OPINION: American Indian/Alaskan Native youth suicide is a public health crisis that demands action

by Amy E. Green | The Trevor Project
Monday, 30 November 2020 09:07 GMT

FILE PHOTO: The Fort Laramie treaty riders set out in the morning from the Rockyford School towards the Badlands National Park in the Pine Ridge Reservation in Rockyford, South Dakota, U.S., April 21, 2018. REUTERS/Stephanie Keith

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* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.

American Indian/Alaskan Native LGBT+ youth were 2.5 times more likely to report a suicide attempt in the past year compared to their LGBT+ peers

Amy E. Green is vice-president of research for The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBT+ young people

Despite a long history of systemic oppression that has resulted in collective trauma and severe mental health disparities, American Indian/Alaskan Native youth are often underrepresented in studies of American young people.

This underrepresentation is attributed to complications around collecting a large enough sample size, as American Indian/Alaskan Native youth account for less than 2% of the U.S. population. However, the failure to obtain sufficient sample sizes contributes to the ongoing erasure of a historically marginalized group and limits the knowledge base necessary to implement effective response strategies, thus allowing for inequities to persist.

American Indian/Alaskan Native individuals have consistently faced the highest rates of suicide deaths compared with other demographic groups. Disturbingly, data from the Centers for Disease Control and Prevention demonstrate that they faced not only the highest rates of suicide deaths from 1999 to 2017 but also the largest increase in suicide deaths over that same time period. 

Research has shown that LGBT+ young people attempt suicide at more than four times the rate of their straight/cisgender peers — and that those who hold multiple marginalized identities are more susceptible to poor mental health.

That’s why it is crucial to specifically examine suicide risk among American Indian/Alaskan Native youth who identify as LGBT+ or “Two-Spirit,” a term used to describe those who “embody diverse sexualities, gender identities, roles, and/or expressions” in indigenous communities.

These young people are exposed to both racism and LGBT+-based stigma, which can have exacerbating effects.

According to our new research, American Indian/Alaskan Native LGBT+ youth disproportionately experience housing instability, food insecurity, and foster care — and were 2.5 times more likely to report a suicide attempt in the past year compared to their LGBT+ peers.

This a public health crisis that requires attention and urgent action.

The Minority Stress Modela well-established conceptual model  — tells us that experiences of discrimination, stigma, and violence are compounded and can produce negative mental health outcomes.

For American Indian/Alaskan Native people, the devastating impacts of “historical trauma” — or the collective history of systematic oppression and bloodshed transmitted across generations — cannot be understated. Not only must we consider the cycles of poverty and victimization caused by historical and ongoing colonization, but also the chronic stress that stems from having a marginalized social status in society.

To improve mental health outcomes for American Indian/Alaskan Native people, we must start by breaking down structural barriers and de-colonizing systems that perpetuate oppression. Rather than acting as colonizers and pretending to know what’s best for indigenous communities, policymakers and leaders in the suicide prevention space must work closely with tribal nations and involve these young people themselves in the development of mental health programs.

The outlook from our research may seem dire, but these data also offer sources of hope.

For example, American Indian/Alaskan Native youth who reported high levels of social support from family members or stated that their school was LGBT-affirming were nearly 60% less likely to report a suicide attempt in the past year.

This should serve as a clarion call for government officials, educators, and youth-serving organizations alike to implement LGBT-inclusive policies and foster the creation of safe, affirming environments where youth can survive and thrive.

Research is powerful. It shines a light on the disparities present in our society and empowers us with the knowledge necessary to problem-solve. Without greater public investment in research and interventions focused on American Indian/Alaskan Native youth, the unique challenges they face will persist, as they have for generations.

With everything we now know about historical trauma, American Indian/Alaskan Native people deserve more resources dedicated to improving mental health services and preventing suicide.

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