Bemidji State prof launches new screening tool for Native suicide risk

BEMIDJI — Suicide is a grim subject across all backgrounds, but its risks are keenly felt in Indigenous communities.

The statistics are equally grim: the Centers for Disease Control and Prevention reports in 2022, the second leading cause of death for Native youths was suicide, and the overall death rate from suicide for American Indians and Alaska Natives was 91% higher than the total population.

While prevalent, it’s a difficult subject to talk about in Indigenous communities, said Bemidji State University Professor Mark Baez.

“It's a very, very sensitive topic — a lot of our people do not want to bring up something such as suicide, because we may believe that as soon as we bring the spirit about of death, then we bring it around our people and our community,” Baez explained in a Wednesday, Oct. 1, interview. “So, it's taboo to be speaking about death.”

Baez is a member of the Tap Pilam Coahuiltecan tribe’s Waterbird clan. The Coahuiltecan people share geography with Texas. Baez is also of Mohawk and Pawnee descent. The Mohawk tribe traditionally resided in what is now southeastern Canada and northern New York state, and the Pawnee people are of the Great Plains, now Oklahoma and Nebraska.

Baez has practiced psychology and related fields for more than 15 years across Indian Country and is a published author on numerous papers in his field. In addition to his research and his role as assistant professor at Bemidji State, he also co-directs the Indigenous Students in the Psychology Program at BSU and serves as president of the Society of Indian Psychologists.

After personal loss with family members either attempting or completing suicide, he felt it was imperative to develop a screening tool that addresses the unique factors for suicide risk of Indigenous people.

“It's important that we understand where we came from, and where we overcame and being resilient, but it's also just as important that we talk about generational healing,” Baez said. “That we don't just talk about historical trauma, intergenerational trauma, and say, ‘Thank you all for coming,’ and leave.”

But developing screening questions that set it apart from Westernized assessments, which can often be perceived as culturally insensitive, was no easy task. After consulting with Indigenous peers in his field, he said he went “old school” for further research.

“I needed to go into ceremony saying, ‘Creator, we need to do something about our lives, for those that continue to choose to take their life, and how we can honor who they are and provide support and motivation and strategies to keep them alive and honor their spirit while they are alive?’” he said.

Baez said the elders he consulted with agreed that something needed to be done and helped guide him toward the “how.”

“We need to do it in a way that we do not, one, bring up that spirit. And to me, that's as a psychologist, it's don't retraumatize,” Baez said. “Every time we ask, ‘Hey, you want to kill yourself?’ We're bringing that spirit back up. We have to change the language.”

He said he spent several months developing the screening questions, ensuring they were culturally sensitive and relevant while consulting with Indigenous practitioners until the elders gave him more advice.

“They were saying, ‘You need to incorporate allies,’” Baez said. “And I was a little hesitant— because I'm like, ‘This is why we're in a predicament that we are, is because you have a lot of non-Native individuals that may not truly understand our ways.’ So instead of providing that word or that question that should be presented, they may not ask it because, ‘I'm not Native and maybe I don't want to offend them so let me just kind of bypass that.’

“But the elders were saying, the majority of practitioners across the United States that are administering suicide screening tools are non-Native.”

Consulting with non-Native mental health workers with multiple years of experience of working in Indian Country helped fine tune what’s called the Indigenous Suicide-Assessing-Factors of Event Screening tool, which is about to start its pilot study with tribal agencies neighboring Bemidji.

“We want to make sure that it is able to identify risk factors for suicide in addition to being able to recognize and identify protective factors," Baez said.

After the initial Northern Minnesota study, Baez said the next step is a larger pilot study including tribes across the United States.

“[It’s] looking at the questions, to see if it is sensitive culturally. If it does capture suicide risks, does it also capture cultural supports and/or cultural factors that provide that guidance for the individual? And [we’re] hoping that even looking at some of those steps, we're going to be comparing what they currently use.”

If you or a loved one has thoughts of suicide, help is available. The 988 lifeline is a free, confidential mental health hotline that connects people with counselors 24/7, on matters beyond suicidal thoughts, such as economic worries, substance use disorder, intimate partner violence and more.