摘要：As part of the National Action Alliance for Suicide Prevention’s American Indian and Alaska Native (AI/AN) Task Force, a multidisciplinary group of AI/AN suicide research experts convened to outline pressing issues related to this subfield of suicidology. Suicide disproportionately affects Indigenous peoples, and remote Indigenous communities can offer vital and unique insights with relevance to other rural and marginalized groups. Outcomes from this meeting include identifying the central challenges impeding progress in this subfield and a description of promising research directions to yield practical results. These proposed directions expand the alliance’s prioritized research agenda and offer pathways to advance the field of suicide research in Indigenous communities and beyond. Although the Surgeon General published a call to action to prevent suicide in 1999, 1 national rates of suicide have shown little improvement, and from 2002 to 2010 suicide moved from the 11th to the 10th leading cause of death in the United States. 2,3 National s uicide rates are consistently higher among White men aged 65 years and older than in younger age groups. 3 However, suicide remains one of the top 5 causes of death for American adults younger than 45 years and one of the top 3 for adolescents and young adults. 2 Although suicide is clearly an important public health priority for all Americans, it is an especially critical issue for American Indians and Alaska Natives (AI/ANs). North America’s Indigenous peoples have disproportionately high rates of suicide deaths, attempts, and ideation, and suicide deaths are approximately 50% higher for AI/AN people than for White people. 1,3 However, AI/AN elder suicides are quite rare. Suicide is the second leading cause of death among AI/AN adolescents and young adults, and their rate of suicide is 2.5 times as high as the national average across all ethnocultural groups. 2 AI/AN young men are particularly vulnerable 4 ; the Centers for Disease Control and Prevention has reported that AI/AN youths aged 10 to 24 years have the highest suicide rates of all ethnocultural groups in the United States, at 31.27 per 100 000 among male youths and 10.16 per 100 000 among female youths. To eliminate this health disparity, research identifying the unique factors contributing to AI/AN suicide is essential to tailor interventions to fit the particular cultural and situational contexts in which they occur. 1 Driven by the pressing need to better understand and reduce AI/AN suicide, the AI/AN Task Force of the National Action Alliance for Suicide Prevention (NAASP) created a working group to identify research priority areas that have the most potential to reduce suicide and suicidal behavior in AI/AN communities. For this purpose, we (L. W., T. L., and J. P. G.) worked with Jeff Schulden from the National Institute on Drug Abuse and LaShawndra Price from the National Institute of Mental Health to convene a 2-day, multidisciplinary meeting of suicide researchers in August 2013. The working group identified 3 undertakings as crucial for advancing research in this area: the need to (1) summarize current knowledge about the problem of Indigenous 1 suicide, (2) designate key challenges in Indigenous suicide research, and (3) propose future directions that might spur innovation in suicide research among Indigenous people. Several innovative and promising approaches are currently unaddressed in the NAASP research agenda. 5 We, as Indigenous suicide research experts, believe that 3 core issues in research and clinical care are vital for suicide prevention in AI/AN and other communities. Our suggestions are not meant to be prescriptive but rather to highlight the ways in which some dominant approaches can constrain AI/AN suicide research. The proposed areas of study offer some promising new directions for AI/AN research and for suicide research more generally.
