Improving Care to Prevent Suicide Among People with Serious Mental Illness Proceedings of a Workshop (2019) / Chapter Skim
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5 Native Americans and Alaska Natives
5 Native Americans and Alaska Natives
Pages 57-70
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From page 57... ...
• In a health care system example, the Southcentral Foundation of Alaska uses integrated primary care teams, case management, telemedicine, local community and behavioral health aides, spe cialty behavioral health services, and programs specific to suicide prevention, all supported by a strong data collection and analy sis process and an independent research team.
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From page 58... ...
As with veterans, these groups have many distinctive attributes, but experiences with effective suicide prevention programs in these groups also bear lessons that apply to all groups. UNMET NEEDS AMONG NATIVE AMERICANS AND ALASKA NATIVES Much can be learned from Native American and Alaska Native communities about how to prevent suicide, said Allison Barlow, director of the Johns Hopkins Center for American Indian Health, despite some of the complications that surround the study of these groups.
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From page 59... ...
. Though effects of historical trauma on serious mental illness are unknown, American Indians and Alaska Natives experience PTSD at twice the rate of the general population.
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From page 60... ...
"It's a problem for some Alaska Native people." Alaska Natives also share many social determinants of health, including marginalization, intergenerational trauma, and rapid involuntary change, along with culturally distinctive protective factors. Some communities have not had a death by suicide for 30 years, while others have seen waves of FIGURE 5-1 The suicide rate for American Indians and Alaska Natives peaks in adolescence and young adulthood.
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From page 61... ...
Effective suicide prevention is culturally tailored to the population it serves, Allen concluded. Culture provides protective factors as tools for prevention, and cultural practices provide effective implementation strategies.
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As in other Native American and Alaska Native populations, suicide rates prior to 1950 were very low and then started to rise, with spikes in youth suicide in the late 1980s that have continued until the present. The community has a variety of strengths that it has brought to bear on this problem.
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From page 63... ...
Of the youth who attempted suicide, 64 percent were referred to local behavioral health systems, but only 60 percent of those attended. "That means that less than 40 percent of the total who attempted ever got any medical health care," noted Barlow.
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From page 64... ...
With a population of just 740,000 eople -- 17 percent of whom are Alaska Natives or American Indians -- p there were 200 deaths by suicide in the state in 2015, and 32 percent of those deaths were among Alaska Natives and American Indians. Reducing the incidence of suicide is among the family wellness corporate initiatives of the Southcentral Foundation, which is one of 12 regional Native corporations and health centers in Alaska.
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From page 65... ...
, has integrated behavioral health into primary care, has organized a depression collaborative, has instituted a suicide prevention plan, and has signed a memorandum of understanding with the state of Alaska to share suicide data. In addition, specific services are focused on suicide prevention, including the Quyana Clubhouse, which integrates primary care with behavioral interventions, colocated and integrated care in shelters for adolescents and adults, a specialized suicide prevention intensive case management program called Denaa Yeets', traditional healing, and complementary medicine.
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From page 66... ...
, who discussed suicide prevention efforts among the Red Lake Nation in Northern Minnesota. Minnesota Natives are five times more likely to die from a drug overdose than their white counterparts, disparities that are linked to the inter generational effects of historical trauma and cultural genocide and a lack of access to Native providers and culturally specific trauma-informed care.
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From page 67... ...
Health equity is a major consideration in all the clinic's programs, said Myhra. In addition, meeting the needs of the community requires workforce development, including the training of behavioral health providers, community health workers, and people who can provide peer support.
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In addition, public health nurses and community health representatives can advance suicide prevention, though legislation has been proposed to eliminate community health representatives, "which would be a tragedy." Federal funding
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From page 69... ...
PUTTING A SPOTLIGHT ON PROTECTIVE FACTORS In a final comment, Shaw noted that, while some Alaska Native and American Indian communities have high rates of alcohol and substance use, they also have high rates of abstinence. This bi-modal distribution of risk and protective factors "often gets lost in these discussions." The same may well apply to serious mental illness, she speculated.
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From page 70... ...
2014. A protective factors model for alcohol abuse and suicide prevention among Alaska Native youth.
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