A multiyear public health program successfully reduced the rate of suicidal attempts among teenagers living on an American Indian reservation, according to a “look-back” study.

During the program, designed to reduce teen suicide and educate communities about suicide and its related problems, such as child abuse, the number of self-destructive acts dropped by 73 percent, but suicide deaths stayed relatively constant.

This “remarkable downward trend” in suicidal behavior is “indicative of the program’s success,” Dr. Philip A. May of the University of New Mexico in Albuquerque and colleagues write in a report in the American Journal of Public Health.

Similar programs may also help decrease suicidal behavior among other American Indians and Alaskan Natives, the authors suggest.

The report is based on results collected from teen members of an unnamed American Indian Tribal Nation in New Mexico. In 1988, the annual rate of suicides and attempts among tribal members was 15 times higher than in other Americans, and 5 times higher than in other American Indians living in New Mexico.

To address the problem, the tribe established a suicide prevention program in 1990 targeting teenagers and young adults. As part of the program, experts and community members helped identify people at risk and provide them with mental health services and other resources to discourage them from suicide, while educating the community about the signs of and problems underlying suicide.

As part of the study, May and his colleagues looked at suicidal behavior among 769 people ages 10 to 24 in 1990, and 829 10- to 24-year olds in 2000. Eighty percent of people aged 16 and older were unemployed.

In the first two years of the program, the number of suicidal attempts per year fell from close to 20 to less than 9, and dropped to only 4 attempts in 2002. However, from 1988 through 2002, the rate of completed suicides remained at 1 to 2 per year.

Close to half of suicidal gestures and attempts occurred in women, but men made up all but 5 percent of suicidal deaths.

Two-thirds of self-destructive acts were linked to alcohol, and most people who exhibited suicidal behavior had a family history of trauma, such as abuse or violent death. Most people who committed suicidal acts were unemployed.

SOURCE: American Journal of Public Health, July 2005.