\u201cMapping suicide prevention initiatives targeting Indigenous S\xe1mi in Nordic countries\u201d

Jon Petter A Stoor,Anne C Silviken,Heidi A Eriksen

doi:10.1186/s12889-021-12111-x

Abstract

BackgroundSuicide is a major public health issue among Indigenous Sámi in Nordic countries, and efforts to prevent suicide in the Sámi context are increasing. However, there is no literature on suicide prevention initiatives among Sámi. The aim of the study was to map suicide prevention initiatives targeting Sámi in Norway, Sweden, and Finland during 2005–2019.MethodInitiatives were identified and described through utilizing networks among stakeholders in the field of suicide prevention among Sámi, acquiring documentation of initiatives and utilizing the authors first-hand experiences. The described initiatives were analyzed inspired by the “What is the problem represented to be?” (WPR)-approach.ResultsSeventeen initiatives targeting Sámi were identified during 2005–2019, including nine in Sweden, five in Norway, one in Finland and two international initiatives. Analysis with the WPR-approach yielded 40 problematizations regarding how to prevent suicide among Sámi, pertaining to shortcomings on individual (5), relational (15), community/cultural (3), societal (14) and health systems levels (3). All initiatives were adapted to the Sámi context, varying from tailor-made, culture-specific approaches to targeting Sámi with universal approaches. The most common approaches were the gatekeeper and mental health literacy training programs. The initiatives generally lacked thorough evaluation components.ConclusionWe argue that the dominant rationales for suicide prevention were addressing shortcomings on individual and relational levels, and raising awareness in the general public. This threatens obscuring other, critical, approaches, such as broadening perspectives in prevention planning, improving health systems for Sámi, and promoting cultural empowerment among Sámi. Nevertheless, the study confirms considerable efforts have been invested into suicide prevention among Sámi during the last 15 years, and future initiatives might include a broader set of prevention rationales. To improve evaluation and identify the most promising practices, increased support regarding development of plans and implementation of evaluation components is needed.

Highlights

Suicide is a major public health issue among Indigenous Sámi in Nordic countries, and efforts to prevent suicide in the Sámi context are increasing
The World Health Organization (WHO) highlights that Indigenous peoples often qualify as at-risk groups, and suicide in those contexts should be understood in relation to community and group factors related to the colonization of Indigenous territories: “among Indigenous groups, territorial, political and economic autonomy are often infringed and native culture and language negated
Attitudes towards suicide in Sámi risk groups for suicidality was, if anything, less problematic than among non-Sámi peers, reindeer herding Sámi had no different attitudes to suicide as compared to the majority of Swedes [24] and young adult Sámi were less prone to think that talking about suicide increases the risk, less likely to think that one could not stop an individual whose mind was made up, and more aware of suicide in general when compared to Swedish peers [25]

Summary

Introduction

Suicide is a major public health issue among Indigenous Sámi in Nordic countries, and efforts to prevent suicide in the Sámi context are increasing. The WHO highlights that Indigenous peoples often qualify as at-risk groups, and suicide in those contexts should be understood in relation to community and group factors related to the colonization of Indigenous territories: “among Indigenous groups, territorial, political and economic autonomy are often infringed and native culture and language negated These circumstances can generate feelings of depression, isolation and discrimination, accompanied by resentment and mistrust of state-affiliated social and health-care services, especially if these services are not delivered in culturally appropriate ways” [7]. Influential scholars in the study of suicide prevention among Indigenous peoples in the US have critiqued previous research in the field for being almost exclusively focusing on “universally measurable individual variables” [8] They suggest that, such approaches have revealed much individual despair among Indigenous peoples, it has yielded few ways forward in terms of addressing the community-level causes of individual despair. Indigenous peoples are themselves adding to such perspectives through developing their own suicide prevention policies, for example, in Australia and northern Canada [13, 14]

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