Episode 5: Teen Suicide in the Navajo Nation

This episode takes us to the Navajo Nation of New Mexico where McClellan Hall explains the issue of teen suicide and the collaborative work C4 did with the community to combat such a tragic problem. Joined by Celeste Rabago, the panel dives into generational trauma and the importance of working with community elders.

 

   

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Jack O’Donnell Welcome to the fifth episode of the C4 Recovery Solutions podcast. I am your host, Jack O’Donnell. Some of you might know me as the CEO of C4 Recovery Foundation. As many of you know, C4 is dedicated to improving access to high quality ethical treatment services for behavioral health and social wellness. We are fierce advocates for the often overlooked individuals and underserved populations within our society. Through innovation and forward-thinking, C4 has developed service delivery systems for addiction and recovery programmes throughout the US and throughout the world, in some of the most challenging environments.

Each week on this podcast, we will hear stories, from people who have benefited directly from programmes C4 developed, those who assisted C4 in the process, and especially those still involved in the implementation of the programmes today.

On today’s episode, we’re discussing the issue of teen suicide in the Navajo Nation in New Mexico. For many Navajo teenagers, life on the reservation had simply become unbearably painful. Their deep psychological pain is driven worse by high rates of depression and anxiety. Such mental health issues are only worsened by feelings of worthlessness, anger, and hopelessness. Seeing no way out of their suffering, many contemplate and, in some cases, turn to suicide.

From 1999 to 2013, suicide was a leading cause of death among youth ages ten to twenty-four the Navajo Nation, with sixty-two reported in 2013 alone. The suicide rate for youth fourteen to twenty-five years old nationally was ten-point-one per one hundred thousand in 2009. While in New Mexico, the rate was double, at twenty-one-point-two per one hundred thousand.

In 2011, C4 wrote a grant application for SAMHSA grant to specifically assist the Navajo Nation in New Mexico in addressing the tragic reality of teen suicide. The project was called Project K’é. K’é is a Diné word for relations or relationships, and it conceptually defines a Navajo individual’s place in the world, community, family, and with self. The overreaching goal of Project K’é was to create prevention-prepared communities, along with youth suicide prevention and early intervention strategies grounded in collaboration among many stakeholders, including chapter houses, schools, educational institutions, juvenile justice, foster care systems, substance abuse, and mental health programmes, and other child and youth-supporting organizations.

From 2011 through 2014, C4 was involved in the design and implementation, even to the extent of doing hands-on training in the schools, which were fundamental to the programme design. The schools themselves have a unique opportunity to reduce the number of youth suicides. They provide an optimal environment for identifying and assisting the individuals and their families. The programme and training C4 provided was for teachers and administrators on suicide risk factors, protective factors, and warning signs of suicide. Also included was how to respond to a student presenting with the warning signs or an actual attempt. In addition, there was training on how to respond to the other classmates after a completed suicide. This is where Mac Hall comes in. As the CEO and founder of the National Indian Youth Leadership project, or the NIYLP, Mac’s focus has been on positive youth development based on traditional wisdom and values common to Indigenous people across North America for thirty-three years. And now, here is his story.

McClellan Hall The issue of teen suicide in any reservation, really, is very complex. And there isn’t – there isn’t one particular thing that causes one to happen. And once it happens, it tends to spread. And there’s often a cluster of suicides that happen around the same time, one after another. And some of the suicides were twelve years old and up, as I recall. In a community like that, there’s a lot of kids who aren’t in school. And then, most of them are. But there’s quite a few that aren’t. And so, suicides, as I remember it, were not all kids that were actually in school, but they were the age of kids who should have been in school. It’s a whole combination of things that come back to the historical trauma issues and the experienced that a lot of Native people have had in residential schools, boarding schools, and things like that, where they have lost the natural transmission of child-rearing skills, for example, don’t happen.

And so, people go back home totally unprepared for how to deal with kids when they got them. So, you have parents who never learned how to be parents, never had that role modeling and. A lot of times, they emulate the system that they came up in, which is authoritarian, Don’t do this. Don’t do that kind of stuff. And a lot of times those schools in the US and Canada tended to try to wipe out the traditional spiritual practices in favor of Christianity, which is not always a good fit. Some families were able to hold onto those traditional practices, but some haven’t. And the kids are really the ones that suffer generationally from stuff that might have happened two or three generations back.

We’re talking about a really small community, isolated community, on the Navajo Nation. But Thoreau as a tiny, little community that’s separated off from the rest of the Navajo Nation. Just the fact that there were several suicides within a fairly short period of time with young people got everybody’s attention. And when that happens in our community, there’s a response from the tribal government and the local political areas that are called chapters on the Navajo Reservation. And so, they all realized that there was a need to do something. But I think people didn’t really know how.

The respond to first steps, as I recall, were sort of bureaucratic in a way. There… They declared a state of emergency with the Navajo Nation and with Indian Health Service. And one of the first things that they did was to set up, like, a command post, the kind you would do in some kind of natural disaster situation or something in the community. And so, they set that up. And the schools and the health facilities were all on alert for kids that are, you know, with that suicide ideation and to possibilities. The most – the most vulnerable kids and the kids that have been receiving counseling and mental health support, trying to get them in to see a health care professional, a mental health person.

Project K’é was the outcome here after C4 got involved and they had connections within the Navajo tribal government and offered their help. And one thing led to another. And a grant was written to SAMHSA, I believe. And the portion that C4 addressed was training and working with the mental health professionals and that sort of thing. And our involvement in it was strictly being part of the community group, but working with the kids directly in the schools. And that was where we came into the picture. Our organization focuses on positive youth development and we have a unique model that’s evidence-based and the most effective Native youth programme in the United States for Native kids.

Several years ago, the Canadian government was under a mandate to find an evidence-based programme for our First Nations communities in Canada. And so, they discovered us, because we’re the first Native evidence-based programme in the US. And so, they adopted our project venture model and we’ve had programs in nine provinces over the last fourteen years in Canada. And we’ve also had inquiries from Aboriginal people in New Zealand and Australia about our programme. And we also have active programmes for almost twenty years now in Hawaii.

In the Navajo culture, you don’t talk about death and – and you don’t talk about suicide, especially generally. I’m sure that kids to do talk about it. But in the traditional culture, it’s a subject that’s handled very carefully. And that complicates things, too. Getting kids in to seek behavioral health help who may be more vulnerable. You know, there – there’s a reluctance probably to go seek help. And that contributes to the problem, because some of those kids go ahead and do it anyway.

And I think some of the results were just really raising awareness of the issue in the schools with the teachers and the – and the administration there and looking at what’s a culturally appropriate response. You know, if you expected kids to just line up and voluntarily go seek mental health support, that – that probably wasn’t going to happen. And so, we have an interesting approach to working with kids and – and we have a – a set of positive norms that we introduce and guiding principles around strength-based work. And, you know, again, there’s – there’s a sort of natural mistrust of outsiders coming in from somewhere else and a possibility that they don’t really understand Navajo culture that well. And it was kind of a learning process two ways. C4 brought her professional level of expertise that complimented the local IHS and other agencies that were working with the community at that time.

Jack O’Donnell As Mac touched on, teen suicide is a very difficult issue for everyone involved. It is tragic for someone so young to feel such desperation. And at the same time, it is very often difficult to see the warning signs. A comprehensive training and awareness programme based on early intervention seemed logical to take place in the schools. But an equal core element of the programme C4 designed was the inclusion of the entire tribal community with a deep understanding and appreciation of the rich cultural history of the tribe.

To dive deeper into this programme, for today’s panel, we are joined by Mac Hall and experiential educator, Celeste Rabago.

Celeste Rabago (speaks in Diné) As a Diné woman, we’re asked, when we introduce ourselves, we introduce who we’re related to and all relations. And that’s actually part of K’é. What it means is building relationships. And part of that is connecting our clanships with other people. And as me, as a Towering House, it’s Kinyaa’áanii.. So, I come from Kinyaa’áanii with my matrilineal, from my mom’s side. And from my father’s side, I come from the Big Water clan. So, those are the two clans that represent who I am.

Jack O’Donnell Tell me what your role was in this project.

Celeste Rabago So, the position I had or I still do work with National Indian Youth Leadership Project, I work as an experiential educator at the time when we were doing the K’é project.

Jack O’Donnell I’m just trying to put myself in your shoes. And, you know, it must have been horrible watching this issue unfold with the tribe. So, tell me, if you can, why you believe that this issue became so pervasive at this particular time and with this particular group of vulnerable young kids.

Celeste Rabago As an Indigenous woman, and also as Indigenous being, we come from a line of historical trauma. We come from a line of just history. You know, colonization. And, unfortunately, that comes down generation after generation not knowingly. Me, as an adult woman, I could say myself, I didn’t see I had trauma until I was an adult, ‘til I could see that, you know, a lot of what the students are feeling. They see their parents either making wrong choices, neglect, or trying to run from whatever mental state that they’re in. And, unfortunately, a lot of the times they go to drugs and alcohol. So, you know, to say that it’s something in the norm, it is unfortunate. So, that’s why we as NIYLP, a lot of our staff see that so clearly, because we – we relate to a lot of our students. And I feel like when we see that, it’s more that we comfort and that we understand and that we’re there.

Jack O’Donnell Yeah. I mean, it sounds very much like a generational issue, which – which happens with a lot of mental health issues today, whether it’s addiction or suicide. If it’s in your past and you’ve witnessed it or heard somebody that suffers that, you know, it winds up a pattern that repeats itself.

You know, this seems like when the project began that it was such a logical thing that, you know, the tribe and the community would embrace itself with. But, Mac, I did hear that it really took at least a year to get this programme launched. Was that just the logistics? Or was there some resistance locally or at the tribal level to – to undertaking this – this effort?

McClellan Hall Yeah. I think there’s a sort of a inherent distrust of outsiders coming in to help tribal people and especially, at the tribal leadership level, the president’s office on down. I’ve experienced that myself, just having a non-profit that works with the tribe and tribal communities and tribal programmes. You run into people who are distrustful and mis-… You know, just suspicious. And it’s kind of hard to work sometimes in that environment. And so, this was actually pretty amazing that it happened in the timeframe that it did. It could have been a lot worse, I think. But there was some resistance to it, I think. And we helped to clear the way a little bit, because we have our main offices in Gallup, just a short ways from Thoreau. And we have a long history with the Navajo Nation. But leadership changes every four years or so. So, this time around, it was – it was fortunate that everything came together as quickly as it actually did. So, things could get done and programmes could be put in place.

Jack O’Donnell Yeah. I mean, and in a sad way, I guess, the acute nature of this problem probably helped move this along. You know, just because it was such a tragic thing for – for the community to watch.

You know, Celeste, you know, once this programme did get launched, you know, what was the reaction from the teachers in the community early on? You know, were they… Did they embrace it? Were they hopeful? Once they decided that they were going to do the programme, did they really want this to happen?

Celeste Rabago I think the teachers were very hopeful, because they themselves, as teachers, have experienced loss, seeing the, you know, students every day and then all of a sudden it’s like they don’t see their students anymore. And so, I think the teachers at this point were just very hopeful that there was intervention coming and there was something that was going to help their students and support their students. And also because, as I – as I said in the beginning, building relationships like the clanships, but also as, as an Indigenous person coming in and being from the Diné Nation as well, I felt that I was welcomed. You know, and also we did a professional development with all the teachers beforehand. Before we even worked with the students, myself and two other of our staff. They came and we did a professional development just so they can understand and see how we’re going to be working with our – with their students. And also that if they had any questions, they could ask us. But I felt like the support at the school, we had great support from the principal there. At… Through middle school, we had great support from the counselors and the teachers.

Jack O’Donnell If you could, tell me a little bit about the logistics or the path, so to speak. What happened when an individual was identified as at-risk? How was that person processed or – or – or comforted or whatever you might call it at that point?

Celeste Rabago When we worked with the students again, it was really building a relationship with these students. We don’t just go in and, like, “This is who we are. This is why we’re here.” It’s more about building relationships with activities and getting to know new initiatives. And the more we built that relationship with the students, myself and three other staff, the more the students were likely to come to us and let us know if they were feeling down or if they just had a rough day. Because in the beginning, we always talk about our group values. These are our group values. This is how we uphold each other. And it’s okay that you’re having a down day. Like, if – if you’re having a down day, then it’s really good that you come to us and say, like, “You know, I just don’t feel like participating, but I’m going to be here.” You know? So, that way, they have that comfort of telling us how they’re feeling.

And if we saw someone at high risk, then we would just kind of take them to a side, check in with them personally, one-on-one. If we felt that it was more mental or thoughts, then we would bring in the counselor. And there was just this… I don’t know how you would call it, but this chain of command of the if we did one-on-one and we had a radar of something happening, then we would go to the counselor. And then, the counselor would pull in the student and then deal with the student by just talking to them.

Jack O’Donnell But it sounds like you kept the student within the safety of the school itself. You didn’t isolate that student from the population. Was that part of the programme?

Celeste Rabago Yeah. It’s more about inclusive rather than isolate. Like, if, for instance, if a child was out of line or they’re talking or they’re being rude to another student or backlashing against us, we just go back to the group values and bring in upon the big group, not isolating or not, like, pointing out one person. It’s saying, Hey. You know, like, I want to go back to our group value of being here. What does that mean? Do you feel like we’re being here right now? And they’re like, No or it’s I’m – I’m really feeling, you know, uneasy. And one of our group values is being safe. Is that being safe right now? And really giving it to the group to have that dynamic to talk to each other, talk to us. That’s why it’s always… For us, as NIYLP, having the group values and building that relationship from the beginning is very important.

You know, we use that word k’é. It’s a sacred word. A lot of people can see it as just, like, building relationships and that’s it. But for me, I grew up learning that k’é is more than just building relationships. It’s family. It’s sacredness. It’s bringing us together. So, at this sensitive time, when we were starting this project, we had to come with that mind of a relationship-building. Like, talk to these children as if they’re our own, as if they’re our little brothers or little sisters. And that’s how we have to continuously look at that, that they are family.

Jack O’Donnell You know, it’s interesting to me, because some of the jargon that goes on in mental health and addiction today is shame reduction. And this seems like this was the earliest stages of shame reduction. Shaming gets you nowhere. So, you bring people in and comfort them. I just think it’s a, you know, a beautiful concept that you folks were way ahead of.

Ultimately, this programme was successful. What were the results early on and where does it stand today?

McClellan Hall You know, I’m not really sure. I know that we still have a relationship with the Thoreau middle school and high school and have brought grants in to keep our piece of the programme going. And I don’t know really what the carry-over has been in the community. We work in so many different communities all over the US and Canada and Hawaii. And so, even though we’re twenty miles down the road or less, we’re not really informed about what goes on in that community. But we’ve maintained our relationship with that school. And we haven’t had suicides in our programmes anywhere over the last thirty-some years. We don’t. It just doesn’t happen.

And so, the relationship building that Celeste was talking about is one of our core values. That’s how we operate. We – we do treat these kids as if they’re our own kids or our siblings. Little brothers and sisters and things like that. And we helped them build a relationship with each other, too. Understanding the clan system and who’s related to and how all that works. We’ve – we’ve just done a lot of research into what goes on in the traditional rites of passage ceremonies. And we include that in our curriculum. And we talk to kids about gender specific issues and how to respect. Boys and girls respect each other. And all that stuff is part of our curriculum. And a lot of those kids are not getting that at home. And so, we’re – we’re filling in some gaps there that for the families. These things happen in lots of communities everywhere. They’re happening all over the country, on – in reserves in Canada and in Hawaii and other places. And so, we’ve – we’ve come to create a model that really works.

Jack O’Donnell You know, an incredibly successful story. If you go from sixty-three deaths, you know, in one year to one of which you’re saying you don’t have them anymore. That’s pretty amazing. Has – has the programme been duplicated in other areas? Have people come to look at this model and say, “Hey. Teach us.”

McClellan Hall It’s been replicated in close to a hundred sites across the US and Canada and Hawaii in the last thirty years. And we do trainings every year multiple times. We have the highest level of evidence-based status of any Native programme in the US. And it’s totally based on wisdom of the elders that we work with. And they told us how to work with kids and how not to. And we really took that to heart and built a programme around it. That’s had the highest level of recognition in the country.

Jack O’Donnell Well, I think that that cultural understanding is… You’ve both made it very clear that that’s critical to, you know, to the success of this programme. And – and I think it’s also probably very significant that – that this programme continues to exist, because it’s Native people promoting this and you don’t have that initial resistance when you go into a community. Well, we were certainly proud to help get it started. But we know that, you know, that you folks are – are the folks doing this great work.

You know, I normally just close by saying, “Thank you. We’re proud of you. We love the work that you’re doing.” But I’m also going to give you an opportunity to say, you know, anything else you guys might want to add to this today.

McClellan Hall Well, one of the things I want to add is my – my mentor for the last thirty-five years is an old Cherokee man. A medicine man, healer. He’s ninety-one years old now. And when I – I came to him originally, after I had a dream that I didn’t understand back in the seventies, and when I met him in the early eighties, got to be friends with him, and he translated this dream. And it was this programme that came out of my dream. And so, he said, “Basically, this is what you’re being asked to do.” And I’m forty years into it now and still going.

Celeste Rabago I just want to say thank you for this opportunity and also for NYILP and Mac and all the staff who continue to strive to do this work, even in this time that we are now. That we’re still just keeping in touch with our students. And just – just for an update with the Project K’é, a lot of those students that we worked with are now in our mentor programme, in ninth through twelfth grade. We just had our graduating class two years ago that went through the programme and continued to be our mentors. And then now, you know, living life. But it’s still nice to see that a lot of those students continue to reach out to us and keep us updated on their lives and they continue to want to be in our programme in high school. So, it makes us happy that we can continue to be a part of their lives.

Jack O’Donnell From writing the grant in 2011, C4 not only stayed involved through 2014, but implemented a training programme that gave Project K’é the ability to last. Designed to include community events, Project K’é really took the unique cultural needs of the Navajo Nation into consideration. While this was a successful project, there’s still more need for such programmes today as Native American teens continue to face the devastating issue of suicide.

I don’t want to be corny at the end, but you’re both lifesavers. Your organization has literally saved lives. And I think on behalf of – of – of the students’ lives that you’ve saved, I’m sure that we all would say thank you. And I look forward to seeing this programme continue to grow. And I thank you both for your time today.

Jack O’Donnell Thank you for listening to this week’s episode of the C4 Recovery Solutions podcast, brought to you by C4 Recovery Foundation. For more information, please visit our website at c4recoveryfoundation.org or email us at contact@c4recovery.org. You can find both our email address and website in the show notes.

Be sure to rate, review, and subscribe on Apple Podcasts, Spotify, Stitcher, or wherever you like to listen. I’ll see you next time on the C4 Recovery Solutions podcast.