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A Path Towards HopeBrad Armstrong

A Path Toward Hope (continued)

ON HER ARMS, SHE HAS MORE THAN 50 CUTS, elbows to wrists. She knows the times and dates for each one.

The girl lives in turmoil. Last year, her father and a grandfather died. Then a friend died by suicide. Her home life is upended by alcoholism. She finds temporary refuge in school. After her classes end, she walks … anywhere but home. Late in the evening, she slips into her house to go to sleep, says Melanie Alchesay, a community mental health specialist for an innovative suicide prevention program developed by the tribe and the Bloomberg School’s Center for American Indian Health (CAIH).

Alchesay once asked the girl why she engages in cutting, a risk factor for suicide. “It’s because of my home situation, because of my family,” the girl replied. “Woman, I’m so stressed out!”

She is 14 years old.

“I wish I had a house to provide her,” says Alchesay. “I wish I could hug her and tell her you’ll be okay. I wish I had a big house. I’d take them all in.”

The suicide rate among young people ages 15 to 24 on the White Mountain Apache Reservation is among the highest in the U.S.—13 times the U.S. average, according to a 2009 American Journal of Public Health article by CAIH authors, including Apaches and Baltimore-based researchers. From 2001 through 2006, 25 people on the reservation under the age of 25 died by suicide—a devastating toll for a community of 15,500. And for every suicide, there were 36 attempts. More than 200 attempts were recorded annually in 2005 and 2006; two-thirds of the attempts were by young people under 25. (In the U.S population, suicide peaks much later in life.)

“There are certain ills, certain challenges out there that we thought we would never see,” says Lupe. “But we know how to saddle up and ride and see what it looks like in that challenge.”

Even a single youth suicide is ineffably sad, but the issue requires perspective, says David Yost, MD, clinical director at the Indian Health Service hospital who has worked on the reservation for 22 years. “We always have to remember the overwhelming majority of our young people are healthy,” Yost says. “It is important not to judge the community by what shows up in our emergency room.”

At the same time, many in the community have been touched by suicide in one way or another.

The tribe and CAIH confronted the issue by creating the Celebrating Life program that works to reduce the suicides one youth, one family, one community at a time. Every day, the program’s staff—all Apaches—help young people overwhelmed by daunting economic, historical, social and interpersonal issues.

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