Journal of Psychiatry

Suicide Interventions for American Indian and Alaska Native Populations: A Systematic Review of Outcomes

Webinar of 8^th Annual Congress on Mental Health

March 07, 2022 | Webinar

Tony V Pham

Harvard Medical School, USA

Scientific Tracks Abstracts: J Psychiatry

Abstract:

Objective: A 2018 Center for Disease Control and Prevention report estimated that 22.1 per 100,000 American Indian/Alaska Native (AI/AN) individuals died by suicide, much higher than the overall U.S. rate of 14.2. To understand how to remedy this problem, we performed a systematic review in response to the following question: “What interventions work to prevent AI/AN suicide?” Method: We adopted a broad inclusionary stance while searching, screening, and extracting data. Our search strategy yielded 1605 unique citations, and after screening 28 items met the set criteria. Results: While participants from each study reported an improvement on at least one targeted measure, particularly along community-driven outcome measures, several methodological modifications arose to meet the ideals of both practice- and evidence-based research. For example, only 11 studies featured assessments that measured changes in direct suicide outcomes. Among these 11 studies, only four featured either a randomized or a non-randomized controlled trial. Furthermore, only one intervention produced consistent outcomes across several studies. Nevertheless, the results from our reviewed corpus were methodologically innovative and suggest an overall benefit to AI/AN communities. Conclusions: The case for these interventions could be augmented through a variety of methodological advancements. Thus, we propose that future studies dismantle their interventions into underlying processes, evaluate these processes using direct, standardized measures of suicidal behavior, and incentivize AI/AN recruitment into research trials outside of Indian Country.

Biography :

Tony V. Pham, MD, MScGH, is a psychiatrist at the Depression Clinical & Research Program. Tony completed his undergraduate training at the University of Virginia, where he majored in psychology and cognitive science. He volunteered extensively with Hurricane Katrina survivors and went on to pursue an MD at Tulane University. During medical school, Tony continued to volunteer in the New Orleans area before transitioning to facilitate a survivor program following the 2011 Japan earthquake, tsunami, and nuclear disaster. After medical school, Tony completed a psychiatry residency and a Master's in Global Health at Duke University. As a psychiatry resident, Tony completed a project that examined the role of spirituality among chronic kidney disease patients of rural Robeson County, North Carolina. As a Global Health Pathway and Fogarty International Fellow, he investigated the intersection between Nepali traditional healers and conventional psychotherapy. More recently, Tony completed a Harvard post-doctoral fellowship that examined the role of "culture as treatment" among American Indian communities.