Bill introduced to assist tribes' suicide prevention services

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WASHINGTON -- Sen. Byron Dorgan, D-N.D., has introduced a bill that would
assist tribes in the fight against suicide among American Indian youth.

The new legislation, titled Indian Youth Telemental Health Demonstration
Project Act of 2006, would establish a demonstration project with the use
of telecommunications to assist in psychotherapy, provide education and
counseling for individuals.

The demonstration project will allow five tribal programs or organizations
to apply for grants. The tribes and organizations applying must have
telehealth capabilities, according to Dorgan's bill.

The grantees would provide mental health services through telecommunication
technology for youth counseling for suicide prevention, intervention and
treatment. Medical advice and other assistance to providers would be
included with training for tribal members, elected officials, tribal
educators and health workers, or anyone who deals with youth directly. The
teleconferencing will originate with the Department of Health and Human
Services' mental health division.

Culturally sensitive information will be available as part of the training
and counseling process.

Suicide rates among youth aged 14 -- 25 in Indian country are three times
higher than the national average. In the Plains, mental health officials
claim that the suicide rate is five to seven times higher among all
residents. Where Indian country suicide rates are concerned, the Plains
region is 10 times higher, data prove.

"I believe that solutions [should] be put forward now to deal with this
troubling problem," Dorgan said.

"The needless loss of young boys and girls whose whole lives lay ahead of
them is a very serious problem. Time is running out for addressing this
tragic issue," he said.

Remoteness, hopelessness, family dysfunction, economic disparity, alcohol
and drugs are the most frequently listed reasons for attempted suicide.
Mental health professionals have testified at hearings that alcohol is
almost always involved with attempts and completed suicides.

Tribal leaders in the Plains have prepared a list of health priorities and
mental health has been rising toward the top throughout the last few years.
For fiscal year 2006, mental health is listed as a No. 2 priority, right
behind diabetes. Alcohol and substance abuse is listed as a No. 3 or 4
priority by the tribal chairmen.

This project will help those at the tribal level reach a better
understanding about what prevention tactics work. Many communities in the
Plains and across the nation have formed community-based suicide prevention
groups.

The organizations seeking grants must work directly with American Indian
youth and priority for grants will be given to tribes and tribal
organizations.

According to the proposed bill language, psychotherapy, psychiatric
assessments and diagnostic interviews, therapies for mental health
conditions predisposing to suicide, and treatment and for alcohol and drug
abuse treatment will be eligible.

Clinicians will be afforded interactive medical advice, guidance and
training, assistance in diagnosis and interpretation. Crisis counseling and
intervention will also be part of the program offered through
telecommunication.

Individuals who work with youth, parents and others who are not
professionals in mental health will also benefit from the educational
information, training and assistance in this project.

This proposal runs parallel to one submitted by Dorgan in the 2005 session.
The new plan does not negate that which was included as an amendment to the
Indian Health Care Improvement Act of 2005, which was approved.

Dorgan said testimony received by the Senate Committee on Indian Affairs in
2005 played a major role in the development of this legislation.

Twilla Rough Surface, Standing Rock Sioux Tribe, testified at a committee
hearing that after members of her family committed suicide, and the suicide
attempts of others, not one professional ever contacted her or family
members.

Rough Surface said she lost a niece to suicide following the death of her
brother in a car accident. She said her sister couldn't deal with the loss
of her son and a daughter, and attempted suicide also.

The loss of her nephew also had an impact on one of his friends, who was
chosen as a pallbearer: he committed suicide on the day of her nephew's
funeral.

"The effect of deaths in my family has touched many and continues to be a
concern. I must mention that at no point did any mental health
professionals contact our family. I feel if there had been intervention
with grief counseling and support for my sister and her children, my niece
may have had a chance to grow to be an elder of the community," Rough
Surface said.

On the Cheyenne River Sioux Reservation in South Dakota there are anywhere
from three to seven suicide attempts a week.

In 2001 -- '02, there were eight completed suicides, 48 attempts and 28
threats; in 2002 -- '03, there were three suicide completions, 152 attempts
and 72 threats.

In the past, suicide clusters have been a problem on Cheyenne River. At one
time, a group of 17 youths made a pact and drew numbers. Each was found
hanging in their homes, according to Julie Garreau, Cheyenne River Youth
Project.

"We are heartbroken that it may have taken an incident like the school
shootings at the Red Lake Reservation in Minnesota to bring national
attention to the crisis our children are facing in Indian country, but are
so relieved that someone is finally hearing our voices.

"Our children in Indian country are in crisis," Garreau said.

Standing Rock set up a task force earlier this year to meet with
communities and maintain statistics on suicide. The Standing Rock Sioux
Tribe and others in the Plains had not had time to study the proposed bill,
and no hearings had been scheduled.