A culturally informed approach to American Indian/Alaska Native youth suicide prevention. In N. Zane, G. Bernal, & F. T. L. Leong (Eds.). Evidence-based psychological practice with ethnic minorities: Culturally informed research and clinical strategies

According to scholarly accounts, suicide has disproportionately affected the American Indian/Alaska Native (AI/AN) population for well over half a century. Since the introduction of the Garrett Lee Smith Act of 2004, various forms of evidence-based intervention (EBI) efforts within AI/AN communities have attempted to combat this devastating epidemic. Though well-intentioned and scientifically sound, these interventions have historically been culturally disconnected and therefore have failed to bring about any real and long-lasting change. We begin this chapter with a discussion of the unique risk and protective factors of the subgroup of AI/AN adolescents who struggle with being suicidal. We assert that to be successful, the content of AI/AN suicide prevention interventions should be based first and foremost on comprehensive knowledge of culturally unique factors. Second, intervention developers should be responsive to the needs of the AI/AN community and actively engage its members in intervention design, evaluation, and implementation. We present the development and evaluation of the American Indian Life Skills (AILS) curriculum as an account of one suicide prevention intervention that acknowledges the importance of both of these tenets. The implementation and subsequent evaluation of the AILS reflect the particular challenges associated with addressing the evidence-based practice mandate of federally funded programs in AI/AN communities (Walker & Bigelow, 2011). Although the gold standard for determining evidence-based practice involves a strict experimental approach with random assignment of participants to treatment groups, doing so becomes challenging in cases where a community is averse to a randomization scheme. Consideration of these challenges is particularly important in light of the current dialogue surrounding tensions between conventional intervention evaluation protocol and maintaining respect for AI/AN life ways.