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Suicide is epidemic for American Indian youth: What more can be done?

By Stephanie Woodard
100Reporters

A youth-suicide epidemic is sweeping Indian country, with Native American teens and young adults killing themselves at more than triple the rate of other young Americans, according to federal government figures.

In pockets of the United States, suicide among Native American youth is 9 to 19 times as frequent as among other youths, and rising. From Arizona to Alaska, tribes are declaring states of emergency and setting up crisis-intervention teams.

“It feels like wartime,” said Diane Garreau, a child-welfare official on the Cheyenne River Sioux Reservation, in South Dakota. “I’ll see one of our youngsters one day, then find out a couple of days later she’s gone. Our children are self-destructing.”

So dire is the alarm that of 23 grants the U.S. federal government awarded nationally to prevent youth suicides in September, 10 went to Native American tribes or organizations, with most of them receiving nearly $500,000 per year for three years.


A former Democratic senator from North Dakota, Byron Dorgan, who chaired the U.S. Senate Committee on Indian Affairs for 18 years, called those efforts good but insufficient. Dorgan is founder of the Center for Native American Youth, which promotes Indian child health and emphasizes suicide prevention. He describes the Indian Health Service, which serves the nation’s 566 tribes, as chronically underfunded.

"We need more mental-health services to save the lives of our youngest First Americans,” Dorgan said. “Tribes and nonprofits may get two- or three-year grants to address an issue that cannot possibly be resolved in that amount of time. We fund programs, then let them fall off a cliff.

"The perception may be that tribes have a lot of gaming funds, but that is simply not true for more than a few,” Dorgan said.

Legacy of trauma
The suicide risk factors for Native youth are well known and widely reported. In their homes and communities, many Native youngsters face extreme poverty, hunger, alcoholism, substance abuse and family violence. Diabetes rates are sky high, and untreated mental illnesses such as depression are common. Unemployment tops 80 percent on some reservations, so there are few jobs—even part-time or after-school ones. Bullying and peer pressure pile on more trauma during the vulnerable teen years.


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Native youngsters are particularly affected by community-wide grief stemming from the loss of land, language and more, researchers reported in 2011. As many as 20 percent of adolescents said they thought daily about certain sorrows—even more frequently than adults in some cases, the researchers found.

“Our kids hurt so much, they have to shut down the pain,” said Garreau, who is Lakota. “Many have decided they won’t live that long anyway, which in their minds excuses self-destructive behavior, like drinking—or suicide.”

Suicide figures vary from community to community, with the most troubling numbers in the Northern Plains, in Alaska and in parts of the Southwest. In Alaska, the suicide rate for young Native males is about nine times that of all young males in the United States, while Native females in Alaska kill themselves nineteen times as often as all U.S. females their age, according to the Alaska Native Tribal Health Consortium.

After a cluster of suicides in 2001, the White Mountain Apache Tribe wanted to develop a prevention program. It mandated reporting of all suicides and attempts on their Arizona reservation, discovering that between 2001 and 2006, their youth ended their lives at 13 times the national rate.

The trauma behind the numbers is excruciating. “When my son died by suicide at age 23, I didn’t even know how to think,” said Barbara Jean Franks, who is Tlingit and was living in Juneau, Alaska, at the time. “I couldn’t imagine that hope existed.”

The tragedies ripple through entire communities. Reservations are essentially small towns, and tribal members are often related, whether closely or distantly, Garreau said. “People are numbed, overwhelmed. Sometimes they’ll say, I just can’t go to another funeral.”

Because suicide is so common in some Native communities, it’s become an acceptable solution for times when burdens build up, said Alex Crosby, medical epidemiologist with the CDC’s injury-prevention center: “If people run into trouble—relationship problems, legal problems—this compounds the underlying risk factors, and one of the options is suicide.”

"Is it in our blood?"
“It crosses your mind,” said Jake Martus, whose Yupik/Eskimo/Athabaskan father was born in a tiny, remote village on the Yukon River. “I’ve never acted on suicidal thoughts, but they’ve been there my entire life. It’s sad, it’s shocking, but in our communities it’s also somehow normal.”

Martus, who is 26 and a patient advocate for the Alaska Native Epidemiology Center, said suicide is so frequent among his people, he has to ask, “Is it in our blood?” Martus’ father killed himself in jail after being arrested for drunk driving. Behind his dad’s alcoholism were overwhelming memories of sexual abuse by his village’s Catholic priest, Martus said. Similar stories echo throughout Indian country, where lawsuits against the Catholic Church have detailed sexual, physical, and emotional abuse by clerics in parishes or on staff at the notoriously violent boarding schools that Native children were forced to attend until the 1970s.

The lasting effect of the abuse and the loss of land and culture is often called historical trauma. Martus calls it genocide. “They set us up to kill ourselves," he said. "The point of all the policies was ‘take them out.’”

In some communities, suicide has become so ordinary that boys in particular may dare each other to try it, said Ira Vandever, a Ramah Navajo chef in western New Mexico. He works with Music Is Medicine, a local group that brings guitars, drums and lessons from rock and traditional musicians to Native youngsters. Speaking after dinner at his restaurant, La Tinaja, he said, “Around here, some who have died by suicide weren’t depressed. They were just responding to a dare.”

Incredible as it may sound to adults, adolescents may not fully understand that shooting or hanging themselves can have permanent results, said social worker Patricia Serna, who helped develop a nationally recognized suicide-prevention program for a New Mexico tribe. “Youth who survived suicide attempts would tell us they just wanted a break from their problems, a little time off.” She explains that important decision-making parts of the brain are not fully developed in adolescents—of all population groups, not just Native youngsters. As a result, they may not foresee the consequences of their actions.

Part of the boys’ difficulty is misunderstanding the warrior tradition that makes up much of Native male identity, according to Alvin Rafelito, Ramah Navajo and director of his community’s health and human services department. “We have a prayer that describes a warrior as someone who goes the distance spiritually for his people. Nowadays, that ideal has been reduced to simply fighting and violence. In teaching kids to be modern warriors, we have to convey the term’s full, traditional meaning.”

Tradition as a life raft
Tradition is key, said Anderson Thomas, Ramah Navajo and director of the community’s behavioral health program. On his reservation, he points out, it’s typically young men who are dying by suicide, not young women. “I’d say more than 90 percent of girls here go through their traditional coming-of-age ceremony,” he said. In contrast, little is done for young males. In large part, he said, that’s because traditional male activities like hunting have diminished, so rituals related to them have dropped off as well. Though Ramah Navajo men and boys can obtain conventional therapy, they also need ceremonies, Thomas said.

“It was my tradition that brought me to safety,” Franks said. As time went on, she went back to school, got a degree and these days promotes suicide prevention statewide on behalf of the Alaska Native Tribal Health Consortium. “Now, I can move forward. Instead of saying my son died by suicide, I can say he gave me 23 years of his life.”

According to Crosby, tradition is one of the so-called “protective factors” that can counter the risk factors—even the deeply embedded ones that afflict tribes. For indigenous people, tradition is distinctive and powerful, say researchers. It incorporates family and clan relationships, reverence for elders and a deeply-held spiritual life. Supporting these traditions and ties makes Native youngsters feel valued and gives them encouragement to seek help, U.S. and Canadian scientists have concluded in study after study.

You don’t have to be a scientist to figure this out. Alaska Native Tessa Baldwin was a 17-year-old high school student when she learned that feeling connected is vital. At age 5, she had lost an uncle to suicide and in succeeding years, several friends and a boyfriend. “I finally realized it wasn’t something affecting just me,” she said. “It was a lot bigger.” In 2011, she founded Hope4Alaska, one many small grassroots suicide-prevention groups in Indian country.

Through Hope4Alaska, Baldwin traveled to schools in Alaska Native villages to tell her story and find out what other teens thought would help.

“We had youth–elder discussions, and the kids said they felt useless. They wanted to better their communities but saw no way to make a contribution. The elders were touched, and the kids felt they’d connected with them in an important way,” recalls Baldwin, who has just started her freshman year at the University of California, San Diego.

To make sure Cheyenne River’s children feel part of a community that values them, Diane Garreau’s sister, Julie, runs the Cheyenne River Youth Project, a busy after-school facility. Kids listen to elder storytellers, play basketball and tend a two-acre organic garden. They get healthy meals and homework help. They study in a library, go online in an Internet café, stage fashion shows and organize local beautification projects. In 2011, a youth-leadership group visited the White House.

“Everything we do—from serious to seemingly frivolous—is about letting our kids know we care,” Julie Garreau said.

Continuity counts
“You could define many things—a school camping trip, a traditional dance group—as suicide prevention,” said Zuni Pueblo’s Superintendent of Schools Hayes Lewis, co-creator  of the Zuni Life Skills Development curriculum, one of the first suicide-prevention programs designed for Native Americans, in the late 1980s. The school-based lesson series teaches coping skills like stress management, as well as role-playing responses to suicide threats. It was created after a rise in youth-suicide rates at Zuni—thirteen deaths between 1980 and 1987, according to a paper Lewis co-wrote in 2008.

After Zuni adopted the curriculum in 1991, youth suicide stopped almost immediately, according to Lewis’s co-author, Stanford University education professor Teresa LaFromboise. Fifteen years later, the pueblo’s schools shelved the program. Suicides crept back, and the shocked community asked Lewis to resume the post of school superintendent and re-establish the curriculum. Over the past two years, he’s done just that, he said.

When the Zuni school system ended its program, the officials there didn’t realize “how fragile the peace was,” Lewis testified to the Senate Committee on Indian Affairs in 2009, telling then-Senator Dorgan and other members: “Suicide prevention and intervention require constant vigilance.”

Agencies, nonprofits, foundations and others can partner with tribes in the effort to protect Native children. Ultimately, though, it’s up to the communities, Lewis said. “We adults have to practice our core cultural values of compassion, respect, cooperation and concern for our children. We have to talk to youngsters about relationships, clans, societies—all the connections they’re a part of.”

“We have to tell our kids how wonderful they are,” adds Julie Garreau. “We have to give them safe places to learn and have fun and reassure them that they can have a productive life with healthy relationships.”

Franks recently participated with grieving family members in a memorial walk. The group circled a lake in one direction to honor those they’d lost, and the other direction to express support for those who remain. “Prevention includes acknowledging the bereaved and helping them talk about what happened,” Franks said.

Rafelito was hopeful. He was standing in a Ramah Navajo community garden, surrounded by ripening squashes, corn and other heirloom crops. He noted that today’s Native people and their traditions endure, despite centuries of depredations and violence. “Look at our history,” Rafelito said. “It’s been survival of the fittest. We’re the smartest and the toughest anyone can be.

“Our message to our kids should be, ‘We’re OK.’”

Stephanie Woodard is a member of 100Reporters, a nonprofit investigative news center. This article, the first in a series on preventing Native youth suicide, was made possible by grants from the Fund for Investigative Journalism and The California Endowment Health Journalism Fellowships, a program of USC’s Annenberg School of Journalism. The series will be co-published with Indian Country Today.