Abstract: Community-Based Suicide Surveillance and Follow-up: A Tribally Initiated Public Health Response (Society for Prevention Research 23rd Annual Meeting)

Schedule:

Thursday, May 28, 2015

Congressional D (Hyatt Regency Washington)

* noted as presenting author

Mary Cwik, PhD, Assistant Scientist, The Johns Hopkins University, Baltimore, MD

Lauren Tingey, MPH, MSW, Research Associate, Johns Hopkins University, Baltimore, MD

Novalene Goklish, BA, Senior Research Program Coordinator, The Johns Hopkins University, Whiteriver, AZ

Francene Larzelere Hinton, BA, Senior Research Program Coordinator, The Johns Hopkins University, Whiteriver, AZ

Allison Barlow, PhD, Assistant Scientist, The Johns Hopkins University, Baltimore, MD

Introduction: Suicide rates among AIs aged 10 to 24 are the highest of any U.S. racial/ethnic group, and suicide is the second leading cause of death for AIs aged 15 to 24. Surveillance has been recommended as part of the National Strategy for Suicide Prevention, but many challenges have precluded widespread and timely implementation of reporting. The White Mountain Apache Tribe (Apache), with technical support from Johns Hopkins, has been able to address these limitations through a comprehensive system which can serve as a model for other communities.

Methods: This presentation describes the background, methods, and process data from 2007-2011 for the Apache Surveillance System. Every community member is required by tribal law to report any suicidal ideation, attempts and deaths, as well as non-suicidal self-injury (NSSI) and binge drinking. Apache paraprofessionals attempt to complete an in-person follow-up visit with the at-risk individual to confirm the behavior, gather further information, and facilitate connections to care.

Results: For a community of approximately 17,000 members, the total number of initial reports was 2,640 from 2007 to 2011: 976 for suicide ideation, 758 for NSSI, and 906 for suicide attempts. During this time, reports increased from 519 to 627, most likely related to greater awareness and willingness to report events. Most importantly, the proportion of individuals referred who report subsequently seeking treatment has nearly doubled from 39% in 2007 to 71% in 2011.

Conclusions: Mandating reporting of self-injurious behavior is an innovative public health approach to suicide prevention reflecting the tribe’s dedication to give similar attention to mental health as to infectious diseases and child abuse. The system holds promise to reduce morbidity, mortality and burden to the health care system through use of paraprofessionals to promote identification, engage and connect at-risk individuals, and develop prevention strategies based on the resulting data.

Abstract: Community-Based Suicide Surveillance and Follow-up: A Tribally Initiated Public Health Response (Society for Prevention Research 23rd Annual Meeting)

282 Community-Based Suicide Surveillance and Follow-up: A Tribally Initiated Public Health Response