Integrating Intergenerational Cultural Knowledge Exchange with Zero Suicide
is an innovative study in collaboration between UNM and the Pueblo of San Felipe that incorporates screening and providing treatment for suicide and other behavioral health issues into primary care settings using an evidence based practice called Zero Suicide. The goal is to determine the effectiveness of Zero Suicide plus an intergenerational knowledge sharing cultural component,
Intergenerational Cultural Knowledge Sessions (KICKS), compared to Zero Suicide alone on suicidal ideation, behaviors, and resiliency. The Pueblo has been actively involved in suicide prevention planning and implementation over the past 7 years supported by funding from the Substance Abuse and Mental Health Services Administration. During this time staff have provided extensive outreach to community members, including youth programming in the schools and sharing information at community events. Staff were trained on evidence based practices such as Mental Health First Aid, Cognitive Behavioral Therapy for Suicide Prevention, and Counseling on Access to Lethal Means. Formal agreements were put into place with San Felipe behavioral health staff and local schools to ensure that students receive school-based suicide prevention and youth leadership training, as well as access to behavioral health services and supports. A key aspect of the program are tribal members trained as certified peer support workers providing services alongside licensed behavioral health providers. This insures the cultural appropriateness of programming. In October, the Pueblo was funded by SAMHSA to implement Zero Suicide in the community. This grant supports service implementation, while the TREE grant supports the researching of this innovative approach.
The study includes
content in the KICKS model. Historical trauma is cumulative, emotional and psychological wounding across generations, including one’s lifespan (Brave Heart, Chase, Elkins, & Altschul, 2001).
Historical trauma response
features include suicidal and self-destructive behavior, prolonged mourning, and grief. The intergenerational transfer of trauma can increase risk for suicidal ideation and behaviors. American Indians and Alaska Natives (AIAN) have faced collective massive generational trauma emanating from the original colonization and federal policies of forced separation of children from their parents and tribal communities, including the placement of children, as young as five years of age, in boarding schools in collaboration with the federal government. Children were prohibited from speaking Native languages or practicing spiritual traditions. Particularly in early boarding schools, severe abuse, incarceration, and solitary confinement were common. Children had their hair forcibly cut (hair has a sacred meaning for many tribes), and were stripped of traditional tribal spiritual practices and sacred objects. This historical legacy resulted in traumatic responses. Parents raised in boarding schools were deprived of traditional cultural role models of healthy AIAN parenting practices which typically did not include corporal punishment and the traditional view of children as sacred beings who were gifts from the Creator, to be cared for and nurtured. The Pueblo of San Felipe is a forerunner in this innovative National Institute of Minority Health and Health Disparities-funded study founded on building resiliency through cultural knowledge.
- Deborah Altschul, PhD. & Maria Yellow Horse Brave Heart, PhD.