On June 15, the Senate Committee on Indian Affairs heard testimony on suicide among Native American youth.
Ranking Member Byron Dorgan (D-ND), who chaired the hearing, described the issue as “very important” and “very sensitive.” Pointing out that youth suicide is “more acute on Indian reservations,” he noted that suicide is the second leading cause of death for Native American youth between the ages of 15 and 24. “We all want a better life for our children,” Sen. Dorgan said, adding, “These are the first Americans, and yet in many cases they live in Third World conditions.” Sen. Dorgan proposed that as the committee reauthorizes the Indian Health Care Improvement Act (S. 1057), “a portion of that might begin to address this issue.”
Sen. Gordon Smith (R-OR), whose son committed suicide at age 21, stated, “This is a problem that can be addressed successfully if it is done in an effective way. There is nothing worse than a life without hope. There is help that can be found.” Under the Garrett Lee Smith Memorial Act (P.L. 108-355) named for his son, $82 million was authorized through FY2009 (see The Source, 9/10/04). Sen. Smith urged that $27 million be appropriated in FY2006 “to stay on course.” He said, “If we’re serious about being pro-life, we should help these children who suffer find a way to get the help they need.”
Department of Health and Human Services (HHS) Surgeon General Richard Carmona confirmed the high suicide rates for Native American youth: “For 5- to 14- year-olds, the suicide rate is 2.6 times higher than the national average. And there is an even greater disparity in the later teenage years and into young adulthood. The suicide rate for American Indian /Alaska Native youth aged 15 to 24 is 3.3 times higher than the national average.” Dr. Carmona explained that recent data suggests “these young people act more impulsively than planned, are usually responding more to external stimuli (including significant family or interpersonal problems), have been using alcohol and/or other substances, and they tend not to have been previously seen in any behavioral health clinical setting.” He stressed the need for “public health and community interventions as much as clinical interventions,” adding that the “Administration’s FY 2006 budget request for IHS [Indian Health Services] includes a total of $59 million for mental health, an increase of $4.3 million, or 8 percent, over FY 2005.”
Highlighting the importance of collaboration in addressing this “ongoing crisis,” Dr. Carmona said that HHS, the Department of the Interior, and other agencies have worked together to address the goals established at a 2002 tribal consultation, called by IHS Director Charles Grim. He outlined the current strategies: 1) crisis response teams, which “provide emergency short-term and intermediate-term direct services, training, and infrastructure support to communities in crisis;” and 2) the IHS Director’s National Behavioral Health Initiative, which has “established surveillance, training, and prevention programming for the American Indian/Alaska Native communities.” As an example of success, Dr. Carmona offered the community-based intervention strategy of the Jicarilla Apache of northern New Mexico: “The strategy brought together tribal leadership, community members, youth, clinicians, researchers from the University of New Mexico, and IHS personnel to design and implement the program. The program involves the entire community, from tribal government, to schools, to social service and law enforcement agencies. The result is that over the past decade, suicidal activity has fallen by approximately 60 percent among the Jicarilla Apache of Northern New Mexico — and has been maintained at that level.”
Chair John McCain (R-AZ) asked Dr. Carmona why Native American youth have higher rates of suicide than others, such as inner city youth, who also live in poverty. He suggested that the answer relates to the history of Native Americans, to their “exploitation and placement.” Dr. Carmona agreed, and said that the “burden of centuries” is being felt today.
Standing Rock Sioux Tribe member Twila Rough Surface, whose niece committed suicide this year, described her tragedy and detailed the lack of mental health services in the community: “Few schools and communities have suicide prevention plans that include screening, referral, and crisis intervention programs for youth. Programs designed to assist children and families dealing with severe trauma are not readily available on Standing Rock…Transportation and access to a telephone is essential to regular therapy, however, this is not a luxury the majority of our families have.” She stressed the need for families to “learn the warning signs” and “be willing to listen.”
Testifying on behalf of the American Psychological Association, Program Manager and Clinical Supervisor Joseph Stone stated, “Tribal youth are raised in families and communities subjected to ongoing cultural oppression, health disparities and lack of equal access to services, lack of economic opportunity and chronic poverty…For tribal families, these factors translate to double the number of native youth reporting using marijuana, cocaine, tobacco, and alcohol in past month prevalence data than youth of other races.” Mr. Stone highlighted the lack of qualified native mental health providers and said that “both county and state agencies are often reluctant to hospitalize mentally ill native clients and/or suicidal native clients” because of cost issues. His recommendations included “suicide prevention as the top preventative focus for the IHS” and a “national center for excellence for suicide prevention in native and tribal communities.”
