This study was initiated by the administrator of a county jail in the Northern Plains of the United States who was concerned about the incidence of suicide behaviors in that facility, particularly among the American Indian population. It was a two-year project designed to evaluate the existing admissions suicide screening tool and to improve the instrument's cultural relevance for the American Indian population. The existing screening instrument used in the county jail to interview inmates at their intake was developed in New York. The main objective of the first year of the project was to determine if that instrument was culturally appropriate for the jailed American Indian population. The principal objective of the second year of the project was to determine whether the employment of different suicide screening protocols would make a difference in the responses of new detainees with regard to the likelihood of securing their honest reports of experiencing suicide ideation and its associated risk factors. For the duration of the project, all male and female inmates aged 18 and older who were booked into the jail went through the customary booking procedure that included the administration of the New York Suicide Prevention Screening Guidelines. In the first year of the project, researchers also administered a short self-report survey consisting of measures commonly associated with suicidal ideation. The self-report survey measured stress, anxiety, suicide ideation, hopelessness, and suicidal behavior history. The protocols in the second year of the project reflected efforts to test different screening conditions for four experimental groups and one control group of new detainees. The outcome variables of the short self-report survey consisted of measures of demographics, comfort experience during booking and the screening process, self-efficacy and management of depression, knowledge of mental health support available within the jail, and general well-being. In addition to the quantitative data collection, qualitative data were also collected to develop a straightforward assessment of suicide ideation criteria in this specific jail setting using semi-structured focus group interviews.

BackgroundWhen a person dies by suicide, it takes a reverberating emotional, physical, and economic toll on families and communities. The widespread use of social media among youth and adolescents, disclosures of emotional distress, suicidal ideation, intent to self-harm, and other mental health crises posted on these platforms have increased. One solution to address the need for responsive suicide prevention and mental health services is to implement a culturally-tailored gatekeeper training. The Northwest Portland Area Indian Health Board (NPAIHB) developed Mind4Health, an online gatekeeper training (90 min) and text message intervention for caring adults of American Indian/Alaska Native (AI/AN) youth.MethodsThe Mind4Health intervention was a multi-phase, single-arm, pre-and post-test study of users enrolled in the intervention that is available via text message (SMS) or via a 90 min online, self-paced training. We produced four datasets in this study: Mobile Commons, pre-survey data, post-survey data, and Healthy Native Youth website’s Google Analytics. The analysis included data cleaning, basic frequency counts, percentages, and descriptive statistics. Qualitative data were analyzed using thematic content analysis methods and hand-coding techniques with two independent coders.ResultsFrom 2022 to 2024, 280 people enrolled in the Mind4Health SMS training, and 250 completed the 8-week intervention. Many messages in the sequence were multi-part text messages and over 21,500 messages were sent out during the timeframe. Of the 280 subscribers, 52 participated in the pre-survey. Pre-survey data show that 94% of participants were female, and nearly one-fourth lived in Washington state, 92% of participants in the pre-survey were very to moderately comfortable talking with youth about mental health (n = 48). Most participants interact with youth in grades K–12. Post-survey data demonstrate changes in knowledge, beliefs, comfort talking about mental health, and self-efficacy among participants. Mind4Health improved participant’s skills to have mental health conversations with youth and refer youth to resources in their community.

Suicide methods considered among veterans who experienced past-year suicidal ideation.