Indigenous Suicide Prevention Research and Programs in Canada and the United States: Setting a Collaborative Agenda
Bi-national conference organizers:
National Institute of Mental Health (NIMH)
Indian Health Service (IHS)
Division of Behavioral Health, Health Canada
Canadian Institutes of Health, Institute of Aboriginal Peoples' Health
Support provided by the organizers, as well as:
NIH Office of Rare Diseases (ORD)
NIH Office of Research on Women's Health (ORWH)
NIH Office of Behavioral and Social Sciences Research (OBSSR)
National Institute of Drug Abuse (NIDA)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Library of Medicine (NLM)
Substance Abuse and Mental Health Services Administration (SAMHSA)
In February 2006, a conference was convened to bring together representatives from research, service organizations, youth, community programs, and governments (across a range of countries, tribes, and villages) to share the most current information on Indigenous suicide, to find ways to foster communication and collaboration, and to form and support workgroups to bring substantive research and prevention efforts forward in a multi-year effort. The conference hosted participants from the United States, US Territories, and Canada. The goals of this bi-national effort were stated as:
- Fostering knowledge exchange regarding what works to prevent suicide in Indigenous communities, including best practices and promising strategies;
- Increasing the number of Indigenous researchers and research projects that utilize community-based participatory research methods;
- Promoting collaborative action for suicide prevention initiatives across borders.
Suicide in Indigenous communities has been the cause of great international concern, particularly as it has most significantly affected youth. Suicide is currently the second leading cause of death for American Indian and Alaska Native youth, ages 14 to 24, and is 2.5 times higher than the national average1. Suicide rates for Aboriginal youth are 5-7 times that of non-aboriginal youth, with the suicide rates for Inuit youth being among the highest in the world, at 11 times the national average in Canada2. Suicide rates have been steadily on the rise in Micronesia and Guam, with suicide being the leading cause of death among young men in Micronesia. Similarly, according to Hawaii state records, the rates of suicide for Native Hawaiians ages 15-24 year olds are about five times the national rate, and over seven times the national average rate for 25-44 year olds1.
Listed below are the major themes participants discussed throughout the course of the conference.
Language, Barriers and Definitions
Participants expressed the need for community-specific language and definitions through the discussion of the language and definitions concerning suicide and prevention.
- As Indigenous communities are individually governed and culturally diverse, there exists a need for community-specific language and approaches based on language, traditional knowledge, and cultural practices.
- Researchers and practitioners need to be aware of and work within the language, approaches, and definitions of diverse communities.
- Shame, taboos, and readiness to discuss the issue of suicide are common barriers to prevention for many Indigenous communities.
- Prevention in Indigenous communities needs to be focused on life-affirming messages and strategies, rather than on suicide and death.
Cultural Knowledge and Health Determination
Indigenous participants expressed strong agreement that cultural knowledge, beliefs, and practices need to be the basis of understanding and determining the health of communities.
- Suicide needs to be understood within the cultural and historical context of colonization and globalization for Indigenous cultures.
- Traditional knowledge, along with the roles of Elders and spiritual leaders needs to be respected as a basis of community health.
- The issue of self-governance is central to the experience of health and is an important factor in determining Indigenous community health.
- The quality of relationship between government agencies, policy makers, and community members can also be an important factor in developing successful and sustainable prevention efforts.
Research, Best Practices, and Capacity Building
A central theme of the conference was the recognition of the importance of Indigenous communities involvement at all levels of research, planning, and service delivery to create successful prevention programs that are truly community-led and driven.
- Researchers need to be trained and aware of the unique cultural practices and protocols of a community prior to initiating work.
- Capacity building needs to happen at all levels in order to develop the competencies and relationships needed for collaboration.
- The development of culture-specific programs can help integrate systems and services towards the goal of suicide prevention.
- Funding agencies need to support long-term initiatives for suicide research efforts to be more successful in Indigenous communities.
Networking, Communication, and Collaboration
Throughout the working groups, participants shared suggestions for ways to continue the collaborations started at the conference and to expand the network to include other partners who also need to be part of the discussion around suicide prevention.
- Participants suggested that communication between Indigenous communities and programs be supported by formal networks, for the sharing of data, best practices, funding information, and other resources.
- Collaboration needs to be built across services and disciplines in order to create better suicide response and prevention strategies.
- Relationships between programs, researchers, and policy makers need to be strengthened in order to build long-term research and prevention initiatives in Indigenous communities.
- Working groups need to be convened to work on special topics, such as youth, and regional specific needs and approaches.
Conclusions and Outcomes
- Representatives from many Indigenous communities were able to gather and share information specifically about suicide and suicide prevention across international boundaries.
- An international list-serve was established to allow participants to maintain an open dialogue regarding resources and issues.
- Indigenous researchers, along with other researchers working in Indigenous communities, were able to meet and form networks to enhance the state of suicide prevention research internationally.
- A working group for youth was convened at the conference, with an outcome being the creation of the International Indigenous Youth for Life Council and leadership for planning future youth events.
- A special working group for the Caribbean, Pacific Islands, and US Territories was also convened to form working relationships.
- Peer to peer support was provided through the working group sessions and network opportunities at the conference.
- As a result of this conference, a number of participating programs are in the process of adjusting their program models and plans.
- Following the suggestions made by the working groups on the final day, plans were made to support continued collaboration by convening suicide prevention working groups and meetings at the next IHS/SAMHSA Mental Health Conference in June of 2006.
1. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (accessed 2006).
2. Langlois S, Morrison P (2002). Suicide deaths and suicide attempts. Health Reports 13(2): 9-22.