Reducing the Incidence of Suicide in Indigenous Groups – Strengths United through Networks (RISING SUN)
RISING SUN is an initiative under the U.S. chairmanship of the Arctic Council, coordinated by the Sustainable Development Working Group, and designed as a follow-on activity to the mental wellness project of 2013-2015, led by Canada and collaborating countries. Whereas the project under the Canadian chairmanship of the Arctic Council focused on best practices from the literature and community-based interventions, RISING SUN is designed to take the next logical step: identifying a toolkit of common outcomes to be used in evaluating suicide prevention efforts to assess the key correlates associated with suicide prevention interventions across Arctic states. Common outcomes and their measures, developed through engagement with indigenous peoples’ organizations (i.e., Arctic Council Permanent Participants) and community leaders, as well as mental health experts, will facilitate data sharing, assessments, and interpretation of interventions across service systems in the Arctic region. The ultimate goal is to generate shared knowledge that will aid health workers in better serving their communities, and help policy-makers measure progress, evaluate interventions, and identify regional and cultural challenges to implementation. Arriving at common outcomes, their measures, and reporting systems is especially important in the Arctic, where the vast geography, high number of remote communities, and breadth of cultural diversity, pose challenges for systematic approaches to suicide prevention.
Partners & Sponsors
RISING SUN is a joint effort of the National Institute of Mental Health (NIMH), in collaboration with the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the Office of Global Affairs in the Department of Health and Human Services; the U.S. Department of State; the Canadian Institutes of Health Research; the National Institute of Public Health (Denmark); the Norwegian Institute of Public Health; and the Inuit Circumpolar Council.
The proposed approach for RISING SUN is an adaptation of the Delphi technique used for the NIMH Grand Challenges in Global Mental Health initiative. Panel members are selected to provide a representation of the diverse clinical, policy, advocacy, research groups, and communities whose interests are covered within the initiative’s scope of suicide prevention among indigenous Arctic populations. To this approach, we add a process for incorporating the viewpoints of key local stakeholders through face-to-face meetings across circumpolar regions to achieve a shared vision and inclusive priority-setting.
The Delphi method’s structured, sequential questioning with controlled feedback, complemented by regional face-to-face meetings for group consensus, is ideal for attaining the goals of this initiative: distilling knowledge and building reliable consensus to produce a toolkit of outcomes, their measures, and interventions to help reduce the incidence of suicide among indigenous communities of the Arctic.
Activities, Timing, and Outcomes
The core of RISING SUN will be a series of three meetings, accompanied by a virtual Delphi process to build consensus, during which we will move sequentially through the steps needed to arrive at a toolkit with common outcomes and their measures for Arctic suicide prevention efforts:
- Meeting 1 (Fall 2015, Anchorage, Alaska) was a workshop for key stakeholders including service providers, Arctic Council Permanent Participants and community leaders, researchers, survivors and families, and both regional and national government officials. Participants reviewed the suicide prevention landscape and the accomplishments of partnering countries, as well as the aims of the RISING SUN initiative, and provided feedback on efforts to develop a toolkit. Further input is being sought between Meetings 1 and 2 through the Delphi process.
- Meeting 2 (Spring 2016, Tromsø, Norway) convened participants to review stakeholder feedback, come to consensus on the best outcomes and measures available, specify gaps in available measures that may require further development, and identify potential implementation challenges (e.g., cultural and linguistic differences).
- Meeting 3 (Spring 2017, Iqaluit, Nunavut) focused on reporting the findings from the RISING SUN initiative including the outcomes from the Delphi process and in-person meetings; a discussion of methodological approaches; the form and function of the RISING SUN toolkit; the knowledge gaps that remain; and future opportunities for dissemination, implementation, and research.
This NIMH-led initiative resulted in an online RISING SUN Toolkit with common outcomes and available measures for suicide prevention efforts, applicable across the Arctic, to expand Arctic states’ capacity to evaluate the implementation of evidence-based interventions to combat suicide. An Executive Summary synthesizing results of the RISING SUN activities was also delivered at the end of the U.S. Chairmanship. Lastly, the SAG outlined Strategies for using the RISING SUN Toolkit (e.g., for evaluation of interventions), which can be implemented at the discretion of Arctic Council member states and their respective mental health stakeholders.
Roberto Delgado, Jr., PhD, Scientific Program Manager
Office for Research on Disparities and Global Mental Health (ORDGMH), NIMH/NIH
Tel: 1-301-443-4372 / E-mail: Rising-Sun@mail.nih.gov