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Frazer H, Giles AR. Are sport and traditional Inuit games identified as tools in current Inuit suicide prevention strategies?: A content analysis. Int J Circumpolar Health 2023; 82:2276983. [PMID: 37992403 PMCID: PMC10997296 DOI: 10.1080/22423982.2023.2276983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/25/2023] [Indexed: 11/24/2023] Open
Abstract
Eekeeluak Avalak, an 18-year-old Inuk wrestler who won the first-ever gold medal for Nunavut at the Canada Summer Games in 2022, dedicated his win to his late brother who died by suicide in 2015. Avalak openly attributed sport - specifically wrestling - to saving his own life. This story raises important questions about the role of sport and traditional games in Inuit suicide prevention strategies. Few studies have examined the role of sport or traditional games in Inuit suicide prevention strategies. In an attempt to reduce Inuit suicide rates, in addition to the National Inuit Prevention Strategy, three of the four land claim regions that constitute Inuit Nunangat have suicide prevention strategies. In this study, we used settler colonial theory, critical Inuit studies, and content analysis to examine if and how sport and Inuit traditional games are identified as prevention tools in these Inuit suicide prevention strategies. The results demonstrate that sport and traditional games have largely been overlooked as protective factors in current Inuit-wide and land-claim specific suicide prevention strategies. Moving forward, evidence-based and community-driven approaches could be funded, created, implemented, and evaluated as culturally-safe Inuit mental health intervention models to address the disproportionately high suicide rates among Inuit in Inuit Nunangat.
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Affiliation(s)
- Hannah Frazer
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Audrey R. Giles
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Markowski KL, White L, Harcey SR, Schmidt T, McEachern D, Habecker P, Wexler L. What Kinds of Support are Alaska Native Youth and Young Adults Reporting? An Examination of Types, Quantities, Sources, and Frequencies of Support. Health Promot Pract 2023; 24:863-872. [PMID: 36047453 PMCID: PMC10729876 DOI: 10.1177/15248399221115065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
American Indian and Alaska Native (AI/AN) youth, particularly males, experience disproportionately high rates of suicide compared to other young people in the United States. Therefore, enacting suicide prevention efforts for AI/AN youth is especially important. Since research shows that strengthening social, cultural, and emotional support can reduce suicide risk, many recent prevention efforts focus on these strategies. Yet, to reinforce and to extend the positive impact of these strategies for suicide risk reduction, we argue it is useful to identify baseline levels and other features of already-existing support. Toward this end, we describe the types (i.e., category), quantities (i.e., distribution and average number), sources (i.e., from whom), and frequencies (i.e., how often) of social support that AN young people report receiving, and we examine if these "support profiles" differ by age and sex. We use survey data from 165 ANs under age 30, collected as part of a participatory intervention study focused on Promoting Community Conversations About Research to End Suicide (PC CARES). We find that: 1) most ANs reported receiving nearly all supports, 2) compared with females, males reported receiving fewer supports on average, 3) family was the most selected support source, followed by close friends and service providers, and 4) family (e.g., parents, siblings, and grandparents) provided support regularly (i.e., monthly or more). Though our findings may suggest fruitful avenues for interventions targeted toward AN males, we discuss these findings in relation to the gendered nature of suicide prevention and assessment.
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Allen J, Wexler L, Rasmus S. Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:59-72. [PMID: 34169406 DOI: 10.1007/s11121-021-01265-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
The ongoing challenge of American Indian and Alaska Native (AIAN) youth suicide is a public health crisis of relatively recent historical origin inadequately addressed by contemporary prevention science. A promising development in AIAN suicide prevention highlights the role of protective factors. A protective factor framework adopts a social ecological perspective and community-level intervention paradigm. Emphasis on protection highlights strength-based AIAN cultural strategies in prevention of youth suicide. Attention to multiple intersecting levels incorporates strategies promoting community as well as individual resilience processes, seeking to influence larger contexts as well as individuals within them. This approach expands the scope of suicide prevention strategies beyond the individual level and tertiary prevention strategies. Interventions that focus on mechanisms of protection offer a rigorous, replicable, and complementary prevention science alternative to risk reduction approaches. This selected review critically examines recent AIAN protective factor suicide prevention science. One aim is to clarify key concepts including protection, resilience, and cultural continuity. A broader aim is to describe the evolution of this promising new framework for conducting primary research about AIAN suicide, and for designing and testing more effective intervention. Recommendations emphasize focus on mechanisms, multilevel interactions, more precise use of theory and terms, implications for new intervention development, alertness to unanticipated impacts, and culture as fundamental in a protective factors framework for AIAN suicide prevention. A protective factor framework holds significant potential for advancing AIAN suicide prevention and for work with other culturally distinct suicide disparity groups, with broad implications for other areas of prevention science.
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Affiliation(s)
- James Allen
- Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team-American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Duluth, MN, 55812, USA.
| | - Lisa Wexler
- Department of Social Work and Research Center for Group Dynamics, Institute for Social Research, Univeristy of Michigan, Ann Arbor, MI, 48104, USA
| | - Stacy Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, 99775, USA
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Fraser S, Plourde-Léveillé L, Kirmayer LJ. Exploring the potential roles of community-university partnerships in northern suicide prevention implementation research. Int J Circumpolar Health 2020; 79:1835271. [PMID: 33175672 PMCID: PMC7671706 DOI: 10.1080/22423982.2020.1835271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/21/2020] [Accepted: 10/08/2020] [Indexed: 10/27/2022] Open
Abstract
This paper discusses the lessons learned from a partnership project on suicide prevention carried out with Inuit organisations in Nunavut and Nunavik. The aim was to identify research needs, processes, and opportunities for knowledge translation to guide suicide prevention activities. Key reflections among partners regarding regional needs and the potential roles of research in suicide prevention in northern Canada are described as well as the three identified priorities: (1) focusing on community mobilisation; (2) supporting access to scientific information; and (3) supporting the adaptation of evaluation criteria and protocols of ongoing community activities. Strategies to address these priorities are presented.
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Affiliation(s)
- Sarah Fraser
- School of Psychoeducation, Pitutsimajut Partnership Research, University of Montréal, Montréal, Québec, Canada
| | - Léa Plourde-Léveillé
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Laurence J. Kirmayer
- Division of Social and Transcultural Psychiatry, Department of Psychiatry, McGill University, Montreal, Québec, Canada
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Suicide amongst the Inuit of Nunavut: An Exploration of Life Trajectories. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061812. [PMID: 32168793 PMCID: PMC7143601 DOI: 10.3390/ijerph17061812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
This article reports results of the life trajectories from 92 Inuit who died by suicide, matched for age and gender with 92 living-controls. A proxy-based procedure and semi-structured interviews with informants were conducted to obtain trajectories of developmental events occurring over the life course for suicide and community-matched controls. Results from this research indicate two different trajectories that differentiate the control-group from the suicide-group throughout the life course. Even though the number of suicide attempts are similar between both groups, the suicide-group had a more important burden of adversity, which seemed to create a cascading effect, leading to suicide.
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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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Williamson AK, Riendeau RP, Stolzmann K, Silverman AF, Kim B, Miller CJ, Connolly SL, Pitcock J, Bauer MS. An Exploratory Analysis of Self-Reported Protective Factors against Self-Harm in an Enrolled Veteran General Mental Health Population. Mil Med 2019; 184:e738-e744. [DOI: 10.1093/milmed/usz111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/30/2019] [Indexed: 12/28/2022] Open
Abstract
Abstract
Introduction
The purpose of this study is to characterize self-reported protective factors against suicide or self-harm within free-response comments from a harm-risk screening.
Materials and Methods
Veterans enrolled in Department of Veterans Affairs mental health care were administered a self-harm and suicide screening as part of the baseline assessment in an ongoing implementation trial. Veterans indicated if they had thoughts of harming themselves and if so, what kept them from acting on them. Responses were coded based on established Centers for Disease Control protective factor categories. Descriptive analyses of demographic factors (such as age, gender, and race), clinical factors, and quality of life measures were conducted across groups depending on levels of self-harm risk.
Results
Of 593 Veterans, 57 (10%) screened positive for active thoughts of self-harm or suicide. Those with thoughts of self-harm had lower quality of life scores and higher rates of depression diagnoses. Of those individuals, 41 (72%) reported protective factors including Personal Resources (17%), Community Resources or Relationships (68%), and Other including pets and hobbies (15%). Those with stated protective factors had higher rates of employment and lower rates of PTSD diagnoses.
Conclusion
This is one of the first open-response studies of harm-risk protective factors, allowing for a patient-centered approach that prioritizes the individual’s voice and values. New protective factors emerged through the open-response format, indicating important factors that kept Veterans safe from self-harm or suicide such as pets and hobbies. Increasing focus on strengths and positive aspects of Veterans’ lives that serve as protective factors may ultimately improve mental health treatment and prevention of suicide and self-harm.
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Affiliation(s)
- Alicia K Williamson
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- School of Information, University of Michigan, 4322 North Quad, 105 S. State St, Ann Arbor, MI 48109
| | - Rachel P Riendeau
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- University of Iowa, Department of Anthropology, 114 Macbride Hall, Iowa City, Iowa 52242
| | - Kelly Stolzmann
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
| | - Allie F Silverman
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- College of Social Work, University of South Carolina, 1512 Pendleton St, Columbia, SC 29208
| | - Bo Kim
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215
| | - Christopher J Miller
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215
| | - Samantha L Connolly
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
| | - Jeffery Pitcock
- U.S. Department of Veterans Affairs, Central Arkansas Veterans Healthcare System, 4300 W 7th Street, Little Rock, AR 72205
| | - Mark S Bauer
- U.S. Department of Veterans Affairs, Center for Healthcare Organization and Implementation Research (CHOIR), 150 South Huntington Ave, Boston, MA 02130
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215
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Sisask M, Kõlves K. Towards a Greater Understanding of Suicidal Behaviour and Its Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081629. [PMID: 30071699 PMCID: PMC6121881 DOI: 10.3390/ijerph15081629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/31/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn 11615, Estonia.
- School of Governance, Law and Society (SOGOLAS), Tallinn University, Tallinn 10120, Estonia.
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention (AISRAP), WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Mt Gravatt Campus, Mount Gravatt QLD 4122 Australia.
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