Suicide is the second leading cause of death among American Indian adolescents. However the rate varies among tribes & pueblos from 8/100,000 to 47/100,000. The lowest suicide rate occurs in Indian communities with the greatest number of intact traditional religious, clan, & extended family structures. Psychological autopsies on over 200 adolescent suicides in the Southwest identify 6 important factors which resemble data for a Los Angeles adolescent population. Intervention ideas are discussed.