Suicide prevention in American Indian and Alaska Native communities: a critical review of programs.

This article presents a critical review of selected suicide preventive intervention programs being utilized in several American Indian and Alaska Native communities. The programs examined are (1) the Zuni Life-Skills Development Curriculum, (2) the Western Athabaskan Natural Helpers, (3) the Wind River Behavioral Health Program, (4) the Tohono O'odham Psychology Service, (5) the Indian Suicide Prevention Center, (6) the Blue Bay Healing Center, (7) the Acoma Cañoncito-Laguna Adolescent Health Program, (8) the Rainbow Lodge Alcohol Recovery Home, and (9) the Positive Reinforcement in Drug Education (PRIDE). The first five programs were implemented by communities to address the rising suicide rate among their youth. The other four programs contain suicide components as part of broader-spectrum efforts to address problem behaviors within their communities. The article contains a description of the targeted population group, risk and protective factors addressed, intervention method, research design, program implementation, and outcomes for each program. Additionally, implications for practice and policy are identified and recommendations for research made.