Resources for Native American suicide awareness and prevention

WASHINGTON DC – The Substance Abuse and Mental Health Services Administration (SAMHSA) leads nationwide initiatives aimed at enhancing behavioral health. Since 1989, it has celebrated National Recovery Month each September to advocate for new evidence-based treatments, provide support for the recovery community, and honor the commitment of service providers and communities that facilitate recovery from substance use disorders and mental health difficulties, including suicidal depression.

For Native Americans, there is a critical focus on healing from historical and intergenerational trauma, the aftermath of traumatic loss, and the long-lasting effects of European colonization.

No judgment. Just help.

In alignment with National Recovery Month, September 8, 2024, marks the first annual 988 Day. This event aims to raise awareness of the 988 Suicide and Crisis Lifeline—an essential resource providing support for those encountering suicidal thoughts. This initiative is a collaboration between SAMHSA and the 988 Crisis Response Systems Training and Technical Assistance Center (CSR-TTAC), emphasizing the recovery theme: “No Judgment. Just Help.”

In 2020, Congress introduced the 988 dialing code to be seamlessly integrated into the existing National Suicide Prevention Lifeline. SAMHSA perceives this new code as a significant advance toward reforming crisis care in America.

Understanding high suicide rates among Native Americans

According to the Centers for Disease Control and Prevention (CDC), Non-Hispanic Indigenous individuals in the U.S. face the highest suicide rates among any racial or ethnic group. Despite numerous efforts in suicide prevention research over the years, these rates have stubbornly persisted, particularly among Indigenous youth aged 10 to 24. Experts assert that the primary issue lies in the national suicide prevention strategy’s lack of cultural relevance and sensitivity to Native American values and experiences.

The causes for elevated suicide rates in Indigenous populations are multifaceted. Native Americans often endure a higher prevalence of adverse childhood experiences compared to other groups, including emotional, physical, and sexual abuse, domestic violence, mental illness, parental separation or divorce, incarceration, and poverty. These communities are further burdened by a history marked by forced relocation, land loss, and cultural assimilation, coupled with ongoing traumas stemming from colonial oppression.

Intergenerational trauma compounds these issues, as Native Americans grapple with the legacy of systemic racial discrimination and the historical trauma of government-sanctioned abduction to boarding schools that persisted into the 1970s.

Joseph P. Gone, a Gros Ventre (Aaniiih) tribal member and professor at Harvard University, highlights a pervasive sense of hopelessness in many Indigenous communities, stating, “It’s easy to conclude that nothing can fix it.” While tribal nations express a strong interest in collaborative research, securing adequate funding for such initiatives remains a significant hurdle.

Pamela End of Horn, an Oglala Lakota social worker at the Indian Health Service (IHS), illustrates this disparity, noting, “The Department of Veterans Affairs has a suicide coordinator in every medical center across the U.S.; IHS has just me.” The political climate plays a crucial role here, as tribal leaders advocate for more robust suicide prevention programs but often lack the necessary political support.

Additionally, mental health professional retention is challenging due to the remote nature of many reservations, contrasted with the more accessible VA services located in larger cities.

Efforts to combat the crisis

Responding to this crisis, SAMHSA and the National Institute for Mental Health (NIMH) are building collaborative research partnerships with tribal nations and launching new grants and culturally informed programs aimed at reducing suicide rates in these communities. NIMH researchers are adapting standard suicide screening tools to include culturally relevant language tailored for Indigenous populations.

Indigenous researchers like Teresa Brockie from the Fort Belknap Aaniiih Tribe are implementing suicide prevention approaches that incorporate traditional beliefs and practices, including smudging—using medicinal plants for spiritual cleansing. Brockie, who is leading one of the first randomized controlled studies focused on Indigenous mental health, emphasizes that mistrust towards healthcare systems stems from a historical lack of positive interactions. Her project aims to help caregivers manage their trauma while fostering children’s cultural identity and spirituality.

A 2015 study conducted by Brockie found that cumulative adverse childhood experiences correlate strongly with increased suicide risk, while strong family connections, tribal identity, and staying in school serve as protective factors against suicide.

Community solutions: The Native and Strong Lifeline (NSLL)

Robert Coberly, a member of the Tulalip Tribes, started experiencing suicidal thoughts at a young age. Upon seeking help, he found support from Indigenous therapists who incorporated traditional practices like attending sweat lodge ceremonies into his treatment. This blend of Western and Indigenous methodologies provided him the healing he sought.

He now serves as a counselor for the Native and Strong Lifeline (NSLL), the first 988 crisis line specifically designed for Indigenous people. Staffed by Native crisis counselors who have strong community ties, calls to the NSLL are met with culturally aware support and intervention. The NSLL operates within the broader framework of the 988 Suicide & Crisis Lifeline, ensuring that even out-of-state callers receive appropriate resources and referrals.

Since its launch, the NSLL has successfully catered to the community’s needs, having received over 4,150 calls within its first year, illustrating the demand for culturally competent mental health support. The foundation for this initiative stemmed from community conversations that gathered input on the specific needs and barriers faced by Indigenous peoples in accessing crisis care services.

Rochelle Hamilton, Director of Tribal Services at Volunteers of America, expressed hope that the success of the NSLL could inspire similar efforts across the country. Crucially, NSLL crisis counselors do not need formal academic degrees; they bring vital lived experiences and cultural insights into their roles, fostering a comfort level among callers that can be lacking in more traditional helplines.

Hamilton notes that this relatability is significant, saying, “Our callers feel more at ease speaking with our counselors than with those at other lifelines.” Along with crisis training, NSLL counselors receive extensive cultural training to incorporate traditional healing methods into their practices, ensuring they are grounded in the communities they serve.

Moving forward

Although the NSLL does not aim to erase historical traumas, it offers a framework based on cultural understanding and community-centered healing practices. This approach is evident in its all-Native counseling staff, who embody the community’s resilience and wisdom.

Mia Klick, the NSLL Coordinator, remarked on their journey, acknowledging the initial uncertainty about the line’s acceptance but expressing gratitude for the range of calls received—from crises to celebratory check-ins about sobriety. “This line has evolved into something more than we could have anticipated,” she stated.

To further support Indigenous and tribally affiliated individuals navigating the complicated behavioral health landscape, the Washington Indian Behavioral Health Hub has been established, which connects various stakeholders, including agencies and healthcare providers.

Resources for support

For anyone in crisis, simply calling or texting 988 or visiting 988lifeline.org can connect them with compassionate care for any mental health or substance use-related issues. The 988 Lifeline has reported that approximately 98% of those who reach out receive the support they need without requiring further intervention at that moment.

As mental health challenges, anxiety, and overdose rates rise, it remains crucial for individuals to have access to immediate support. SAMHSA continues to build partnerships at federal, state, local, and community levels to ensure everyone has someone to talk to, someone to help them, and a safe space for recovery.

SAMHSA also provides a free “Recovery Month Toolkit,” emphasizing that with the proper resources, treatment, and support, recovery is attainable for everyone. This toolkit can be accessed at tinyurl.com/5n8zfey5.

For more information on NSLL and the 988 Lifeline, visit www.doh.wa.gov/988.

(Contact Grace Terry at graceterrywilliams@gmail.com)

 

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