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Brockie T, Kahn-John M, Mata Lopez L, Bell E, Brockie T, Brockie T, Decker E, Glass N, Has Eagle H, Helgeson K, Main NJ, Kazemi M, Perez-Monteau R, Myrick A, Nelson KE, Ricker A, Rider T, Roberts T, Wilson DH, Yazzie K, Perrin N. A mixed-methods study protocol on factors contributing to suicide clusters among Native American youth in a northern plains reservation. Front Public Health 2024; 11:1281109. [PMID: 38259800 PMCID: PMC10800579 DOI: 10.3389/fpubh.2023.1281109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Suicide and suicide clusters within Native American Reservation communities are devastating to the entire community and increase individuals' risk for suicide over the lifespan. The objective of this paper is to describe the Indigenous community-based participatory research protocol implemented in partnership with the Fort Belknap Indian Community in Montana, United States. The study protocol was developed to understand suicide risk and protective factors, and community-derived solutions, in a reservation community with history of a suicide cluster and high rates of youth suicide. Methods In this mixed-methods study, qualitative data from youth, adults, and service providers and quantitative data from 200 adolescents and young adults (aged 14-24 years) were collected in Fort Belknap, Montana from May - December of 2022. Qualitative data were collected first via in-depth interviews and focus groups. Survey questions included validated and pre-tested measures of factors youth experience across socio-ecological levels. Thematic analysis was applied to the qualitative data; and logistic regression models were used to examine relationships within the quantitative data. Discussion This study will add a multi-dimensional perspective to our current understanding of (1) risk and protective factors for suicide, community-derived postvention solutions, and insights on community assets, and (2) the current health and psychosocial status of youth in the Fort Belknap community. This study may serve as an exemplar of co-created, culturally safe solutions designed to address mental health resource gaps. Next steps include development of a suicide crisis response tool kit and a culturally aligned postvention intervention that will enhance individual, family, and community survivance.
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Affiliation(s)
- Teresa Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Eleesha Bell
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Truth Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Terry Brockie
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Ellie Decker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Nona J. Main
- Montana Family Planning, Bozeman, MT, United States
| | - Mina Kazemi
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Alicia Myrick
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Katie E. Nelson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Adriann Ricker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Tammy Rider
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Teeah Roberts
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Deborah H. Wilson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Auckland University of Technology, Auckland, New Zealand
| | - Karen Yazzie
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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Paiva de Araujo JA, Fialho É, Oliveira Alves FJ, Cardoso AM, Yamall Orellana JD, Naslund JA, Barreto ML, Patel V, Machado DB. Suicide among Indigenous peoples in Brazil from 2000 to 2020: a descriptive study. LANCET REGIONAL HEALTH. AMERICAS 2023; 26:100591. [PMID: 37732137 PMCID: PMC10507632 DOI: 10.1016/j.lana.2023.100591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/22/2023]
Abstract
Background Previous studies in Australia, Canada, and Brazil, found that suicide among ethnic minority groups is higher than in the general population. Indigenous peoples in Brazil have been reported to have a high suicide rate, with reports of suicide clusters occurring in several communities. The objective of this study was to report trends in countrywide suicide rates among Indigenous peoples in Brazil between 2000 and 2020, and to compare these with the non-Indigenous population. Methods This ecological study used Indigenous suicide data collected from all regions of Brazil during a 21-year period, between 2000 and 2020. We used suicide estimates from the Mortality Information System (SIM), available at the Brazilian Health Ministry website (DATASUS). Suicide mortality rates by state and region were calculated using the estimated Indigenous population from the 2010 census, and estimated population proportions for the other years. We performed a trend analysis and compared trends in suicide between the Indigenous and non-Indigenous population during the period studied. Findings Suicide rates among Indigenous Brazilians have reached more than two and a half times the levels for the overall Brazilian population in 2020 (17.57 suicide deaths versus 6.35 suicide deaths per 100,000 inhabitants, respectively). The Central-West region of Brazil had the highest suicide rates among Indigenous Brazilians over the study period, reaching 58.8 deaths/100,000 inhabitants in 2008. The younger age group (10-24 years old) had the highest suicide rates for all the years studied. Time-series analyses showed a trend of statistically significant increases in suicide rates in Brazil for both the Indigenous and non-Indigenous population during the study period. The North region, and specifically Amazonas state, has shown a decisive increase in suicide rates among the Indigenous populations. The suicide rate for Indigenous people in Brazil, excluding cases in Amazonas and Mato Grosso do Sul states, were similar to those for the entire Brazilian population, showing that the Indigenous peoples who are the most vulnerable to suicide reside in these locations. Interpretation While there were statistically significant increases in suicide rates for all Brazilians over the study period, they remained alarmingly high among Indigenous people, compared to their non-Indigenous counterparts. The high suicide rates among Indigenous people, and younger individuals in particular (aged between 10 and 24), reinforces the need for specific prevention strategies for these populations. Further studies should be concentrated on determining risk factors in distinct ethnic groups, specifically within regions experiencing an elevated risk, such as the states of Amazonas and Mato Grosso do Sul. Funding Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under award number R01MH128911-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Affiliation(s)
| | - Érika Fialho
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Flávia Jôse Oliveira Alves
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Andrey Moreira Cardoso
- National School of Public Health, Oswaldo Cruz Foundation (ENSP/FIOCRUZ), Rua Leopoldo Bulhões, 1480, Rio de Janeiro, Brazil
| | - Jesem Douglas Yamall Orellana
- Leônidas and Maria Deane Institute (ILMD), Oswaldo Cruz Foundation (FIOCRUZ), Rua Teresina, 476, Adrianópolis, Manaus, Amazonas, Brazil
| | - John A. Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
| | - Mauricio L. Barreto
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
| | - Daiane Borges Machado
- Center of Data and Knowledge Integration for Health (CIDACS), Fiocruz, R. Mundo, 121. Salvador, Bahia, Brazil
- Department of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, United States of America
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Benson R, Rigby J, Brunsdon C, Cully G, Too LS, Arensman E. Quantitative Methods to Detect Suicide and Self-Harm Clusters: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095313. [PMID: 35564710 PMCID: PMC9099648 DOI: 10.3390/ijerph19095313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022]
Abstract
Suicide and self-harm clusters exist in various forms, including point, mass, and echo clusters. The early identification of clusters is important to mitigate contagion and allocate timely interventions. A systematic review was conducted to synthesize existing evidence of quantitative analyses of suicide and self-harm clusters. Electronic databases including Medline, Embase, Web of Science, and Scopus were searched from date of inception to December 2020 for studies that statistically analyzed the presence of suicide or self-harm clusters. Extracted data were narratively synthesized due to heterogeneity among the statistical methods applied. Of 7268 identified studies, 79 were eligible for narrative synthesis. Most studies quantitatively verified the presence of suicide and self-harm clusters based on the scale of the data and type of cluster. A Poisson-based scan statistical model was found to be effective in accurately detecting point and echo clusters. Mass clusters are typically detected by a time-series regression model, although limitations exist. Recently, the statistical analysis of suicide and self-harm clusters has progressed due to advances in quantitative methods and geospatial analytical techniques, most notably spatial scanning software. The application of such techniques to real-time surveillance data could effectively detect emerging clusters and provide timely intervention.
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Affiliation(s)
- Ruth Benson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Correspondence:
| | - Jan Rigby
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Christopher Brunsdon
- National Centre for Geocomputation, Maynooth University, W23 F2H6 Maynooth, Ireland; (J.R.); (C.B.)
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
| | - Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3053, Australia;
| | - Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, T12 XF62 Cork, Ireland; (G.C.); (E.A.)
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, T12 XF62 Cork, Ireland
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, QLD 4122, Australia
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de Souza RSB, de Oliveira JC, Alvares-Teodoro J, Teodoro MLM. [Suicide and indigenous populations in Brazil: systematic reviewEl suicidio y los pueblos indígenas brasileños: revisión sistemática]. Rev Panam Salud Publica 2020; 44:e58. [PMID: 32612644 PMCID: PMC7323757 DOI: 10.26633/rpsp.2020.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 02/28/2020] [Indexed: 01/07/2023] Open
Abstract
Objective To describe the frequency, characteristics, and factors contributing to suicide in indigenous populations in Brazil. Method A systematic review of the literature was performed in PubMed, SciELO, PsycINFO, and LILACS. All population-based studies focusing on suicide among indigenous populations in Brazil were included. Results The search identified 111 articles, of which nine met the inclusion criteria. Three of these studies were performed in the Midwest and four in the North of Brazil, while two covered all Brazilian regions. The ethnic groups investigated were specified in three studies (Terena, Kadiweu, Guato, Ofaie-Xavante, Guarani, Guarani-Kaiowá, and Guarani-Nandeva). Suicide rates were highest among males, single individuals, those with 4 to 11 years of schooling, and those aged 15 to 24 years. Suicides occurred most often in the home and on weekends, mostly by hanging. The main risk factors for suicide identified in the articles were poverty, historical and cultural factors, poor wellbeing indicators, family disintegration, social vulnerability, and lack of life or future perspective. Conclusions All the studies indicated the need to engage communities in developing strategies, considering their cosmovision and the social, historic, and cultural view of each ethnic group to minimize risk factors and reduce suicide rates.
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Affiliation(s)
- Ronaldo Santhiago Bonfim de Souza
- Universidade Federal de Minas Gerais (UFMG) Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom) Belo HorizonteMG Brasil Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil
| | - Júlia Costa de Oliveira
- Universidade Federal de Minas Gerais (UFMG) Programa de Pós-Graduação em Psicologia Belo HorizonteMG Brasil Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia, Belo Horizonte (MG), Brasil
| | - Juliana Alvares-Teodoro
- Universidade Federal de Minas Gerais (UFMG) Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica Belo HorizonteMG Brasil Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Belo Horizonte (MG), Brasil
| | - Maycoln Leôni Martins Teodoro
- Universidade Federal de Minas Gerais (UFMG) Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom) Belo HorizonteMG Brasil Universidade Federal de Minas Gerais (UFMG), Programa de Pós-Graduação em Psicologia: Cognição e Comportamento (CogCom), Belo Horizonte (MG), Brasil
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Kelbert EF, Pinheiro LM, Souza LDM, Pinheiro CAT, Pinheiro KAT, Motta JVS, Barros MMD, Coelho FMC, Souza MS, Martins CSR, Pinheiro RT. Suicide risk in people living with AIDS/HIV: the effect of childhood trauma is mediated by mental disorders and social vulnerability. AIDS Care 2019; 32:512-517. [PMID: 31801367 DOI: 10.1080/09540121.2019.1695732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Suicide is an important problem in people living with HIV/AIDS (PLWHA). The importance of mental disorders and social vulnerability on suicidal behaviors is described in the literature; however, the impact of childhood traumatic events in this scenario is not clear. The aim of this study was to verify the mediation effect of mental disorder comorbidities and social vulnerability in association with childhood trauma intensity and suicide risk level. This cross-sectional study of HIV-positive outpatients was conducted in a specialized care service in the city of Pelotas in Southern Brazil. Sociodemographic data and HIV-related information were collected and the Childhood Trauma Questionnaire was applied. A total of 364 patients underwent psychiatric evaluation using MINI Plus including module C of suicide risk severity. Suicide risk was present in 39.3% of the sample. The relation between childhood traumatic events and the level of suicide risk is mediated by mental disorder comorbidities and socioeconomic vulnerability. Specific psychosocial interventions in PLWHA should consider the potential role of abusive traumatic experiences in the current mental health conditions and suicidal behaviors.
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Affiliation(s)
- E F Kelbert
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - L M Pinheiro
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - L D M Souza
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - C A T Pinheiro
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil.,Serviço de Assistência Especializada, Universidade Federal de Pelotas, Pelotas, Brazil
| | - K A T Pinheiro
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - J V S Motta
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - M M D Barros
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - F M C Coelho
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - M S Souza
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - C S R Martins
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - R T Pinheiro
- Programa de Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
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Souza MLPD. [Mortality from suicide in indigenous children in Brazil]. CAD SAUDE PUBLICA 2019; 35Suppl 3:e00019219. [PMID: 31433029 DOI: 10.1590/0102-311x00019219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/17/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the characteristics, distribution, and mortality rates from suicide in indigenous children in Brazil compared to non-indigenous children. This descriptive study covered the years from 2010 to 2014, using national databases. The study collected deaths in individuals 10 to 14 years of age whose underlying cause was "inentional self-inflicted injury". Hanging was the most frequently used means in both indigenous and non-indigenous children, although it was more frequent in the former. Among indigenous children, suicides in hospitals or other healthcare establishments were less common than in non-indigenous. Approximately three-fourths of suicides in indigenous children occurred in just 17 municipalities. The mortality rate from suicide among indigenous children was 11.0/100,000 (8.4-14.3), or 18.5 times higher (10.9-31.6) than in non-indigenous, which was 0.6/100,000 (0.5-0.6), with no differences between boys and girls. This study showed for the first time on a national scale the specific characteristics of suicide in indigenous children, with high rates, and also identified priority areas for interventions.
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