All the reasons that put young people at risk of suicide in the country at large are amplified on Indian reservations.

Indian children are more likely to be abused, see their mothers being abused and live in a household where someone is controlled by drugs or alcohol. They have the highest rates of emotional and physical neglect and are more likely to be exposed to trauma.

“The unfortunate and often forgotten reality is that there is an epidemic of violence and harm directed toward this very vulnerable population,” Dolores Subia BigFoot, director of the Indian Country Trauma Center at the University of Oklahoma, testified a before the Senate Committee of Indian Affairs during hearings on the Indian Youth Suicide Prevention Act of 2009.

“American Indian/Alaska Native children and youth experience an increase risk of multiple victimizations,” she said. “Their capacity to function and to regroup before the next emotional or physical assault diminished with each missed opportunity to intervene. These youth often make the decision to take their own lives because they feel a lack of safety in their environment. Our youth are in desperate need of safe homes, safe families and safe communities.”

Safety can be an elusive commodity on isolated, remote reservations where poverty and its offspring — substance abuse and violence — are self-perpetuating.

She said that in states with reservations, an estimated 75 percent of suicides, 80 percent of homicides and 65 percent of motor vehicle deaths among Native Americans involve alcohol. Violent death accounts for 75 percent of all mortality in the second decade of life, BigFoot said.

Poverty is generational and community deep. High unemployment rates are the norm. Good-paying jobs — or the prospects of any employment at all — are often off the reservation. Leaving the reservation means entering an alien culture that may not always be welcoming, and where there are no grandmothers, aunts and cousins to watch your back. About 50 percent of Montana's native population lives in urban areas.

Suicide rates among urban Indian youth are higher even than those on the reservations.

“We don't know what goes on behind closed doors at home,” said Shawn Silbernagel, who is youth coordinator for Planting Seeds of Hope, a suicide prevention program sponsored by the Montana-Wyoming Tribal Leaders Association.

“The average Indian child has a lot of adult things, negative adult things, they have to deal with at a very young age,” he said.

Dealing with trauma

Funerals and grief are common to children in tribal cultures where large extended families are essentially the same as the immediate family in the general population, he said.

Teaching children how to deal with the trauma in their lives is the theme of many programs throughout Indian Country aimed at reducing suicides among Native Americans.

The Tribal Leaders Association has one year left on its second three-year grant to bring a comprehensive suicide prevention plan to Montana's seven reservations and the Wind River Reservation in Wyoming.

“We have eight partnering tribes,” said Stephanie Iron Shooter, manager of the program. “Each tribe has a youth council or committee as a way for kids to address the tribal councils and community.”

Through the “Honoring Your Life Project,” the tribes fashion a grassroots program based on tribal creation stories and philosophies of life and death, she said. Tribal elders play a key role and many of the projects seek to restore the bonds between elders and tribal youth.

Weakening of those bonds and loss of culture and spirituality are among the reasons young people cannot find their way, she said.

Others describe historical and cultural trauma that remains ingrained in the Native American psyche. Colonization and racism and the abrupt end to traditional life still reverberate in new generations, said Clayton Small, a Cheyenne, who works in a nonprofit suicide prevention program.

Generational trauma weighs heaviest on the male population, he said. They commit suicide at a far higher rate than female Native Americans.

“In Indian Country the role of our men has been significantly altered,” Small said. “Then throw in poverty and violence and it descends into drug and alcohol abuse.”

He said one out of three Native American males end up incarcerated at some time during their lives, in part because their cases are brought in the relatively unforgiving federal system. With a criminal record, employment is nearly impossible to find and they suffer the indignity of not being able to support their families, Small said.

“We have to teach kids that they don't have to continue this cycle,” he said. “We have to teach them to cope with the stress and trauma they see every day.”

When Montana Superintendent of Public Instruction Denise Juneau last spring initiated her “Schools of Promise” program to transform the state's lowest-performing schools — all of them on Indian Reservations in the eastern half of the state — she looked at what it would take to change failing schools on the Crow, Northern Cheyenne and Fort Peck Reservations.

“We learned very quickly that it went far beyond academics,” she said. “There is a lot of trauma in these communities”

OPI in partnership with the tribes, BIA, IHS and the Montana-Wyoming Tribal Leaders Association formed a plan to provide “wrap-around” services for schools that include health, mental health and social services needed to keep children alive and in school.

Juneau said a $600,000 grant to implement the program will provide training, coordination and support to “knit services together in a comprehensive, systematic and cohesive system” over the next three years.

Community-based meetings

The state superintendent said the first step will be community-based meetings to get a perspective on the local problem. Much of project will be aimed at teaching students how to help each other.

Changing the climate at schools is another piece of the agenda, said Sara Casey, administrator of OPI's Special Education Division.

“There are a lot of people in our schools working on climate issues in a very big way,” Casey said.

Among those issues are bullying, safety, self-discipline and other behavioral problems.

“We're doing everything we can,” said Karl Rosston, Montana's suicide prevention coordinator.

A 17-year-old Poplar girl has recorded four anti-suicide commercials that will run four times a day on the Fort Peck Reservation for the next year, he said. Soon they will be going statewide.

A “Talk to Youth” training program is available at no cost to schools, he said. It teaches how to question, persuade and refer someone who may be at risk. Another free program, “Signs of Suicide” has been sent to 144 schools statewide. It teaches how to talk to at-risk students.

Last year, Rosston did 43 training programs for a total of 1,500 people, including 440 teachers.

Many of the tribes have worked to provide safe places for at-risk children when home is not a good option.

Fort Belknap has established an emergency home, and shelters have been opened on the Blackfeet Reservation and at Busby in southeastern Montana, said Louise Reyes of BIA Social Services for the Rocky Mountain Region.

When a child who has attempted or is contemplating suicide is referred for additional help, BIA tries to find a foster family specially trained to deal with at-risk children, she said. But foster homes for these children are hard to find.

“If we have to remove a child, we have difficulty placing them,” she said.

Some are referred to New Day Inc. in Billings, a residential therapeutic program.

Resources have always been a stumbling block and are likely to continue to be. But efforts to coordinate anti-suicide programs, end duplication and streamline services, combined with new emphasis on peer-to-peer support, may knock a few obstacles away.

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