Lifesaving Suicide Prevention Resources Available for More Native American Communities

Tribal-academic collaboration builds on a program that reduced suicide attempts by 50% in the White Mountain Apache Tribe in Arizona

Today the Bloomberg American Health Initiative announces new resources that build on the successful Celebrating Life Suicide Prevention Program of the White Mountain Apache Tribe in Arizona. The program, established 20 years ago, addresses alarming rates of suicide in the community with community-based surveillance and case management support. In the program’s first 12 years, the White Mountain Apache Tribe saw a 38% decrease in suicide deaths and a 53% decrease in suicide attempts across ages.

The new resources, now widely available to other Native American tribes, were developed with tribal leadership with support from the Johns Hopkins Center for Indigenous Health and the Bloomberg American Health Initiative, both at the Johns Hopkins Bloomberg School of Public Health.

Native Americans have the lowest life expectancy among racial and ethnic groups in the U.S.—70.1 years versus 78.5 years for white people—according to the U.S. Centers for Disease Control and Prevention. CDC data shows Indigenous Americans experienced the highest overall suicide rate in 2021, increasing 26% over the previous year, the highest year-over-year increase since 2018. To address these inequities, White Mountain Apache Tribal leaders and academic collaborators at the Bloomberg School are making this evidence-based and community-driven Celebrating Life Suicide Prevention Program more accessible to other tribes. 

Expanded resources for tribes include:

• Policy guidelines, including templates for tribal policies and resolutions to support mandated data collection
• Data-collection tools, electronic forms
• A digital database template to track suicide behaviors, substance use, and non-suicidal self-harm
• A case management training program for suicide prevention teams
• Budget recommendations for training and program management 

The Johns Hopkins Center for Indigenous Health and the Bloomberg American Health Initiative are based at the Johns Hopkins Bloomberg School of Public Health. The new resources were announced today at the seventh annual Bloomberg American Health Summit in Washington, D.C., an event that brings together public health leaders across sectors to address pressing public health issues. 

“The growing interest from other tribal nations in our initiatives has motivated us to expand this crucial program, allowing us to share our compassionate approach with even more communities,” says Novalene Goklish, DBH, MS, assistant scientist and behavioral interventionist and member of the White Mountain Apache Tribe. “By collaborating with additional tribes and organizations, we aim to enhance our resources and outreach, ultimately saving more lives and promoting mental wellness throughout the world.”

Developed with input from tribal communities, the resources scale up the Celebrating Life Suicide Prevention Program model, offering an opportunity for widespread implementation and flexibility to modify the tools for diverse and culturally appropriate contexts.

The White Mountain Apache Tribe Celebrating Life Suicide Prevention Program mandates that members of the community and individuals who work on the reservation report self-injurious behaviors, suicidal ideation, suicide attempts, death by suicide, and non-suicidal self-injury. Each tribal community would determine their own reporting requirements. A group of community mental health specialists is responsible for providing real-time case management follow-up visits to support individuals in crisis. The mental health specialists will also track cases and overall trends in a confidential database.

“As one of the few programs addressing one of the most critical inequities facing Native Americans, Celebrating Life has garnered interest from over 35 Indigenous communities and organizations seeking to adopt this model,” says Mary Cwik, PhD, associate director of the Center for Indigenous Health. “These resources will significantly expand our ability to share this life- saving intervention, strengthening Native American suicide prevention efforts across the nation.”

The new resources and more information about the Celebrating Life Suicide Prevention Program are available at online here. The Center for Indigenous Health will also offer training and technical assistance as part of the program’s implementation. 

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About the Bloomberg American Health Initiative
The Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health was developed to tackle five core issues that deeply challenge the nation’s health: addiction and overdose; adolescent health; environmental challenges; food systems; and violence. The Initiative’s work with faculty, Bloomberg Fellows, and collaborating organizations is building a dynamic nationwide network committed to harnessing data and developing new approaches to public health that will ensure a healthier future for all Americans. Learn more here: Bloomberg American Health Initiative.