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More Mental Health Resources Needed to Battle Teen Suicides in American Indian and Alaska Native Communities

by U.S. Medicine

May 24, 2010

WASHINGTON, DC—Addressing the problem of teen suicides continues to pose a challenge for American Indian and Alaska Native (AI/AN) communities, officials told a Senate committee. “Indian Country has communities where suicide can take on a contagious form, often referred to as suicide clusters. The suicide act becomes a form of expression of the despair and hopelessness experienced by some Indian youth,” Randy Grinnell, PhD, deputy director of IHS, told the Senate Indian Affairs Committee.

Suicide is the second leading cause of death for Indian youth ages 15-24 residing in IHS service areas, and is 3.5 times higher than the national average. Overall, suicide is the sixth leading cause of death for males in IHS service areas and ranks ahead of homicide.

Indian Affairs Committee Chairman Sen Byron Dorgan, D-ND, who held a hearing on teen suicides, called the clusters of teen suicides very troubling. “We have clusters of suicides that are very troubling and we are trying to do everything we can to recognize it, put a spotlight on it and understand how to address it.”

IHS Addresses Suicide

An insufficient number of mental health providers is one challenge IHS faces. Grinnell told the committee that many of the IHS, tribal, and urban mental health programs that provide services do not have enough staff to operate 24/7. “Some providers are so overwhelmed by the demand for services, particularly during suicide outbreaks, that even well-seasoned providers become at risk for burnout.”

In his written testimony to the committee, he stated that there are situations where the appropriate treatment is known, such as counseling therapy for a youth survivor of sexual abuse, but that there are simply no appropriately trained therapists in the community.

Grinnell said that over the years IHS has attempted to increase mental health providers in Indian country through special pay incentives, loan repayment scholarships, active recruitment, the development of the Indians into Psychology Program, and emergency deployment of the United States Public Health Service Commissioned Corps.

According to Grinnell, IHS is developing strategic plans to address both behavioral health and suicide in the Indian health system. “These two plans will foster collaboration among tribes, tribal organizations, urban Indian organizations, and other key community resources and provide the tools and framework for the next five years.”

IHS also has received funding for an initiative called the Methamphetamine and Suicide Prevention Initiative (MSPI) that supports the development of pilot projects for model practices for methamphetamine and suicide reduction programs in
Indian Country. MSPI now supports 129 community developed prevention and intervention pilot programs across the country, according to Grinnell.

Resources to Address Suicide

Dr Paula Clayton, MD, medical director for the American Foundation for Suicide Prevention, told the committee that the major risk factors for suicide are the presence of an untreated psychiatric disorder, the history of a past suicide attempts, and a family history of suicide or suicide attempts. The most important interventions are recognizing and treating these disorders, according to Clayton.

She said that more funding should be allocated to address a shortage of treatment resources in Indian Country. “Obviously, if there is a shortage of treatment resources, which there seems to be, then dollars need to be allocated to develop innovative new treatments for Native American [youth],” she said.

Mental health screening is an important way to identify mental health problems in teens, Laurie Flynn, executive director of the TeenScreen National Center for Mental Health Checkups at Columbia University, said in written testimony. The TeenScreen program supports mental health screening in more than 900 sites in 43 states, including tribal settings. “A mental health checkup using an evidence-based, standardized tool should be incorporated into the annual well-child visit for all adolescent youth as part of routine preventive care. We now know that in youth up to age 21 there is a window of opportunity of two to four years, between the first symptoms and the onset of the full-blown diagnosable disorder, when treatment is most effective at reducing the severity of specific disorders,” according to Flynn’s testimony.

Coloradas Mangas, a 15-year-old teen from Ruidoso, NM, testified about the many young people he knew who committed suicide. He said that he did not think that there are enough mental health resources in his community. “We have a mental health clinic with only one full-time psychologist. One psychologist to serve a community of 4,500 children, youth and adults.”

In addition to more resources to address suicide, he said that the youth needed more activities to “get them away from drugs, alcohol, and idle trouble.” “We need more leadership activities to inspire our youth to change their life course,” he said.

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