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For more than 70 years, suicide prevention models have largely been designed to identify and mitigate risk through an individualized approach. But as suicide rates have steadily risen for the past few decades, momentum is growing for a new paradigm – one that focuses instead on teaching communities how to build off their cultural strengths. Indigenous researchers in Alaska have been testing this type of model in two of the nation’s most impacted populations for suicide – Native villages and military installations – with hopes that their approach could scale both nationally and abroad.

Indigenous prevention programs seek to address persistently high suicide rates

Brandon Kapelow
/
KYUK
Albert Simon, 29, strikes a seal with a harpoon while hunting outside Hooper Bay, Alaska. Simon has volunteered with the Center for Alaska Native Health Research (CANHR)'s Qungasvik program to help provide access to seal hunting for Alaska Native youth in his village.

The Yukon-Kuskokwim Delta is one of the most remote regions in the United States. It’s also home to the nation’s highest rates of suicide.

Freshly painted headstone markers sit onstage at the Paimiut Tribal Council building in Hooper Bay, Alaska. In February, two young people in the village died consecutively by suicide. The tribal council building hosts a weekly practice for a Yup’ik dance group - one of many activities supported by the Qungasvik program that experts believe help bolster community mental health.
Brandon Kapelow
/
KYUK
Freshly painted headstone markers sit onstage at the Paimiut Tribal Council building in Hooper Bay, Alaska. In February, two young people in the village died consecutively by suicide. The tribal council building hosts a weekly practice for a Yup’ik dance group - one of many activities supported by the Qungasvik program that experts believe help bolster community mental health.

“Suicide hurts,” said Gideon Green. The 29-year-old has lived in the coastal village of Hooper Bay his whole life. “It took me three years to get over that grief of losing a close friend, ” he said.

Mental health experts say that high suicide rates can’t be reduced to a single cause. But researchers think that a lack of behavioral health resources, social isolation, access to guns, and generational trauma from colonialism all play a role in the Yukon-Kuskokwim (Y-K) Delta.

“Back in, I guess it was 2015, we had three suicides in less than a week,” Green said. That year, he decided to volunteer with an innovative program from the University of Alaska Fairbanks called Qungasvik, a Yup’ik word meaning “toolkit.”

The program aims to reduce suicide risk by providing young people with activities and learning that draw on their Alaska Native traditions. “They got us some stuff so we could start with the youth group Eskimo dance practice,” Green said.

Every week in Hooper Bay, a dance group gets together for practice in the tribal council building. Tables are swept to the side, and rows of folding chairs are laid out facing a small stage where a group of about 20 locals are gathered. A row of drummers plays in the front, while Elders teach young people to dance.

Gideon Green, center, sings with a group of drummers at a Yup’ik dance practice in Hooper Bay that’s been supported by Qungasvik. For Green, who has lost several close friends to suicide, the group has proven integral to his healing.
Brandon Kapelow
/
KYUK
Gideon Green, center, sings with a group of drummers at a Yup’ik dance practice in Hooper Bay that’s been supported by Qungasvik. For Green, who has lost several close friends to suicide, the group has proven integral to his healing.

Green is one of the drummers. “Doing our Eskimo dances and drumming, it takes your stress away,” he said. “It takes my depression away when I’m hitting the drum. It just takes out all the anger.”

Since the outset of the program, the University of Alaska Fairbanks (UAF) team has provided support and funding for a wide variety of Yup’ik subsistence and cultural activities. For some – like beading, or dancing – it's been easier to get funders to sign off. But when it comes to things like hunting that many communities identified as being essential, they’ve faced greater challenges.

“In one of our first grants, our university risk management caught wind of us paying people to be boat drivers," said Stacy Rasmus, the director of the Center for Alaska Native Health Research (CANHR) at UAF. “They were like, ‘Whoa, whoa, whoa. You’re taking big groups of young people out on the open coast and they have firearms?’ The liability issue, it restricts us from doing life saving care. But what’s the liability of not taking these young people out?”

Over the years, access to subsistence activities has also become increasingly tied to the cost of key supplies like fuel and ammunition. This can prove prohibitive for many remote communities, where common goods can cost more than five times the national average.

The Qungasvik program has tried to address the barrier of rising costs by providing villages with access to vehicles and supplies.

A flight is loaded with cargo at the airport in Bethel. Due to the added cost of delivering supplies by air, prices for common goods in the villages of the Y-K Delta can be as much as five times the national average.
Brandon Kapelow
/
KYUK
A flight is loaded with cargo at the airport in Bethel. Due to the added cost of delivering supplies by air, prices for common goods in the villages of the Y-K Delta can be as much as five times the national average.

“To go out and do a big boating trip it’s at least $200, just for that one day. So it’s just not gonna be something that a lot of young people are going to have access to,” said Rasmus. “Cash money is now required to continue a subsistence way of life.”

Sustainably funding and implementing the program is also a big challenge. Qungasvik receives federal grants that are typically funded on three-to-five-year cycles. This can be a problem for programs that seek to address complex, longstanding issues like suicide.

Holly Wilcox, a national suicide prevention researcher and a professor at Johns Hopkins University, explained: "It could be that you're just finally making momentum and able to do things at high quality, and then the grant ends."

These short funding cycles, along with working among small populations, make it hard to measure whether the program has directly contributed to a drop in suicide deaths. But in two studies, published in 2017 and 2022, CANHR was able to show that the program did help participants feel more connected to what’s called “reasons for living” over the two-year study periods – a factor that is known to protect against suicide risk.

In January, the U.S. Bureau of Indian Affairs awarded CANHR a $2 million grant to establish a nonprofit and construct a training center that can deliver Qungasvik sustainably into the future.

Panik John, 65, (right) teaches her granddaughter, Bernadette Wiseman, 6, (left) how to process a baby seal using a traditional Uluaq knife at their home in Toksook Bay, Alaska. Panik and her husband Simeon lead CANHR’s programs and research projects in Toksook Bay, including Qungasvik.
Brandon Kapelow
/
KYUK
Panik John, 65, (right) teaches her granddaughter, Bernadette Wiseman, 6, (left) how to process a baby seal using a traditional Uluaq knife at their home in Toksook Bay, Alaska. Panik and her husband Simeon lead CANHR’s programs and research projects in Toksook Bay, including Qungasvik.

These promising results have left Rasmus and her colleagues feeling optimistic that their community-centric approach could be applied in other contexts.

“Every community and culture has a real strong foundation and set of protections that have allowed us to survive and thrive,” Rasmus said. “We all have that.”

Through their work in the villages of the Y-K Delta, the CANHR team felt that they had developed a process for identifying community strengths that could be used as a model elsewhere. And in 2021, they had their first opportunity to demonstrate their approach in a totally different group: the U.S. military.

In the next part of this series, we’ll explore CANHR’s new military initiatives and their implications for the next generation of suicide prevention efforts across the country.

This story is part of a series from KYUK focused on community-based suicide prevention. Find the rest of the series at KYUK.org. Support for this reporting was provided by Stanford University’s Bill Lane Center for the American West. 

If you or someone you know may be considering suicide or is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline.

Brandon Kapelow