Suicide Among Aboriginal People in Canada - Institut universitaire ...

Chapter 5usually only a small expectation of benefit, and this small benefit can easily be outweighed by a small risk(Rose, 2001:432).Population level approaches vary in their definitions of the population they address. For Aboriginalpeople, the relevant population can range from a global or North American population of Indigenouspeople, a specific Aboriginal group or First Nation, the general Canadian or provincial or territorialpopulation, or else a regional or single community population. Organizing prevention strategies at eachlevel has different implications, not only in terms of the type and scale of resources required for thetarget population, but most importantly in terms of the degree of political involvement and control ofthe intervention by Aboriginal people. The degree of community involvement in the development andcarrying out of prevention programs may be a crucial factor in their positive impact.As discussed in Chapter 3, many Aboriginal communities have specific demographic groups at greaterrisk for suicide. Young men in particular constitute an identifiable group at risk. Substance abuse,particularly heavy alcohol use and any history of solvent use, is a strong indicator of increased risk.Solvent abuse often occurs among preadolescents and points toward significant individual and familyproblems. Other risk factors that can guide screening and intervention programs are listed in Table5-2. However, epidemiological studies show that the suicidal ideation and attempts are so widespreadamong young people in some communities that the concept of an “at-risk group” may be misleading and abroader community-based approach is needed. A community-wide approach has two added advantages:it avoids stigmatizing a specific group of individuals and it fits with broader goals of communitydevelopment that will have a positive effect on the mental health of the whole population as well asvulnerable individuals.Table 5-2) Risk and Protective Factors Relevant to Suicide PreventionRisk Factors• Male gender• Previous suicide attempt• Violence victimization• Violence perpetration• Alcohol use• Drug use• Inhalant or solvent use• School problems• Mood disorder (i.e. major depression)• Social isolation• PovertyProtective Factors• Perceived parent and family connectedness• Emotional well-being (esp. for females)• Success at school• Community involvement andconnectednessSources: American Academy of Child and Adolescent Psychiatry, 2001a; Barney, 2001; Borowsky et al., 2001; Gould et al.,1996; Evans, Hawton, and Rodham, 2004; Malone et al., 2000.84