Community Perspectives on Social Influences on Suicide Within a Native American Reservation

Abstract

Relative to the general population, Native Americans (NA) bear a disproportionate burden of suicide-related mortality rates. NA males and females aged 15 to 24 years experience suicide rates nearly 3 times than the U.S. all races rates in this age group. Although efforts have been made to understand and reduce suicide in tribal communities, a large portion has focused on individual characteristics with less attention given to social factors that may also inform suicide. This article aims to build on a local conceptual model of NA youth suicide by examining additional potential social factors through qualitative interviews. Findings from the thematic analysis resulted in the identification of seven perceived social influences: contagion, violence and abuse, discrimination and bullying, negative expectations, spirituality, social support, and cultural strengths. Public health approaches to reduce suicide should consider local social factors that resonate with tribal communities to build resilience.

Social zeitgeber and sleep loss as risk factors for suicide in American Indian adolescents

“…In a more recent study of indigenous children in Chile, suicidal and non-suicidal participants did not differ on depression or anxiety scores, but they did significantly differ on their levels of cultural involvement, with lower cultural involvement being correlated with suicidal behavior and higher cultural involvement appearing to be protective (Caqueo-Urizar et al, 2014). Thus, there are several studies supporting the idea that disruptions in family and other social relationships perhaps lead to fewer feelings of "connectedness" and may be important factors in AI/AN youth suicide (see also Cwik et al, 2022). These findings align with the interpersonal theory of suicide and with well-established research supporting low belongingness and perceived burdensomeness with elevated risk for suicide across diverse samples (Chu et al, 2017;Joiner, 2005;Van Orden et al, 2012).…”

“…We propose that these disruptions in relationships can be interpreted as a loss or disruption in "social zeitgebers," which may subsequently disturb biological rhythms and thereby increase risk for depression and suicide. Connection to family and tribe, in addition to spirituality, culture, and land, is important in AI/AN communities in order to buffer the enduring impact of historical loss and/ or intergenerational trauma (see Cwik et al, 2022;Gone & Trimble, 2012;Gray & Cote, 2019). Further investigation of these findings across different tribes, regions, and age groups across AI/AN individuals, including the role of sleep in the context of risk, is warranted.…”

“…Among AI/AN young adults and adolescents in the United States, suicide has become a public health emergency, with rates as much as three times higher than those seen in young adults and adolescents of other ethno-racial groups (Chartier et al, 2013;Department of Health and Human Services et al, 2009;Herne et al, 2014). While suicide rates are higher in the AI/AN population compared to the general U.S. population samples-especially in adolescents-rates differ significantly by geographic region, tribal affiliation, and whether one is living on a reservation or in an urban area (see Bolton et al, 2014;Chachamovich et al, 2015;Cwik et al, 2011Cwik et al, , 2014Cwik et al, , 2016Cwik et al, , 2022Freedenthal & Stiffman, 2004;Livingston et al, 2019;Shaw et al, 2019;Trout & Wexler, 2020;Wexler et al, 2015). Several studies have suggested that cultural differences between AI/AN groups may account for the heterogeneity observed in suicidal thoughts and acts between tribal groups (Bolton et al, 2014;Livingston et al, 2019;Novins et al, 1999).…”

Risk Factors for Suicidal Behaviors in American Indian and Alaska Native Peoples: A Systematic Review

“…In the broader suicide literature, experiences of discrimination have been linked with suicide attempts and capability for suicide (Brooks et al, 2020; Gomez et al, 2011). Moreover, qualitative literature suggests the role of bullying (Bell et al, 2014) and discrimination-based bullying as related to youths’ suicide (Cwik et al, 2022). To inform effective intervention and prevention strategies, it will be necessary to capture the role of experiences of discrimination when considering vulnerable periods of development and the role of humiliation, isolation, and lack of belongingness in suicide behavior.…”

Genetic Factors Associated with Suicidal Behaviors and Alcohol Use Disorders in an American Indian Population

“…Suicide rates remain even higher among American Indians/Alaska Natives (AI/AN), with rates more than 50% greater when compared to the general U.S. population across all age groups (2)(3)(4)(5). While suicide rates are unquestionably higher in the AI/AN population as a whole as compared to other US populations, rates also vary based on geographic region, tribal affiliation and whether one is living on a reservation (6)(7)(8)(9)(10)(11)(12). American Indian/Alaska Natives also suffer from a disproportionate burden of the effects of alcohol, tobacco, and drug dependence (13,14).…”