Wexler Lisa, White Jennifer, Trainor Bridie
Department of Public Health, University of Massachusetts Amherst, MA, USA.
School of Child and Youth Care, University of Victoria, Victoria, Canada.
Crit Public Health. 2015;25(2):205-217. doi: 10.1080/09581596.2014.904039. Epub 2014 Apr 7.
The need for effective youth suicide prevention is uncontested, and is particularly urgent for Indigenous populations. The Indigenous youth suicide rates in some North American communities can be 18 times greater than for other young people. Despite the clear need, evidence in support of Indigenous youth suicide prevention strategies remain mixed. The most common approach to youth suicide prevention - gatekeeper training - may have limited effects in Indigenous communities. Based on recent work undertaken with Indigenous leaders in rural Alaska, we describe culturally grounded, practical alternatives that may be more effective for Indigenous communities. We highlight the ways in which research informed, grassroots interventions can address cultural, practical and systemic issues that are relevant when addressing risks for suicide on a community level. Built on a transactional-ecological framework that gives consideration to local contexts, culture-centric narratives and the multiple, interacting conditions of suicide, the innovative approach described here emphasizes community and cultural protective factors in Indigenous communities, and extends typical suicide prevention initiatives in ways that have important implications for other ethnically diverse communities.
有效预防青少年自杀的必要性无可争议,对于原住民群体而言尤为紧迫。在北美一些社区,原住民青少年自杀率可能比其他年轻人高出18倍。尽管需求明确,但支持原住民青少年自杀预防策略的证据仍然参差不齐。预防青少年自杀最常见的方法——守门人培训——在原住民社区可能效果有限。基于最近与阿拉斯加农村地区的原住民领袖开展的工作,我们描述了一些基于文化、切实可行的替代方法,这些方法可能对原住民社区更有效。我们强调基于研究的基层干预措施如何能够解决在社区层面应对自杀风险时相关的文化、实际和系统性问题。本文所述的创新方法建立在一个考虑当地背景、以文化为中心的叙述以及自杀的多重相互作用条件的交易生态框架之上,强调原住民社区中的社区和文化保护因素,并以对其他种族多样化社区具有重要意义的方式扩展了典型的自杀预防举措。