Department of Psychiatry and Behavioral Sciences and Department of Global Health, University of Washington, Seattle (Collins); National Science Foundation, Alexandria, Virginia (Delgado); South Central Foundation, Anchorage, Alaska (Apok, Dillard); North Star Hospital, Anchorage (Baez); National Institute of Health, University of Southern Denmark, Copenhagen, and Center for Health Research, University of Greenland, Nuuk (Bjerregaard); Institute for Circumpolar Health, Northwest Territories and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (Chatwood); Alaska Native Tribal Health Consortium, Anchorage (Chipp); Department of Psychiatry, University of Toronto, Toronto (Crawford); Centers for Disease Control and Prevention, Atlanta (Crosby); University of Virginia School of Medicine, Charlottesville, Virginia (Driscoll); Utsjoki Health Care Centre, Utsjoki, Finland (Ericksen); Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, and Federation of Sovereign Indigenous Nations, Saskatchewan, Canada (Hicks); National Institute of Public Health, University of Southern Denmark, Copenhagen (Larsen); Substance Abuse and Mental Health Services Administration, Rockville, Maryland (McKeon); Saami Council, Kiruna, Sweden (Partapuoli); Department of Psychiatry and Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada (Phillips); National Institute of Mental Health (NIMH), Bethesda, Maryland (Pringle); Center for Alaska Native Health Research, Institute of Arctic Biology, and College of Rural and Community Development, University of Alaska Fairbanks, Fairbanks (Rasmus); School of Health Sciences, University of Akureyri, Akureyri, Iceland (Sigurðardóttir); Centre for Sámi Health Research, Department of Community Medicine, University of Tromsø-the Arctic University of Norway, Tromsø (Silviken); Sami Norwegian National Advisory Unit on Mental Health and Substance Abuse, Finnmark County Hospital Trust, Karasjok, Norway (Silviken, Stoor); Institute of Public Health, Northern State Medical University, Arkhangelsk Region, Russian Federation (Sumarokov); School of Public Health and Health Sciences, University of Massachusetts, Amherst (Wexler). Kathleen M. Pike, Ph.D., and Pamela Scorza, Sc.D., M.P.H., are editors of this column.
The Arctic Council, a collaborative forum among governments and Arctic communities, has highlighted the problem of suicide and potential solutions. The mental health initiative during the United States chairmanship, Reducing the Incidence of Suicide in Indigenous Groups: Strengths United Through Networks (RISING SUN), used a Delphi methodology complemented by face-to-face stakeholder discussions to identify outcomes to evaluate suicide prevention interventions. RISING SUN underscored that multilevel suicide prevention initiatives require mobilizing resources and enacting policies that promote the capacity for wellness, for example, by reducing adverse childhood experiences, increasing social equity, and mitigating the effects of colonization and poverty.
Background. Suicide is a serious public health challenge in circumpolar regions, especially among Indigenous youth. Indigenous communities, government agencies and health care providers are making concerted efforts to reduce the burden of suicide and strengthen protective factors for individuals, families and communities. The persistence of suicide has made it clear that more needs to be done. Objective. Our aim was to undertake a scoping review of the peer-reviewed literature on suicide prevention and interventions in Indigenous communities across the circumpolar north. Our objective was to determine the extent and types of interventions that have been reported during past decade. We want to use this knowledge to support community initiative and inform intervention development and evaluation. Design. We conducted a scoping review of online databases to identify studies published between 2004 and 2014. We included articles that described interventions in differentiated circumpolar Indigenous populations and provided evaluation data. We retained grey literature publications for comparative reference. Results. Our search identified 95 articles that focused on suicide in distinct circumpolar Indigenous populations; 19 articles discussed specific suicide-related interventions and 7 of these described program evaluation methods and results in detail. The majority of publications on specific interventions were found in North American countries. The majority of prevention or intervention documentation was found in supporting grey literature sources. Conclusion. Despite widespread concern about suicide in the circumpolar world and active community efforts to promote resilience and mental well-being, we found few recorded programs or initiatives documented in the peer-reviewed literature, and even fewer focusing specifically on youth intervention. The interventions described in the studies we found had diverse program designs and content, and used varied evaluation methods and outcomes. The studies we included consistently reported that it was important to use community-based and culturally guided interventions and evaluations. This article summarizes the current climate of Indigenous circumpolar suicide research in the context of intervention and highlights how intervention-based outcomes have largely remained outside of peer-reviewed sources in this region of the world.