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Native American Youth Suicide

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Sarah Devlin

on 13 June 2013

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Transcript of Native American Youth Suicide

INTERVIEW PROCEDURES
How do health issues compare
with Native American youth on and
off reservations?

Particularly suicide
1989-1998, 462 Native American children and youth committed suicide.
Rates highest among those age 15 to 19 years.
52% of suicides were committed with a firearm, and more than one third were by hanging/suffocation.
1997–1998, suicide rates for Native American males were 5.2 times greater than rates for black males and 3.6 times greater than white males. The suicide rate for Native American females was 4.7 times greater than black females and 3.4 times greater than white females.
Suicide rates for Native American males and females remained unchanged from 1989 to 1998.
CDC Injury Prevention

http://www.cdc.gov/ncipc/pub-res/american_indian_injury_atlas/11d-Allmaps-suicide.htm
Suicidal Behavior in Urban American Indian Adolescents: A Comparison With Reservation Youth in a Southwestern State
Stacey Freedenthal, MSW and Arlene Rubin Stiffman, PhD
Comments/Statistics:

1981-1998, the average rate of completed suicide for American Indians aged 15-19 (20.5 per 100,000) was twice the national rate for all youth in the same age group (10.0 per 100,000) (Centers for Disease Control, 2002)
15%-30% of American Indian youth reporting a suicide attempt (Blum, Harmon, Harris, Bergeisen & Resnick, 2002)
Risk factors for suicide: higher than average rates of poverty, isolation, alcoholism, and other drug abuse (Frantz, 1999). However, American Indian adolescents may benefit by maintaining the cultural identity, community, and traditions that can accompany tribal life (Johnson & Tomren, 1999)
METHODS
American Indian Multisector Help Inquiry (AIM-HI), funded by the National Institute of Drug Abuse
One urban based, one reservation based
Same southwestern state, 20 miles away from each other
SAMPLE
300 reservation-based and 300 urban-based youth aged 12–20 for a brief interview. Records included names who dropped out or entered GED programs.
150 from each setting were randomly selected
The study added 50 youth from each site whose scores on the brief screening instruments, indicated they might have mental health or behavioral problems.
Final Study: 144 urban reared youth and 170 reservation reared
Average age: 15.6, 56.4% female
Conducted in 2001
The field supervisors and most of the interviewers were American Indian. AIM-HI held a 6-day training session for field supervisors and a 4-day training session for 11 interviewers.
Computer interviews.
All interviews were audio-taped.
No youth had intent to commit suicide that needed immediate attention
“Has there ever been a period when you thought about committing suicide?” “Did you ever try to end your own life (whether or not you thought about it ahead?)” “Do you feel this way now?”
CONTINUED...
Mental Health and Substance Abuse Problems: series of yes or no questions
Cultural Identity: questions of traditional American Indian activities such as memorials, healing ceremonies, naming ceremonies, giveaways, etc.
Social Indicators: five questions posed on family satisfaction
Social support: three separate questions on whether adolescents could depend on a family member, someone else such as a friend or a group.
Income: public assistance of youth or youth's family was used to represent income
RESULTS
Urban reared (16 years old) almost a year older than the reservation reared (15.2 years)
Both samples had slightly more girls than boys
More reservation reared youth stated their families used public assistance
21% of urban youth stated a history of suicide ideation and 32.6% of reservation youth
However, !8% reservation youth and 14% urban youth actually attempted
Other
Abuse History
Potential Protective Factors
Friends and Family Behavior
Mental Health & Behavioral Problems
Characteristics of Urban-and Reservation-Reared Youth
1.) Depression
16.7% Urban, 18.3% Reservation
2.) Conduct Disorder
14.6% Urban, 25.6% Reservation
3.) Alcohol Dependence/Abuse
7.7% Urban, 16.9% Reservation
4.) Substance Abuse/Dependence
18.1% Urban, 31.5% Reservation
5.) Cigarette Smoking
50.2% Urban, 65.5% Reservation
6.) Gang Involvement
6.3% Urban, 20.0% Reservation
7.) Police/Court History
34.0% Urban, 52.3% Reservation
1.) Friend attempted or completed suicide
31.0% Urban, 31.8% Reservation
2.) Family member attempted or completed suicide
13.3% Urban, 19.5% Reservation
3.) Family history of substance abuse or dependence
58.7% Urban, 67.0% Reservation
1.) Physical Abuse
15.0% Urban, 17.6% Reservation
2.) Sexual Abuse
8.9% Urban, 8.2% Reservation
1.) Reports discrimination due to native status
20.6% Urban, 40.1% Reservation
2.) Out-of-home placement
6.8% Urban, 13.9% Reservation
1.) Cultural Identity
8.7 Urban, 8.3 Reservation
2.) Social Support
2.2 Urban, 2.2 Reservation
3.) Family Satisfaction
20.1% Urban, 19.6% Reservation
4.) Grade Point Average
2.3 Urban, 2.1 Reservation
Arrest History
Substance Abuse/Dependence
Out-of-Home Placement
Family Substance Abuse History
Depression
Table 2. Bivariate Analysis of Psychosocial Characteristics' Associations with Attempted Suicide in Urban-Reared and Reservation-Reared American Indian Youth in a Southwestern State
Yes 13.1% Urban, 42. 4% Reservation
No 14.5% Urban, 12.1% Reservation
Conduct Disorder
Yes 28.3% Urban, 33.1% Reservation
No 11.9% Urban, 12.3% Reservation
Alcohol Abuse/Dependence
Yes 46.5% Urban, 38.9% Reservation
No 11.6% Urban, 13.3% Reservation
Yes 24.3% Urban, 26.2% Reservation
No 12.1% Urban, 13.7% Reservation
Cigarette Smoking
Yes 16.4% Urban, 24.1% Reservation
No 12.1% Urban, 5.5% Reservation
Gang Involvement
Yes 21.7% Urban, 23.8% Reservation
No 13.8% Urban, 15.5% Reservation
Yes 12.3% Urban, 22.8% Reservation
No 15.6% Urban, 11.5% Reservation
Friend Attempted/Completed Suicide
Yes 25.9% Urban, 26.1% Reservation
No 9.2% Urban, 12.5% Reservation
Family Member Attempted/Completed Suicide
Yes 39.6% Urban, 27.6% Reservation
No 10.5% Urban, 14.9% Reservation
Yes 16.5% Urban, 24.7% Reservation
No 11.4% Urban, 3.0% Reservation
Physical Abuse
Yes 33.4% Urban, 31.0% Reservation
No 11.1% Urban, 14.7% Reservation
Sexual Abuse
Yes 40.7% Urban, 45.5% Reservation
No 11.9% Urban, 14.6% Reservation
Yes 22.1% Urban, 36.0% Reservation
No 12.7% Urban, 16.9% Reservation
Discrimination
Yes 13.4% Urban, 28.6% Reservation
No 14.5% Urban, 10.8% Reservation
RISK FACTORS
history of previous suicide attempts, family history of suicide, symptoms of depression or other mental illness, alcohol or drug abuse, stressful life event or loss, easy access to lethal methods, exposure to the suicidal behavior of others and incarceration (CDC, 2008)
Mental Health Considerations
Ethnic/Cultural Considerations
American Indian/Alaska Native youth have more serious problems with mental health disorders related to suicide, such as anxiety, substance abuse, and depression (Olson, Wahab, 2006).
Mental health services are not easily accessible due to: lack of funding, culturally inappropriate services, mental health professional shortages, etc. (Ibid, Gone, 2004).
According to the U.S. Commission on Civil Rights, Native Americans experience higher rates of poverty, poor educational achievement, substandard housing, and disease (U.S. Commission on Civil Rights).
Pine Ridge Reservation, South Dakota
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