Attempted suicide in American Indian and Alaska Native populations: A systematic review of research on protective factors

American Indian and Alaska Native (AIAN) populations contend with disproportionately high rates of suicide. The study of protective factors is essential for highlighting resilience and formulating potential interventions for suicide. We systematically review factors that are posited to protect against suicide attempts for AIAN peoples. Seventeen (12 journal articles, five theses/dissertations) articles met inclusion criteria. Results indicate that protective factors are typically situated at one of four levels of analysis: individual (e.g., self-esteem), family (e.g., parent caring), community (e.g., positive adult relationships), and cultural (e.g., cultural spiritual orientation). Notably, there were trends in protective factors across age, sex, and geographic region. Based on these findings, we propose recommendations for moving the field forward in future identification of protective factors as a means of AIAN suicide prevention.