Change pathways in indigenous and non-indigenous youth suicide

Objective - Suicide prevention efforts seek to reduce risk for suicidal thoughts and behaviors and increase factors that help strengthen, support, and protect individuals from suicide. The purpose of this study is to examine the relationship among suicide attempts, anxiety symptoms, depressive symptoms, hope and help-seeking across time in Native Hawaiian and non-Hawaiian adolescents.

Methods - Participants were adolescents from the National Center on Indigenous Hawaiian Behavioral Health’s high school health survey who were part of a five-year longitudinal cohort study (N = 7,317). Contemporary longitudinal dynamic structural equation models were used to analyze the multiple dynamical relationships among anxiety symptoms, depressive symptoms, help seeking, hope, and suicide attempts for non-Hawaiian and Native Hawaiian groups.

Results - At time 1, 4.3% of adolescents reported having attempted suicide in the six months; decreasing to 3.2% at times 2 and 3, and 2.0% at time 4.  The rate of decrease was significantly less among Native Hawaiian youth. While no significant ethnic differences were detected in the influence of previous suicide attempts on symptom change scores, there were differences in hope and help-seeking with Native Hawaiian youth increasing help-seeking and decreasing hope.

Conclusions - The extent to which hope and help-seeking relate to suicide attempts provides support for more thoughtful and purposive inclusion of mental health infrastructure in suicide prevention and intervention strategies. More collaborative and youth-centered approaches to suicide prevention in the cultural context of the community are essential in enhancing well-being in indigenous communities.