Developing a Process to Address Suicide among American Indian/Alaska Native Youth

background:  American Indian Health and Family Services of Michigan developed and implemented a youth suicide prevention program (ages 10-24): entitled the “Manidookewigashkibjigan Sacred Bundle R.E.S.P.E.C.T. project.” Aims were to 1) increase awareness of suicide; 2) train community members/providers to identify, manage and treat at-risk youth; 3) screen to increase identification of at-risk youth; and 4) provide culturally appropriate services.

methods:To ensure that suicide screeners were adequately trained we conducted this project in 4 phases:  1) informed the adult advisory council (AC) of the project and created a youth advisory council (YAC); 2) assessed community awareness/knowledge of suicide; 3) trained community member and provider gatekeepers; and 4) utilized gatekeepers to screen youth.

results: The adult AC was informed of the project and a YAC was formed. Community Readiness Assessment interviews (N= 37) were conducted and informed the community of the prevalence of AI/AN suicides. We trained 246 community members and providers in ASIST, QPR, and safeTALK in preparation for screenings. Individuals trained in ASIST administered The Hope and Wellness Screen which was adapted from the Patient Health Questionaire-9 to include a cultural identity measure, strengths-based questions (YAC recommendation) and a positive title (AC recommendation). In years two and three, 125 youth were screened and at-risk youth referred for services.

conclusions: Community engagement was key to developing a process for screening and referring at-risk AI/AN youth for services as well as gathering much needed AI/AN suicide data. We have obtained funds to replicate this process with Michigan tribes.