Cultural and cognitive considerations in the prevention of American Indian adolescent suicide

A description of cultural considerations associated with American Indian adolescent coping is presented within a transactional, cognitive-phenomenological framework. Select cultural values and cultural beliefs of American Indians associated with death are discussed in terms of person variables and situational demand characteristics that interplay in the transactional coping process. Three situational demand characteristics (ambiguity of identity, frequency of loss, and pervasiveness of hardships) are then presented to illustrate the reciprocal relationship between environmental contingencies and American Indian individual and community efforts at coping. The dynamic interdependence between person and environmental variables is emphasized and considered essential for inclusion in the design of interventions to prevent suicide. Existing intervention efforts with American Indian adolescent suicide attempters are reviewed and a school-wide cognitive behavioural approach based on the transactional model of coping with suicide is described. It is suggested that on-going cognitive restructuring, social skills training, and peer counselling training activities be culturally adapted and integrated into relevant areas of the school curricula in order that coping be enhanced and suicide ameliorated.