As the nights grow longer and winter settles in across the north, a team of health researchers is using a "community mobilization" approach to translate research into practice for an Alaska Native youth suicide prevention program in 15 remote Alaska towns.
The intervention, "Promoting Community Conversations About Research to End Suicide" (PC CARES) was developed by Lisa Wexler and Cris Smith at the University of Massachusetts Amherst with colleagues from Northwest Alaska and the University of Alaska Fairbanks.
Wexler and colleagues pilot-tested the program in 10 far-flung Native Alaska communities over the past year. They recently received a five-year, $ 3.5 million grant from the National Institutes of Mental Health to expand the project, "re-envisioning it to adapt to a new region," as she explains.
Wexler says that rural Alaska Native suicide rates are up to 18 times higher for young people when compared to all American youth, 124 vs. 6.9 per 100,000, and the health disparity of youth suicide continues to plague rural indigenous communities in Alaska. The current system of care with a focus on mental health is not effective, she adds, 79% of suicide decedents and 62 percent of attempters received no mental health care.
PC CARES you seek to respectfully provide Native communities with a practical method for translating scientific research into culturally relevant ways to reduce suicide risk factors and increase safety, help-seeking, and support; she points out.
Wexler, associate professor of community health education at UMass Amherst's School of Public Health and Health Sciences, adds, "So much suicide prevention focuses on mental health services, but in an area where there are no roads, and a mental health professional may visit only one or two days a month, putting more effort into that kind of resource is not really helpful to the community. PC CARES
For example, Wexler says, studies show that suicide deaths can be reduced by making it a little harder, adding even just 10 minutes, to delay access to lethal, dangerous means. In practical terms to Alaska Native communities where approximately 50% of deaths are by gunshot, this may mean that taking the bullets out of a gun or fitting it with a gun lock can make the difference.
"If you can make it 10 minutes or longer that people can not get access to the weapon, you have a bigger chance to save a life," she says. Sharing such information widely and irrelevantly is not easy or straightforward in Alaska Native communities, but the results of their pilot study suggest to Wexler and colleagues that promoting community conversations is helpful.