Risk and protective factors with Native American Indian and Alaska Native children who have a history of suicidal behavior

Suicide is a leading public health problem in the United States, and Native American Indians and Alaskan Native individuals are at an increased risk for suicide. This study sought to understand the demographic and clinical risk and protective factors for young Native American Indians and Alaskan Native children who were hospitalized due to suicide ideation, or an attempt. The demographic and clinical variables evaluated included religious preference, sexual orientation, prior suicidal behavior and psychiatric admissions, history of abuse, CPS involvement, family history of mental illness, family history of substance use, family history of suicidal behaviors, domestic violence, recent significant losses, and sleep disturbances including nightmares and night terrors. Recommendations included providing increased support for LGBTQ youth, increased access and utilization for mental health and medical services, preventative education regarding suicide prevention, and increased follow-up care posthospitalization. 2 Journal of Indigenous Research, Vol. 8 [2020], Iss. 2020, Art. 2 https://digitalcommons.usu. edu/kicjir/vol8/iss2020/2 DOI: https://doi.org/10.26077/6qnp-z328 Suicide is considered to be a fatal and self-directed act with the explicit, or inferred, intent to die. Suicide is a major health problem in the United States (Olson & Wahab, 2006). It is the 10 leading cause of death for adults, and the 2 leading cause of death for youth in our country (AFSP, 2018; CDC, 2018). Native American Indians and Alaska Natives have the highest rate of suicide of all ethnic groups in the United States (AFSP, 2018; CDC, 2018). The suicide rate among Native American Indians and Alaska Natives ages 15 to 24 is three times higher than that of other young people in the Unites States (Indian Health Service, 2004). There are several different risk factors that have been identified for Native American Indian and Alaska Native youth including lack of access to mental health treatment, barriers to seeking help, family conflict, prior suicide attempts, loss of ethnic identity, substance use, depression, anxiety, and poverty (Freedenthal & Stiffman, 2007; Olson & Wahab, 2006; de Schweinitz, Nation, DeCou, Stewart, & Allen, 2017). Borowsky, Resnick, and Ireland (1999) conducted a large-scale study of over eleven thousand Native American Indian and Alaska Native youth and found the most significant risk factors to be having a friend or family member who committed suicide, substance use, access to guns, gang involvement, being a victim of physical or sexual abuse, and general health concerns. LaFrombois, Medoff, Lee and Harris (2007) posited that the Native American Indian and Alaska Native youth face historical trauma, acculturation stress, and geographic isolation, which may also contribute to the increased risk for suicide. In particular, they found a strong predictive correlate between the psychiatric diagnoses of depression and substance use for this population (LaFromboise et al., 2007). Walls, Chapple and Johnson (2007) found several strains were related to suicidal behavior with Native American Indian and Alaska Native youth which included coercive parenting, caretaker rejection, negative school attitudes, and perceived 3 Weniger et al.: Risk and protective factors with Native American Indian and Alask Published by DigitalCommons@USU, 2020 discrimination. In addition, depression and anger mediated the key predictors of suicide for this group. There is considerable information regarding the risk factors for the Native American Indian and Alaska Native population, and adolescents over age 15; however, there is a paucity of information for young Native American Indian and Alaska Native children under age 15. Information regarding the risk factors and demographics for preadolescent Native American Indian and Alaska Native children who have attempted suicide has been overlooked in the research. This is valuable information as over the past 30 years suicides among preadolescent children have increased significantly in the United States (Greydanus & Calles, 2007; Pompili et al., 2005). When a child is at risk for suicide either by contemplating self-harm, or making an attempt, stabilization may be warranted at an inpatient psychiatric facility. There are few inpatient psychiatric hospital facilities in Southern California. In particular, in the geographic region of the Inland Empire with over 4 million residents there is only one pediatric psychiatric inpatient unit. This study occurred at the only pediatric psychiatric unit in the Inland Empire region.