Indian Country Suicide Prevention: A Critical Investment for our Communities

Nov 06, 2018

By Tara Jensen

Suicide continues to be a major public health issue for Montana and is among the leading causes of preventable death in the state. The legislature should continue to invest in suicide prevention, with a specific focus on American Indians, American Indian youth, and veterans. Suicide prevention efforts are critical to improving health outcomes, supporting the state economy, and most importantly, saving lives. Suicide in Montana For almost 40 years, Montana has had one of the highest suicide rates in the country.^[1] In 2016, the state’s growing suicide rate ranked first in the nation, at 29.2 (per 100,000 people), nearly double the national rate of 15.4.^[2] Reasons for the high and growing rates include access to lethal means (firearms), undiagnosed and untreated mental illness, and a societal stigma against depression.^[3] Groups at increased risk of suicide include American Indians and veterans.

American Indian males aged 10 to 24 have the highest suicide rate of any ethnic or racial group in the country. Sources:  Kauffman & Associates, Inc. and Montana Department of Public Health and Human Services

Nationally, whites have the highest rate of suicide, followed by American Indians.^[4] In Montana, this trend is reversed. Between 2012-2016, the American Indian suicide rate was 28.5 (per 100,000 people), compared to 23.1 for whites.[^5] The suicide rate is even higher among American Indian youth and young adults. In fact, death by suicide rates among American Indians peak during youth and young adulthood, unlike non-Indian populations, for whom rates peak in adulthood.^[6] American Indian males aged 10 to 24 have the highest suicide rate of any ethnic or racial group in the country.^[7] Also noteworthy is that between January 2014-March 2016, 19 percent of American Indians who died by suicide were veterans.^[8] Veterans in Montana represent roughly one in ten residents,^[9] and between 2014-2015, their suicide rate was 65.7 (per 100,000 people), triple the national rate.^[10] Table 1 provides a comparative breakdown of additional suicide statistics in Montana for the years 2007-2016. This data indicates that a focused investment on suicide prevention in Montana and Indian Country is needed to address this prolonged public health issue. Table 1. Montana Suicide Rates (by race, gender, and age, per 100,000 people)^[11]

	Race	Male (all ages)	Female (all ages)	Male (ages 10-24)	Female (ages 10-24)
American Indian	26.7	40.2	13.4	55.4	21.4
White	23.0	36.2	9.7	23.1	6.2

  The Economic Costs of Suicide In addition to the emotional toll on families, friends, loved ones, and attempt survivors, suicide impacts individuals’ and families’ finances, as well as the state’s economy. These costs include medical costs for individuals and families, lost income for families, and lost productivity for employers. In 2010, suicide cost Montana over $253 million in associated medical costs and work-lost costs, with the average cost for each suicide reaching over $1 million.^[12] Based on the 267 deaths by suicide in 2016,^[13] the total cost would have amounted to over $298 million for the state. For comparison, the 2019 biennium budget allocates just over $298 million to the Addictive and Mental Disorders Division of the Department of Public Health and Human Services, the division responsible for providing adult mental health services.^[14] Research finds that every $1 spent on interventions involving a psychologist and interventions that strengthen the connection between care providers saves $2.50 in suicide costs.^[15] Investing in suicide prevention efforts could yield significant savings for Montana and help families across the state. Policy Recommendations for the Legislature

• Continue to invest in suicide prevention programs, with a specific focus on American Indians, American Indian youth, and veterans, and make funding permanent.