Alaska Native suicide: thoughts on moving forward

“If the populations of ‘mainland’ Canada, Denmark and the United States had suicide rates comparable to those of their Inuit populations, national emergencies would be declared.”
– Upaluk Poppel, 2005

Every Alaska Native has been touched by suicide. It’s a pervasive challenge in our communities that has too often been rendered taboo and off the table for discussion until recently. Taking place within a context of colonialism, widespread poverty, and political racism, the suicide epidemic is the elephant in the room when it comes to discussion of social and economic progress for Alaska Native peoples. This is because in the last half century, the suicide rate for Alaska Natives has remained elevated and stable – a reflection of the cumulative trauma that remains largely unaddressed in Alaska Native societies. I believe that understanding the ways this trauma manifests as well as the connections between these manifestations and suicidal behavior, is key to better understanding this challenge and developing more effective prevention measures.

As do most of the Native people I know, I have friends and relatives that have attempted or died by suicide. I first learned about suicide from my parents when I was six years old and my uncle used a firearm to kill himself in Anchorage. Twenty years later, it seems that little has changed about the nature of this epidemic, except perhaps that today it’s more openly discussed.

In 1989, the Anchorage Daily News published a ten part story titled “A People in Peril.” The story spotlights the crippling effects of the suicide epidemic rocking the Alaska Native community, and chronicles some of the social challenges that form the backdrop for suicide in rural Alaska Native communities.

That was nearly a quarter century ago. Today, the suicide rate for Alaska Native peoples remains the highest of any demographic in the U.S., and our elevated suicide rates are still regularly in the news. That’s because Alaska Native peoples – especially youth – die by suicide at a rate more than three times the U.S. rate, and that hasn’t changed much in the past 43 years.

A 1973 paper (“Suicidal Behavior in Alaskan Natives”) by Robert F. Kraus, M.D. of the University of Washington examines the nature of Alaska Native suicide between 1950-1970, remarking that “The problem of suicides in Alaskan Natives [sic] parallels that of American Indians in that it is a phenomenon of suicide in adolescents and young adults.”

Kraus approximates the 1970 Alaska Native suicide rate to be 33 per 100,000 – or about three times the U.S. rate – with a Native population at that time of about 60,000. Kraus also calculates five-year average annual rates between the periods 1961-1965 and 1966-1970, which were 13 per 100,000 and 25 per 100,000 respectively. (Calculating five-year averages yields a more accurate suicide rate due to small population size and the high variability in the number of suicides from year to year.)

A July 2012 report published by Alaska’s Department of Health and Social Services found that between 2003-2008, the average annual suicide rate for Alaska Native peoples was 40.4 per 100,000 compared to about 11.2 per 100,000 during the same period for the U.S. as a whole.

These rates vary dramatically by region, with Iñupiat in the Northwest Arctic dying by suicide at a rate more than twice the Alaska Native rate (93 per 100,000 between 2003-2008). The Canadian sociologists Frank J. Tester and Paule McNicoll cite Travis (1990) in their 2004 paper, who reports the Iñupiat suicide rate to be 90.8 per 100,000 in the early 1980s, only slightly lower than today’s rate.

Like our Inuit cousins in Canada and Greenland, we Iñupiat share the unfortunate distinction of having the highest suicide rates on the planet, and it is our young people who are suffering most. Lisa Wexler, whose research focuses on Iñupiat youth suicide in the Northwest Arctic region, places the suicide rate for Iñupiat aged 15 to 18 at 190 per 100,000, almost 17 times the U.S. rate, a number which shows that stark contrast between patterns of suicide in Indigenous populations and non-Indigenous populations, with the elderly tending to have the highest suicide rates in Western societies.

The Northwest Arctic Borough, the region where Wexler conducts her research.

How is it that after nearly half a century, Alaska Native people continue to die by suicide at astronomical rates that have largely remained unchanged, and in some regions appear to be rising?

Part of the answer, I believe, is that so much remains undocumented from a research, advocacy, and policy standpoint about the environmental factors that influence suicide.

Because there is a lack of information about the environmental risk factors that influence suicide, or an understanding of how they do so, prevention efforts continue to focus on transforming the individual from a suicidal person to a mentally healthy person, without addressing the root causes of suicidal behavior. This can be seen in PSA campaigns that encourage youth to ‘choose life’, in community walk for life campaigns, and sporadic culture and healing camps aimed at preventing suicide.  These efforts and the people responsible for them are doing remarkable work, and have in some cases produced glimmers of hope, but I suspect that a focus on transforming the social and economic environment in which our high suicide rates persist would go a long way in helping to reduce suicide.

In many cases, suicidal behavior among Alaska Natives takes place within high stress or traumatic environments. Crowded housing, food insecurity, and widespread poverty place enormous stress on many families and communities. Too many individuals grow up facing adversity and trauma as a result of household violence, child sexual abuse, and sexual assault. Addictions are often symptom of these challenges.
And more often than not, schooling does not provide young people with the resources needed to understand the historical context that produced them, a context that includes epidemics, religious and cultural persecution, community relocation, and a federal policy of cultural assimilation through boarding schools.

The negative ways this trauma manifests, and the pervasiveness of these manifestations, forms the backdrop for our elevated suicide rates. People intuitively know this, but what’s needed is coordinated investment by stakeholders – including the State of Alaska, Alaska Native advocacy organizations, and Alaska Native Corporations – in research that looks at the role environmental factors such as child sexual abuse and household violence play in the lives of people who exhibit suicidal behavior or have died by suicide.

A 2011 ‘Walk for Life’ event in Northwest Alaska

A suicide prevention and healing camp facilitated by Evon Peter (Gwich’in) and Earl Polk (Yup’ik) outside of Kotzebue, AK.

As a first step, we need to gather this information. In the Alaskan Arctic, for example, the region in which suicide rates are highest, there is little publicly accessible baseline health data. This makes it difficult to see the big picture of how various social and economic challenges are interconnected, and the role these challenges may play in suicidal behavior. Having this more complete understanding of the context in which suicide takes place can help inform the development of more innovative suicide prevention measures by policy makers and practitioners.

To give you an example of what I mean, there is a growing body of research showing that dating violence and child sexual abuse in at least some populations is associated with suicide attempts. This shouldn’t come as a surprise given that many survivors of sexual assault experience Post-traumatic Stress Disorder, and the connection between PTSD and suicide is a widely-publicized phenomenon, at least among veterans of war. By many accounts, child sexual abuse and sexual assault are pervasive in some parts of Alaska, and the barriers that often stand in the way of justice for the victims of these crimes is well documented. This should make us wonder what information about violence, sexual assault, and child sexual abuse in Alaska Native communities can tell us about our high suicide rates. By documenting and understanding suicide in the bigger picture of these and other social challenges, there is a greater chance that we will be able to develop more successful suicide prevention efforts by striking at its root causes.

There are some jurisdictions that have taken this approach to suicide prevention. Information about child sexual abuse was captured in Nunavut, Canada, as part of the Community and Personal Wellness section of the 2007-2008 Inuit Health Survey. Nunavut Tunngavik, Inc., the primary Inuit advocacy organization in Nunavut, was part of the steering committee responsible for designing and implementing the survey in Nunavut’s 25 communities, and was integral to its success. In a sample of 1,710 adults, the survey found:

  • 41 percent of participants indicated that they had experienced severe sexual abuse during childhood, which includes someone threatening to have sex with them, touching the sex parts of their body, trying to have sex with them or sexually attacking them.
  • Women (52 percent) were more likely than men (22 percent) to be survivors of severe sexual abuse during childhood.
  • 50 percent of participants had experienced at least one form of physical abuse as an adult, with women (52 percent) slightly more likely than men (46 percent) to have experienced violence.
  • 18 percent of participants said they had experienced a form of attempted forced sexual activity, with women (27 percent) much more likely than men (5 percent) to have experienced forced or attempted forced sexual activity.

With respect to suicidal ideation, the survey found:

  • 48 percent of survey participants said they had thought seriously about committing suicide in their lifetime, including 14 percent in the last twelve months.
  • 29 percent reported having attempted suicide in their lifetime, including 5 percent in the last twelve months.
  • Of those who had attempted suicide in their lifetime, women (31 percent) were slightly more likely than men (25 percent) to have attempted suicide, as were those under 50 (34 percent).

This is information that Nunavut Tunngavik, Inc. is now able to actively incorporate into its advocacy work, which includes the development of a territory-wide Suicide Prevention Strategy and a Suicide Prevention Action Plan in partnership with the Government of Nunavut, RCMP, and the Nunavut-based Embrace Life Council. This information has helped advocates and policy makers in Nunavut understand suicide as a product of the environment in which it takes place – an environment whose social challenges have, to a large degree, been shaped by colonial federal policies that were similar to those implemented in Alaska, including residential schooling and community re-location.

A 2012 PSA by Nunavut’s Embrace Life Council

The Inuit Health Survey has not led to a perfect understanding of the causes of suicide in Nunavut, but it has helped solidify an understanding among advocates, practitioners and policy makers in Nunavut that suicide in the territory is a symptom of larger social, economic and historical challenges, and that these challenges must be dealt with in addition to suicidal behavior itself. As the territory’s Prevention Strategy and Action Plan state, this calls for inter-agency collaboration by government, and investment in prevention, intervention and post-vention measures. These measures encompass everything from strengthened Inuit-specific mental health services to increasing access to early child develop programs. It will be years and possibly decades before we see the net-effect of this work in Nunavut.

Yet, I think this work represents progress. Progress because suicide and social challenges like child sexual abuse and sexual assault are no longer taboo subjects to the degree that they once were, and are now openly recognized as challenges that are part of the social environment in which suicide takes place. Progress because research about suicide in Nunavut has led to cooperation among territorial stakeholders and a sense of shared responsibility. Progress because this research and these efforts reflect at least the beginning of an understanding of what’s needed to prevent this horrific epidemic from consuming our grandchildren and their children, and that’s certainly something for us to aspire to in Alaska.

Please see the publications page for more literature about this topic.

Advertisements

1 Comment

Filed under Author: aqukkasuk

One response to “Alaska Native suicide: thoughts on moving forward

  1. Dear Aqukkasuk:
    I hope you are doing great!! I am writing about suicide in Alaska and due to this specific quote “I have friends and relatives that have attempted or died by suicide. I first learned about suicide from my parents when I was six years old and my uncle used a firearm to kill himself in Anchorage,” and the great post, I would like to interview you and have you as character of my story. Please, email me to charlsalinas@gmail.com and I would love to arrange it as soon as possible. Thanks =)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s