Senate Urged to Address Suicide in American-Indian Youth

But a key problem he and others working in the area of American-Indian mental health have found is a lack of top-quality “culture-based interventions.” He urged the Senate committee to support innovative research on culture-based interventions through research mandates and financial support.

Such an approach also was urged by Teresa LaFromboise, Ph.D., an associate professor of counseling psychology and chair of Native-American Studies at Stanford University. She said the decisions related to suicidal behavior among the majority of American-Indian youth may be attributed to direct learning or modeling influences, such as the influence of family members' suicide attempts or deaths by suicide. Many risk factors for suicide are similar to risk factors for other problematic behaviors, she noted, such as alcohol and drug abuse or engaging in unsafe sex.

“When cast from this more social cognitive perspective, suicide and other forms of risk behavior are more likely to be preventable,” LaFromboise said.

Other approaches, including treating suicidal thoughts and behaviors as a chronic illness, also offer promise, Walker said.

“The illness often begins in childhood and develops over years as a vulnerability, propensity, ability, and, finally, a determination to suicide,” Walker said. “Providing opportunities to develop life skills, commitment to community service, and involvement with nurturing and shaping family relationships create resiliency and capacity to meet the crises and challenges that otherwise precipitate suicide.”

Another area ripe for increased federal support is increased training for physicians and other professional staff in the skills of suicide risk assessment and intervention. In particular, Walker called for support of telehealth training services that can provide on-the-job continuing education through the resources of colleges and universities.

The urgent need for stepped-up suicide-prevention efforts was echoed by others.

Senate Majority Leader Harry Reid (D-Nev.) testified about his father's death by suicide at age 60.

He described as “significant steps forward” the passage in the last Congress of mental health insurance parity legislation and a measure to lower Medicare's coinsurance requirement for outpatient mental health care to the level charged for all other types of medical treatment.

Reid said he plans to reintroduce and push for passage of the Indian Health Care Improvement Act, which would authorize the Indian Health Service to establish a behavioral health prevention and treatment plan and create an Indian youth “telemental health program” focused on suicide prevention and intervention. The measure passed the Senate last year but was not acted on by the House.

Information about the Senate hearing is posted at<http://indian.senate.gov/public> under “Recent Hearings.” ▪