'Cry for help' in youth suicide brings about a 'battle for hope'

WASHINGTON
The suicide rate among Indians ranges from one and a half to three times the national average, and young people aged 15 to 34 make up more than two-thirds of Indian suicides. In Alaska, Alaska Native teens commit suicide at a rate five times higher per 100,000 than non-Native teenagers. Among American Indian and Alaska Native youths aged 15 to 24, suicide is the second-leading cause of death behind unintentional injury and accidents.

In the United States at large, more than half of all who commit suicide have never received mental health treatment; the percentage is much higher in tribal communities, according to Charles Curie, of the Substance Abuse and Mental Health Services Administration.

If anything good can be found in such facts, testimony before the Senate Committee on Indian Affairs on May 17 brought it out. For one thing, Indians are not alone in facing this malady of the human condition - suicide claims the lives of approximately 30,000 Americans annually, and worldwide it accounts for 49.1 percent of violent deaths. This means a wide range of sympathy and expertise may be available for intervention purposes as mental health planning and treatment gets more attention. Just as importantly, the one in five or so American Indian and Alaska Native teens who consider suicide, and the one in six or seven who actually attempt it, are sending a message that is there to be heard before it's too late.

In the words of Jerry Gidner, deputy director for tribal services at the BIA, ''The youth of Indian country are crying out for help.''

The consensus of witnesses before the committee was that Native youths consider suicide because they feel sad and hopeless, but they also signal their feelings. Their signals can become intervention points for programs offered by the IHS, the BIA, the Substance Abuse and Mental Health Services Administration at the Department of Health and Human Services, and Congress under the Garrett Lee Smith Memorial Act, authorizing a national suicide prevention resource center. The Senate only recently - in early May - approved ''telemental health'' legislation that would help to overcome the problem of timely intervention in rural communities that are far removed from cadres of medical professionals.

Lack of intervention in rural and remote Native communities has contributed to suicide in the past, but modern research is producing new public health intervention models for contemporary use, said Gidner and Curie. Curie stressed the importance of collaborating with local agencies to identify youth suicide risk factors in Native communities and then introduce ''protective factors'' for youth - heritage, strong youth initiatives, a sense of family and tradition, ''and help them see what their future may hold'' so they'll focus on that.

''I think we are still engaged in a battle for hope,'' IHS Director Charles Grim maintained, in written testimony that filled out his much more brief oral remarks. ''For those young people who see only poverty, social and physical isolation, lack of opportunity or family dissolution, hope can be lost and self-destructive behavior becomes a natural consequence. The initiative and programs I have described are some methods and means to restore that hope and engage youth and their communities to sustain and nurture it. These efforts are not sufficient, in and of themselves, to significantly change many peoples' living conditions. However, if we can act together, among agencies, branches of government, tribes, states and communities, I believe that the tide can be turned and hope restored to these young people who have lost hope.''

Grim repeatedly emphasized that progress against suicide involves communities and partnerships. ''The most important thing to remember is that it's not a single problem. It's a single response to multiple problems ... The social complex factors, housing, education, safety in the community, all those are part of it. It is just such a complex issue that we have to have more partnerships, I believe.''