Suicide does not discriminate in Indian Country.
It shadows every member of every tribe. It has no regard for age or gender.
Earlier this year, an 8-year-old girl on the Fort Peck Indian Reservation tried to hang herself in her bathroom. Another 8-year-old spoke openly about killing herself. And a 9-year-old planned to kill herself by taking her parents’ medications.
Each of these attempts was caught in time. But, a staggering number are successful.
In fact, Montana Native Americans have the highest rate of suicide in a state that has the highest rate in the nation.
All the factors that contribute to Montana's alarming number of suicides -- high rates of alcohol use and gun ownership, insufficient mental health care, rural isolation and joblessness -- are compounded on the state's Indian reservations.
During the winter on some reservations, unemployment can jump to 80 percent. Sexual and domestic violence is endemic and the high school dropout rate hovers at about 44 percent.
On top of that is a taboo in some Native American cultures against speaking of the dead, especially the victims of suicide.
Lana Lambert-Mikkelsen, the Fort Peck Indian Tribe's suicide prevention coordinator, said her current caseload includes people aged 8 to 76.
“Who is at greatest risk?” asked an incredulous Lambert-Mikkelsen. “Everybody. I don’t have a specific gender. I don’t have a specific age group. I don’t have specific indicators.”
And, that's true on all seven of Montana's Indian reservations.
Suicide is the second leading cause of death for Native Americans aged 15-34, after accidents, and the rate is 2.5 times higher than the national average for that age group.
Rates are highest for young Native American men, who make up 40 percent of all suicides in Indian Country.
And the suicides can run in clusters.
Within two months in 1985, nine young men on the Wind River Reservation in Wyoming hanged themselves.
More recently, in a span of six months during 2010, at least six students on the Fort Peck Indian Reservation killed themselves. Four hanged themselves, one used a gun, and another stepped in front of a train. The youngest was 13.
It could have been even worse. During the same period, at least 20 other young people on the Fort Peck reservation attempted suicide.
And, this year got off to a bad start. In January, a 23-year-old woman killed herself on the Northern Cheyenne Reservation. Two weeks later, a 17-year-old high school student on the Crow Reservation killed herself. That was followed by a 15-year-old Northern Cheyenne girl's suicide. Two of the women were relatives; all three knew each other.
A state of emergency
At 27.2 deaths per 100,000 people, Native Americans in Montana have the highest rate of suicide in the state. By comparison, the rate for Caucasians in the state is 22.2 per 100,000 people.
Historically, suicide rates for Native Americans in Montana tracked just slightly higher than the state’s Caucasian population, but lately that gap has been widening, according to Karl Rosston, the state's suicide prevention coordinator.
Native Americans make up around 6.4 percent of Montana’s population, about 64,000 people in a state that recently topped one million residents.
Because the Native population is relatively small, the occasional suicide cluster can paint an unfair picture of what's happening on the state's Indian reservations, said Fort Peck's Lambert-Mikkelsen.
“We have so many people living in a small area and if a couple of them complete suicide, statistically it looks horrible,” she said.
But, the numbers really are higher for Native Americans.
In a 2011 Youth Risk Behavior Survey, at least 6.5 percent of all Montana students in grades nine through 12 said they had attempted suicide during the past 12 months.
For Native American students on reservations, at least 16.2 percent had attempted suicide during the same period. For Native American students in urban settings, the number was even higher. Nearly 19 percent reported having attempted suicide in the last year.
“There is a crisis out there,” said Don Wetzel Jr., a member of the Blackfeet Tribe who spent 14 years working for the Montana-Wyoming Tribal Leaders Council where he led a suicide-prevention program. “There’s a lot of drug and alcohol abuse out there on the reservations. That leads to a lot of the issues that we deal with, with suicide being the final rung on the ladder.”
After the 2010 Fort Peck suicide cluster, tribal leaders declared a state of emergency. Federal health officials visited the reservation for several months to provide counseling and to develop a prevention strategy. The Senate Indian Affairs Committee held a field hearing with U.S. Sen. Jon Tester, D-Mont., presiding.
Though the rate of suicides has waned, tribal and health leaders say it's still the largest challenge facing young people in Indian Country.
“It’s considered an acceptable solution, when the burdens of the day become unbearable,” said Alex Crosby, medical epidemiologist with the Centers for Disease Control and Prevention’s injury prevention center.
Federal money not enough
Of 23 youth-suicide prevention grants the U.S. government awarded nationally in September, 10 went to Native American tribes or organizations, with most of them receiving nearly $500,000 per year for three years. The Northern Cheyenne Tribal Council in Lame Deer received $456,783 and the Chippewa Cree Tribe in Box Elder received $472,686.
“That’s a start,” Tester said. “It’s getting mental-health care professionals on the ground. It’s making sure we’ve got a place for people to go when they are in trouble.”
Byron Dorgan, a former Democratic senator from North Dakota who chaired the U.S. Senate Committee on Indian Affairs for 18 years, concurred. He is the founder of the Washington, D.C.-based Center for Native American Youth, which promotes Indian child health and underscores suicide prevention.
The solution to reducing suicides in Indian Country is better mental-health services, he said, although he has little faith in the “woefully underfunded” and “dysfunctional” Indian Health Service.
Positions often go unfilled for months, he told The Gazette. And, incompetent people are frequently transferred within the federal agency instead of being fired.
“When I say dysfunctional, it affects almost everything that they do, unfortunately,” Dorgan said. “It’s just a mess. There are some diligent, good people working in the Indian Health Service, but the service itself has very serious problems in addition to desperately lacking funds to do the things that are necessary.”
Montana Attorney General Tim Fox, who grew up in Hardin on the edge of the Crow Reservation, said he saw firsthand how substance abuse and poverty impacted the lives of his Native American friends. He has pledged to look for new ways to partner with tribal law enforcement while respecting the sovereignty of Indian County.
Acknowledging he has no authority over sovereign tribal nations, Fox said he would like to see the Montana Highway Patrol have cooperative law enforcement agreements with all Montana tribal governments.
The Department of Justice has conducted on-site training for tribal law enforcement on interview techniques, DUI laws and prescription drug abuse, and he wants to do more.
Fox also has also met with state Superintendent of Public Instruction Denise Juneau about partnering on school safety in Indian Country.
“Our goal is to ensure that Montana’s Native young people can count on having safe communities, safe schools, and safe families,” Fox said. “…It’s our hope that the despair and risk factors that drive these native youths to want to take their own lives can be lessened, not just for this generation, but for those that follow.”
Speaking of the dead
It has only been in the past 20 to 30 years that Native Americans have begun culturally to talk about suicide. It is still considered taboo, said Gordon Belcourt, executive director of the Montana-Wyoming Tribal Leaders Council.
But at 68, Belcourt does not shy away from discussing the topic.
“If you’re going to relay a story, you need to be candid,” said Belcourt, whose own grandson committed suicide.
“I’m not talking from an academic tome here,” he said. “I know what it means to have half of your heart ripped out. It’s created a whole sense of urgency and awareness to me.”
Hope hard to come by
Many people who kill themselves don’t really want to die, said Clayton Small, a Northern Cheyenne tribal member who works as a consultant for the Indian Health Service and Bureau of Indian Affairs.
“But, they don’t see any hope,” he said.
When considering their future, many young people look to their parents and grandparents, who often are themselves troubled.
“A kid will settle in and just say, ‘What’s the point?’ Wetzel said.
Young people fear there is no one to rescue them. Part of that is rooted in the physical, sexual and emotional abuse that Native American children suffered in the boarding schools they were forced to attend until the 1970s, Wetzel said.
That came on top of the loss of their land and identity, and increasingly, their language, he added.
“We have a lot of hopeless and lost people out there,” he said. “We need to get these kids to understand who they are.”