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Peterson A, Smith-Morris C. Teen Perspectives on Suicides and Deaths in an Affluent Community: Perfectionism, Protection, and Exclusion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:456. [PMID: 38673367 PMCID: PMC11050056 DOI: 10.3390/ijerph21040456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Clusters of youth suicide and death are tragic for communities and present long-term consequences for the surviving youths. Despite an awareness of community-based patterns in youth suicide, our understanding of the social and community factors behind these events remains poor. While links between poverty and suicide have been well documented, wealthy communities are rarely targeted in suicide research. In response to this gap, we conducted ethnographic research in a wealthy U.S. town that, over a recent 10-year period, witnessed at least four youth suicides and seven more youth accidental deaths. Our interviews (n = 30) explored community values and stressors, interpersonal relationships, and high school experiences on participant perceptions of community deaths. Youth participants characterize their affluent community as having (1) perfectionist standards; (2) permissive and sometimes absent parents; (3) socially competitive and superficial relationships; and (4) a "bubble" that is protective but also exclusionary. Our qualitative findings reveal network influence in teen suicides and accidental deaths in a wealthy community. Greater attention paid to the negative effects of subcultural values and stressors in affluent communities is warranted. Further, our work promotes the value of ethnographic, community-based methodologies for suicidology and treatment.
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Affiliation(s)
- Abigail Peterson
- Department of Anthropology, Southern Methodist University, Dallas, TX 75275, USA
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Carolyn Smith-Morris
- Peter O’Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX 75390, USA;
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Wexler L, White LA, O'Keefe VM, Rasmus S, Haroz EE, Cwik MF, Barlow A, Goklish N, Elliott E, Pearson CR, Allen J. Centering Community Strengths and Resisting Structural Racism to Prevent Youth Suicide: Learning from American Indian and Alaska Native Communities. Arch Suicide Res 2024:1-16. [PMID: 38240632 DOI: 10.1080/13811118.2023.2300321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The persistence of extreme suicide disparities in American Indian and Alaska Native (AI/AN) youth signals a severe health inequity with distinct associations to a colonial experience of historical and on-going cultural, social, economic, and political oppression. To address this complex issue, we describe three AI/AN suicide prevention efforts that illustrate how strengths-based community interventions across the prevention spectrum can buffer suicide risk factors associated with structural racism. Developed and implemented in collaboration with tribal partners using participatory methods, the strategies include universal, selective, and indicated prevention elements. Their aim is to enhance systems within communities, institutions, and families by emphasizing supportive relationships, cultural values and practices, and community priorities and preferences. These efforts deploy collaborative, local approaches, that center on the importance of tribal sovereignty and self-determination, disrupting the unequal power distribution inherent in mainstream approaches to suicide prevention. The examples emphasize the centrality of Indigenous intellectual traditions in the co-creation of healthy developmental pathways for AI/AN young people. A central component across all three programs is a deep commitment to an interdependent or collective orientation, in contrast to an individual-based mental health suicide prevention model. This commitment offers novel directions for the entire field of suicide prevention and responds to calls for multilevel, community-driven public health strategies to address the complexity of suicide. Although our focus is on the social determinants of health in AI/AN communities, strategies to address the structural violence of racism as a risk factor in suicide have broad implications for all suicide prevention programming.
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Canetto SS, Menger-Ogle AD, Subba UK. Studying Scripts of Women, Men and Suicide: Qualitative-Method Development and Findings from Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6032. [PMID: 37297636 PMCID: PMC10253003 DOI: 10.3390/ijerph20116032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
Information about suicidal behavior in Nepal is limited. According to official records, suicide rates were high until the year 2000 and declined thereafter. Official records are considered unreliable and a gross undercounting of suicide cases, particularly female cases. Suicide research in Nepal has been mostly epidemiologic and hospital-based. Little is known about how suicide is understood by Nepali people in general-including dominant suicide attitudes and beliefs in Nepal. Suicide attitudes and beliefs, which are elements of a culture's suicide scripts, predict actual suicidality. Drawing on suicide-script theory, we developed and used a semi-structured survey to explore Nepali beliefs about female and male suicide. The informants were adult (Mage = 28.4) university students (59% male). Female suicide was believed to be a response to the society-sanctioned oppression and abuse that women are subjected to, in their family and community. The prevention of female suicide was viewed as requiring dismantling ideologies, institutions, and customs (e.g., child marriage, dowry) that are oppressive to women, and ensuring that women are protected from violence and have equal social and economic rights and opportunities. Male suicide was believed to be a symptom of societal problems (e.g., unemployment) and of men's psychological problems (e.g., their difficulties in managing emotions). The prevention of male suicide was viewed as requiring both societal (e.g., employment opportunities) and individual remedies (e.g., psychological counseling). This study's findings suggest that a semi-structured survey can be a fruitful method to access the suicide scripts of cultures about which there is limited research.
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Affiliation(s)
- Silvia Sara Canetto
- Department of Psychology, Colorado State University, Fort Collins, CO 80523, USA
| | | | - Usha Kiran Subba
- Department of Psychology, Trichandra College, Kathmandu 44600, Nepal
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Anderson K, Elder-Robinson E, Gall A, Ngampromwongse K, Connolly M, Letendre A, Willing E, Akuhata-Huntington Z, Howard K, Dickson M, Garvey G. Aspects of Wellbeing for Indigenous Youth in CANZUS Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13688. [PMID: 36294264 PMCID: PMC9602510 DOI: 10.3390/ijerph192013688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Indigenous children and young people (hereafter youth) across CANZUS nations embody a rich diversity of cultures and traditions. Despite the immense challenges facing these youth, many harness cultural and personal strengths to protect and promote their wellbeing. To support this for all youth, it is critical to understand what contributes to their wellbeing. This review aims to identify components contributing to wellbeing for Indigenous youth in CANZUS nations. Five databases were searched from inception to August 2022. Papers were eligible if they: focused on Indigenous youth in CANZUS nations; included views of youth or proxies; and focused on at least one aspect of wellbeing. We identified 105 articles for inclusion (Canada n = 42, Australia n = 27, Aotearoa New Zealand n = 8, USA n = 28) and our analysis revealed a range of thematic areas within each nation that impact wellbeing for Indigenous youth. Findings highlight the unique challenges facing Indigenous youth, as well as their immense capacity to harness cultural and personal strengths to navigate into an uncertain future. The commonalities of Indigenous youth wellbeing across these nations provide valuable insights into how information and approaches can be shared across borders to the benefit of all Indigenous youth and future generations.
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Affiliation(s)
- Kate Anderson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Elaina Elder-Robinson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Alana Gall
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | | | - Michele Connolly
- International Group for Indigenous Health Statistics, Columbia, MD 21045, USA
| | - Angeline Letendre
- Alberta Cancer Prevention Legacy Fund, Population, Public and Indigenous Health, Alberta Health Services, 102 Anderson Hall, 10959 102 ST NW, Edmonton, AB T5H 3V9, Canada
| | - Esther Willing
- Kōhatu–Centre for Hauora Māori, University of Otago, Dunedin 9054, New Zealand
| | | | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Michelle Dickson
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Gail Garvey
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
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VanEvery R, Latimer M, Naveau A. Clinical Strategies to Develop Connections, Promote Health and Address Pain From the Perspectives of Indigenous Youth, Elders, and Clinicians. FRONTIERS IN PAIN RESEARCH 2022; 3:857624. [PMID: 35634453 PMCID: PMC9137308 DOI: 10.3389/fpain.2022.857624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/22/2022] [Indexed: 11/26/2022] Open
Abstract
In this article we discuss findings from a community based, participatory action research study. The aim was to understand how Indigenous youth describe, experience, manage pain and hurt and how they seek care. A critical analysis guided by Two-Eyed Seeing and Medicine Wheel frameworks highlighted important clinical strategies for Indigenous youth to balance their health and reduce pain. This study is a partnership project with an Aboriginal Health Centre in Southern Ontario and the Canadian Institute of Health Research funded Aboriginal Children's Hurt and Healing Initiative (ACHH). The study gathered perspectives of Indigenous youth, Elders, and health clinicians using conversation sessions guided by a First Nations doctoral student and nurse researcher. Using the medicine wheel framework three main thematic areas emerged across the three groups and include (1) Predictors of Imbalance; (2) Indicators of Imbalance; and (3) Strategies to re-establish balance health in relation to pain. The main strategy includes considerations for clinicians using the acronym LISTEN (Language, Individual, Share, Teachable moments, Engage, and Navigate) approach that outlines strategies for clinicians that will be a safe guide to manage pain and hurt.
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Affiliation(s)
- Rachel VanEvery
- Department of Health, Aging, and Society, McMaster University, Hamilton, ON, Canada
- *Correspondence: Rachel VanEvery
| | - Margot Latimer
- Faculties of Health and Medicine, Dalhousie University, Centre for Pediatric Pain, IWK Health, Halifax, NS, Canada
- Margot Latimer
| | - Angela Naveau
- De dwa da dehs nye>s Aboriginal Health Centre, Hamilton, ON, Canada
- Angela Naveau
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Chaniang S, Klongdee K, Jompaeng Y. Suicide prevention: A qualitative study with Thai secondary school students. BELITUNG NURSING JOURNAL 2022; 8:60-66. [PMID: 37521082 PMCID: PMC10386795 DOI: 10.33546/bnj.1746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/31/2021] [Accepted: 12/15/2021] [Indexed: 08/01/2023] Open
Abstract
Background Suicide is the second leading cause of death among adolescents around the globe. Therefore, understanding its causes and prevention is needed. Objective This study aimed to explore Thai secondary school students' perceptions related to causes and preventions of suicide and the learning needs of suicide prevention. Methods A descriptive qualitative approach was employed in this study. Purposive sampling was used to select 32 adolescents for focus group discussions and ten adolescents for in-depth interviews. Data were collected from September 2019 to March 2020 and analyzed using content analysis. Results Causes of suicide included seven sub-categories: parents' expectations of children's academic achievement, bullying, family problems, teenage love, lack of stress management skill, imitation behavior on social media, and substance use behavior. Suicide prevention consisted of five sub-categories: peer support, parental support, school support, health professionals and significant support, and knowing the value and believing in self. In addition, students' learning needs had two sub-categories: developing online learning platforms regarding suicide prevention and mental health promotion and prevention projects. Conclusion The findings of this study could guide nurses and other health professionals to develop a suicide prevention program for secondary school students. The study results could also be used as essential evidence for driving health care policy in promoting and preventing suicide in adolescents with the involvement of key stakeholders.
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Affiliation(s)
- Surachai Chaniang
- Boromarajjonani College of Nursing Nakhon Phanom, Nakhon Phanom University, 48000, Thailand
| | - Kamonnat Klongdee
- Boromarajjonani College of Nursing Nakhon Phanom, Nakhon Phanom University, 48000, Thailand
| | - Yupared Jompaeng
- Boromarajjonani College of Nursing Nakhon Phanom, Nakhon Phanom University, 48000, Thailand
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Gonzalez MB, Sittner KJ, Saniguq Ullrich J, Walls ML. Spiritual connectedness through prayer as a mediator of the relationship between Indigenous language use and positive mental health. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2021; 27:746-757. [PMID: 34291975 PMCID: PMC8497410 DOI: 10.1037/cdp0000466] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The objective of this study is to understand how Indigenous language and spirituality revitalization efforts may affect mental health within Indigenous communities. Although Indigenous communities experience disproportionate rates of mental health problems, research supporting language and spirituality's role in improving mental health is under-researched and poorly understood. METHOD Data for this study are from a Community-based Participatory Research Project involving five Anishinaabe tribes in Minnesota and Wisconsin. Participants were sampled from clinic records of adults with a diagnosis of type 2 diabetes, living on or near the reservation, and self-identifying as American Indian (mean age = 46.3; n = 191). RESULT Structural equation modeling illustrates that language use in the home is associated with positive mental health through spiritual connectedness. CONCLUSION Results support tribal community expressions of the positive effects of cultural involvement for Indigenous wellbeing, and improve what is known about the interconnectedness of language and spirituality. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Miigis B Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes Hub
| | | | | | - Melissa L Walls
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes Hub
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Hochhauser S, Rao S, England-Kennedy E, Roy S. Why social justice matters: a context for suicide prevention efforts. Int J Equity Health 2020; 19:76. [PMID: 32450868 PMCID: PMC7249373 DOI: 10.1186/s12939-020-01173-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/14/2020] [Indexed: 11/16/2022] Open
Abstract
Suicide is among the 10 leading causes of death in the US and has the potential to suddenly change many lives. It often occurs when people are disproportionately affected by societal conditions, including inequities, discrimination, oppression, and historical trauma. We posit that a social justice framework can improve suicide prevention efforts when incorporated into existing strategies because it mandates that inequities be addressed. It does so through education, engagement, advocacy, and action, and can be especially effective in states and nations with high suicide rates and entrenched societal inequities.
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Affiliation(s)
- Shirley Hochhauser
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
| | - Satya Rao
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
| | - Elizabeth England-Kennedy
- Department of Health & Physical Education, Rhode Island College, 138 Murray Center, 600 Mt. Pleasant Ave, Providence, RI, 02908, USA.
| | - Sharmistha Roy
- College of Health and Social Services Building, 1335 International Mall, Suite 326, P.O. Box 30001 MSC 3HLS, Las Cruces, NM, 88003-8001, USA
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Elm JHL, Walls ML, Aronson BD. Sources of Stress Among Midwest American Indian Adults with Type 2 Diabetes. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2020; 26:33-62. [PMID: 30690701 DOI: 10.5820/aian.2601.2019.33] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Despite alarming health disparities among American Indians (AIs) and acknowledgement that stressors negatively influence health, conceptualization of the full spectrum of stressors that impact Indigenous communities is underdeveloped. To address this gap, we analyze focus group transcripts of AI adults with type 2 diabetes from five tribal communities and classify stressors using an inductive/deductive analytical approach. A Continuum of American Indian Stressor Model was constructed from categorization of nineteen stressor categories within four domains. We further identified poverty, genocide, and colonization as fundamental causes of contemporary stress and health outcomes for AIs and conclude that stressors are generally experienced as chronic, regardless of the duration of the stressor. This work on AI-specific stressors informs future health research on the stress burden in AI communities and identifies target points for intervention and health promotion.
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Abstract
Aspects of social integration including religion and residential stability have often been found to serve as protective factors against suicide in sociological analyses. However, empirical research on Canadian indigenous suicidality has neglected these dimensions of integration. The present study fills this gap, while controlling for other major predictors of suicide ideation (SI). Methods: Data are from a national representative sample (N = 15,294) from the 2012 Aboriginal Peoples Survey. The dependent variable is a dichotomy: lifetime prevalence of SI. Measures of social integration include religious affiliation, marital status, family ties, and residential stability. Controls are incorporated for alternative predictors of SI including psychiatric symptoms (e.g., mood disorder), economic strain, ethnicity, and demographics. Results: Findings from a multivariate logistic regression analysis confirmed an association between SI and most measures of social integration (e.g., married persons were 14% less apt to report SI than non married persons), but not with religious affiliation. Further, each unit increase in income reduced the risk of SI by 3.8%. Psychiatric symptoms increased risk of SI (e.g., mood disorder, OR = 3.16, substance abuse, OR = 2.38), and Inuit ethnicity increased SI risk by 57% (OR = 1.57). The model explained 26.1% of the variance in SI. Conclusions: Generally, measures of social integration, psychiatric symptoms, and economic strain predicted SI. However, there was no evidence that religion acted as a protective factor against SI. Future research is needed on other dimensions of religion such as self-reported religiousness, which may protect against suicidality.
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O'Keefe VM, Haroz EE, Goklish N, Ivanich J, Cwik MF, Barlow A. Employing a sequential multiple assignment randomized trial (SMART) to evaluate the impact of brief risk and protective factor prevention interventions for American Indian Youth Suicide. BMC Public Health 2019; 19:1675. [PMID: 31830933 PMCID: PMC6909588 DOI: 10.1186/s12889-019-7996-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study is built on a long-standing research partnership between the Johns Hopkins Center for American Indian Health and the White Mountain Apache Tribe to identify effective interventions to prevent suicide and promote resilience among American Indian (AI) youth. The work is founded on a tribally-mandated, community-based suicide surveillance system with case management by local community mental health specialists (CMHSs) who strive to connect at-risk youth to treatment and brief, adjunctive interventions piloted in past research. METHODS Our primary aim is to evaluate which brief interventions, alone or in combination, have the greater effect on suicide ideation (primary outcome) and resilience (secondary outcome) among AI youth ages 10-24 ascertained for suicide-related behaviors by the tribal surveillance system. We are using a Sequential Multiple Assignment Randomized Trial with stratified assignment based on age and suicidal-behavior type, and randomizing N = 304 youth. Brief interventions are delivered by AI CMHSs, or by Elders with CMHS support, and include: 1) New Hope, an evidence-based intervention to reduce immediate suicide risk through safety planning, emotion regulation skills, and facilitated care connections; and 2) Elders' Resilience, a culturally-grounded intervention to promote resilience through connectedness, self-esteem and cultural identity/values. The control condition is Optimized Case Management, which all study participants receive. We hypothesize that youth who receive: a) New Hope vs. Optimized Case Management will have significant reductions in suicide ideation; b) Elders' Resilience vs. Optimized Case Management will have significant gains in resilience; c) New Hope followed by Elders' Resilience will have the largest improvements on suicide ideation and resilience; and d) Optimized Case Management will have the weakest effects of all groups. Our secondary aim will examine mediators and moderators of treatment effectiveness and sequencing. DISCUSSION Due to heterogeneity of suicide risk/protective factors among AI youth, not all youth require the same types of interventions. Generating evidence for what works, when it works, and for whom is paramount to AI youth suicide prevention efforts, where rates are currently high and resources are limited. Employing Native paraprofessionals is a means of task-shifting psychoeducation, culturally competent patient support and continuity of care. TRIAL REGISTRATION Clinical Trials NCT03543865, June 1, 2018.
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Affiliation(s)
- Victoria M O'Keefe
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA.
| | - Emily E Haroz
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Novalene Goklish
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Jerreed Ivanich
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | | | - Mary F Cwik
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
| | - Allison Barlow
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Center for American Indian Health, 415 N. Washington Street, 4th Floor, Baltimore, MD, 21231, USA
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Shaw JL, Beans JA, Comtois KA, Hiratsuka VY. Lived Experiences of Suicide Risk and Resilience among Alaska Native and American Indian People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3953. [PMID: 31627325 PMCID: PMC6843805 DOI: 10.3390/ijerph16203953] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/04/2019] [Accepted: 10/13/2019] [Indexed: 11/25/2022]
Abstract
This study explored the lived experiences of suicidality and help-seeking for suicide prevention among Alaska Native and American Indian (AN/AI) people in a tribal health system. An interpretive phenomenological approach was used to analyze semi-structured, in-depth interviews with 15 individuals (ages 15-56) with self-reported histories of suicide ideation and/or attempt. Several factors were found to be central to acquiring resilience to suicide risk among AN/AI people across a wide age range: meaningful and consistent social connection, awareness about how one's suicide would negatively effect loved ones, and knowledge and utilization of available health services. Findings highlight the mutable nature of suicide risk and resilience, as well as the importance of interpersonal factors in suicidality.
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Affiliation(s)
- Jennifer L Shaw
- Research Department, Southcentral Foundation, Anchorage, AK 99508, USA.
| | - Julie A Beans
- Research Department, Southcentral Foundation, Anchorage, AK 99508, USA.
| | - Katherine Anne Comtois
- Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, University of Washington, 325 9th Ave, Box 359911, Seattle, WA 98104, USA.
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A qualitative systematic review of experiences and perceptions of youth suicide. PLoS One 2019; 14:e0217568. [PMID: 31188855 PMCID: PMC6561633 DOI: 10.1371/journal.pone.0217568] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022] Open
Abstract
Background Suicide remains a global issue with over 800,000 people dying from suicide every year. Youth suicide is especially serious due to the years of life lost when a young person takes their own life. Social interactions, perceived support, genetic predisposition and mental illnesses are factors associated with suicide ideation. Objectives To review and synthesize qualitative studies that explored the experiences and perceptions of suicide in people 25 years old and younger. Design Qualitative systematic review. Data sources PubMed, PsycINFO, Scopus and CINAHL were searched alongside hand-searching reference lists up to October 2018. Methods Methodological quality was assessed using the qualitative Critical Appraisal Skills Programme checklist. The 27 studies included in the review centered around youth suicide and included interviews with young people and members of the wider community. Thematic synthesis focused on factors leading to suicide attempts, elements important to recovery, beliefs within the community, and treatment/prevention strategies. Results Thematic analysis of the articles revealed four categories: i) triggers and risks leading to suicidality; ii) factors involved in recovery; iii) need for institutional treatment/prevention strategies; and iv) beliefs about suicide at a community level. The first category was further subdivided into: i) behaviours; ii) feelings/emotions; iii) family influences; iv) peer influences; and v) other. The second category was split into: i) interpersonal; ii) cultural; and iii) individual influences, while the third category was divided into i) education; and ii) treatment. Conclusion Youth suicide is a complex issue with many causes and risks factors which interact with one another. For successful treatment and prevention, procedural reform is needed, along with a shift in societal attitudes toward emotional expression and suicide.
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Rocchetta MJ. A Critical Examination of the Factors That Influence School Performance of Indigenous Students in Northern Ontario. INTERROGATING MODELS OF DIVERSITY WITHIN A MULTICULTURAL ENVIRONMENT 2019:15-44. [DOI: 10.1007/978-3-030-03913-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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15
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Beaudoin V, Séguin M, Chawky N, Affleck W, Chachamovich E, Turecki G. Protective Factors in the Inuit Population of Nunavut: A Comparative Study of People Who Died by Suicide, People Who Attempted Suicide, and People Who Never Attempted Suicide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010144. [PMID: 29337928 PMCID: PMC5800243 DOI: 10.3390/ijerph15010144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 12/05/2022]
Abstract
Epidemiological data shows an alarming prevalence of suicide in Aboriginal populations around the world. In Canada, the highest rates are found in Inuit communities. In this article, we present the findings of a secondary analysis conducted with data previously collected as part of a larger study of psychological autopsies conducted in Nunavut, Canada. The objective of this secondary analysis was to identify protective factors in the Inuit population of Nunavut by comparing people who died by suicide, people from the general population who attempted suicide, and people from the general population who never attempted suicide. This case-control study included 90 participants, with 30 participants in each group who were paired by birth date, sex, and community. Content analysis was first conducted on the clinical vignettes from the initial study in order to codify the presence of protective variables. Then, inferential analyses were conducted to highlight differences between each group in regards to protection. Findings demonstrated that (a) people with no suicide attempt have more protective variables throughout their lifespan than people who died by suicide and those with suicide attempts within the environmental, social, and individual dimensions; (b) people with suicide attempts significantly differ from the two other groups in regards to the use of services; and (c) protective factors that stem from the environmental dimension show the greatest difference between the three groups, being significantly more present in the group with no suicide attempt. Considering these findings, interventions could focus on enhancing environmental stability in Inuit communities as a suicide prevention strategy.
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Affiliation(s)
- Véronique Beaudoin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Monique Séguin
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - Nadia Chawky
- Mood Disorders and Related Disorders, McGill Group on Suicide Studies, Douglas Mental Health University Institute & Québec Network on Suicide, Montreal, QC H4H 1R3, Canada.
| | - William Affleck
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Gatineau, QC J8X 3X7, Canada.
| | - Eduardo Chachamovich
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Department of Psychiatry, Douglas Institute, McGill University, Montreal, QC H3A 0G4, Canada.
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16
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Wilk P, Maltby A, Cooke M. Residential schools and the effects on Indigenous health and well-being in Canada-a scoping review. Public Health Rev 2017; 38:8. [PMID: 29450080 PMCID: PMC5809999 DOI: 10.1186/s40985-017-0055-6] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background The history of residential schools has been identified as having long lasting and intergenerational effects on the physical and mental well-being of Indigenous populations in Canada. Our objective was to identify the extent and range of research on residential school attendance on specific health outcomes and the populations affected. Methods A scoping review of the empirical peer-reviewed literature was conducted, following the methodological framework of Arksey and O’Malley (2005). For this review, nine databases were used: Bibliography of Native North Americans, Canadian Health Research Collection, CINAHL, Google Scholar, Indigenous Studies Portal, PubMed, Scopus, Statistics Canada, and Web of Science. Citations that did not focus on health and residential school among a Canadian Indigenous population were excluded. Papers were coded using the following categories: Indigenous identity group, geography, age-sex, residential school attendance, and health status. Results Sixty-one articles were selected for inclusion in the review. Most focused on the impacts of residential schooling among First Nations, but some included Métis and Inuit. Physical health outcomes linked to residential schooling included poorer general and self-rated health, increased rates of chronic and infectious diseases. Effects on mental and emotional well-being included mental distress, depression, addictive behaviours and substance mis-use, stress, and suicidal behaviours. Conclusion The empirical literature can be seen as further documenting the negative health effects of residential schooling, both among former residential school attendees and subsequent generations. Future empirical research should focus on developing a clearer understanding of the aetiology of these effects, and particularly on identifying the characteristics that lead people and communities to be resilient to them.
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Affiliation(s)
- Piotr Wilk
- 1Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada.,2Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada.,3Children's Health Research Institute, London, Ontario Canada
| | - Alana Maltby
- 1Department of Epidemiology & Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario Canada
| | - Martin Cooke
- 4Department of Sociology and Legal Studies, University of Waterloo, Waterloo, Ontario Canada.,5School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario Canada
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17
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Guillaume Grandazzi. Familles et communautés face aux « grappes localisées » de suicides de jeunes : deux exemples en populations québécoise et autochtone. ENFANCES, FAMILLES, GÉNÉRATIONS 2016. [DOI: 10.7202/1038115ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
À partir d’entretiens réalisés dans deux localités au Québec, dont une en milieu autochtone, touchées par des grappes localisées de suicide de jeunes, les représentations et les répercussions de ces évènements sont interrogées. L’objectivation d’une série de suicides dans un temps et un lieu donnés ne suffit pas à qualifier le phénomène, qui renvoie à une réalité à la fois physique et sociale, et qui fait l’objet d’un processus de construction sociale. Celui-ci va contribuer ou non à transformer plusieurs tragédies individuelles et familiales en enjeu collectif qui concerne et interpelle l’ensemble de la collectivité affectée. Au-delà de la proximité temporelle et géographique des cas de suicides, c’est le fait que le phénomène atteigne des adolescents et des jeunes adultes, dans des proportions parfois importantes, qui interpelle profondément les communautés concernées et qui oblige les adultes à se questionner sur les raisons pour lesquelles une partie de la jeunesse manifeste, au travers de l’acte suicidaire, une grande vulnérabilité qui ébranle les fondements de la vie sociale et de la transmission intergénérationnelle.
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18
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Wexler L, Chandler M, Gone JP, Cwik M, Kirmayer LJ, LaFromboise T, Brockie T, O'Keefe V, Walkup J, Allen J. Advancing suicide prevention research with rural American Indian and Alaska Native populations. Am J Public Health 2015; 105:891-9. [PMID: 25790403 PMCID: PMC4386511 DOI: 10.2105/ajph.2014.302517] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2014] [Indexed: 11/04/2022]
Abstract
As part of the National Action Alliance for Suicide Prevention's American Indian and Alaska Native (AI/AN) Task Force, a multidisciplinary group of AI/AN suicide research experts convened to outline pressing issues related to this subfield of suicidology. Suicide disproportionately affects Indigenous peoples, and remote Indigenous communities can offer vital and unique insights with relevance to other rural and marginalized groups. Outcomes from this meeting include identifying the central challenges impeding progress in this subfield and a description of promising research directions to yield practical results. These proposed directions expand the alliance's prioritized research agenda and offer pathways to advance the field of suicide research in Indigenous communities and beyond.
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Affiliation(s)
- Lisa Wexler
- Lisa Wexler is with the Department of Health Promotion and Policy, Community Health Education, School of Public Health and Health Sciences, University of Massachusetts, Amherst. Michael Chandler is with the Department of Psychology, University of British Columbia, Vancouver. Joseph P. Gone is with the Departments of Psychology and American Culture, University of Michigan, Ann Arbor. Mary Cwik is with the Division of Social and Behavioral Interventions, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laurence J. Kirmayer is with the Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Quebec. Teresa LaFromboise is with the Stanford Graduate School of Education, CA. Teresa Brockie is with the National Institutes of Health Clinical Center, Nursing Research and Translational Science, Bethesda, MD. Victoria O'Keefe (Seminole/Cherokee), is a Doctoral Candidate in the Department of Clinical Psychology, Oklahoma State University, Stillwater. John Walkup is with the Department of Psychiatry, Weill Cornell Medical College, New York, NY. James Allen is with the Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth Campus
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19
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Kumar MB, Walls M, Janz T, Hutchinson P, Turner T, Graham C. Suicidal ideation among Métis adult men and women--associated risk and protective factors: findings from a nationally representative survey. Int J Circumpolar Health 2012; 71:18829. [PMID: 22901287 PMCID: PMC3417687 DOI: 10.3402/ijch.v71i0.18829] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 06/28/2012] [Accepted: 07/02/2012] [Indexed: 11/14/2022] Open
Abstract
Objective To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Study design Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.
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Affiliation(s)
- Mohan B Kumar
- Métis Centre, National Aboriginal Health Organization, Ottawa, ON, Canada.
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