Risk factors associated with attempted suicide among American Indian youth in Montana

Background: Although attempted suicide is an important public health problem among American Indian (AI) teens, little research focuses on this population. The objective of this study was to examine associations between risk behaviors, victimization and risk for attempted suicide among Montana AI teens.

Methods: Data for AI youth were extracted from the 2003-2007 Montana Youth Risk Behavior Survey (n=703, suicide attempts=101). Logistic regression analyses, stratified by gender, were used to determine associations between self-reported attempted suicide (in prior 12 months) and the following risk factors: partner victimization, violence, substance abuse, promiscuity, early risk taking, and sadness.

Results: Both girls and boys who attempted suicide in the prior 12 months were more likely to have been sad (OR=6.8 [3.5-13.0]; OR=4.9 [2.3-10.4], respectively), physically forced to have sexual intercourse (OR=5.6 [2.8-11.2]; OR=6.6 [2.7-16.4]), hit by boy/girlfriend (OR=4.6 [2.4-9.2]; OR=2.7 [1.1-6.5]), carried a weapon (OR=3.6 [1.9-6.6]; OR=2.0; [1.3-3.1]), engaged in risk behaviors related to promiscuity (OR=3.2; [1.4-7.2]; OR=[2.9; 1.1-8.2]), tobacco, alcohol or drugs (OR=1.3[ 1.1-1.5]; OR=1.5; [1.2-1.8]), or engaged in risk taking behaviors before age 13 (OR=1.3 [1.1-1.6]; OR=1.4; [1.1-1.7]). The OR for sadness persists after controlling for these other covariates.

Conclusions: Sadness appears to be a factor over and above other covariates for girls. Forced sex appears to be the strongest factor for boys. AI youth who report sadness, hitting by boy/girlfriend, forced sex, or carrying weapons are more likely to have reported also attempting suicide. Mental health and partner violence screening, referral and interventions that are culturally-relevant and gender-specific are warranted.