Medicine Wheel Messaging: Suicide Prevention for Native Youth

LorenAshley Buford - Yamassee of FLProgram Manager, Wellness WarriorsUnited National Indian Tribal Youth Inc. la.buford@unityinc.org

Objectives

To better our understanding of how the traditional teachings in the medicine wheel relate to native youth risk and protective factors

To gain a better understanding of effective suicide prevention messaging

Examine examples of Native Youth Suicide Prevention Campaigns and how they relate to medicine wheel values

Medicine Wheel

7 DirectionsUNITY Fire

Traditional Approaches to Mental Health and Balanced Wellness

Goal: BalanceI AM A WELLNESS WARRIOR

www.unityinc.org

Safe & Effective Messaging for Native Youth Suicide Prevention

Safe and Effective Messaging Guidelines The Do’s

● Help-seeking:● Where to Find Help ● Prevention:● Warning Signs ● Risk Factors ● Protective Factors ● Treatment Options

The Don’ts

● Glorify Suicide ● Normalize Suicide ● Events A Result of Stress● Suicide being Inexplicable ● Details of Suicide, Details of

Victims or Methods

Safe and Effective Messaging for Suicide Prevention Suicide Prevention

Resource Center (SPRC)

Risk Factors

● Mental Illness ● Alcohol and/or Substance

Abuse ● History of trauma or abuse ● Family history of suicide ● Previous attempt● Feelings of hopelessness ● Major physical illnesses

•Impulsive or aggressive tendencies •Isolation or lack of social support •Easy access to lethal means •Exposure to suicide/clusters •Barriers to mental health treatment •Loss (Job, Financial, Relational, Social) •Stigma associated with help seeking •Certain cultural and religious beliefs

Arizona Suicide Prevention Coalition, Inc.

Protective Factors

● Effective clinical care for mental, physical and substance use disorders ● Easy access to a variety of clinical interventions and support for help

seeking ● Restricted access to highly lethal means of suicide● Strong connections to family and community support ● Support through ongoing medical and mental health care relationships ● Skills in problem solving, conflict resolution and nonviolent handling of

disputes ● Cultural and religious beliefs that discourage suicide and support self

preservation

Arizona Suicide Prevention Coalition, Inc.

Belonging

Belonging

https://www.samhsa.gov/sites/default/files/gona-goan-curriculum-facilitator-guide.pdf

Belonging on the Medicine Wheel represents infancy and childhood, a time when we need to know “how we belong”

“Call it a clan, call it a network, call it a tribe, call it a family…whatever you call it, whoever you are, you need one.” Jane Howard (1935–1996) American writer and educator

Belonging

Six Phases of Historical Unresolved Grief – Dr. Maria Yellow Horse Braveheart

Boarding School Period 1870s-1934

• Destroyed family system

• “Kill the Indian Save the Man”• Outlaw of their cultures

Belonging

What does Prevention Science say about Belonging?

Connectedness and suicide prevention in adolescents: Pathways and implicationsJ Whitlock, PA Wyman, SR Moore - Suicide and life-threatening …, 2014 - Wiley Online Library

Need for belonging, relationship satisfaction, loneliness, and life satisfactionD Mellor, M Stokes, L Firth, Y Hayashi… - Personality and individual …, 2008 - Elsevier

Resilience among men farmers: the protective roles of social support and sense of belonging in the depression-suicidal ideation relationS McLaren, C Challis - Death Studies, 2009 - Taylor & Francis

Social relationships as predictors of depression and suicidal ideation in older adults

RK Vanderhorst, S McLaren - Aging & mental health, 2005 - Taylor & Francis

Belonging

REFLECTION - Next Steps

What Risk Factors Could be Associated with a lack of belonging?

What Protective Factors Could be liked to a Strong Connection to Belonging?

What Are Current Examples of Belonging in Native American still practiced today?

UNITY #IWillLiveLife Connections

BELONGING

https://unityinc.org/i-will-live/

UNITY #IWillLiveLife Connections

BELONGING

https://unityinc.org/i-will-live/

Mastery

Mastery

https://www.samhsa.gov/sites/default/files/gona-goan-curriculum-facilitator-guide.pdf

Mastery of and dealing with what holds us back

Part of grieving cycle A Time and Season for everything

“Trauma is a tree with many roots.”

Dolores Subia BigFoot, Ph.D.

Mastery

Six Phases of Historical Unresolved Grief – Dr. Maria Yellow Horse Braveheart

Removal, Relocation & Reservations1820s-1870s

● Horrific violence forced removal● Land as sacred “place based

identity”● Wards of federal government as

“domestic dependent nations”● Reservations then and now

What does the past have to do with me?

Great-Grandma

Grandma

Mother

Daughter

Newborn/Child

Boarding Schools

Relocation

Assimilation

Loss of Traditions

Loss of Language

Sexual AbuseAlcoholism

Diabetes

Domestic Violence

Identity Confusion

Drug Use

Child Abuse/Neglect

Confusion?Confusion?

Confusion?

Confusion?

Confusion?

Confusion?

? ??

??

Mastery

What does Prevention Science say about Mastery?

Identity formation and cultural resilience in Aboriginal communitiesCE Lalonde - Promoting resilience in child welfare, 2006 - books.google.com

Resilience and indigenous spirituality: A literature reviewJ Fleming, RJ Ledogar - Pimatisiwin, 2008 - ncbi.nlm.nih.gov

Low resilience in suicide attemptersA Roy, M Sarchiapone, V Carli - Archives of Suicide Research, 2007 - Taylor & Francis

Resilience as positive coping appraisals: Testing the schematic appraisals model of suicide (SAMS)

J Johnson, PA Gooding, AM Wood, N Tarrier - Behaviour Research and …, 2010 - ElsevierAssociations between attempted suicide, violent life events, depressive symptoms, and resilience in adolescents and young adultsL Nrugham, A Holen, AM Sund - The Journal of nervous and …, 2010 - journals.lww.com

MASTERY

REFLECTION - Next Steps

What Risk Factors Could be Associated with a lack of Mastery?

What Protective Factors Could be liked to a Strong Connection to Mastery?

What Are Current Examples of Mastery in Native American still practiced today?

#WarriorSpiritWe Shall Remain

MASTERY

Much like fire, this pain can either be devastatingly destructive or wisely harnessed to become fuel that helps us to rise up and move forward in life with joy, purpose and dignity.

Youtube: The StyleHorse Collectivehttps://youtu.be/Gs0iwY6YjSk

Interdependence

Interdependence

https://www.samhsa.gov/sites/default/files/gona-goan-curriculum-facilitator-guide.pdf

Even when people are strong and committed

to healing themselves and others, it is no

match for the power of the community.

“Humankind has not woven the web of life.

We are but one thread within it.

Whatever we do to the web,

we do to ourselves.

All things are bound together.

All things connect.” Chief Seattle, 1854

Interdependence

Six Phases of Historical Unresolved Grief – Dr. Maria Yellow Horse Braveheart

TERMINATION & RELOCATION II1945-1961

Over 100 tribes seen to be “civilized enough”

not to be considered a tribe anymore.

Relocates over 100,000 Native people to

urban areas away from reservations to

supposed job training and placement

programs; reservation poverty deepens

Pan-Indian identity and activist movement

Interdependence

What does Prevention Science say about Interdependence?

Poor social integration and suicide: fact or artifact? A case-control studyPR Duberstein, Y Conwell, KR Conner… - Psychological …, 2004 - cambridge.org

Inupiat youth suicide and culture loss: Changing community conversations for prevention

LM Wexler - Social Science & Medicine, 2006 - Elsevier

American Indians and suicide: A neglected area of researchLM Olson, S Wahab - Trauma, Violence, & Abuse, 2006 - journals.sagepub.com

Interdependence

REFLECTION - Next Steps

What Risk Factors Could be Associated with a lack of Interdependence?

What Protective Factors Could be liked to a Strong Connection to Interdependence?

What Are Current Examples of Interdependence in Native American still practiced today?

#Community#Family #Thrive

INTERDEPENDENCE https://www.sprc.org/resources-programs/thrive-media-campaign-suicide-prevention-materials

Generosity

Generosity

https://www.samhsa.gov/sites/default/files/gona-goan-curriculum-facilitator-guide.pdf

Recognize as one of the highest values of many AI/AN cultures the importance of giving back to others and to the community

Recognize the many resources residing within the community that contribute to the overall wellness of the community.

“If we bring a basket of food and share it, together we have a feast.” Maori saying

Generosity

Six Phases of Historical Unresolved Grief – Dr. Maria Yellow Horse Braveheart

ALLOTMENT Era 1870s-1934

Through “checkerboard” land reform (Dawes

Act), forced reeducation, outlaw of their

cultures; results in widespread poverty, loss

of lands/resources, abuse and neglect

Potlatch Ceremony or GiveAways

Self-Determination Period (1960s-Present)

● Indian Civil Rights Act of 1968

● Indian Self-Determination and

Education Assistance Act of 1975

● Indian Child Welfare Act of 1978

Generosity

What does Prevention Science say about Generosity?

… a job was viewed as an important way to contribute to the family and community and validate the sense of self-worth

Healing fractured families: Parents' and elders' perspectives on the impact of colonization and youth suicide prevention in a Pacific Northwest American Indian tribeCJ Strickland, E Walsh… - Journal of Transcultural …, 2006 - journals.sagepub.com

GENEROSITY

REFLECTION - Next Steps

What Risk Factors Could be Associated with a lack of Generosity?

What Protective Factors Could be liked to a Strong Connection to Generosity?

What Are Current Examples of Generosity in Native American still practiced today?

#WeNeedYouHere#WeRNative

GENEROSITY

https://www.wernative.org/

REFLECTION

Belonging, Mastery, Independence, & Generosity

In what ways can your community improve their prevention messaging?

What examples of the Medicine Wheel teachings resonated with you most?

What other examples of Native youth Suicide Prevention or Awareness Campaigns have you seen?

QUESTIONS? COMMENTS

References & Suggested ReadingsExamining two facets of American Indian identity: Exposure to other cultures and the influence of historical trauma

HN Weaver, MYHB Heartz - Journal of Human Behavior in the …, 1999 - Taylor & Francis

The American Indian holocaust: Healing historical unresolved grief

MYHB Heart, LM DeBruyn - American Indian and Alaska …, 1998 - search.proquest.com

So she may walk in balance: Integrating the impact of historical trauma in the treatment of Native American Indian women.

M Braveheart-Jordan, L DeBruyn - 1995 - psycnet.apa.org

Historical trauma in American Indian/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities

T Evans-Campbell - Journal of interpersonal violence, 2008 - journals.sagepub.comA college suicide prevention model for American Indian students.

JJ Muehlenkamp, S Marrone, JS Gray… - … : Research and Practice, 2009 - psycnet.apa.org

A community-based treatment for Native American historical trauma: Prospects for evidence-based practice.

JP Gone - 2013 - psycnet.apa.org

Culturally responsive suicide prevention in indigenous communities: Unexamined assumptions and new possibilities

LM Wexler, JP Gone - American Journal of Public Health, 2012 - ajph.aphapublications.org

Advancing prevention research on the role of culture in suicide prevention

S Joe, SS Canetto, D Romer - Suicide and Life-Threatening …, 2008 - Wiley Online Library

Healing fractured families: Parents' and elders' perspectives on the impact of colonization and youth suicide prevention in a Pacific Northwest American Indian tribe

CJ Strickland, E Walsh… - Journal of Transcultural …, 2006 - journals.sagepub.com

References & Suggested ReadingsSuicide prevention in Aboriginal communities: application of community gatekeeper training

K Capp, FP Deane, G Lambert - Australian and New Zealand …, 2001 - Wiley Online Library

Historical trauma among indigenous peoples of the Americas: Concepts, research, and clinical considerations

MYH Brave Heart, J Chase, J Elkins… - Journal of psychoactive …, 2011 - Taylor & FrancisThe historical trauma response among natives and its relationship with substance abuse: A Lakota illustration

MYHB Heart - Journal of psychoactive drugs, 2003 - Taylor & FrancisA conceptual model of historical trauma: Implications for public health practice and research

M Sotero - 2006 - papers.ssrn.com

Struggling against suicide: The need for an integrative approach.

D De Leo - Crisis: The Journal of Crisis Intervention and Suicide …, 2002 - psycnet.apa.org

Suicide prevention and social capital: A Samoan perspective

RR Stewart-Withers, AP O'Brien - Health Sociology Review, 2006 - Taylor & FrancisSuicide survivors and the suicidology academe: Reconciliation and reciprocity

J Cutcliffe, PB Ball - Crisis, 2009 - econtent.hogrefe.comStress buffering effects of social support on depressive symptoms in middle age: Reciprocity and community mental health

T Takizawa, T Kondo, S Sakihara… - Psychiatry and …, 2006 - Wiley Online LibraryCultural and cognitive considerations in the prevention of American Indian adolescent suicide

TD LaFromboise, DS Bigfoot - Journal of Adolescence, 1988 - Elsevier

Working in the midst of ideological and cultural differences: Critically reflecting on youth suicide prevention in Indigenous communities

J White - Canadian Journal of Counselling, 2007 - search.proquest.com

Linear Timeline of Six Federal Indian Policy Eras for Reference

1776-1810s

EARLY INDIAN & US RELATIONS

Commerce Clause added to the U.S. Constitution (1789)

U.S. government treats some Indians as sovereign nations establishes federal jurisdiction in dealings with Indian people

Removal, Relocation & Reservations

◻ Horrific violence forced removal

◻ Land as sacred “place based identity”

◻ Wards of federal government as “domestic dependent nations”

◻ Reservations then and now

1820s-1870s

1870s-1934ALLOTMENT and ASSIMILATION

Cultural GenocideLarge-scale attempts are made to dismantle tribes and assimilate Indian people into the “mainstream”through land reform (Dawes Act), forced reeducation, outlaw of their cultures; results in widespread poverty, loss of lands/resources, abuse and neglectBoarding Schools: “Kill the Indian: Save the Man”

Reform and Reorganization 1920s-1945

◻ Indian Citizenship (1924)

◻ Miriam Report (1928) ⬜ Poverty recognized ⬜ Health disparities

◻ Indian Reorganization Act (1934)⬜ Western style constitutional forms of

government

1945-1961 TERMINATION & RELOCATION

Over 100 tribes seen to be “civilized enough” not to be considered a tribe anymore.

Relocates over 100,000 Native people to urban areas away from reservations to supposed job training and placement programs; reservation poverty deepens

Pan-Indian identity and activist movement

Self-Determination Period (1960s-Present)

◻ Indian Civil Rights Act of 1968

◻ Indian Self-Determination and Education Assistance Act of 1975

◻ Indian Child Welfare Act of 1978

◻ National Congress of American Indians

◻ Tribal Policy ◻ Government to

Government Relationships