Practice implications for addressing Native American youth suicide : an integrative review

Abstract

American Indian/Alaska Natives experience the highest rate of suicide compared to all ethnic groups in the United States, and the youth of this minority population account for 40 percent these suicides. The aim of this integrative literature review was to provide information and direction to health care professionals, including nurses, who deliver care to the AI/AN youth across Indian Country. An integrative review, including a comprehensive computer-assisted search of three separate databases, and a subsequent review of the reference lists of selected articles was completed. Forty-one articles met the inclusion/ exclusion criteria. The findings, recommendations and practice implications were documented in a chart (Appendix C) and then organized according to the biological systems theory model (Appendix D), which allowed for illustration of the multi-layered risk unique to Native youth, the importance of considering the social context in which Native youth suicide occurs, and assisted in identifying practice implications specific to Native American youth. The risk factors ranged from individual and family "day-to-day realities," to factors that were a part of the adolescent's environment but not necessarily a direct influence, to cultural, economic and political issues, and historical events that remain active as factors affecting the lives of Native youth. The results of this integrative literature review provided the evidence for the need to develop a collaborative approach that is culturally anchored in the world of the Native youth. The need for increased research related to addressing the Native American youth suicide crisis is described as imperative with suggestions to focus on studying current culturally appropriate, holistic care in attempts to determine its effectiveness.