Suicide clusters within American Indian and Alaska Native communities: A review of the literature and recommendations

The purpose of this report is to examine what is known about suicide clusters within American Indian and Alaska Native (AI/AN) populations and to use that information to develop recommendations for stakeholders working to prevent and contain suicide clusters within AI/AN communities. This paper provides the results of the review based on: (1) the research on suicide clusters and contagion in general and within AI/AN communities; (2) discussions with several subject matter experts; and (3) interviews with representatives from the Centers for Disease Control and Prevention (CDC) and the Indian Health Service (IHS). The authors also reviewed the CDC Recommendations for a Community Plan for the Prevention and Containment of Suicide Clusters (“CDC Guidelines”) and made recommendations on how the CDC Guidelines could be updated to address the specific needs of AI/AN communities. AI/AN adolescents and young adults, who—in some tribes—have alarmingly high suicide rates, are at greater risk for suicide contagion and cluster formation than other age demographics. Suicide clusters within typically close-knit, rural AI/AN communities can be devastating to AI/AN youth, families, and communities. Yet, the existing research on suicide clusters and contagion is limited and in some cases is several years old, particularly for this population. Any
strategies that address suicide clusters and their impact on AI/AN communities must consider the factors that contribute to, and mitigate, suicide cluster formation, and must include solutions that reflect the traditions, culture, and diversity of AI/AN peoples.