White Mountain Apache Tribe Decreases Suicide Deaths and Attempts

A comprehensive suicide surveillance and prevention program has decreased the suicide rate among the White Mountain Apache Tribe during a period when suicide rates among both the general population of the United States and American Indians/Alaska Natives have increased.

The suicide rate on the Fort Apache Indian Reservation dropped 38.3 percent, from an average of 40 per 100,000 between 2001 and 2006, to an average of 24.7 per 100,000 between 2007 and 2012. During this period, the suicide rate among the general population increased from 10.9 to 12.3 per 100,000 and the suicide rate among American Indians/Alaska Natives increased from 18.3 to 18.5 per 100,000. On the reservation, rates dropped for all ages, with the exception of 10- to 14-year-olds. Although the rate of suicide attempts fluctuated, the authors reported an overall downward trend after the implementation of the surveillance and prevention program.

In addition to tracking suicidal behaviors and risk factors, the surveillance system was used to identify and offer services to tribal members at risk of suicide, based on reports of suicidal ideation, attempts, self-injury, and binge substance use. The tribe also utilized Substance Abuse and Mental Health Services Administration Garrett Lee Smith funding to create a comprehensive youth suicide prevention program, which included universal interventions such as a public education campaign, selective interventions that sought to identify at-risk youth, and indicated interventions that targeted youth exhibiting suicidal ideation and attempts.

Cwik, M. F., Tingey, L., Maschino, A., Goklish, N., Larzelere-Hinton, F., Walkup, J., & Barlow, A. (2016). Decreases in suicide deaths and attempts linked to the White Mountain Apache suicide surveillance and prevention system, 2001–2012. American Journal of Public Health106(12), 2183-2189.

Read more about the White Mountain Apache Tribe surveillance success story from the Suicide Prevention Resource Center.