Health & Education
Help is available for Tribal members contemplating suicide
Grand Ronde Behavioral Health Department
8 a.m. to 5 p.m. weekdays, excluding holidays.
Polk County Behavioral Health
503-623-9289 (weekdays from 8 a.m. to 5 p.m., excluding holidays)
503-581-5535 or 1-800-560-5535 (after-hours line)
Yamhill County Crisis Services
1-844-842-8200 (emergency contact number). Emergency evaluations and crisis intervention are provided at local hospital emergency rooms
Onsite services: 8:30 a,m. to 5 p.m., 627 N. Evans St., McMinnville, 503-434-7523
National Suicide Prevention Lifeline:
1-800-273-8255, 24 hours a day, 365 days a year
By Danielle Frost
Smoke Signals staff writer
Suicide or thoughts of harming oneself can be a taboo topic to discuss openly. Some people worry they will be thought of as crazy, others don’t believe anyone cares, or they struggle with fears of being a burden to loved ones.
Each year, more than 41,000 people die by suicide, leaving behind families to try to answer the often unanswerable: Why?
In Tribal communities, suicide is the second leading cause of death for American Indian and Alaska Natives between the ages of 15 and 24, according to the Indian Health Service, and the adjusted suicide rate for AI/AN individuals between those ages is four times higher when compared to all-race rate statistics across the United States.
Additionally, suicide rates peak during adolescence and young adulthood in AI/AN communities and then decline. This is a different pattern than for the general population, where suicide peaks in mid-life, with individuals in the 45- to 54-year-old age group at highest risk.
With September as National Suicide Prevention Awareness Month, the Grand Ronde Health & Wellness Center wants Tribal members to know there is help available locally for those who are struggling with suicidal thoughts, with emphasis placed on being culturally sensitive and integrating Tribal spirituality into the range of services. These services are available to all Grand Ronde Tribal members, descendants and other Natives for outpatient services.
“We encourage all eligible individuals to come in or call us for services,” Quality Improvement Manager Dawn Doar says. “The Behavioral Health staff is available to help with assessing, intervention or preventive mental health and alcohol and drug services.”
Although the Tribal health center doesn’t have crisis intervention services, it’s something that is being considered.
“It takes lots of planning to see what we need to do to best serve our people,” says Executive Director of Health Services Kelly Rowe. “Right now, we do screenings for signs of depression fairly regularly. This (crisis services) is something that is on the radar, something that we know we need to have.”
Indian Country often has its own risk factors with suicide when compared to the population at large. Those communities with high suicide rates often have limited local health care resources. Also, youth have experienced historical trauma and often live in areas that lack economic opportunity and have high poverty, according to a study conducted by the Substance Abuse and Mental Health Services Administration.
Although the Grand Ronde Tribe has its own health care center and Behavioral Health, Youth Prevention and Social Services departments available for those who need help, seeking it can be another matter entirely.
“In small communities like this, it is (sometimes) a challenge because if you go in the door of Behavioral Health for services, people know,” says Youth Prevention Manager Nicole Hewitt. “And if you live farther away and don’t have a car, you may not be able to make it to access services at all.”
Hewitt also notes that although Native American suicide rates are high, it is important to remember that some Tribes’ rates are a lot higher, which raises the overall number for all Native Americans.
“Those with higher rates are usually located on Reservations with extreme poverty and limited resources,” Hewitt said. “But we all get grouped as a whole.”
That being said, Hewitt says that intergenerational trauma seminars that the Grand Ronde Tribe has had in recent years have helped develop a framework of guidance.
“You have adults with trauma and as Native Americans, we have increased risk for all health issues. … If that is the community and family environment, your thoughts of suicide and depression may be higher. We need to not only focus on the youth, but look at the family as well.”
Hewitt says she is fortunate to work in Grand Ronde, which offers a number of preventive services for families before there is a full-blown crisis.
“Our community has drug and alcohol treatment, Tribal-based practices, parenting classes, Youth Education, Youth Prevention and cultural classes,” she says. “These look at not just the youth, but the family as well. We can’t just say, ‘Why that kid?’ We need to look at what is going on in the family. We view culture and recreational opportunities as prevention and want to engage all youth.”
Youth Prevention will be taking several students to participate in Salem’s “Out of the Darkness” walk on Saturday, Sept. 28, and is also working at bringing a speaker out to the Tribal campus.
Native American Suicide Prevention Act
The higher rate of suicide among Native Americans has not gone unnoticed by federal legislators. Earlier this year, Sens. Elizabeth Warren (D-Mass.), Lisa Murkowski (R-Alaska), along with Reps. Raul M. Grijalva (D-Ariz.) and Tom Cole (R-Okla.), re-introduced the bipartisan Native American Suicide Prevention Act.
The legislation requires collaboration among states and Tribal governments in the design and implementation of statewide suicide intervention and prevention strategies. It is still in the committee review stage.
Several Native American-related organizations wrote letters of support for lawmakers’ efforts, including the National Indian Health Board, Johns Hopkins Center for American Indian Health and National Council of Urban Indian Health.
“Suicidality is often in combination with other behavioral and mental health issues, including depression, feelings of hopelessness, trauma, substance abuse, domestic violence, sexual abuse and other negative social issues,” National Indian Health Board Chair Vinton Hawley says. “By requiring states to collaborate with Tribes, Tribal organizations and urban Indian organizations, it ensures that these factors will be addressed in a comprehensive way. Too often, Tribes are left out of critical funding and programming decision, which further exacerbates the health disparities experienced in many Tribal communities.”
The Center for American Indian Health notes that a community-based approach has shown improved outcomes, including increased connections to mental health care, as well as decreased suicide attempts and deaths.
“Tribes are eager to partner on community-based, participatory efforts to reduce suicide,” Associate Director Mary Cwik says. “A bill that holds states receiving funding accountable to include Tribal partners is consistent with critical needs and concerns.”
(Editor’s note: Smoke Signals is joining with other Oregon media outlets to highlight the problem of suicide in the state and recognize Sept. 8-14 as National Suicide Prevention Week. More than 800 people killed themselves last year in Oregon.)