Pathways to Hope: Preventing Suicide on the Pine Ridge Indian Reservation

Problem Statement:

American Indians between the ages of 15 and 24 have been plagued by suicide for over a decade. In Pine Ridge, the extent of suicidal behavior among youth is particularly concerning. Each year, for the past five years, 250-420 adolescents on the reservation have tried to kill themselves. Altogether, this number amounts to about four percent of the population of Pine Ridge.

As a former health administrator, you may or may not be aware of some of the deeply ingrained systems that perpetuate unhealthy lifestyles among the constituents of communities like Pine Ridge. I present to you three such norms that I find to be most problematic for the mental wellbeing of the community’s youth:

1. Alcoholism

Among American Indian youth in New Mexico, 69% who committed suicide engaged in alcohol or drug consumption of some sort. This statistic confirms that alcoholism is an important predictor of suicidal behavior among American Indian populations, a fact that is not altogether surprising considering that both types of behavior are expressions of despair. According to Pastor Leon Blunt Horn Matthews, 80-90% of the people living in Pine Ridge consume alcohol on a daily, weekly, or monthly basis. The fact that they buy and consume the alcohol not in Pine Ridge, but in the neighboring town of White Clay, Nebraska, points to a dearth of positive social diversions on the reservation.

2. Lack of available information about traditional pathways to hope

For struggling youth on many Indian reservations, including Pine Ridge, the options they have for seeking help are typically restricted to one or two mental health professionals who come from an exclusively western medical care background. Although studies show that 34-49% of youth would prefer to confide in indigenous healers, many of these healers are not adequately licensed. Some youth may not connect with their providers of western origin and simultaneously lose touch with and faith in traditional ways of healing.

3. Unemployment

Eighty percent of people in Pine Ridge are unemployed, primarily due to the lack of opportunities for work on the reservation, which are limited to a casino and a few small businesses. Of the people who do have jobs, 90% leave the reservation for work and thus have to travel long distances day in and day out. The idleness and poverty of unemployment and the grueling lifestyle of working far away from home take a significant mental toll on young people who have completed their schooling or who, more likely, have recently dropped out. Not having a job is especially disempowering and can lead youth down the path to suicide.