American Indian college student suicide: risk, beliefs, and help-seeking preferences

Native American Speech-Language Pathology Assistants: Expanding Culturally Responsive Services in Reservation Schools

Purpose:

Native Americans are one of the least represented races within the profession of speech-language pathology. As a result, Native American school children are among the least likely to receive speech and language services from a provider who shares their same culture and heritage. The purpose of this tutorial is to describe how expanding opportunities for Native American college students to enter the field of speech-language pathology as speech-language pathology assistants (SLPAs) offers a solution for improving culturally responsive services in reservation schools.

Method:

The article reviews research describing factors impacting the current disparity of Native Americans within the field of speech-language pathology. Additionally, we explore increasing opportunities for Native American college students to obtain education and licensing as SLPAs while maintaining ties to their community, tribal land, and local school system. The author then suggests steps speech-language pathologists in reservation schools can take to expand their culturally responsive services by participating in the development of, and collaboration with, Native American SLPAs.

Conclusions:

There is a need for increased culturally responsive speech and language services for Native American students in reservation schools. It is the obligation of speech-language pathologists serving this population to explore solutions for improving culturally responsive services, which includes investing in a new generation of Native American SLPAs.

Suicide Across Buddhism, American Indian-Alaskan Native, and African Traditional Religions, Atheism and Agnosticism: An Updated Systematic Review

Religion can exert a powerful influence on human behavior, including suicide. Research has demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior, but may also, at times, serve as a risk factor. In clinical practice with individuals managing suicidality, a clear understanding of the influence of religion on suicidality is required to effectively assess for risk of suicide. In the 10 years since the article, 'Religion and suicide: Buddhism, American Indian/Alaskan Native (AIAN) and African religions, Atheism, and Agnosticism' (Lizardi and Gearing, J Relig Health 49:377-384, 2010), there has been a significant increase in research advancing our understanding of the nature of this relationship across faiths and beliefs. Consequently, this article provides an expanded and updated review of the research in the 10 years since our original publication examining the relationship between suicide and religion across Buddhism, AIAN, African religions, as well as atheism, agnosticism. The databases PsycINFO, MEDLINE, SocINDEX, and CINAHL databases were searched for published articles on religion and suicide over the last decade, between 2009 and 2019. Epidemiological data on suicidality across these world religions, and attitudes and beliefs toward suicide are presented. Updated recommended practice guidelines for effectively incorporating religiosity into suicide risk assessment and treatment are provided, and areas of future research are identified.

The prevalence of distress, depression, anxiety, and substance use issues among Indigenous post-secondary students in Canada

This study aimed to estimate the prevalence of mental illness and substance use among Indigenous students attending Canadian post-secondary institutions. We obtained data from the National College Health Assessment - American College Health Association Spring 2013 survey, which includes 34,039 participants in 32 post-secondary institutions across Canada. We calculated prevalence estimates with 95% confidence intervals (CI). We compared Indigenous and non-Indigenous students using age- and sex-adjusted prevalence ratios (PR) obtained from Poisson regression models. Of the total sample, 1,110 (3.3%) post-secondary students self-identified as Indigenous. Within the past 12 months, Indigenous students had higher odds of intentionally injuring themselves (PR = 1.53, 95% CI = 1.27-1.84), seriously considering suicide (PR = 1.32, 95% CI = 1.12-1.56), attempting suicide (PR = 1.74, 95% CI = 1.16-2.62), or having been diagnosed with depression (PR = 1.26, 95% CI = 1.08-1.47) or anxiety (PR = 1.18, 95% CI = 1.02-1.35) when compared with non-Indigenous students. Indigenous students also had higher odds of having a lifetime diagnosis of depression (PR = 1.31, 95% CI = 1.17-1.47) when compared with non-Indigenous students. Indigenous students were more likely to report binging on alcohol (PR = 1.10, 95% CI = 1.02-1.19), using marijuana (PR = 1.21, 95% CI = 1.06-1.37), and using other recreational drugs (PR = 1.32, 95% CI = 1.06-1.63) compared to non-Indigenous students. This study demonstrates that Indigenous students at post-secondary institutions across Canada experience higher prevalence of mental health and related issues compared to the non-Indigenous student population. This information highlights the need to assess the utilization and ensure the appropriate provision of mental health and wellness resources to support Indigenous students attending post-secondary institutions.

Suicide Risk among Immigrants and Ethnic Minorities: A Literature Overview

Recent studies have demonstrated that immigrants and ethnic minorities may be at higher risk of suicidal behaviour as compared to the general population. We conducted a literature search to identify studies in English from 1980 to 2017 related to suicide risk among immigrants and ethnic minorities. Six hundred and seventy-eight reports were screened, and 43 articles were included in the qualitative synthesis of the review. Some studies reported lower rates of suicide attempts, while other findings suggested higher rates of suicidal behaviour and deaths among immigrants as compared to the native population. Also, a positive correlation was found between suicidal behaviour and specific countries of origin. Non-European immigrant women were at the highest risk for suicide attempts, a group which included young women of South Asian and black African origin. Risk factors among migrants and ethnic minorities were found to be: language barriers, worrying about family back home, and separation from family. The lack of information on health care system, loss of status, loss of social network, and acculturation were identified as possible triggers for suicidal behaviour. Overall, results suggest that specific migrant populations and ethnic minorities present a higher risk of suicidal behaviour than native populations, as well as a higher risk of death by suicide.

Suicide, Resilience, and Connectedness Across the Lifespan: Lessons From American Indian and Alaska Native Elders

Rates of suicide and associated costs are high and increasing in the United States. From 1999 through 2014, the age-adjusted suicide rate increased 24%, with the pace of increase being greater since 2006. American Indian and Alaska Native persons have significantly lower rates of suicides than other ethnic groups as elders despite experiencing some of the highest rates during adolescence. This article examines literature pertaining to suicide rates in American Indian and Alaska Native communities and proposes a framework for understanding their lower rates of suicide as elders. Such understanding offers opportunities for developing strategies for suicide prevention across lifespan.