988 Tribal Response provides culturally relevant crisis response and suicide prevention

RAPID CITY, SD – Patricia “Trish” Collins (Rosebud Lakota) and Kate Swallow (Cheyenne River Lakota) are Program Navigators for Great Plains 988 Tribal Response, a program whose purpose is to improve response to 988 contacts from Tribal communities and/or Lakota residents.

When people call, text, or chat with the 988 Lifeline, they are connected to trained crisis counselors who are part of the existing 988 Lifeline network, made up of over 200 local crisis centers nationwide. These crisis counselors are trained to provide free and confidential emotional support and crisis counseling to people in emotional distress or suicidal crisis and connect them to local resources that can literally save lives.

These services are available 24 hours a day, seven days a week, across the US. Numerous studies have shown that callers feel less suicidal, less depressed, less overwhelmed, and more hopeful after speaking with a 988 Lifeline crisis counselor. Funding for the 988 Lifeline and the 988 Tribal Response program comes through the federal Substance Abuse Mental Health Services Administration (SAMSHA).

Before July 16, 2022, callers reached this free service by calling the National Suicide Prevention Line through a 10-digit number. Transitioning to the 3-digit 988 number stream-lined the process. (Calls to 211 go to an Information and Referral Services line and calls to 911 are for medical emergencies.)

Non-Hispanic Indigenous people in the United States die by suicide at higher rates than any other racial or ethnic group, according to the Centers for Disease Control and Prevention. Despite decades of research into suicide prevention, suicide rates among Indigenous people have remained stubbornly high, especially among Indigenous people ages 10 to 24. Experts say that’s because the national strategy for suicide prevention isn’t culturally relevant or sensitive to Native American communities’ unique values and challenges.

According to samhsa.gov, the website for SAMHSA, the 988 Tribal Response program is intended “to (1) ensure American Indians/Alaska Natives have access to culturally competent, trained 988 crisis center support through existing and/or new 988 Lifeline centers; (2) improve integration and support of 988 crisis centers, Tribal nations, and Tribal organizations to ensure there is navigation and follow-up care; and (3) facilitate collaborations with Tribal, state and territory health providers, Urban Indian Organizations, law enforcement, and other first responders in a manner which respects Tribal sovereignty,”

The South Dakota 988 Tribal Response program became active in 2024. Collins and Swallow began their work as Program Navigators earlier this year. In addition to previous professional education and training relevant to this work, they have received additional specialized training for their new positions.

For example, they recently completed an intensive 3-day culturally relevant suicide prevention training offered by the Native American Fathers and Families Association (NAFFA). By completing the 3-day training, they are now certified to teach a 12-week suicide prevention course developed by NAFFA. For more information, visit www.nativeamericanfathers.org.

They say their broad goal is “to bring awareness to tribal communities about the 988 call, text, or chat line.” They have become “road trip warriors,” attending powwows and other Lakota-focused gatherings state-wide to spread the message that 988 services are available to ALL citizens. They are exhibiting at the 2024 Black Hills Powwow in Rapid City on October 11 – 13.

When they exhibit at an event, they distribute culturally relevant literature and giveaways with the 988 number, such as key chains, magnets, stickers, and pens. They also give away wokphan kits, an abalone shell with sage and other grasses for smudging. They say this has all been very well received.

In addition to attending powwows, in the coming year they plan to participate in other tribally sponsored events all over South Dakota, including horse relays, youth days, health fairs, and others. They also expect to initiate and organize at least one crisis prevention/crisis response event on each Lakota reservation in the state within the coming year.

Many Lakota to whom they speak in their outreach efforts are unfamiliar with the 988 services and unaware the services are available. A common question they hear is, “Is this for Natives?” However, they also often hear remarks like, “This number saved my life (when I contacted it)” or “I’ve already called this number four times this month!”

Sadly, they also often hear from people whose relatives have died by suicide. Those left behind when there is a suicide loss are at higher risk statistically than the general population for suicide attempts and completion. One woman they met had lost two sons to suicide.

Collins and Swallow reach out to families who have experienced suicide loss to provide support, small gifts, and resources. This is sometimes called suicide “postvention” but both Collins and Swallow agree that “POSTvention is PREvention.” When an individual or family has been bereaved by a suicide, having a compassionate visit from 988 Tribal Response helps the survivors feel supported and know where to turn if and when they feel the need for further support.

Swallow and Collins find that when beginning a conversation about the 988 Tribal Response Program, it’s best to say, “988 is a crisis lifeline” rather than using the words suicide or suicide prevention. There is still significant stigma attached to the word “suicide.” They agree that simply having an open and non-judgmental conversation about suicide reduces stigma. They also want to reduce the stigma of simply asking for help. One of their messages is, “It’s a brave and courageous thing (to ask for help).

They emphasize that people do not have to wait until they are having thoughts of suicide to reach out to 988 with a call, text, or chat. Callers can reach out to 988 at any time, even if it’s a situation of “I’ve had a bad day and just need someone to talk to for a bit.” This helps to deescalate stressful situations and prevent stressors from becoming life-threatening.

Collins and Swallow both freely share their personal stories of how suicide has touched their own lives.

Swallow said that at two separate times in her life she experienced suicidal ideation. Once was after a major heartbreak in a personal relationship. The second was when she was diagnosed with rheumatoid arthritis. What worked for her both times to bring her out of her potentially suicidal depression was a combination of prayer, nature, self-help literature, healthy tears to release her sadness, and loving support from friends and family.

Collins had served more than ten years as a professional health advocate before joining the team at 988 Tribal Response. She had experienced the death of 5 cousins by suicide.  Also, her child was diagnosed with schizophrenia in his early adulthood. He became more and more withdrawn and would have spent all his time isolated in his room if she had not insisted that he come out at least once a day.

Fortunately, her son was diagnosed correctly and prescribed appropriate medications. After his medications helped him stabilize, he admitted that he had seriously considered suicide and even had a plan to end his life.

Both Collins and Swallow are passionate about their current opportunity to have a positive impact in the lives of their people. Both say they truly enjoy meeting and talking to relatives at public events.  Swallow said, “It’s all exciting. …and everything is for the relatives.”

Martina Martinez (Lac Courte Oreilles,Wisconsin) is the Program Manager for Great Plains 988 Tribal Response. She comments, “I am genuinely honored to manage our SAMSHA grant 988 TR. I have lost many family members, friends, and community members to suicide. After each tragic loss, I was always struggling with what could be done to help. Now I am in the position to share this valuable resource with our community and the 9 tribes in SD. We have an amazing staff that cares deeply about the relatives we serve. I feel that there are no coincidences in life, and our creator guided me to where I am today to help spread awareness and help others who are struggling.”

For more information, readers may contact Collins at 605.415.2765 or patricia.collins@gptcha.org and Swallow at 605.355.2566 or linda.swallow@gptcha.org.

(contact Grace Terry at graceterrywilliams@gmail.com)

 

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SOURCES:

 

Personal interviews and email correspondence with Trish Collins and Kate Swallow

Email correspondence with Martina Martinez

www.greatplainstribalhealth.org/suicide-prevention.html

www.samhsa.gov/grants/

988lifeline.org/current-events/the-lifeline-and-988/

www.nativeamericanfathers.org/suicideprevention

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