CONTENTS

About This Course

Table of Contents

1. The Nature and Scope of Suicide
2. Recognizing the Progressive Development of Suicide
3. Substance Abuse as a Major Contributor to Suicide
4. Suicide Across the Life Span
5. Special Populations and Suicide Risk
6. Prevention and Early Intervention for Suicide and Substance Abuse Problems

Supplements
References
Resources

Holding the Lifeline
A Guide to Suicide Prevention

Indian Health Initiatives

Beginning in 2002, the Indian Health Service (IHS) convened a tribal consultation on behavioral health. Over 200 tribes and tribal organizations were represented, providing recommendations for long-term goals to revitalize and improve behavioral health in Indian Country. ref

Federal collaboration among the IHS, the Office of Force Readiness and Deployment of the U.S. Public Health Service, SAMHSA, and the U.S. Department of the Interior was enhanced to develop better Federal response capability.

The Jicarilla Apache of Northern New Mexico developed a reservation-based suicide prevention program over a period of ten years.ref At one time, the suicide rate on this reservation was one of the highest in the United States. By bringing key players in their community together, the suicide rates were significantly decreased. Tribal leadership, community members, youth, clinicians, researchers from the University of New Mexico, and IHS personnel designed and implemented the program.

Another successful suicide prevention program involves the Phoenix Indian Medical Center, the second largest Indian Medical Center in the United States. This Center stopped scheduling mental health appointments, because there were patient waiting lists up to six months long. Instead, the Phoenix Center instituted an "Open Access Model of Care," where a patient can come as a walk-in between the hours of 8:00 a.m. and 2:00 p.m. and see a mental health professional the same day. The Phoenix Center reports that in the first five months that the open access program was in operation, there was not one suicide completion noted among active patients in the service. The Center sees an average of 18,000 patients per year. ref

The Behavioral Health Aid program in rural Alaska trains community members as paraprofessionals to screen and intervene in the smallest villages. Specific training is provided in screening, crisis intervention, referral, and consultation, with supervision and culturally-sensitive techniques available. This program has allowed first responders to exist in communities that are too small and too isolated to otherwise access behavioral health professionals. This program is still quite new, but it is considered a promising program with hopes of replicating it elsewhere. ref

Many American Indian and Alaska Native communities, however, are vastly underserved in terms of behavioral and physical health needs. As the above initiatives show, however, communities have found innovative and culturally appropriate ways to reduce the toll of suicide.