The American Indian Youth Suicide Epidemic: Mental Health Professionals as Superheroes

David Walker, PhD
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Hi. It’s been quite a while since I’ve written, and I apologize . . . honestly, I haven’t exactly been taking a break.

My previous pieces for Mad In America caught friendly eyes at Indian Country Today Media (ICTM), and they’ve recruited me to write a forthcoming multipart series on oppression in mental health in Indian Country. I only have so much time and feel I need to make getting the word out more widely a priority.

I’m very grateful for this opportunity, especially to you, dear reader, and all the folks at Mad In America. I’ll be linking ICTM readers to my blog site here and will hope it causes them to investigate the MIA website more deeply. I’ll also be letting MIA know when my pieces appear in ICTM.

Before I back away for a while, however, let me offer a few words about the current epidemic of youth suicide at Pine Ridge Reservation, and a recent story for the New York Times penned by Julie Bosman. In her story, Ms. Bosman suggests that a factor in this calamity is having only “six mental health professionals” which “many people agree is not enough.” I’m not sure if her remarks are based on a particular local survey, the pleas of desperate people suffering profound loss, or the opinions of ‘mental health professionals’ at the Indian Health Service (IHS).

I’d like to make it abundantly clear, however, that IHS behavioral health services haven’t ever done anything to successfully lower the suicide rate of American Indian youth. At a budget of $266 million per year, we all might wish for much more, but it’s an entirely false hope that IHS could ever succeed. We need to be careful about which superheroes we believe in.

According to the Center for Disease Control (CDC) and several other official sources, the suicide rate in the U.S. for youth aged 15 to 24 nearly tripled from 1958 to 1982 (from 4.5 per 100,000 to 12.1 per 100,000). Since 1999, this rate has remained stable at between 10 and 11 per 100,000. For example, in 2013, the suicide rate for youth in the U.S. was 11.1 per 100,000.

With respect to this overall rise, thousands of superhero ‘mental health professionals’ have brought their best thoughts to bear upon the scary issue of youth suicide, and this includes me. We’ve studied the ‘factors,’ designed crisis programs, developed screening tools, and sought to ‘intervene’ in whatever manner might prevent young people from giving up and destroying themselves.

Our superhero wish to please has led to an occasional tyranny of benevolence. I’ve even witnessed young people jumped upon by multiple attendants, then tied into four-point restraints, and shot up with haloperidol, solely because they were trying to remain out of the view of peeping superhero ‘mental health professionals’ determined to remain certain they didn’t hurt or harm themselves. My revulsion at these sorts of suicide ‘interventions’ led me to depict just such a scene in my first novel, Tessa’s Dance.

I’m not suggesting that nothing works to help suicidal kids – I truly believe compassion, lovingkindness, and a respectful, caring dialogue about life and its many problems can be very affirming and even lifesaving. Some people need professional training in order to learn to do this.

I also don’t subscribe to the naïve, minority view that suicide should be an individual choice. Few of us live in such a vacuum that a self-destructive decision won’t create terrible tragedy for other people. I can’t accept that there’s some sort of inalienable right to inflict that kind of hurt, having experienced it and sat with others who have felt it too. But this doesn’t mean I don’t believe in the right to terminate one’s own life due to intractable physical pain or its inevitability. I just don’t think we should call that kind of undertaking ‘suicide.’

So I do believe we have a moral and social responsibility to try to help prevent suicide and especially so among those of us not yet fully grown. Thus far across many years in the ‘mental health profession,’ I haven’t witnessed anything less effective in suicide prevention than the proliferation of psychiatric medications and labels.

I had a minor confrontation during a Q&A with a presenter on suicide prevention not too long ago who tried to get me to believe that the FDA’s black box warning on SSRI antidepressants was responsible for a slight uptick in the youth and young adult suicide rate in recent years. I nearly felt badly pointing out to him that most U.S. soldiers committing suicide were in this particular age range, and after all, the two wars so many of them had been compelled to take multiple tours within likely had more influence than the FDA finally accepting to undertake its fiduciary duties.

I do believe that the ‘mental health profession’ does exceedingly poorly with suicide crisis intervention. We might as well send the police to deal with it, which we usually do. Our hotline call centers fail to have any impact on suicide rates, and our screening measures tell us as much as noticing that a bird appears to be flying toward a window – we say what might happen, but we don’t really know if the bird truly intends to hit the window. A history of flying into windows is a much better predictor that the bird’s going to do it than the ‘mental health professionals’ ability to notice they’re heading in that general direction.

So what really troubles me about the NYT piece by Ms. Bosman is the implication that having more ‘mental health professionals’ around – particularly those who practice within the bio-medically-dominated Indian Health Service – will have some noticeable impact on the problem of epidemic youth suicide at Pine Ridge.

In 1982, similar ‘mental health professionals’ in Indian Country surely knew that the suicide rate for American Indian youth was about two and a half times greater than that of the general U.S. youth population (28.6 per 100,000). In 1989, similar ‘mental health professionals’ studied 291 American Indian youth aged 14 to 18 years old attending a Pacific Northwest boarding school and learned that nearly forty percent had seriously contemplated suicide, while twenty-five percent of boys and thirty-six percent of girls had made already at least one attempt.

This kind of information was already over a decade old by the time I began my own consulting work with a tribal school. On the occasion of my very first visit, the school counselor reached in the back of her file drawer to pull out a summary of a youth survey conducted by the local Bureau of Indian Affairs office pertaining to her students. Twenty percent of them had attempted suicide in the year just prior to my arrival.

So when you visit the CDC and plumb through the most updated plethora of data only to discover that the current suicide rate for American Indian youth now stands at a high of 31 per 100,000, or three times that of the rest of U.S. youth, you can bear witness to how effective the emphasis on psychiatric medications and labels by Indian Health Service ‘mental health professionals’ has proven over the years.

Then consider how well their ‘interventions’ could ever work in addressing an internalized intergenerational experience of genocide, displacement, boarding schools, loss of language, and cultural destruction alongside day-to-day abject poverty, educational obstacles, institutionalized and overt racism, and a four time greater chance of ending up in foster care than white kids.

Lastly, consider the pieces on this blog to date, particularly in how these ‘interventions’ might emanate from the same social movement responsible for creating the stereotypes of dumb, drunk, or crazy Indian with which these youth must contend everyday.

I do believe ‘mental health professionals’ should be able to contribute thoughtfully to a community collaboration aimed at suicide prevention. But we cannot rescue native youth, even if we wish we could.

Native youth have always been the superheroes rescuing themselves. Every single day. And it’s a wonder we haven’t lost even more of them given all they’ve had to fight.

We all as a nation need to come together, stand with them, and help.

 

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46 COMMENTS

  1. Brilliant blog, full of insight. Thank you, Dave. We need to get this to a much Wider audience.

    I had to laugh when I read about the NYT article. Whenever things don’t look good on the wellbeing front, we need more mental health professionals… According to mental health professionals and their ‘advocates’. Oh, please, let’s stop that nonsense.

    For those of you who haven’t read Dave’s book Tessa’s Dance, it’s an excellent read.

  2. Thank you for articulately advocating for indigenous people; it is an important community service!

    I contend that mental distress (including suicide) is predominately caused by distressful experiences; mental health problems are significant among American Indians because of a distressful history of racism and genocide. The Pine Ridge Reservation may have increased mental health problems because it was the location of conspicuous genocide in 1890 and a defeat for American Indian rights in 1973.

    Mental health problems (including suicide) among American Indian youths would improve substantially if they felt hopeful about the future rather than hopelessness about the future. So how can American Indian youth feel hopeful about the future? One suggestion would be for them to counter their loss of Mother earth by advocating for the land- by taking over the leadership of the environmental movement. Who better to advocate for better stewardship of the land? It can be a real struggle to reclaim lost land but it is totally fair for American Indians to reprimand those who took their land for poor stewardship. Advocating for better stewardship of Mother earth is a way of empowering American Indians to confront the American public over some distressful issues. This is important cultural heritage that American Indians can share with the larger community.

    Best wishes, Steve

    PS- I advocate a mental health therapy program that classifies seven types of alternative therapies to drugs; it is published online at NaturalPsychologyTherapy.org. I would greatly appreciate any criticism or comments about the program.

  3. As a First Nations person I greatly appreciate this blog and the ideas that you express in it. And I say to all the readers here, go to any reservation in this nation today and you will immediately see why the rate for suicide is three times higher than for other groups in this country. The racism against the original inhabitants of this country is unbelievable and the lack of opportunities for these kids is disgusting. But no one does one damned thing about it other than a few individuals. I am grateful to the author for standing up and pointing out this atrocity. These kids don’t need more “mental health professionals” in their lives to keep them from killing themselves in abject despair. What they need is dignity and respect and opportunities for making better lives for themselves on an equal footing with the children of White people.

  4. I know I’m repeating what everyone has already said, but I think these ideas should be repeated over and over. People kill themselves, or try to, because of their life situations. This is so clear that anyone paying attention can see the truth. How the damn “mental health” system has managed to turn being justifiably unhappy into a “mental illness” is beyond me. This situation is another example of how psychiatry has turned into a religion, a religion that demands human sacrifices.

  5. “I’ve even witnessed young people jumped upon by multiple attendants, then tied into four-point restraints, and shot up with haloperidol, solely because they were trying to remain out of the view of peeping superhero ‘mental health professionals’ determined to remain certain they didn’t hurt or harm themselves.”

    The best way to lower the suicide rate but to increase the murder +/- suicide rate (and really who could blame the poor kid). It’s in fact remarkable that so few people subjected to this kind of abuse actually come back with vengeance. How delusional and arrogant can anyone be to think this helps? Or all these people are cynical sadistic psychopaths?

  6. Dr. Walker,

    I wonder sometimes about all of mental health services: If the drug causes more harm than good, up the dose. If a small group of professional cause more injury than healing, find more professionals. If the suicide prevention programs cause more death, expand them.

    This is the power of bureaucracy at its best. I’m curious about how many federal agencies it takes to fix the plumbing or provide clean drinking water on a reservation? A half dozen? Because it takes a half dozen to manage the land.

    If throwing money at thise who live in this broken system breaks the spirit, throw more money at it, and at them.

    It takes a free person to overcome helplessness, and caring people who are aware they are equals to provide support and love. Not more professionals, more bureaucracy; not the oppression that comes from all this *help*.

    Real love, real hope – starting with *stopping* the things that don’t work; beginning to do things that do work.

    Duane

  7. Aside from outright poverty most of this is being driven by the rampant use of drugs and alcohol. Both legal and illegal drugs. I grew up on the Crow Creek Reservation over 40 years ago and don’t remember a single youth suicide. I don’t believe there was a single child of school age that was diagnosed with ADD or ADHD or other contrived mental illnesses or were they on prescription amphetamines (Adderall and others). I can only imagine today how many are on some form of prescription drug.

    The fix today is handed out in a pill bottle. The reality is there might be to many doctors and to much government aid. White Christianity swoops in to save the day only to drive these people further from their own spiritual past.

    The first step is to drive out the pill pushers and preachers. Require the Indians that want to live and survive on the Rez to survive on their own using their historical teachings and ways. Put the spirit back into the people. Some that think this is crazy need only look at the Hutterites of South Dakota and the Amish in Iowa and how they survive and live with the spirit of their belief.

    These people are like the canary in the coal mine and the white man will not save them that’s for sure.

    • Warmac

      Very well put.

      My grandfather would not allow any of us to take money from the government because he claimed that it corrupted us. We didn’t live on a reservation. My family’s ancestors escaped being restricted to a reservation. I believe that he was right. The money payments were done to keep people from developing any incentive to make something of themselves and it made sure that people stayed on the reservation since the money payments were revoked if you left. This was all well planned to keep people down and in their places and it worked very well. I know that this is going to cause some frothing at the mouth, but it’s sort of like keeping people on SSI all their lives because they’re supposedly “mentally ill and they will be so for all the rest of their lives”.

      And, I absolutely agree with you about the “preachers”. The preachers were never our friends in any form. Let the people go back to their own spirituality which served them so well until the coming of the “preachers”.

      • Stephen: I was on the SSI dole for around three years and even had a disability half fare bus pass. Somehow as a disabled person I was able to complete three degrees and ride my bicycle thirty miles a day. Thinking back on this, it is pretty absurd, though the money is not enough to live independently,’unless one works the system as well for discounted rent and free food.

  8. It is a sad thing in life when those that are so badly oppressed ,both historically and in the present , that should have love and respect and reparations coming their way and a chance to succeed in life, instead find only more opression .It can become a deep spiritual question inside as to why this is happening to me and or us . Why could G-d or the Great Spirit allow this to happen. Finding out what happened in the past and that it really happened is traumatic enough. Mean selfish people did it. And they are still doing it.Seeing a future ahead forming up as a variation of the same theme takes friends and family , loved ones and everyone else to help bare up to it and try to make it better. Health insurance that only covers mainstream all around health care , AMA medicine, APA psychiatry, ADA dentistry really only makes it worse and is the straw that can break the proverbial “camel’s back. Google see what Russell Blaylock MD retired neurosurgeon has to say about vaccinations and brain inflammation, mercury and other ADA dentistry , and whats happening to veterans too. You take someone that’s got troubles and then insomnia , things can get bad quick. These youths are connected to all of us and what is happening is not a good sign and also a warning . Somethings are badly wrong and if we humanity do not work together to correct our imbalance with each other, ourselves ,and the planet who can say what this estrangement will do to us ?

  9. Psychotropic drugs cause suicide, and “mental health” workers facilitate the process. Screenings drag innocent people into the “mental health” system, where their problems are diagnosed as “mental illness,” and then they are drugged. The drugs ruin the brain and crush the spirit, until suicide seems like the only way out.

    Please read Dr. Peter Breggin’s “Medication Madness” (http://www.breggin.com/index.php?option=com_content&task=view&id=55) and SSRI Stories (http://ssristories.org/).

  10. I imagine that suicide is based on the belief that death will bring relief to chronic personal suffering. In many cultures, death is an illusion, merely a transition in which consciousness remains with us. While oppression and negative self-beliefs do cause chronic suffering, people who are revered in the world and seem to have it all commit suicide, too. (e.g. Robin Williams).

    Perhaps a deeper understanding of what ‘death’ is and is not would save lives, because it would shift our perception to what is more truth than cultural programming-based illusion.

  11. This comment is out of frustration and hopelessness.

    I plan to commit suicide, no one knows what it’s like to walk in my shoes, to feel the sting on a daily base of rejection, being insulted, and total loneliness. I tried the mental health system and as far as I’m concerned the whole profession is a joke. You know what would help people? Getting involved their lives, being their friend, showing them that someone genuinely cares about them, but no we can’t have any of that, because that would be a ethical violation (sarcasm). These walls between the so called “mental health professionals” and the people (notice I don’t refer to them as clients or consumers) their supposed to be helping, is completely devoid of any real compassion or empathy. The whole thing is extremely unethical and cold, but most of those who work in the profession seem to live in a little world of their own convincing themselves with their degrees and textbooks that their method is correct and if a person argues against this, it only proves they are mentally ill. Psychiatry is so damned arrogant, believing they have all the answers, when they have no clue what it’s like to walk in the shoes of those who suffer.

    • Hey FrayedEnds,

      I hear you and I’m so sorry for what you are going through. 🙁 I don’t know what it’s like to be you, but I do know what it’s like to face daily rejection, insult, and loneliness, and to get no help at all from the so-called “mental health” system. You’re not alone. I know what it’s like to want to die and I hope you don’t have to. I hope there can be some other way.

    • “I tried the mental health system and as far as I’m concerned the whole profession is a joke…These walls between the so called “mental health professionals” and the people (notice I don’t refer to them as clients or consumers) their supposed to be helping, is completely devoid of any real compassion or empathy. The whole thing is extremely unethical and cold, but most of those who work in the profession seem to live in a little world of their own convincing themselves with their degrees and textbooks that their method is correct and if a person argues against this, it only proves they are mentally ill. Psychiatry is so damned arrogant, believing they have all the answers, when they have no clue what it’s like to walk in the shoes of those who suffer.”

      Frayed, you echo exactly how I feel after having gone through they system, myself. This is after doing my own training and internship in counseling psychology, I actually was part of this field. After going through the system, however, I feel it is exactly what you say, and after doing a few things for my own personal vindication, including speaking my complete and unadulterated truth about the matter, and to help bring in some change even if only small scale–at least some awareness raising where everyone is in the dark–I got out of there like a bat out of hell. It’s not only ‘a joke,’ it’s actually an extremely dangerous one.

      I was driven to a suicide attempt by these people, who treated me exactly like what you’re saying, and in doing so, convinced me I was worthless and had no future of which to speak. The psychiatrist I used to see attributed all my negative feelings on the fact that I had “lost my dreams,” which I had not considered to be true, not even had thought this. That’s what was on my mind the night I tried to kill myself, that I had “lost my dreams,” he repeated it often, until it really got in there. (These days, I’m living my dreams, so as far as I’m concerned, he was projecting his own failures onto me, I think that is obvious, because I never lost my dreams as he insisted).

      I’d never felt like that about myself nor did anyone, until these clowns got me in their clutches, unsuspectingly. Of course, I believed them, their words and actions against me broke down my defenses and my mind was screwed up from meds withdrawal, so I was extremely vulnerable, as most of us are when we enter that cockamamie world.

      They confused everything normal and natural about me and my creative process with mental illness, so of course I didn’t have a chance with them. It was all them! Pure projections, no ownership or self-responsibility whatsoever, like ZERO. They were wrong about me, so thank God my suicide attempt failed, and I chose to stay in this lifetime, see what I could make out of this mess. Thing turned around, finally, and all is well. I had to trust, one day at a time, and little by little, I got more and more clarity, and was able to make better choices for myself.

      Although it was close, I was on my way out, about a minute or so from death, if even that. My body had already lost it’s ability to hold me up. During that time, I had the epiphany that were I do die at that time from my own doing, then I’d have to come back and repeat all of this, get back to the same point in time, and try to get over that hurdle again. I don’t know why I thought this, but I did, and it prompted me right back into my body, so that I could keep going and try to figure this all out, one way or another. After all, I had come this far..

      Turns out these are spiritual teachings which I hadn’t even been taught yet (I learned this from a spiritual teacher years later), so I figured I was on to something. I decided I had come all this way and at least had some clarity about it, so I figured taking one step at a time forward in my truth, without worrying about the future or dwelling on the past–and without caring what others say, think, or do, might lead me somewhere, and it did. I eventually found exactly what I needed and it all turned around. I HAD to trust that–it was either that or chronic dread and suffering.

      I hope and pray that the light shines truth on you, showing you what incredible value you have to society from all the hurt and pain you’ve gone through, you get it. And you can help others get it, too, if you stick around. We need more truth speakers like you on the planet to help it heal, if that’s your desire. At least there are people who totally agree with you about this field, so you are not alone in that…

      • Wow Alex what a great commentary. I always enjoy reading your posts and remember you are a fan of John Howard Griffins. I think we need to have a group of those of those who were in the field and then were caught in its maws. I think we have a great ability to speak truth to power especially when the fear factor is removed. Glad you were able to talk and get away. I am in and out still worried and waiting for the day when I can speak out loud and clear. Meanwhile I look listen and contemplate what I see around me. I go here and there and observe for a future date.
        Your empathy and concern for the previous poster is and always is kind and to the point. We needs as a movement to work together rather than tear down keeping in mind we all have been traumatized and the cycles of triggers, flashbacks, memories that initiate justified outrage come and go like the tides of the sea. We are all in this .
        Remember there are those that are not automatically against us – some of been knowingly misled, some are just purely innocently ignorant and then there those who know and do not care. The powers that be are the ones that we need to change. We all need to use our own energies and talents to recover and then learn how to best change things so we all can say – Never again!

        • Thanks CatNight, I agree with you that there is a big advantage in perspective when we experience both sides of the fence, and then distance ourselves to get clarity. I got an extremely thorough view of this field, inside and out, and it has been corroborated fully by what I’ve read and experienced in this pool, here online. Never again! is right, that would be the path to healing and owning our lives for ourselves, not for others.

          I think everyone concerned has been indoctrinated one way or another. It’s starts wayyyyyy up at the top, they keep themselves behind a wall, believing they are unseen and untouchable. I believe this is coming to an end, that is what global change is about now. The world is becoming transparent, which is what needed to happen.

          But this is what the fear is about, that’s what they want people to feel, to deter people from speaking their truth. I felt the indoctrination trying to happen within any group related to the ‘mental health’ community. Conform and agree, or be shamed and marginalized.

          For me, healing was finding my own voice and my own truth, regardless of any of this pressure to conform to the “mental health culture.” I did speak up when I was a social worker, which was after I had already been experiencing blatant stigma and discrimination from within the system, and I got fired for it, then I sued and won. I won because it was not a question that I was having great success with clients, which I was able to show was not their priority, in practice. They didn’t just fire me, they tortured me first, knowing how vulnerable I was feeling. Even my co-workers noticed this, and commented to me about it. This was my voc rehab, ironically enough.

          Not a nice journey to take, but empowering and educational nonetheless. These days, I make it a point to keep my power when dealing with an oppressive environment. After all, they can be hard to avoid if we want to be out in the world. But there is a way to be sensitive to the environment without taking on its ills and projections. That’s probably the most important thing I learned in my healing.

          Anyway, I’ve strayed off topic here, but I wanted to acknowledge your post because I really do want to encourage you to keep following your truth, regardless of anything. It’s challenging, but it’s the only way I know how to grow and create change. Those of us who have gone through this and have detached from it all are now the powers that be, if only due to our personal sovereignty. So, indeed, that change is occurring. We’re sure to see more and more of this, yourself included, no doubt! Keep up the brave work.

          • I meant to mention, CatNight, that yes, indeed, I’m a big fan of Mr. Griffin. I grew up in the south in the 1960’s. I read Black Like Me for the first time when I was about 13, made a huge impact on me. I thought it was the most courageous thing ever, to voluntarily walk in the shoes of oppressed people, with that identity projected outward. That’s how to learn, no other way. He achieved pure empathy, which is gold to oppressed people, because from this understanding, the next step is creating the path freedom. That’s an internal process, mostly.

            Otherwise, it’s really quite difficult to describe the extent to which those who have not experienced this will never understand, until they go through it with that same feeling of powerlessness. That is truly a dark night of the soul in our society, to be marginalized and feeling powerless. From this, light and truth will come as we evolve.

            Going through the system after having been a psychotherapist was like this, although it was not my conscious intention to do so. I was simply following my path, and this is where I found myself. Still, it was life’s best education for me, and I was able to heal from the hits I took. Now, I can be of service to others, which is my intention as I continue to follow my own path as a musician and filmmaker.

            Oh yeah, it’s brutal, I’ll personally attest to this at any time.

    • Frayed please talk to yourself. It works for my grandson. He is learning to talk. He has also recently learned to climb the slide at the park and his parents have told him to be careful … “Calvin be careful”, over and over. They have been teaching him to say his last name and because it is an old Irish name he has shorten it to Kenny. The other day he was in the park climbing the slide and his parents could hear him saying to himself “be careful Calvin Kenny, be careful Calvin Kenny”. His spirit told him to talk to himself and how did he know this would help.

    • Sadly you’re 100% correct on psychiatry.

      But I urge you not to give up hope. Sometimes all it takes is to take your life into your hands and push through. I know it’s easier said than than but most people who log and comment here were down there in the trenches and have found their way back and forward. I wish I could help more. Please, hang on in there…

  12. One of the main functions of the psychiatric worldview is to deflect any suggestion that your suffering may be caused by the social conditions you are exposed to and make sure that all the blame lands on YOU, the sufferer, for not “adjusting” to the wonders of modern life. This is particularly absurd when thinking about First Peoples, as each and every one of them has good reason to be depressed, anxious, hopeless and/or righteously infuriated by the way both individuals and the group as a whole is represented and is treated by the larger society. But this view is completely inimical to what psychiatry stands for – it is all about preserving the status quo and assuring that those in power don’t have to worry about the peons of various sorts getting together and objecting to their continued running the world into the ground.

    Instead of taking pills and accepting passive and dependent roles, it’s time we channel this appropriate rage and disaffection into altering the conditions that perpetuate the misery of so many people of whatever race and history. A handful of “mental health workers” will do nothing but try to shove the oppressed further into the mud!

    —- Steve