Appendix A

Statement of Task

The Office of the Assistant Secretary for Health (OASH), in collaboration with the Indian Health Service (IHS), the Centers for Disease Control and Prevention (CDC), the National Institute of Mental Health (NIMH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Substance Abuse and Mental Health Services Administration (SAMHSA), is cosponsoring a National Academies of Sciences, Engineering, and Medicine (NASEM) public workshop to explore the current scope of activities, gaps, challenges, and opportunities to prevent death by suicide in American Indian/Alaska Native (AI/AN) people. Small-group discussions will focus on unique considerations in subgroups to include children and youth, young adults, middle-aged individuals, and the elderly. The NASEM workshop will feature invited presentations and moderated discussions on several related topics including but not limited to:

• Data systems to track suicide rates in AI/AN people
  • Currently available and accessible data at the federal, local, state, regional, and tribal levels
  • Gaps/challenges and limitations of current data systems
  • Opportunities to improve access and quality of data
• Racial and ethnic differences in suicide rates
• Reasons for higher suicide rates in AI/AN populations
  • Example: Role of social determinants of health, historical trauma, adverse childhood experiences, substance use, and complex grief

• • Risk factors and precipitating factors that are unique to specific subgroups to include children and youth, middle-aged and elderly adults, and others.
• Protective factors in AI/AN communities
  • Example: Connectedness to tribal traditions
  • Protective factors that are unique to specific subgroups to include children and youth and middle-aged and elderly adults
• Effective suicide prevention policies and programs in AI/AN and tribal communities
  • Current status, lessons learned, evidence-based practices/best practices, and emerging models and prevention strategies
• Culturally sensitive approaches to identifying, managing, and preventing suicide clusters
• Challenges/gaps and opportunities to provide culturally appropriate, upstream interventions to prevent suicide
• Challenges/gaps and opportunities in providing the continuum of substance use and mental health services for AI/AN individuals in varied settings to include:
  • Primary care
  • Emergency department care
  • Specialty care
  • School-based care
  • Telehealth
• Suicide prevention issues unique to children and youth
• Next steps: Potential actions to address policy, programmatic, and research gaps, to support suicide prevention efforts for AI/AN people

The planning committee will develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions. A summary of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.