Study Identifies Suicide Risk Factors In Native-American Youth
A recent study of suicidal behavior in American Indian youth has improved researchers’ understanding of the problem in that population and helped them to recognize crucial differences in risk factors between those who live on and off reservations.
Researchers at the Buder Center for American Indian Studies and the Comorbidities and Addictions Center at Washington University in St. Louis found that of about 400 American Indian youth aged 12 to 19 living on a reservation and in a nearby city, 30 percent reported having thought about or attempted suicide.
The rate is high, but not entirely unexpected: A 2000 report by the Indian Health Service, an agency within the Department of Health and Human Services, showed that among American Indian youth, 33.9 per 100,000 commit suicide each year, which is 2.5 times the national rate for all youth.
Stacey Freedenthal: “We wanted a more accurate representation of what is found in the American Indian population.”
She explained that within the general population, elderly men commit suicide at the highest rate, but within the American Indian population, adolescent boys have the highest rate of suicide. This translates into “many lost years and generations,” she said.
Freedenthal and her colleagues at Washington University, principal investigators Arlene Stiffman, Ph.D., and Eddie Brown, D.S.W., surveyed American Indian youth as part of the American Indian Multisector Help Inquiry (AIM-HI) study. This is a five-year, longitudinal study that began in 2001 and measures, among other items, help-seeking patterns among American Indians.
The researchers sampled two groups of American Indian youth—one living on a reservation (205) and one in a nearby large city (196)—because the bulk of health care research on American Indians has focused on those who live on reservations, despite evidence that most live in urban areas, according to Freedenthal.
“We wanted a more accurate representation of what is found in the American Indian population,” she said.
The researchers randomly sampled the tribal and school records of American Indian youth in a Southwestern state to select the study population. The researchers have kept the name and exact location of the reservation and urban area confidential at the request of the reservation’s tribal leaders. Once they selected the youth, the researchers used the Diagnostic Interview Schedule, Service Assessment for Children and Adolescents, and Orthogonal Cultural Identity Scale to obtain their data.
Freedenthal and her colleagues found that the youth at both sites had risk factors typically associated with suicidal behavior. For instance, 43 percent had an arrest history, 65 percent had a history of substance abuse in his or her family, 26 percent had a problem with substance abuse, and 18 percent were depressed.
The researchers also examined the correlation between some of these risk factors and suicidal behavior in the reservation and urban samples.
They found that the risk factors correlated with suicidal behavior that were unique to reservation youth were depression, a family history of drug abuse, alcohol abuse (in the youth), an arrest history, and racial discrimination.
According to Freedenthal, many of the reservation youth were bused to schools in predominantly white suburbs. “In focus groups, the youth living on the reservations reported a great deal of discrimination against them, perhaps most surprisingly by their teachers.”
The risk factor correlated with suicidal behavior unique to urban youth was less social support.
Some of the risk factors correlated with suicidal behavior that urban and reservation youth shared were exposure to suicidal behavior by a friend or family member, a history of physical and sexual abuse, and having a diagnosis of conduct disorder or a substance use disorder, according to Freedenthal.
She said, “Our hope is that by studying urban and reservation youth separately, we can develop suicide prevention and intervention programs that take into account each group’s unique strengths and risks.”
The AIM-HI study is funded by the National Institute of Mental Health and the National Institute on Drug Abuse.
More information about the American Indian Multisector Help Inquiry study is posted on the Web at gwbweb.wustl.edu/Users/Cac/amerindy/aim-hi.htm. ▪
