Revaluing Indigenous Models in Suicidology: A Brief Narrative Synthesis
Abstract
:1. Introduction: ‘Evidence’ and the Coloniality of Suicide Research
Colonisation, racism and whiteness have trained researchers to consider ‘Indigeneity’ as a risk factor, these ongoing processes (colonisation, racism and whiteness) have blinded researchers to the real truth. That truth being, that ‘colonisation’ is in actual fact the risk factor. In both questions, Indigenous Knowledges and voice are missing, clearly constructed from a colonial normative framework, underpinned by colonisation and further influenced by whiteness.
2. Materials and Methods
- Suicide was the central issue of the model or program discussed;
- Authorship included Indigenous scholars, sometimes as lead author;
- Models were discussed from a strengths rather than deficit perspective;
- Models were based in settler colonies of Australia, Aotearoa New Zealand, Canada, and US for comparison;
- Models were designed or led by Indigenous communities.
3. Results
Source No. | Review Type | Subject | Citation | Summary of Approach and Findings | Strategies, Characteristics, Theories and Delivery Methods |
---|---|---|---|---|---|
1. | Systemic review | The program rationales of interventions with American Indian and Alaska Native communities | (Pham et al. 2022) (includes Indigenous authors) | Provides an overview of the program theories for interventions aimed at reducing the risk of suicide in American Indian and Alaska Native communities. Synthesises 32 publications. Considerable overlap across literature in terms of strategies and interventions discussed. This review recommends multilevel approaches that incorporate individual-centred strategies that consider local contexts and social systems. | Strategies:
|
2. | Scoping | Indigenous suicide prevention in Circumpolar region | (Redvers et al. 2015) (includes Indigenous authors) | Explores the extent to which interventions focused on Indigenous communities have been reported on from 2004 to 2014. Of 19 articles found to discuss suicide-related interventions, only 7 described evaluation or impact in detail. Most interventions were found in North American countries. | Strategies:
|
3. | Interpretive analysis | Mapping suicide prevention initiatives targeting Sami in Norway, Sweden and Finland | (Stoor et al. 2021) (Indigenous lead author) | Identified 17 initiatives that include prevention rationales focused on Sami self-determination, decolonisation, reducing exposure to violence or discrimination. Found initiatives varied in terms of being tailor-made for Sámi context, adapted or universal approaches and addressed suicide on all levels (individual, relational, community/cultural, societal and health systems levels). Gatekeeper and mental health literacy training programs were most common. Initiatives generally lacked thorough evaluation. Found majority of current initiatives do not address issues related to colonisation and systemic racism. | Strategies:
|
4. | Critical analysis | Tracking progress in public health suicide prevention in Indigenous communities in Canada | (Pollock et al. 2018) (no Indigenous authors; 1 global majority author) | Analysis of challenges related to suicide surveillance in Canada; assesses strengths and limitations of existing data infrastructure for monitoring outcomes in Indigenous communities towards improved public health system surveillance. | Strategies:
|
5. | Narrative overview | Canadian Inuit community engagement in suicide prevention | (Kral et al. 2009) (includes Indigenous authors) | Review of Inuit meanings of suicide, using a strengths-based approach. Centres Aboriginal autonomy, control and community action. Puts forward a hope-driven narrative to discussions of Inuit suicide interventions and research, particularly pointing to the importance of the Inuit reclamation movement and collective agency. | Characteristics:
|
6. | Critical scoping review | Benefits of centring Indigenous knowledge and practices in suicide interventions in Australia, Canada, USA and NZ. | (Sjoblom et al. 2022) (includes Indigenous authors) | Reviewed 56 academic and 16 grey literature sources on Indigenous approaches to reducing the risk of suicide. Uses Metis knowledge to frame analysis. No suicide prevention initiatives from New Zealand were identified. Notable absence of inclusion of considerations for Indigenous sexual minorities and gender diverse persons in suicide prevention. Absence of articles concerning Indigenous approaches to tertiary suicide prevention (i.e., crisis response and postvention). | Characteristics:
|
7. | Meta-synthesis of qualitative research | Suicide prevention amongst Indigenous communities in US | (Richardson and Waters 2023) (Indigenous lead author) | Uses Indigenous ways of knowing as a guiding framework to synthesise 15 qualitive articles on Indigenous suicide prevention. First meta-synthesis to assess suicide prevention interventions and programs amongst Indigenous communities, using an Indigenous Ways of Knowing theoretical framework. | Characteristics:
|
8. | Case studies | Learning from American Indian and Alaska Native Communities | (Wexler et al. 2024) (includes Indigenous authors) | In-depth descriptions of three community-driven American Indian and Alaska Native models. All three programs feature an interdependent or collective orientation, in contrast to an individual-based mental health suicide prevention model. Asserts limitations of individual-focused approaches that ignore social determinants of health and impacts of structural racism. Suggests models in this case study have translational potential across cultures, communities, and contexts. | Characteristics:
|
9. | Discussion paper | Discussion of life promotion strategies in Canada, USA, NZ, Australia | (White and Mushquash 2016) (includes Indigenous author) | Thematic and theoretical discussion of suicide among Indigenous peoples within a broad sociopolitical and historical attention to highlight the legacy of colonisation. Summarises current knowledge base and highlights promising practices. Recommends 5 guiding principles for future interventions. | Characteristics:
|
10. | Theoretical discussion | General, culturally based, and Indigenous theories on suicide | (O’Keefe et al. 2018) (Indigenous lead author and includes Indigenous authors) | Theoretical explanations of suicide from a psychological, sociological, cultural, and Indigenous perspective as applicable in American Indian/Alaska Native communities towards a future culturally grounded conceptualisation of American Indian/Alaska Native suicide. | Relevant theories:
|
11. | Systemic review | Indigenous suicide prevention initiatives in Australia, USA and Canada | (Clifford et al. 2013) (2 global majority authors) | Found 9 evaluations of Indigenous suicide prevention initiatives. Of these, only 3 measured changes in rates of suicide or suicidal behaviour, all of which reported significant improvements. Finds there is a need to increase evaluations of interventions. Recommends combining and tailoring best evidence and culturally specific individual strategies for delivery to whole Indigenous communities/population groups. | Delivery methods:
|
12. | Content analysis | Overview of suicide prevention projects targeting Aboriginal and Torres Strait Islander communities in Australia | (Ridani et al. 2014) (non-Indigenous authors) | Presents an inventory of suicide interventions in Australia, finding 67 interventions, categorised through delivery mode and target group. Key insights: majority of programs (57%) were run by Indigenous organisations or members of communities in partnership with external organizations such as universities or mental health services; majority of programs (63%) made no mention of program outcomes or only evaluated process or outputs; programs not owned or run by Indigenous corporations used workshops as their main delivery method. | Delivery methods:
|
Project No. | Project Name | Type of Approach | Characteristics of Best Practice | Significance to Research Context |
---|---|---|---|---|
1. | Tiaki Whānau—Tiaki Ora (Aotearoa New Zealand) Website: https://centreofmaorisuicideprevention.com/wananga/tiaki-whanau-tiaki-ora/ (accessed on 17 March 2025) Citation: | Family (Whānau) champions model |
| This program seeks to contribute to the evidence base for what works for Māori and Pacific communities and build national leadership and vision to address suicide among Māori and Pacific communities. A key assumption of the program is the belief in the inherent strengths and assets of whānau and Māori communities to facilitate and maintain their own wellbeing, prevent suicide, and provide their own support to each other, that is effective and safe. |
2. | Family Wellbeing Program at Yarrabah (Australia) Website: https://family-wellbeing.squarespace.com/ (accessed on 17 March 2025) Citations: | Family Wellbeing Program Australia |
| This model has been replicated in over 55 Aboriginal and Torres Strait Islander communities across Australia, as well as being used internationally in Timor Leste, Papua New Guinea and China. |
3. | Yiriman Project (Australia) Website: https://kalacc.org/projects/yiriman-project/ (accessed on 17 March 2025) Citations:
| Intergenerational ‘on Country’ cultural program |
| Longstanding project designed and led by Elders in the Kimberley region of Western Australia. Evaluated and cited in several reviews of Indigenous suicide interventions with intergenerational model put forward as a delivery method replicable across contexts. |
4. | Manitoba Keewatinowi Okimakanak Mobile Response Team (Canada) Website: https://mkonation.com/health/mobile-crisis-response-team/ (accessed on 17 March 2025) Citation: | Mobile crisis response team model |
| This program presents an approach that uses a mainstream model (mobile crisis response) tailored, delivered by First Nations community leaders, and governed by First Nations communities. |
5. | Promoting Community Conversations to End Suicide (PC Cares) (US) Website: https://www.pc-cares.org/ (accessed on 17 March 2025) Citations: | Community health education model using learning circles designed and led by the remote communities of northwestern Alaska |
| This model translates Alaska Native perspectives on health and wellness into a viable funding and implementation strategy for western health research, then returns this research to local communities to inform practice. |
6. | American Indian Life Skills Curriculum (US) Website: https://cncfr.jbsinternational.com/node/577 (accessed on 17 March 2025) Citations: | School-based life skills approach developed for replication across communities from Zuni Life Skills program |
| This model was first developed with the Zuni Pueblo in New Mexico and has been expanded into a broader curriculum to be used by a diversity of American Indian and Alaska Native populations with culturally and contextually grounded modifications. |
7. | Elders Resilience Curriculum (US) Website: https://cih.jhu.edu/programs/the-elders-resilience-curriculum/ (accessed on 17 March 2025) Citation: | Intergenerational education model facilitated by Elders in schools |
| Upstream prevention and locally identified, ground-up solutions are underrepresented in suicide research, this curriculum could bring an innovative model to diverse contexts. |
8. | Celebrating Life (US) Website: https://cih.jhu.edu/programs/celebrating-life/ (accessed on 17 March 2025) Citations: | Community-based surveillance and case management follow-up program to collect local data, inform strategies, and enhance continuity of care led by White Mountain Apache Tribe |
| This surveillance system has been adopted by the San Carlos Apache Tribe, the Hualapai Tribe, Cherokee Nation, areas of Navajo Nation, and Colville Confederated Tribes in Washington State. Plans to package model for widespread implementation in other tribal communities. Its strengths for replication have been evaluated as:
|
9. | Qungasvik (Tools for Life) (US) Website: https://canhr.uaf.edu/research/past-canhr-projects/qungasvik-toolbox-indigenous-intervention-science-model-alaska-native-communities/ (accessed on 17 March 2025) Citations: | Culture-as-intervention multilevel approach in rural Alaska Native communities |
| Strength of this model is its recognition of structural racism, social determinants of health and use of a strengths-based approach; making it potentially translatable across cultural, community and practice contexts. |
10. | Culture forward (US) Website: https://cih.jhu.edu/programs/cultureforward/ (accessed on 17 March 2025) Citation: | National resource guide titled for tribal leaders and stakeholders to support youth suicide prevention through cultural strengths |
| This model is potentially translatable to other research and practice contexts due to its central community-engaged strategy. This takes into consideration context-specific factors; community needs and how to disseminate of programs with communities in accessible and engaging ways. |
11. | Hawai‘i’s Caring Communities Initiative (HCCI) for Youth Suicide Prevention (US) Citations: | Youth leadership model |
| This program has been evaluated (Antonio et al. 2020) and showcases the use of a youth leadership model and strengths-based approach. |
Key Themes Presented in Table 1 and Table 2
- Cultural and collective approaches as protective factors;
- Recognising social determinants of health and the impact of colonisation;
- Community control and governance;
- Evaluation and available research.
- Cultural and collective approaches as protective factors
- 2.
- Recognising social determinants of health and the impact of colonisation
- 3.
- Community control and governance
- 4.
- Evaluation and available research
- 5.
- Relationships and connection
4. Discussion
4.1. Recommendations for Future Research
4.1.1. Comprehensive Model
4.1.2. Focus on Colonial Trauma
4.1.3. Mixed-Methods Research
4.1.4. Research on Postvention Programs
4.1.5. Research on Model Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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Brooke, J.; Lenette, C.; Wobcke, M.; Wells, M. Revaluing Indigenous Models in Suicidology: A Brief Narrative Synthesis. Soc. Sci. 2025, 14, 229. https://doi.org/10.3390/socsci14040229
Brooke J, Lenette C, Wobcke M, Wells M. Revaluing Indigenous Models in Suicidology: A Brief Narrative Synthesis. Social Sciences. 2025; 14(4):229. https://doi.org/10.3390/socsci14040229
Chicago/Turabian StyleBrooke, Joanna, Caroline Lenette, Marianne Wobcke, and Marly Wells. 2025. "Revaluing Indigenous Models in Suicidology: A Brief Narrative Synthesis" Social Sciences 14, no. 4: 229. https://doi.org/10.3390/socsci14040229
APA StyleBrooke, J., Lenette, C., Wobcke, M., & Wells, M. (2025). Revaluing Indigenous Models in Suicidology: A Brief Narrative Synthesis. Social Sciences, 14(4), 229. https://doi.org/10.3390/socsci14040229