Fairbanks Native Association (FNA), a tribal organization, is applying for the SAMHSA 988 Tribal Response opportunity. Our project, the Athabascan Suicide Response Project will serve American Indians and Alaska Natives (AI/AN) in our tribal service area, the Fairbanks North Star Borough (FNSB), an area geographically the size of the New Jersey. By joint agreement we serve both Alaska Natives and American Indians. Our response is a cultural response.
On July 16, 2022, the 988-dialing code (988 Suicide and Crisis Lifeline) came on-line in Alaska. The prior 911 call line wasn’t set up to address mental health needs. The intent of 988 dialing is to reduce confrontations with law enforcement and connect people in crisis to the right help right away. People who call or text the number are connected to a trained counselor at the crisis center closest to them. This system has yet to develop a culturally specific strategy for responding to a suicide crisis for AI/AN people. As AI/AN have the highest incidence of suicide both statewide and nationally, a culturally specific suicide crisis response is critical.
As AI/AN culture is community and family-based, the Athabascan Suicide Response Project is framed around the concepts of community, family and culture and integrates elements of each into its suicide response following referral. For AI/AN, healing from the effects of intergenerational trauma and other social issues – including suicide – require a cultural response. Key to the community response is the FNA-sponsored 22 member Behavioral Health Community Coalition (BHCC), which provides infrastructure development and behavioral health leadership in the FNSB. FNA’s Behavioral Health Services department (BHS) partners with the BHCC in all projects.
The Athabascan Suicide Response Project will include the following required activities: A) Train 988 staff to be more culturally resonant, B) Form three three-person Community Response Teams, C) Provide screening, assessment, treatment, and recovery supports, D) Provide group therapy through Talking Circles, and E) Inform the community about 988.
Cultural elements of this project will include the following: 1) project activities led by the community (BHCC) include the development of Community Response Teams, led by a Therapist. The teams may include an Elder, AI/AN community leader, BHCC member, and/or BHCC Youth Council member if client is a youth. The team will be convened upon referral from the call line. 2) A family member of the person referred will identified by the client to provide 3 month support and follow-up post treatment discharge. 3) Meeting in a community versus office setting. 4) Culturally specific suicide prevention materials. 5) Guiding Good Choices, an Evidence Based Practice that BHS has tested for cultural relevance over three years for family training. 6) Culturally specific screening, assessment, treatment, and recovery support services. 7) Training 988 staff in culturally specific communication techniques. 8) Client Participation in a weekly Talking Circles. 9) A culturally specific marketing campaign to inform the community of the change from 911 to 988 and to explain how responses will be culturally specific.