Year: 2015 Source: Journal of Rural Mental Health.(2014).38(2):87-97. SIEC No: 20150334

Suicide prevention in rural areas presents unique challenges, including isolation and lack of support services. In rural Indian Country, suicide continues to be a cause for community concern and can be viewed as one outcome of historical trauma. In light of this, a paradigm shift is needed that honors indigenous perspectives more fully regarding etiology, collective symptomology, and collective responsibility for determining appropriate intervention. Suicide prevention and intervention efforts must occur on individual, community, and systemic levels, and should include integration of traditional healing methods. Community settings such as primary care, emergency departments, and schools can play a critical role in the delivery of mental health and suicide prevention services. This article provides an overview of current challenges and opportunities for service provision in rural tribal communities, as well as an overview of evidence-based and promising practices for intervention. It also provides practical recommendations for schools, communities, and policy leaders.