On a Montana Reservation, Strengthening Tribal Identity to Prevent Youth Suicide

For chil­dren and fam­i­lies of his­tor­i­cal­ly under­rep­re­sent­ed com­mu­ni­ties, evi­dence-based pro­grams that draw on cul­tur­al roots offer the great­est oppor­tu­ni­ties for success.

This real­iza­tion informs the work of Wa’Kan Ye’Zah or ​“Lit­tle Holy One.” With sup­port from the Annie E. Casey Foun­da­tion, the project is apply­ing an inno­v­a­tive cul­tur­al­ly ori­ent­ed approach to cur­tail youth sub­stance abuse and sui­cide at Montana’s Fort Peck Reservation.

Lit­tle Holy One uses research to adapt evi­dence-based prac­tices to the unique expe­ri­ences of Native Amer­i­cans at Fort Peck. Infor­ma­tion col­lect­ed from com­mu­ni­ty vis­its, meet­ings and inter­views ulti­mate­ly enabled the Johns Hop­kins Uni­ver­si­ty School of Nurs­ing to receive a Nation­al Insti­tute of Health research grant and secure the mul­ti-year fund­ing it needs for a full pro­gram launch of Lit­tle Holy One lat­er in 2020.

By pro­mot­ing pos­i­tive aspects of Native Amer­i­can tra­di­tion, iden­ti­ty and cul­ture, Lit­tle Holy One seeks to improve the men­tal health and par­ent­ing capac­i­ties of young adult care­givers while decreas­ing the risk of sub­stance use, sui­cide attempts and oth­er harm­ful out­comes in their chil­dren. The pro­gram serves Assini­boine and Sioux par­ents and care­givers on the Fort Peck Reser­va­tion and their 3- to 5‑year-old chil­dren enrolled in Head Start.

“We know that inter­gen­er­a­tional approach­es are an effec­tive way to address risk fac­tors that have been passed down from gen­er­a­tion to gen­er­a­tion,” says Tere­sa Brock­ie, a researcher at the Johns Hop­kins Nurs­ing and the project’s prin­ci­pal inves­ti­ga­tor. ​“Chil­dren spend the major­i­ty of their time at home, so when it comes to build­ing strength among Native Amer­i­can youth, the best way to reach them is through engag­ing with their caregivers.”

Root­ed in Research

In 2010 — fol­low­ing a wave of sui­cides among young peo­ple in Fort Peck — Brock­ie, a mem­ber of the White Clay Nation from the near­by Fort Belk­nap Reser­va­tion, set out to explore the issue. She led a team of researchers, which doc­u­ment­ed the neg­a­tive child­hood expe­ri­ences and ensu­ing neg­a­tive health out­comes of 288 15-to-24-year-olds on the reservation.

Across the nation, 46% of kids have had at least one neg­a­tive child­hood expe­ri­ence, which can include inci­dents of abuse and neglect as well as expo­sure to vio­lence. On the Fort Peck Reser­va­tion, 78% of the 15-to-18-year-olds sur­veyed by Brock­ie fell into this same category.

This sta­tis­ti­cal dis­par­i­ty mat­ters, since research has linked a rise in neg­a­tive child­hood expe­ri­ences with an ele­vat­ed risk of strug­gling with PTSD, depres­sion, drug use or sui­cide attempts lat­er in life.

Brockie’s study also uncov­ered a link: the stronger a youth’s trib­al iden­ti­ty and edu­ca­tion, the low­er the risk of sub­stance use and sui­cide attempts. The find­ing offered hope — and became the basis for Lit­tle Holy One.

“The pur­pose of Lit­tle Holy One’s pilot­ing and exten­sive test­ing is to be respect­ful of the expe­ri­ences of those who are receiv­ing the pro­gram,” says Cyn­thia Weaver, a senior asso­ciate in the Foundation’s Evi­dence-Based Prac­tice Group. ​“Casey is ded­i­cat­ed to build­ing evi­dence for pro­grams devel­oped by peo­ple of col­or for peo­ple of col­or that use an authen­tic voice to improve the lives of young peo­ple — and that is why we have sup­port­ed Dr. Brockie’s ear­ly work with Lit­tle Holy One.”

More on Lit­tle Holy One

The Lit­tle Holy One cur­ricu­lum cul­ti­vates impor­tant rela­tion­al, emo­tion­al and behav­ioral skills in young par­ents while pro­mot­ing pos­i­tive aspects of Native Amer­i­can iden­ti­ty. It con­sists of:

• Fam­i­ly Spir­it: An evi­dence-based and cul­tur­al­ly spe­cif­ic pro­gram from the Johns Hop­kins Cen­ter for Amer­i­can Indi­an Health that helps young care­givers estab­lish and mon­i­tor their toddler’s dai­ly rou­tines, encour­age ear­ly learn­ing and effec­tive­ly parent.
• Com­mon Ele­ments Treat­ment Approach: A proven method to reduce men­tal health issues in low- and mid­dle-income com­mu­ni­ties by teach­ing par­ents about emo­tion­al and men­tal health, cog­ni­tive cop­ing skills, and how to process trau­mat­ic experiences.
• Native Amer­i­can cul­ture: Lit­tle Holy One pro­motes pos­i­tive trib­al iden­ti­ty in the fol­low­ing four ways: 
  • bring­ing par­ents and chil­dren into a tra­di­tion­al cir­cle nam­ing cer­e­mo­ny and con­nect­ing them to a spir­i­tu­al path;
  • teach­ing and pro­mot­ing smudg­ing, a ther­a­peu­tic heal­ing prac­tice to resolve unset­tling thoughts and feelings;
  • enhanc­ing com­mu­nal mas­tery via activ­i­ties that help a par­tic­i­pant under­stand their sacred rela­tion­ships to oth­ers; and
  • heal­ing his­tor­i­cal trau­ma through cer­e­mo­ny, sto­ry­telling and trau­ma narration.

Learn more about the role of cul­ture in pre­ven­tion programs