Pollock Nathaniel J, Apok Charlene, Concepcion Tessa, Delgado Roberto A, Rasmus Stacy, Chatwood Susan, Collins Pamela Y
School of Public Health, University of Alberta, Edmonton, Canada.
Indigenous Studies, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA.
Indian J Psychiatry. 2020 Jan-Feb;62(1):7-14. doi: 10.4103/psychiatry.IndianJPsychiatry_717_19. Epub 2020 Jan 3.
The purpose of this selective narrative review is to provide an overview of suicide and suicide prevention in the Circumpolar North and the relevance of global strategies and policies to these themes. We conducted a selective review of the English language literature on Arctic Indigenous mental health, suicide, and suicide prevention. We briefly present the social context, epidemiology, and risk and protective factors for suicide in the Arctic, with a focus on Indigenous peoples. We highlight a recent collaborative, intergovernmental response to elevated suicide rates in this region, the Reducing the Incidence of Suicide in Indigenous Groups - Strengths United through Networks Initiative, which used a consensus methodology to identify key outcomes for evaluating suicide prevention interventions in the circumpolar context. In relation to the Sustainable Development Goals, we examine recent policy developments in Indigenous-led suicide prevention and identify opportunities for strengthening policy, community interventions, and research. Globally, suicide prevention is a public health priority, and reducing the number of suicide deaths is a key target for sustainable development. Although overall and country-specific suicide rates have decreased since 1990, there remains wide variation at the regional and local level. This is particularly evident in the Arctic region known as the Circumpolar North, where Indigenous peoples experience marked disparities in suicide risk and suicide deaths compared to non-Indigenous populations. The factors that influence these variations are complex and often rooted in the social and economic consequences of colonization. The integration of science, community-based and Indigenous knowledge, and policies that address upstream risks for suicide will play an important role in suicide prevention alongside the growing number of Indigenous suicide prevention strategies tailored for specific populations.
本选择性叙述性综述的目的是概述北极地区的自杀与自杀预防情况,以及全球战略和政策与这些主题的相关性。我们对关于北极地区原住民心理健康、自杀及自杀预防的英文文献进行了选择性综述。我们简要介绍了北极地区自杀的社会背景、流行病学情况以及风险和保护因素,重点关注原住民。我们着重介绍了近期针对该地区自杀率上升的政府间合作应对举措,即“降低原住民群体自杀发生率——通过网络倡议凝聚力量”,该倡议采用共识方法确定了在北极地区评估自杀预防干预措施的关键成果。关于可持续发展目标,我们审视了原住民主导的自杀预防方面的近期政策发展,并确定了加强政策、社区干预和研究的机会。在全球范围内,自杀预防是公共卫生的优先事项,减少自杀死亡人数是可持续发展的关键目标。尽管自1990年以来总体自杀率和各国自杀率有所下降,但区域和地方层面仍存在很大差异。这在被称为北极地区的环北极地区尤为明显,与非原住民相比,原住民在自杀风险和自杀死亡方面存在显著差异。影响这些差异的因素很复杂,且往往源于殖民化的社会和经济后果。科学、基于社区和原住民的知识以及应对自杀上游风险的政策的整合,将在自杀预防中发挥重要作用,同时为特定人群量身定制的原住民自杀预防策略也越来越多。