On 13 November 2008, 14-year-old Jami Jetty of the Dakota tribe hanged herself from her bunk bed in her family’s home on the Spirit Lake Reservation in North Dakota.
Weeks after the funeral, when her mother, Cora Whiteman-Tiger, returned to work as an executive assistant for the tribal council, she found a flier on her desk from Wiconi Ohitika, the suicide prevention program at Cankdeska Cikana Community College’s suicide prevention program. The flier was an invitation to a “Wiping of the Tears” ceremony and sweat lodge for those who have lost loved ones to suicide.
“I was standing there (at the ceremony) with an open wound,” she recalls. Through the community ceremony, she says, she received messages of comfort and hope from her daughter.
“She told me I should let others know that suicide is not the way to go; it’s really scary. She said the lost spirits of those who committed suicide wander around crying and that we should pray for them,” Whiteman-Tiger says.
With the help of Wiconi Ohitika, which means “Strong Life” in the Dakota language, Whiteman-Tiger has taken Jami’s message to the community through prayer circles, public service announcements and youth dances.
Whiteman-Tiger’s experience exemplifies the successful elements of an American Indian suicide prevention program. Connection with community and her culture empowered her to speak out about suicide and has led to a healing experience for her and the community at large.
The Wiconi Ohitika project is one of several tribal college and mainstream university efforts to address the high rates of suicide among American Indians. According to the U.S. Centers for Disease Control and Prevention, the suicide rate for American Indians and Alaska natives is more than twice the national average for other ethnic groups. It is the second-leading cause of death behind unintentional injuries and accidents for Indian youths aged 15 to 24.
The complex reasons behind these statistics dictate that suicide prevention strategies must recognize American Indians’ unique history and need to be effective, say American Indian mental health providers and researchers.
American Indians experience cumulative trauma across generations resulting from the historical loss of land, culture, family and self-esteem, according to Dr. Jacqueline Gray, an assistant professor at the University of North Dakota (UND) Center for Rural Health at the School of Medicine. The response to this historical trauma is mental illness, alcoholism, substance abuse and suicide.
“This stripping away of culture and land has resulted in a hole in the heart that we may not be able to identify as historical trauma but we experience nonetheless,” says Gray, president-elect of the Society of Indian Psychologists and member of the Choctaw and Cherokee tribes.
The “contagion effect,” in which incidents of suicide increase among those in small, often isolated reservation communities following a peer’s suicide, is a big factor in American Indian suicide rates.
Research findings from the Substance Abuse and Mental Health Services Administration (SAMSHA) also indicate that mental health services are not easily accessible to American Indians and Alaskan natives because of a lack of funding, shortage of culturally appropriate services and the high turnover of mental health professionals. This explains why Indians underuse mental health services and discontinue therapy.
Overall, according to SAMSHA, 90 percent of the 30,000 people who die annually by suicide have a diagnosable mental illness and/or substance abuse disorder. National Violent Death Reporting System data indicate that one-third of all suicide victims tested positive for alcohol and nearly one in five had evidence of opiates. According to Gray, 90 percent of American Indians who committed suicide were under the influence of drugs or alcohol.
A Community Effort
In her research, Gray found that successful suicide prevention programming among American Indian and Alaskan native populations must address these underlying causes using culturally appropriate means. Gray says she and other mental health researchers have found overwhelmingly that the preservation or reclaiming of cultural heritage is associated with a lower prevalence of suicide attempts among American Indians and Alaskan natives.
Such suicide prevention programming should engage all members of the community in order to ensure strong community ownership, says Antonette Halsey of the Dakota tribe, vice president of library and community services at CCCC and coordinator of the Wiconi Ohitika project. Wiconi Ohitika calls on community spiritual leaders and elders to help teach traditional Dakota beading, regalia and star quilt making, singing, and traditional food preparation. These classes provide a natural venue to share the values of Dakota heritage while allowing students and elders to form relationships. Open to students and the reservation community at large, the classes are not exclusively suicide prevention programming but incorporate anti-suicide information in the course curriculum.
“There is a hunger among our young people for our traditional ways,” says Halsey. Unlike mainstream approaches, which typically include public service announcements and require people in crisis to reach out to mental health professionals, programs geared toward American Indians should offer the same anti-suicide message but as part of a cultural activity and include respected American Indian leaders and elders who can engage students on a one-on-one basis, experts say.
This approach is in keeping with research findings described in the article, “Circle of Strength: A Case Description of Culturally Integrated Suicide Prevention Programming,” co-written by Gray and Dr. Jennifer Muehlenkamp, a UND psychologist, and published in the Archives of Suicide Research in April. The authors found that, by engaging the community and incorporating cultural traditions, a tribal college can ensure its students will seek help when they need it. Researchers have also found that young American Indians who are more culturally and spiritually connected exhibit fewer suicidal tendencies and greater resistance to stress.
Tribal colleges and some traditionally White institutions use a variety of suicide prevention protocols in their programming but all share the common approach of including the community and networking for resources from mainstream and tribal sources.
UND’s American Indian Campus Suicide Prevention Program, for example, partners with reservations and tribal colleges to provide comprehensive services to students, and staff may refer UND students seeking more traditional healing practices, as opposed to therapy, to an appropriate tribal person.
Nebraska Indian Community College began offering a suicide prevention counseling certificate program last year. Graduates will be qualified to work under the supervision of a licensed mental health practitioner.
The College of Menominee Nation incorporates the “Question, Persuade, Refer” protocol into its Natamatowak “They Help Each Other” suicide prevention programming. QPR is presented as an emergency life-saving device for those at risk for suicide. According to information from the QPR Institute, people can be trained to recognize the warning signs of suicide crisis and how to refer someone for help.
The Wiconi Ohitika project uses the QPR protocol as well as the Sources of Strength model originally developed for rural and tribal communities. The model uses teams of peer leaders mentored by adult advisers to change peer social norms about seeking help. It promotes and focuses on connectivity, bonding and peer adult partnership and help-seeking behaviors.
Dr. Cynthia Lindquist of the Dakota tribe, president of Cankdeska Cikana Community College, says the most significant component of Wiconi Ohitika is working together.
According to Lindquist, cooperation exemplifies the Dakota way of life in which people must respect the gift of life and accept the responsibility to live in harmony with each other and the earth.
“Tribal colleges have as their core mission the teaching and learning of indigenous culture and language. Since this is rooted in spirituality, we are mobilizing all the spiritual leaders of the reservation and encouraging our families to believe and practice some form of faith and worship,” says Lindquist.
A resistance to confronting suicide lingers in the community, says Whiteman-Tiger.
“But we have to talk about it. I will keep talking and fighting that spirit that took my baby until I can’t fight anymore. That was my promise to the grandfathers in the lodge.”