Setting a Course to Protect Indigenous Cultures and Communities in Our National Suicide Prevention Agenda

It is now more widely acknowledged within the current fields of clinical psychology and psychiatry that suicide in the United States is more than a mental health problem (Barnhorst et al., 2021, p. 299), that social determinants of health are key drivers of increasing suicide death rates (Dev & Kim, 2021), and that for ethnoracially minoritized youth, structural racism constitutes a key social determinant (Alvarez et al., 2022). In response, the Surgeon General’s office has released a Call to Action (U.S. Department of Health and Human Services, 2021) to fully implement the National Strategy on Suicide Prevention. Addressing upstream factors including social determinants of health is now one of six core National Strategy actions to prevent suicide. These developments represent a recent, and arguably long overdue shift in focus from individual psychopathology as primary driver of suicide behaviors toward recognition of multilevel influences in suicide, and in particular, recognition of the impact of societal level structures and systems on suicide outcomes. This shift follows decades of suicide prevention research in Indigenous communities that has specifically focused on socio-ecological models of risk and protective factors.