A mixed methods examination of Indigenous youth suicide

Objective. Suicide and suicidal behaviors among North American Indigenous (American Indian/First Nations) youth represents an important health disparity that tragically affects many Indigenous communities. Although prior research has documented a wide range of risk and protective factors thought to influence Indigenous suicidality, little is known of the potential influence of cultural factors, including traditional spirituality and enculturation. Method. This study utilizes a mixed methods approach to study Indigenous youth suicidality. Qualitative data were obtained from focus group sessions with First Nations elders and service providers. The resulting community feedback was used in conjunction with previous literature and theory (stress process and life course perspectives) to develop study hypotheses tested via quantitative analyses. Quantitative data are from waves 1, 3, and 4 of an ongoing longitudinal lagged sequential study conducted on and in partnership with a total of 9 Midwestern and Canadian reservations and reserves. At wave 1, a total of 746 youths from a single Indigenous cultural group and aged 10–12 were interviewed, with approximately equal numbers of male and female participants. Results. Path analyses indicated that stressors (discrimination and negative life events) were positively related to a variety of ‘proximal’ outcomes, or indicators of suicidality. In general, stress was also positively associated with suicidality. Both commitment to traditional spirituality and enculturation exerted some (direct and indirect) protective influences on non-optimal outcomes, including lower levels of suicidal behaviors. Conclusion. Qualitative and quantitative results of this study suggest the important influence of traditional cultural values and practices as protective factors for a variety of non-optimal health and behavioral outcomes among Indigenous youth and provide empirical evidence for culturally relevant prevention and health promotion efforts within Indigenous communities.