Programs teach community youths that stress is normal and that it can be dealt with in positive ways.

SASKATOON (CUP) — Professor of psychiatry Dr. Jitender Sareen along with his colleagues at the University of Manitoba have teamed up with community members in north-western Manitoba to create the Swampy Cree Suicide Prevention Team.

The Swampy Cree Suicide Prevention Team is made up of representatives from eight Swampy Cree tribal councils, researchers and clinicians from the university and international experts in the fields of aboriginal health, trauma and suicide prevention.

The eight communities that Sareen works with vary in size with populations ranging from 500 to 4,000 people. However, they all have extremely high suicide rates among youth — nearly five times the national average. The national average is ten to 15 per 100,000.

In 2005 the Swampy Cree Suicide Prevention Team received a grant from the Canadian Institutes of Health Research — the federal body that awards grants for health studies — which funded the partnership between the university-based clinicians and community members. They had a goal of designing studies to understand to key elements in suicide prevention.

The first element is being able to identify who is at risk. The second is finding culturally safe and grounded intervention methods that are evidence-based.

“There’s a lot that’s known about suicide risk and suicide intervention but little is known in First Nations communities about what are the specific risk factors and protective factors,” Sareen said. “What are the evidence-based, but also culturally acceptable [and] culturally safe interventions.”

He explained that maintaining strong relationships with the Swampy Cree communities is important so that the people living in these areas can benefit from the research that is being done.

“One of the challenges in First Nations research is that researchers come into the communities and then they take some information surveys [and leave]. Then the communities often feel they have not gotten any benefit.”

Sareen has been maintaining the partnerships with annual meetings and monthly conference calls. These are times when the team talks with community members and asks them directly why they think suicide is an issue in their area, what the related problems could be and what the best prevention strategies would be for them specifically.

“The communities know what their experiences are, what is working in their community and what is not working,” Sareen said. “They give us input as to what is acceptable and what has the best chance of success.”

Sareen is looking to youth peer leaders programs to promote well-being among young people. Aware that young people often listen to their own age group more than they do adults, the Sources of Stress program has youth working with youth to overcome stigmas related to mental health.

Developed in South Dakota, Sources of Stress takes a positive approach to suicide prevention as opposed to trying to “stomp out suicide” by finding at-risk kids, Sareen said. The program identifies different kinds of stress and helps youth see them as normal and common occurrences.

Sources of Stress is currently being tested in over 40 high schools in the United States and has shown positive initial findings. Developers are working with community members to adapt and implement the program for the Swampy Cree communities.

Unlike Sources of Stress, Sareen said many suicide prevention programs are mandated by governments without ever being tested because they merely appear to be promising and reasonable.

Applied Suicide Intervention Skills Training is a two-day long course that prepares individuals for dealing with suicide prevention. The training teaches people how to identify at-risk individuals by asking them questions and how to get these individuals the help they need. Community members such as teachers, coaches and mentors are recommended to take the training. ASIST has been implemented all over the world but has never been fully evaluated.

The Swampy Cree Suicide Intervention Team did a small pilot study of ASIST and found that the program did not have any positive impacts on the communities in which it was implemented.

“We found some disturbing parts,” Sareen said. “We didn’t find that it was helpful. It actually increased some thoughts about suicide from people who [partook] in it.”

The results of the pilot study led to the Canadian government increasing the team’s funding for a more extensive evaluation of ASIST.

Over the last eight years, many of the studies that the Swampy Cree Suicide Prevention Team has done have shown that programs based on family relationships and youth peer leadership are the most successful in suicide prevention.

However, suicide is a complex issue that goes beyond the textbook causes like bullying or depression. Housing, poverty and boredom are all factors that need to be considered. Sareen said these are all challenges in the health sector that require a larger framework when trying to prevent suicide.

“Previous programs have really focused on psychiatric and psychological treatment of mental disorders, which are very important, but in these cases they need to go beyond that,” Sareen said.

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