Rural suicide has no single cause and no easy solution

The numbers are high in the cities, according to the state Bureau of Vital Statistics. But it's worse in rural Alaska.

In the northwest region that includes Kotzebue and surrounding villages, 55 people killed themselves between 1999 and the end of last year, according to preliminary numbers issued by the state earlier this month.

That's a rate of 74 deaths per 100,000 people -- almost seven times higher than the 2006 national average, the most recent figure available.

Rural teens and young adults are particularly at risk.

But while officials at every level say they're trying to slow the deaths -- one former cop in Kotzebue thinks she's on to something -- there's no easy solution because there's no single cause.

Young, rural Alaskans are tangled in a web of problems that range from alcohol and drugs to poverty, domestic violence, sexual abuse and an identity crisis brought about by straddling two sometimes opposing cultures.

"Most households have an immediate family member or an extended family member who has committed suicide in the last 10 years or so," said Selawik middle school teacher Ward Walker, who has also worked in coastal villages such as Stebbins, St. Michael and Unalakleet. "That's kind of a traumatic stress disorder thing that is part of the family."

Kids see successful people on TV and in movies, in sitcoms and music videos, he said. But many see no clear to path to get there.

Look at any indigenous culture that has been overtaken by another culture -- Aborigines, Native Americans, Inuits in Canada, Siberia and Greenland -- and you see a similar pattern, said Dr. Lisa Wexler, a University of Massachusetts assistant professor who studies suicide in Northwest Alaska.

As children, many older adults were plucked from their towns and sent to boarding schools where they were taught not to speak their Native language.

"That recipe of colonialization, where children are taken from their homes and people are systematically taught that their culture is less than the dominant culture, people do poorly," Wexler said. "Particularly young people as they come of age."

But teens, adults and elders in the villages tend to see suicide differently.

Wexler conducted a federally funded survey of adults and teens in Northwest Alaska published in 2006. It asked why young people are killing themselves and what to do about it.

Teens said they were stressed. They talked about needing adults to talk to them, to support them and be role models. In contrast, adults most often said kids need more activities, community gatherings and to learn about their culture.

TAKING STEPS

So what are local, state and regional leaders doing?

This spring in Selawik, the village planned to hold a Sweet 16 birthday party for a boy who had lost his mother. That's the kind of celebration you normally see reserved for elders, said former city manager Clyde Ramoth. Other boys looked forward to an upcoming "wellness" snowmachine race, designed to give kids more to do.

Maniilaq, the regional health corporation, is using a federal grant to, among other things, have kids make short videos about their lives. The nonprofit tries to keep trained counselors in each village, said Michelle Dakai, director of family resources.

Currently, seven of the 11 counselor jobs are filled; there are vacancies in Selawik, Shungnak, Kiana and Kobuk, according to Maniilaq.

Maniilaq also sends letters to check up on people who have tried to kill themselves.

It sounds simple, but the approach has been shown in randomly controlled studies to prevent suicides, said James Gallanos, the state Division of Behavioral Health's lead suicide prevention coordinator.

"It's just a hand-written note that says, 'Hey, how are you doing? We care. ... Please feel free to contact us if you need to talk,' " Gallanos said.

A recent audit of the Alaska Suicide Prevention Council, launched in 2001 to reduce suicide numbers across the state, found that the legislators who sit on the council rarely showed up for meetings and that several seats sat vacant for years.

The state budgeted $915,000 in its current budget for suicide prevention, Gallanos said. There's less for 2010.

The money provides grants for suicide prevention programs around the state. In Northwest Alaska, only the Northwest Arctic Borough School District applied for the grant money, Gallanos said.

NATURAL HELPERS

Last week in Kotzebue, Maniilaq held a conference for young people and elders to talk about suicide and other problems.

Among the organizers were a group of village teenagers whom Michelle Woods -- a former social worker and police detective -- is counting on to help prevent their friends from killing themselves.

Woods is the director of a program the Kotzebue-based district adopted this fall. It's already shown promise elsewhere in Alaska.

It's a peer-to-peer program known as Natural Helpers, and it's become popular nationwide in recent years. Like the letter writing, it's about making personal connections with people who might be considering suicide. In this case, the district goes to each school in the region and asks high school kids whom they would trust with their problems.

The kids write down the name of one of their friends, Woods said. Organizers tally the names and take the kids with the most "votes" to Kotzebue and train them how to talk to their friends about suicide.

These newly minted leaders aren't necessarily basketball stars and honor students, Woods said. They might smoke weed. They might be dropouts.

But in villages where adults and teens struggle to communicate, they're the ones other kids will actually listen to, she said.

The first year the Lower Yukon school district tried the program, the youth leaders said they talked to a total of 35 friends about suicide. Six years later, in 2007, the number grew to 175 interventions, Woods said.

"The more authority that we gave them, the more tasks that we gave them, the more they shined."