Environmental Health Officers Role in Suicide Prevention

Suicide is a serious public health injury problem in Indian Country in the United States.  The suicide rates for 5-14 year old Native Americans is 2.6 times higher than the US whole population.  In the ages of 15-24, the suicide rate is 3.5 times the national average.  For every suicide completion, there are 13 attempts.  In and around Thoreau New Mexico, a community of 2100 people adjacent to the Navajo Nation, six children were lost to suicide over a two month period in 2010.  On the Mescalero Apache Nation, population 4500, in southern New Mexico six young people committed suicide in a 5 period in 2009-2010 (Hummingbird, 2011).  For American Indian and Alaska Native (AI/AN) males, suicide rates are four times greater than other racial groups, whereas, AI/AN females are eleven times higher.

Since the mid-1980’s Indian Health Service (IHS) Office of Environmental Health and Engineering (OEHE), Division of Environmental Health Services (DEHS) Environmental Health Officers (EHOs) have been involved in injury prevention. The IHS Injury Prevention Program (IPP) has four basic principles:

evidence-based community prevention strategies, reliable injury surveillance data, tribal capacity building and fostering collaborative partnerships (Hymer, J, 2010).  For years, many IHS IPP practitioners have struggled with what their role should be in suicide prevention.  In the Shiprock OEHE, DEHS, we have also struggled with our role in suicide prevention, while seeing success in unintentional injury prevention.  Through the work and our membership with a local prevention coalition, the Shiprock DEHS staff found a role that we think can spur other EHOs working in injury prevention.  We are currently working to bring a coordinated community response to suicide in San Juan County New Mexico, to prevent the spread of the suicide contagion in the communities we serve, live in and partner with.  We have served as facilitators in the process of community collaboration, while compiling policies and postvention plans to present to our school partners.  The schools provide a venue for us to assist this effort, as we have established relationships due to our roles as inspectors in them.