Suicide Intervention and Prevention with Indian Adolescent Populations

Abstract

Suicide intervention and prevention among Indian tribes in the rural Northwest is discussed by a white psychiatric nurse who has worked with Plains Indians for approximately five years. Reservation life is described, highlighting environmental factors that place residents at high risk for suicide. The Wind River Reservation suicide epidemic is examined as a case study. Community assessment, and intervention and prevention strategies are presented from a community mental health nursing perspective. Particular emphasis is place on environmental obstacles to be overcome, and practical approaches relevant to the Plains Indian culture and the sparsely populated setting. Professional nurses, in collaboration with other human services workers and tribal leaders, have reduced and can continue to reduce the incidence of adolescent suicide on Indian reservations. Nurses face the challenge of developing intervention strategies that are acceptable within the culture of the Indian client as well as feasible in an isolated, rural setting. On the reservation, the individual psychopathology that may predispose an adolescent to suicide is exacerbated by an environment of poverty, prejudice, and violence. There are, in reality, limited opportunities for youths to develop and prosper, as well as unclear cultural mores to help them learn to deal with and express feelings. Biopsychosocial assessment and holistically oriented intervention, hallmarks of nursing, are much needed strategies for dealing with these complex problems.