Tribal Health: Reaching out InVolves Everyone (THRIVE) is the suicide prevention project at the NPAIHB. THRIVE works to reduce suicide rates among American Indians and Alaska Natives living in the Pacific Northwest by providing programmatic technical assistance, suicide prevention trainings, and resources to the Northwest Tribes.
Project staff facilitate trainings and presentations around the topic of suicide. Common presentation topics include Resources for Youth Suicide Prevention, 988 in Indian Country, Caring Text Messages Suicide Prevention Intervention, and Media and Marketing for Veteran’s Suicide Prevention. The THRIVE team are trainers for two of the most widespread suicide intervention gatekeeper trainings: QPR (Question Persuade Refer) and ASIST (Applied Suicide Intervention Skills Training). These trainings are offered at low- or no-cost for NPAIHB member tribes. To request a training or presentation, please contact project director Colbie Caughlan at ccaughlan@npaihb.org.
Several learning and health communication theories support the use of culturally-tailored media to increase behavior change. Tailored information is more likely to be read, understood, perceived as personally relevant, and remembered. Cultural tailoring is particularly important when addressing sensitive health topics like suicide and sexual health. To view the social marketing campaigns, please go to the Social Marketing Campaigns webpage.
This annual summer conference is for Native youth ages 13-19 from all over Indian Country. The conference brings youth together to learn about health promotion and disease prevention with a strong focus on suicide prevention and mental health. To learn more about the THRIVE Conference please view the “THRIVE Conference” tab.
Caring Text Messages is an evidence-based behavioral intervention and social marketing campaign, developed by the THRIVE team with the help of Native teens, college students, and Veterans. Native youth from anywhere can text “CARING’’ to 65664 to receive two texts per week with hopeful and encouraging videos, songs, and messages. Caring Messages that “express unconditional care and concern have been shown to prevent suicide deaths, attempts, ideation, and hospitalizations”. Fliers and postcards to promote the campaign are also downloadable from Healthy Native Youth’s website, www.healthynativeyouth.org. For the college caring text messages text “COLLEGE” to 65664 and for the Veterans text messages text “VETERAN” to 65664.
Mind4Health is a text message service for caring adults that builds their capacity to facilitate conversations with youth to nurture mental health. The gatekeeper training was designed by the THRIVE team, to meet a need from adults who work with AI/AN youth, to help community gatekeepers identify youth in need of support and connect them to appropriate services. The series walks participants through three steps to fill their mental health toolbox. The Mind4Health training’s videos and handouts are available on Healthy Native Youth’s website, www.healthnativeyouth.org. Collectively, the evaluations of these programs (i.e., Caring Text Messages, BRAVE, and Mind 4 Health) indicate that behavioral interventions can be feasibly delivered via text message to AI/AN communities and that including Native youth in the formative research is critical to designing comprehensive, culturally-responsive interventions. Access Mind4Health here.
The purpose of this toolkit is to provide those who work in AI/AN communities with information, resources, and suggested activities for talking about and healing the generational traumatic impacts boarding schools have had on AI/AN individuals, families, and communities. In January 2023, Northwest Portland Area Indian Health Board (NPAIHB) and Indian Health Services (IHS) contracted with Kauffman and Associates, Inc. (KAI) to develop an electronic toolkit for teachers, public health professionals, mental health professionals, tribal administrators, and public safety professionals. The toolkit is intended to be a brief, reader-friendly resource with information on the historical trauma resulting from Indian boarding schools in the United States. This team conducted a literature review, spoke to boarding school survivors and descendants, consulted with individuals and organizations working in the field of American Indian and Alaska Native (AI/AN) healing and resilience, and collaborated with educators to develop this toolkit.
The THRIVE team hosted a webinar to introduce the Zero Suicide model to new staff at the clinics we are assisting with Zero Suicide implementation. Feel free to check this webinar out and learn about the model!
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Project activities are funded by the SAMHSA Garrett Lee Smith youth suicide prevention grant awarded in June 2019. THRIVE does not currently have funding for Tribal Cooperative Grants but please check back every couple of months to see if there is an update. If you need assistance with honoraria, incentives, training materials, etc. please contact Colbie Caughlan (ccaughlan@npaihb.org or 503-416-3284) to ask if THRIVE can help provide smaller materials for your event(s). Thank you!
American Indians and Alaska Natives are often incorrectly classified as another race (usually White) in vital statistics, such as suicide rates. THRIVE partners with the IDEA NW project to reduce AI/AN misclassification in suicide and mental health data systems. This data can be found at the links below:
Idaho AI/AN Suicide Data 2013 – 2017
Oregon AI/AN Suicide Data 2013 – 2017
Washington AI/AN Suicide Data 2014 – 2016
Northwest AI/AN Suicide Data 2008 – 2012
Oregon Suicide Emergency Department Visits During Pandemic
Oregon Suicide Emergency Department Visits During Pandemic
Data suggest that suicide is a significant problem throughout Indian Country, particularly among Native youth, males, and veterans. From 2002-2006, the average suicide death rate was highest among AI/AN aged 10-24 years at 27.72 cases per 100,000. In the Northwest (ID, OR, and WA), suicide is the 8th leading cause of death for AI/AN people and the 2nd leading cause of death for AI/ANs ages 15-24 years (this is the same for AI/AN youth throughout the U.S.). For data on Native youth well-being, health priorities, and protective factors, see results from the 2022 THRIVE Tribal Youth Wellbeing Assessment
The Portland Area has one of the higher suicide death rates for AI/AN among the IHS service areas. The IHS reported that, from 1996-1998, the age-adjusted suicide death rate for the Portland Area was 22.0 per 100,000, a rate that was exceeded only by Aberdeen, Alaska, Bemidji, and Tucson.
At the state level, annual suicide rates for AI/AN tend to fluctuate widely because the actual number of deaths each year is relatively small. For example, an average of 20 AI/AN suicides occur in Washington each year, 6 in Oregon, and 4 in Idaho. While males typically die by suicide more often than women, studies suggest that women attempt suicide more frequently than men. This pattern is also present among AI/ANs in the Pacific Northwest.
Data on suicide risk factors and attempts, as opposed to mortality, are available from a variety of sources, including the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) and the Youth Risk Behavior Survey (YRBS). Data from these sources and other studies have found that several factors can put a person at higher risk for attempting suicide, including: – Previous suicide attempt(s) – History of depression – Alcohol or drug abuse – Family history of suicide or violence – Physical illness – Feeling alone. Additional research is needed to identify and explore the culturally unique factors that affect AI/ANs.
If you would like to request a suicide prevention training for your Tribe or Tribal staff in WA, OR, or ID, please contact Colbie Caughlan at ccaughlan@npaihb.org. Two different trainings are available as well as suicide prevention presentations or awareness activities:
THRIVE staff would like to say “thank you” to all the partners, facilitators, presenters, volunteers, staff, and chaperones who took the time to invest in these talented youth over the years!
Check out these great memories as youth participants have positively expressed themselves through 4-5 interactive workshops that incorporated AI/AN culture, traditional learning strategies, skill-building activities, and tips on healthy decision-making.
Presented to you by THRIVE, with funding from the Garrett Lee Smith youth suicide prevention grant from SAMHSA and the MSPI grant from the Indian Health Service.
Youth created four meaningful social marketing campaigns by creating their own logos using digital designs inspired by the environment, culture, body and mind. Native youth amplified the advocacy for Missing and Murdered Indigenous Women, honoring tribal elders and sharing teaching passed down to them, reclaiming tribal identity through their ancestors, and being mindful of the environment and mother earth.
The Beats, Lyrics, Leaders (BLL) music track lead by recording artist J Ross Parrelli and a team of talented mentors guided youth to share their powerful voices and stories. Each participant created their own musical lyrics, created their own beats and rhythms, engaged in public speaking, and collaborate in developing an electrifying music video called “So Native.” This unified video is very powerful in sharing their cultural pride and resiliency.
Youth developed a graphic novel using indigenous storytelling, the Trickster story to discuss and learn the impact of substance abuse disorder and addiction in Native communities. Each story represented oral teachings from their respective communities passed from generation to generation.
Youth prepared a healthy snack using traditional foods, hike through an urban forest making connection with indigenous plants, and participate in a service learning project to remove invasive species and protect biodiversity and water quality.
The science and health track with Oregon Health and Science University (OHSU) exposed youth to different health and science fields at OHSU campus. The workshop provides a connection for youth who are interested in health professions and becoming future healers. Youth expressed interest in the respective fields, pharmacy, dentistry, medicine, ophthalmology, pediatrics, nursing, research, chemist, therapist, nutritionist, psychiatry, and public health!
NARA
Crisis Contact List
List of Suicide Prevention Trainers in WA, OR, and ID
Native American Youth Family Center (NAYA)
National Indian Child Welfare Association (NICWA)
THRIVE Linktree
Reducing Access to Lethal Means
How to order 988 Materials
Oregon DHS, Public Health Division – Youth Suicide Prevention Program
Oregon Partnership: Crisis Line
Youth Suicide Prevention Program (YSPP) – website for Washington State youth
Washington Native and Strong Lifeline
Washington State: Youth Suicide Prevention
Clark County Teen Talk
Idaho State University- Institute of Rural Health
Idaho Suicide Prevention Coalition
Idaho State: Suicide Prevention
The Teenline offers a crisis line between 4pM and 10PM at 800-852-8336 or Text NATIVE to 839863
Teen Link 866.TEENLINK (833-6546)
National Institute of Mental Health
National Alliance on Mental Illness
IHS Division of Behavioral Health
Centers for Disease Control and Prevention
WeRNative
Suicide Prevention Resource Center (SPRC)
SPRC AI/AN Suicide Prevention
National Suicide Prevention Lifeline
Trevor Helpline for LGBTQ youth
Yellow Ribbon Suicide Prevention Program
Zero Suicide Institute
Reachout.com
Lethal Means & Suicide Prevention: A Guide for Community & Industry Leaders
When someone dies by suicide, many others are deeply affected. It can begin with family and those closest to the person who took their life and then the impact spreads outward to others such as friends, witnesses, first responders, treatment providers, and colleagues. According to the National Alliance on Mental Illness (NAMI), postvention is activities that reduce risk and promote healing after a suicide death. Although postvention is done after a suicide it is important that we prepare for postvention before a suicide.
The list of resources below include information appropriate for particular settings:
The following postvention resources all discuss demoralization:
Crisis intervention services respond to those experiencing distress or anxiety that results from mental health and substance use disorder. One of the main goals of crisis intervention services is to prevent people, including those from indigenous communities, from needing more restrictive care, such as psychiatric hospitalization or emergency detention. These services are important and available for American Indian and Alaska Native (AI/AN) people.
Project staff facilitate trainings and presentations around the topic of suicide. Common presentation topics include Resources for Youth Suicide Prevention, 988 in Indian Country, Caring Text Messages Suicide Prevention Intervention, and Media and Marketing for Veteran’s Suicide Prevention. The THRIVE team are trainers for two of the most widespread suicide intervention gatekeeper trainings: QPR (Question Persuade Refer) and ASIST (Applied Suicide Intervention Skills Training). These trainings are offered at low- or no-cost for NPAIHB member tribes. To request a training or presentation, please contact project director Colbie Caughlan at ccaughlan@npaihb.org.
Several learning and health communication theories support the use of culturally-tailored media to increase behavior change. Tailored information is more likely to be read, understood, perceived as personally relevant, and remembered. Cultural tailoring is particularly important when addressing sensitive health topics like suicide and sexual health. To view the social marketing campaigns, please go to the Social Marketing Campaigns webpage.
This annual summer conference is for Native youth ages 13-19 from all over Indian Country. The conference brings youth together to learn about health promotion and disease prevention with a strong focus on suicide prevention and mental health. To learn more about the 2023 THRIVE Conference please scroll down and view the “THRIVE Conference” tab.
Caring Text Messages is an evidence-based behavioral intervention and social marketing campaign, developed by the THRIVE team with the help of Native teens, college students, and Veterans. Native youth from anywhere can text “CARING’’ to 65664 to receive two texts per week with hopeful and encouraging videos, songs, and messages. Caring Messages that “express unconditional care and concern have been shown to prevent suicide deaths, attempts, ideation, and hospitalizations”. Fliers and postcards to promote the campaign are also downloadable from Healthy Native Youth’s website, www.healthynativeyouth.org. For the college caring text messages text “COLLEGE” to 65664 and for the Veterans text messages text “VETERAN” to 65664.
Mind4Health is a text message service for caring adults that builds their capacity to facilitate conversations with youth to nurture mental health. The gatekeeper training was designed by the THRIVE team, to meet a need from adults who work with AI/AN youth, to help community gatekeepers identify youth in need of support and connect them to appropriate services. The series walks participants through three steps to fill their mental health toolbox. The Mind4Health training’s videos and handouts are available on Healthy Native Youth’s website, www.healthnativeyouth.org. Collectively, the evaluations of these programs (i.e., Caring Text Messages, BRAVE, and Mind 4 Health) indicate that behavioral interventions can be feasibly delivered via text message to AI/AN communities and that including Native youth in the formative research is critical to designing comprehensive, culturally-responsive interventions.
“The Zero Suicide Model relies on a system-wide approach to improve outcomes and close gaps. Success is achieved when clinical teams embrace the understanding that suicide deaths are preventable in their organization; and when patients feel comfortable disclosing suicide risk and work with clinic staff to lower that risk. The Model is based on the realization that suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted health care system, and on the premise that a systematic approach to quality improvement is necessary” (sprc.org). THRIVE currently has three tribal clinics implementing the ZS model.
Project activities are funded by the SAMHSA Garrett Lee Smith youth suicide prevention grant awarded in June 2019. THRIVE does not currently have funding for Tribal Cooperative Grants but please check back every couple of months to see if there is an update. If you need assistance with honoraria, incentives, training materials, etc. please contact Colbie Caughlan (ccaughlan@npaihb.org or 503-416-3284) to ask if THRIVE can help provide smaller materials for your event(s). Thank you!
American Indians and Alaska Natives are often incorrectly classified as another race (usually White) in vital statistics, such as suicide rates. THRIVE partners with the IDEA NW project to reduce AI/AN misclassification in suicide and mental health data systems. This data can be found at the links below:
Idaho AI/AN Suicide Data 2013 – 2017
Oregon AI/AN Suicide Data 2013 – 2017
Washington AI/AN Suicide Data 2014 – 2016
Northwest AI/AN Suicide Data 2008 – 2012
Oregon Suicide Emergency Department Visits During Pandemic
Oregon Suicide Emergency Department Visits During Pandemic
Data suggest that suicide is a significant problem throughout Indian Country, particularly among Native youth, males, and veterans. From 2002-2006, the average suicide death rate was highest among AI/AN aged 10-24 years at 27.72 cases per 100,000. In the Northwest (ID, OR, and WA), suicide is the 8th leading cause of death for AI/AN people and the 2nd leading cause of death for AI/ANs ages 15-24 years (this is the same for AI/AN youth throughout the U.S.). For data on Native youth well-being, health priorities, and protective factors, see results from the 2022 THRIVE Tribal Youth Wellbeing Assessment
The Portland Area has one of the higher suicide death rates for AI/AN among the IHS service areas. The IHS reported that, from 1996-1998, the age-adjusted suicide death rate for the Portland Area was 22.0 per 100,000, a rate that was exceeded only by Aberdeen, Alaska, Bemidji, and Tucson.
At the state level, annual suicide rates for AI/AN tend to fluctuate widely because the actual number of deaths each year is relatively small. For example, an average of 20 AI/AN suicides occur in Washington each year, 6 in Oregon, and 4 in Idaho. While males typically die by suicide more often than women, studies suggest that women attempt suicide more frequently than men. This pattern is also present among AI/ANs in the Pacific Northwest.
Data on suicide risk factors and attempts, as opposed to mortality, are available from a variety of sources, including the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) and the Youth Risk Behavior Survey (YRBS). Data from these sources and other studies have found that several factors can put a person at higher risk for attempting suicide, including: – Previous suicide attempt(s) – History of depression – Alcohol or drug abuse – Family history of suicide or violence – Physical illness – Feeling alone. Additional research is needed to identify and explore the culturally unique factors that affect AI/ANs.
If you would like to request a suicide prevention training for your Tribe or Tribal staff in WA, OR, or ID, please contact Colbie Caughlan at ccaughlan@npaihb.org. Two different trainings are available as well as suicide prevention presentations or awareness activities:
THRIVE staff would like to say “thank you” to all the partners, facilitators, presenters, volunteers, staff, and chaperones who took the time to invest in these talented youth over the years!
Check out these great memories as youth participants have positively expressed themselves through 4-5 interactive workshops that incorporated AI/AN culture, traditional learning strategies, skill-building activities, and tips on healthy decision-making.
Presented to you by THRIVE, with funding from the Garrett Lee Smith youth suicide prevention grant from SAMHSA and the MSPI grant from the Indian Health Service.
Youth created four meaningful social marketing campaigns by creating their own logos using digital designs inspired by the environment, culture, body and mind. Native youth amplified the advocacy for Missing and Murdered Indigenous Women, honoring tribal elders and sharing teaching passed down to them, reclaiming tribal identity through their ancestors, and being mindful of the environment and mother earth.
The Beats, Lyrics, Leaders (BLL) music track lead by recording artist J Ross Parrelli and a team of talented mentors guided youth to share their powerful voices and stories. Each participant created their own musical lyrics, created their own beats and rhythms, engaged in public speaking, and collaborate in developing an electrifying music video called “So Native.” This unified video is very powerful in sharing their cultural pride and resiliency.
Youth developed a graphic novel using indigenous storytelling, the Trickster story to discuss and learn the impact of substance abuse disorder and addiction in Native communities. Each story represented oral teachings from their respective communities passed from generation to generation.
Youth prepared a healthy snack using traditional foods, hike through an urban forest making connection with indigenous plants, and participate in a service learning project to remove invasive species and protect biodiversity and water quality.
The science and health track with Oregon Health and Science University (OHSU) exposed youth to different health and science fields at OHSU campus. The workshop provides a connection for youth who are interested in health professions and becoming future healers. Youth expressed interest in the respective fields, pharmacy, dentistry, medicine, ophthalmology, pediatrics, nursing, research, chemist, therapist, nutritionist, psychiatry, and public health!
NARA
Crisis Contact List
List of Suicide Prevention Trainers in WA, OR, and ID
Native American Youth Family Center (NAYA)
National Indian Child Welfare Association (NICWA)
THRIVE Linktree
Reducing Access to Lethal Means
How to order 988 Materials
Oregon DHS, Public Health Division – Youth Suicide Prevention Program
Oregon Partnership: Crisis Line
Youth Suicide Prevention Program (YSPP) – website for Washington State youth
Washington Native and Strong Lifeline
Washington State: Youth Suicide Prevention
Clark County Teen Talk
Idaho State University- Institute of Rural Health
Idaho Suicide Prevention Coalition
Idaho State: Suicide Prevention
The Teenline offers a crisis line between 4pM and 10PM at 800-852-8336 or Text NATIVE to 839863
Teen Link 866.TEENLINK (833-6546)
National Institute of Mental Health
National Alliance on Mental Illness
IHS Division of Behavioral Health
Centers for Disease Control and Prevention
WeRNative
Suicide Prevention Resource Center (SPRC)
SPRC AI/AN Suicide Prevention
National Suicide Prevention Lifeline
Trevor Helpline for LGBTQ youth
Yellow Ribbon Suicide Prevention Program
Zero Suicide Institute
Reachout.com
Lethal Means & Suicide Prevention: A Guide for Community & Industry Leaders
When someone dies by suicide, many others are deeply affected. It can begin with family and those closest to the person who took their life and then the impact spreads outward to others such as friends, witnesses, first responders, treatment providers, and colleagues. According to the National Alliance on Mental Illness (NAMI), postvention is activities that reduce risk and promote healing after a suicide death. Although postvention is done after a suicide it is important that we prepare for postvention before a suicide.
The list of resources below include information appropriate for particular settings:
The following postvention resources all discuss demoralization:
Crisis intervention services respond to those experiencing distress or anxiety that results from mental health and substance use disorder. One of the main goals of crisis intervention services is to prevent people, including those from indigenous communities, from needing more restrictive care, such as psychiatric hospitalization or emergency detention. These services are important and available for American Indian and Alaska Native (AI/AN) people.
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