Change Pathways in Indigenous and Nonindigenous Youth Suicide

Abstract

Multivariate dynamic relationships among suicide attempts, anxiety and/or depressive symptoms, hope, and help-seeking were examined across time in Native Hawaiian and non-Hawaiian adolescents, using data from a 5-year longitudinal cohort study (N = 7,317). The rate of suicide attempts decreased over time, but this reduction was significantly less among Native Hawaiian youth than their non-Hawaiian peers. There were also significant differences between groups in hope and help-seeking, with Native Hawaiian youth increasing help-seeking and decreasing hope to a greater degree. Youth-centered, cultural approaches to suicide prevention are essential in enhancing well-being in indigenous communities.

A Mixed-Methods Evaluation to Inform the Hawaiʻi Suicide Prevention Strategic Plan

“…Studies have shown that in Hawaiʻi, a high level of family cohesion, positive friendships, and belonging to a community that enhances connection and care are protective factors against suicide [3,4]. Nevertheless, suicide remains a leading cause of death in are also at a higher risk, with suicide being the second leading cause of death among youth of ages 15-24 and 25-34 years and the fourth leading cause among ages 1 -14, 35-11, and 45-54 years [11].…”

“…Studies have shown that in Hawaiʻi, a high level of family coh ships, and belonging to a community that enhances connection an factors against suicide [3,4]. Nevertheless, suicide remains a lead Hawaiʻi, with an age-adjusted rate of 12.9 deaths per 100,000 in 2021 [5,6].…”

“…Hope focuses on prevention by increasing community awareness around suicide prevention and improving statewide capacity for training. For example, Hawaiʻi's Caring Communities Initiative for Youth Suicide Prevention works to raise suicide awareness and promote protective factors through workshops on hula, lei-making, and other culturally relevant activities [3]. The second strategy, Help, ensures that suicide prevention is a core component of Ha-waiʻi's overall system of care.…”

“…The second strategy, Help, ensures that suicide prevention is a core component of Ha-waiʻi's overall system of care. The University of Hawaiʻi, John A. Burns School of Medicine, Department of Psychiatry (JABSOM-DOP) is a leader in providing suicide prevention training, such as the Connect Suicide Prevention Program and SafeTalk to healthcare providers and the community [3]. JABSOM-DOP has also adopted the Zero Suicide Conceptual Approach and Practice framework to its healthcare system to improve outcomes for those at risk for suicide.…”

Hope, help, and healing: Culturally embedded approaches to suicide prevention, intervention and postvention services with native Hawaiian youth.

“…Local longitudinal research indicated that suicidal ideation, anxiety and parent expectation were the best predictors of suicide attempts for Native Hawaiians and non-Hawaiians with no interaction by ethnic identity (Hishinuma et al, 2017). However, significant differences were found between groups in hope and help-seeking, with Native Hawaiian youth increasing help-seeking and decreasing hope to a greater degree (Goebert, Hamagami, Hishinuma, Chung-Do, & Sugimoto-Matsuda, in press).…”