BILLINGS, Mont. - The rate of suicide for American Indians from 15 to 24 years of age is more than three times the national average, according to the IHS.
There's always speculation as to why a young American Indian is more likely to commit suicide. It usually ranges from poverty, historical despair and substance abuse problems; one girl likened the isolationism of living on a reservation to being in a black hole, not being able to escape. However, each suicide in itself seems to have a history all its own that's not so readily explained - especially when a victim fits none of these ''stereotypical'' molds.
Suicide is a sensitive subject, but it's also the proverbial elephant in the room for Montana and Wyoming Indians. That's why six tribes opted in for the ''Planting Seeds of Hope'' suicide intervention program. Don Wetzel Jr., tribal liaison and data coordinator for the Montana-Wyoming Tribal Leaders Council, is also the PSOH director.
It's a program that has funding through the Substance Abuse and Mental Health Services Administration through the Garrett Lee Smith Memorial Act, named after Oregon Sen. Gordon Smith's son, Garrett Lee Smith, who committed suicide in 2003. This act also helps fund many other tribes and states with suicide prevention programs.
The PSOH program includes Montana's Blackfeet, Crow, Northern Cheyenne, Fort Peck and Fort Belknap, and Wyoming's Wind River Indian populations.
''We just brought everybody together and said, 'Hey, we've got to work to work together on this,''' Wetzel said. ''So we promoted a Proclamation of Unity for Life, which is just a proclamation saying that we all have the suicide problem and that we all have to work together on this.''
The states themselves have pitched in for training and extra fees, which impressed the PSOH staff.
''It's a great team effort. But if you look at it - Wyoming and Montana - everybody's in the same boat,'' Wetzel said. ''Montana and Wyoming are in the top three every year for suicide. So it's something that isn't hard to sell. It's one thing the state and tribes can sit down and say, 'Let's go at this together.' And it's been working pretty well.''
The most pressing problem is the lack of acknowledgment that there is a suicide problem among the Indian populace. In a survey to assess the awareness of the problem, Indian reservations rated very low.
''That means the only thing people are ready for are posters, and talking a little bit about it. A lot of people don't see it as a problem. They just think it's a way of life,'' Wetzel said. ''It's like, 'Yeah, I lost my brother two years ago. It's nothing new.' It's really scary and sad, but that's where we are. Our idea is if [help] comes down from the tribal government level - from the highest power on the reservation - saying, 'Hey, we got a problem here, we got to start handling this,' people will start thinking it's OK to talk about it, and that it's OK to seek help.''
Presenting the Proclamation of Unity For Life from the highest levels, it trickles down to the tribal councils, treatment and mental health facilities, high school student councils, and then perhaps to the potential victims themselves.
The lack of mental health resources in rural areas has always been a problem. More trained people are needed to help, since suicidal thoughts do not run on bankers' hours.
''Because you know, IHS is done at 5. If there's behavioral health people there, there might be two or three of them, and they're booked,'' Wetzel said.
They've created tribal training coordinators to help qualify people to do ''question, persuade and refer'' training. It's a technique that persuades people to open up enough to find a resource to go before harming themselves or others.
''We also have them go through ASIST training, which is Applied Suicide Intervention Skills Training,'' Wetzel said. ''We're having more luck with ASIST, I feel, because ASIST focuses more on the community and a person at risk.''
ASIST involves a grass-roots level of communication of friends and families of potential suicide victims.
In order to get a 24-hour hotline going, PSOH worked with the Montana chapter of the National Suicide Prevention Lifeline Number, called Voices of Hope.
''We've been working with those guys, and they've been great,'' Wetzel said. He explained how they made 800 localized posters for each involved reservation with their own tribal logos on them. ''If you go to the reservation, you'll see them everywhere.''
Voices of Hope has been going with PSOH directly to reservations to gain a greater gist of the culture.
''Anything to get them to understand the Indian communities,'' Wetzel said. ''And they've been gracious enough to go with us and work with us on things. So we're promoting [their] number.''
The media itself must be careful not to glorify and exploit suicide epidemics for their own ends. As has been the case before, seeming copycat suicide attempts from gullible youths have increased after much publicity surrounding an area's suicide problem manifested.
PSOH, however, wants to organize a speaker bureau of American Indian ''heroes'' who have made it through tough times to talk openly and give young people more hope. One young man was a very popular basketball player, who is in a poster that said, ''Honor Your Life, Honor Your Ancestors.''
Wetzel admits that it's been tough, and there are no easy answers to a problem that has plagued American Indian communities for so long.
''You'd be surprised of things we're just trying to figure out,'' he said. ''A lot of it is just getting out and getting the people's trust. It happens on the reservations all the time, but people don't tell other people about it. We're not at the prevention side yet. We're still always in crisis mode all the time. So we're looking to do things hopefully by next year and start preventing things.''