IHS Suicide Prevention Initiative

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IHS Suicide Prevention Initiative

• 2009 National Behavioral Health
• Conference
• August 4-7, 2009
• St. Paul, Minnesota

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Indian Health Service National Suicide
Prevention Initiative

• The National Suicide Prevention Initiative
  addresses the tragedy of suicide in American
  Indian and Alaska Native communities.
• The IHS National Suicide Prevention Initiative
  builds on the foundation of the HHS National
  Strategy for Suicide Prevention and the 11 goals
  and objectives for the Nation to reduce suicidal
  behavior and its consequences, while ensuring we
  honor and respect tribal traditions and
  practices.

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IHS Suicide Prevention Committee Statement of
Purpose

• In 2003, Dr. Grim chartered and tasked the
  Suicide Prevention Committee to develop, advocate
  for and coordinate a comprehensive cultural- and
  community-based approach to
• reduce suicidal behaviors and suicides in AI/AN
  communities.
• Membership includes various disciplines, urban,
  tribal, etc.
• National Suicide Prevention Strategic Plan
• Guidelines for IHS, Tribal, and Urban requests
  for assistance

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National Suicide Prevention Network

• Suicide Report Form Records and tracks the
  number of suicidal events.
• Tele-Behavioral Health Improves access to
  behavioral health services.
• Emergency Services coordinates Commissioned Corp
• Officers deployment to respond to suicide crises.
• Office of Reserve Affairs Inactive Reserve Corp
  Officers
• Recruitment/Retention (i.e. InPsych)

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National Suicide Prevention Network

• Tribal Behavioral Health Advisory Committee
• Behavioral Health Workgroup
• Tribal Epidemiology Centers/CDC
• Collaborations with public and private
  organizations (i.e. SAMHSA, CDC, National
  Institute for Mental Health, Suicide Prevention
  Resource Center, National Suicide Prevention
  Lifeline)
• 14 million for Meth and Suicide Prevention
  Initiatives

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General Data on Suicide among American
Indians/ Alaskan Natives

• CDC (Centers for Disease Control) reports the
  suicide rate for American Indians and Alaska
  Natives is over twice the national average for
  other groups.
• Suicide is the eighth leading cause of death for
  American Indians/Alaska Natives of all ages
• Suicide is the second leading cause of death for
  those from age of 10 to 34 (Suicide Prevention
  Resource Center)

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• In 2005, among males aged 15 to 19 years, the
  homicide
• rate was 3.5 per 100,000 among white
  non-Hispanics and
• 15.4 per 100,000 among American Indian/Alaskan
  Natives.
• In 2007, 15 of high school students seriously
  considered
• attempting suicide, and 11 made a plan. (CDC
  November2008)
• Firearms are the most commonly used method of
  suicide among
• Males (57.6). (www.cdc.gov/injury)

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Risk Factors for Suicide
Increase of drug or alcohol use Anger Previous
suicide attempt Withdrawal from family, friends,
school, etc. Recklessness Dramatic changes in
mood Giving away personal things
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Risk Factors for Suicide
Job loss Loss of a relationship (girl/boy
friend, spouse, parent) Influence by
media Cant get to resources, for example,
Behavioral Health, Police, Health Care,
etc. Sense of being isolated History of
violence (child and adult) Legal problems
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Protective Factors
Strong family and community support Problem
solving skills Strong cultural and spiritual
beliefs Easy access to resources (behavioral
health, substance abuse, etc.) Friends
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Red Hawk ProjectBuilding Strength and
Resilience
United American Indian Involvement, Inc.
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Red Hawk Project

• The Red Hawk Project was funded in June 2006 as a
  research and service delivery project to prevent
  suicide among American Indian and Alaska Native
  youth by providing prevention and early
  intervention services.
• The Red Hawk Project is funded through the
  Substance Abuse and Mental Health Services
  Administration (SAMHSA), Department of Health and
  Human Services. It is a part of the Robert
  Sundance Family Wellness Center at the United
  American Indian Involvement, Inc. located in Los
  Angeles, CA.

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Red Hawk Project Mission
The mission of the Red Hawk Project is to
support youth in the development of overall
wellness that recognizes the resiliency and
strength of the American Indian community.
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Red Hawk Project Goals and Objectives

• Project Goal
• The overall goal of the project is to strengthen
  and develop culturally and linguistically
  appropriate youth suicide prevention and early
  intervention services for the American Indian
  community.
• The Red Hawk Project intends to serve American
  Indian and Alaska Native (AI/AN) children and
  youth (ages 10-24) in Los Angeles County.

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Red Hawk Project Goals and Objectives
Project Objectives The Red Hawk Project will 1)
evaluate the existing service delivery systems
available to American Indian children and
families in Los Angeles County, to describe
services, identify access barriers, and assess
the cultural appropriate of services. 2)
collaborate with other agencies, providers and
organizations to share information and resources
by promoting awareness that suicide is
preventable.
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Red Hawk Project Goals and Objectives
3) develop a culturally appropriate youth suicide
prevention curriculum. 4) implement the public
health approach to suicide prevention as outline
in the Institute of Medicine report, Reducing
Suicide A National Imperative.
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Red Hawk Project Implementation

• The Red Hawk project will provide early
  intervention and assessment services to American
  Indian youth ages 10-24 who are at risk for
  mental or emotional disorders that may lead to
  suicide attempts.
• The Red Hawk project will serve 100-150 AI/AN
  youth and their families per year (relating to
  suicide prevention).
• The project will include skill building support
  groups, parenting support training, case
  management, and referral sources for crisis
  intervention and treatment.
• We will develop a curriculum that is culturally
  relevant, feasible, salient, and effective.

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Strengths-Based Approach
The focus of the program will be to assist urban
AI/AN communities to assess their own spiritual,
mental, emotional and physical strengths. The
Red Hawk project will provide a holistic,
cultural foundation to suicide prevention,
building on the resilience of AI/AN
communities. We will recognize the interaction
of socio-cultural, historical, economic,
biological and spiritual factors contributing to
suicide from an AI/AN perspective.
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So, what do you dowhen your community is in
Indian country and there is a suicide?
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Assess the situation What are your
resources? What do you know about your
community Strengths Weakness? What do we
(providers) know about suicide? What is the
communitys knowledge about suicide is? Identify
your leaders Who are they?
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• Educate ourselves about suicide
• Internet
• Community meetings
• Conferences
• Consultations

• Design a Plan of Action for example, establish
  a Task Force
• Identify programs
• Inform tribal leaders
• Inform community members

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Define the purpose for Task Force

• Reason for the Task Force
• What program/agencies are represented
• Identify roles and responsibilities
• Assess suicide knowledge level
• Obtain support/commitment
• Develop a plan of action

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Task Force membership does not include the
world

• Power struggle
• Confidentiality in jeopardy
• Role confusion

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Design Task Force Rules

• Leave politics outside the meeting room
• Respect all members
• Listen to all opinions and comments

No Rules
Turmoil Confusion Frustration
No collaboration Zero trust Complaints
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Define each Task Force members role
responsibilities

• Consider the following
• What is each members experience and/or
  knowledge?
• What is their authority in the community?
• What are their skills (professional and
  personal)?
• What type of services does their agency/program
  provide
• to the community?
• What is the program/agency relationship with
  Tribal Leaders?

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What happens when there is a suicide?
What?!
Emergency!
Who do I ask?
Its your responsibly!
Where do I go?
Whos going 2 help?
Not again!
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Suicide prevention is not one program or
persons responsibility Suicide prevention is
everyones responsibility
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Task Force in placeWhat is next step?
Network Develop a resource list Negotiate how to
work collaboratively How to gather data and
distribute Inform community and Tribal
Leaders Cross-train!
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Educate Train! The Task Force and Community
In-services
Cross Train!
Radio/newsletter
Share Information