Health in Indigenous Communities (rETHICS), a training curriculum aligned within American Indian and Alaska Native (AI/AN) context, culture, and community‐level ethical values and principles. Beginning with the Belmont Report and the Common Rule that defines research with human subjects (46 CFR 45), the authors convened three different expert panels (N = 37) to identify Indigenous research values and principles common across tribal communities. The resulting culturally grounded curriculum was then tested with 48 AI/AN individuals, 39 who also had recorded debriefing interviews. Using a thematic analysis, we coded the qualitative feedback from the expert panel discussions and the participant debriefings to assess content validity. Participants identified five foundational constructs needed to ensure cultural‐grounding of the AI/AN‐specific research training curriculum. These included ensuring that the module was: (a) framed within an AI/AN historical context; (b) reflected Indigenous moral values; (c) specifically linked AI/AN cultural considerations to ethical procedures; (d) contributed to a growing Indigenous ethics; and (e) provided Indigenous‐based ethics tools for decision making. Using community‐based consultation and feedback from participants led to a culturally grounded training curriculum that teaches research ethical principles and procedures for conducting research with AI/ANs. The curriculum is available for free and the community‐based process used can be adapted for other cultural groups.     

Synergetic Counseling and Native American Indian Students

Traditional school counseling efforts have often failed to meet the needs of Native American Indian students. Because many Native American Indian students have spiritual as well as secular concerns, school counselors must become more emphatic and competent in serving these students. This article argues that synergetic counseling efforts with Native American Indian students increase counseling effectiveness. A vignette and suggestions are offered toward that end.     

A Review of Faith-Based HIV Prevention Programs

HIV disproportionately affects people of color, suggesting a need for innovative prevention programs and collaborations as part of prevention efforts. African Americans have close ties to the church and faith-based organizations. African American faith communities were slow to address HIV prevention, but in recent years, they have become more involved in such activities. This study reviews the empirical literature on faith-based HIV prevention programs among African American populations. Several successful faith-based/public health collaborations are identified, and the limitations and strengths of faith-based prevention programs are discussed. Recommendations are provided for developing effective faith-based/public health collaborations.

Psychological and demographic correlates of early academic skill development among American Indian and Alaska Native youth: a growth modeling study

Research regarding the development of early academic skills among American Indian and Alaska Native (AIAN) students has been very limited to date. Using a nationally representative sample of AIAN, Hispanic, African American, and White children at school entry, the authors used latent growth models to estimate the associations among poverty, low parental education, living in a rural location, as well as child attitudes toward learning and internalizing/externalizing behaviors, with mathematical and reading cognitive skill development across the 1st 4 years of school. Results indicate that AIAN children entered kindergarten with scores on both mathematical and reading cognitive tests that were comparable to their peers from other ethnic groups of color. Importantly, all children who entered kindergarten with lower cognitive skill scores also acquired skills more slowly over the next 4 years. Having a positive approach to learning at the start of kindergarten was associated with cognitive skill levels at school entry nearly 1 standard deviation above the population average. Results are discussed with reference to the shared early educational profiles observed between AIAN and other children of color. These findings provide a much-needed update regarding early academic development among AIAN children.