Choosing life: Native American youth face higher suicide risk
Like most young people, Coloradas Mangas wonders about his future.
He imagines working as a museum curator or as a park ranger at someplace like Yellowstone National Park. Even better, he'd prefer to stay close to home on the Mescalero Apache Reservation and work at the nearby Guadalupe Mountains National Park.
It is autumn 2014. The late afternoon sun sets a grid of light on Mangas' face. With rectangular glasses and long black hair brushed out down his back, Mangas taps slim fingers against the surface of his desk, politely resigned to be talking with a reporter.
And so he begins a story about survival.
Long ago, in a cave within the Guadalupes, two boys hid from chaos. Fleeing from an ambush, the people couldn't bring along the boys, one lame and the other blind. They bundled them in the cave, with food to help them survive until it was safe to return. After a while, their food cache dwindled and the boys feared no one would come for them. Then they heard a sound from the back of the cave. Four deities emerged to stave off sickness, starvation, evil. They saved the boys, reuniting them with their people.
Today, the Mescalero Apache perform crown dances in honor of those spirits, Mangas explains, during times of difficulty, sorrow.
Today is such a time, some say, as Native American youth in New Mexico are dying by suicide at an alarming rate.
For years, Mangas has battled the sorrow. As a Ruidoso High School sophomore in 2010, he spoke against the silence and the stigma that surrounds youth suicide.
In the two years previous, groups of teens on the Navajo Nation and the Mescalero Apache reservation had died by suicide, news that made headlines. At the time, reports tallied nine deaths in the two communities.
That spring, Mangas was one of several Native speakers to appear during a hearing of the U.S. Senate Committee on Indian Affairs, where he ticked off name after name of those who had died during his 16 years.
He testified about the night he checked his phone at a youth meeting of the Mescalero Reformed Church: “I got a message I never thought I would get, a text message from my friend saying she loved me and that I will always have a place in her heart,” he said.
He called the police, he said, but no one responded.
So Mangas went to the forest and searched until midnight: “I looked everywhere, every tree, and I found her. It was a good thing I found her when I did. Otherwise, she would have been gone forever.”
Mangas told the senators a boost in mental health services was needed. So was streamlined Medicaid approval for people who are referred to residential treatment centers. He wished the tribe would build places where young people could hang out and have fun. And he called out Native people for their silence.
“I am also from a new generation of young men and women who believe in breaking the silence and seeking help,” Mangas told the committee. “I believe in change.”
Higher suicide rates
Almost five years later, Mangas is still waiting.
Employed part-time by Systems of Care – just a stone's throw from the squat Indian Health Services hospital that serves the reservation — he works with young people and their parents, talking about coping skills, drugs and alcohol, and suicide prevention. His work there isn't funded by the tribe, but through a federal grant and the University of New Mexico.
“It's not just Native people that face issues like this. Hispanic people face issues like this, Anglo-American people, African-American people – all these other ethnic groups face the same thing,” Mangas says. “We need to work towards trying to prevent suicide for everybody's children.”
Many experts echo his belief that all people face issues that could lead to suicide. But New Mexico's Native youth suicide rates are commonly more than twice as high as those seen in other ethnicities.
To complicate matters, accurately tracking those numbers has proved difficult. An analysis by New Mexico In Depth found that two databases maintained by separate state agencies have differing totals for Native American youth suicides. According to New Mexico vital statistics data kept by the state Health Department, 201 Native Americans between the ages of 9 and 24 died by suicide in New Mexico between 1999 and 2013, the most recent year represented in the database. Meanwhile, the state's Office of the Medical Investigator (OMI) has records of only 161 investigated deaths of Native American youth between 2000 and 2014.
New Mexico in Depth's analysis suggests something else, too: both databases underestimate the true number of Native lives lost to suicide.
But without better data collection, no one can know the true extent of the problem – and young Native people across New Mexico will continue to die.
Many factors contribute to the apparent incompleteness of official statistics. Investigators from OMI lack jurisdiction on federal or sovereign tribal lands and can only investigate reservation deaths when tribal officials invite them to do so. On the Navajo Nation, which crosses four state borders, that means sometimes New Mexico might investigate deaths in Arizona. Even when tribal investigators ask OMI for help, families do not always cooperate. Suicide is stigmatized and taboo; some traditional Natives frown upon autopsies. Loved ones won't always disclose suicide notes to OMI investigators, who are often “outsiders” – Anglos or Hispanics from non-tribal communities.
Often, possible suicides are left unresolved with an “undetermined” cause of death, or they're categorized as accidents. Investigators' opinions about the manner of a death (such as suicide, homicide, or accident) aren't necessarily what's entered on a death certificate. Suicides recorded in the state Health Department's vital statistics database do not always appear in OMI records, and vice-versa.
Studies also show that death certificates, and other government records, frequently misclassify Natives as Hispanic — particularly in urban areas.
The lack of solid data is even more complicated in places like Thoreau, N.M. and communities around it, where a patchwork of state, county, federal and tribal jurisdictions in the Navajo Nation's “checkerboard” country prevents community members and health workers from knowing the exact numbers of suicides over time. The tribe has some numbers. State agencies have others. Other possible suicide deaths may be reported as “undetermined” or as accidents. Reviewing OMI records, New Mexico In Depth also found that Native communities have experienced suicide clusters — a series of two or more suicides in a given area over the course of a year or less.
The suicide clusters on the eastern Navajo Nation and the Mescalero Apache reservation made headlines in 2009 and 2010. But in a review of OMI death investigations conducted between 2000 and 2014, NMID also found evidence of possible Native youth suicide clusters in Gallup, Farmington, the Pueblo of Laguna, and on the Jicarilla Apache reservation.
Roots in Historical Trauma
The death of a young person is demoralizing — for families, peers, and communities as a whole. The loss of even one child — one future leader, spouse, parent, grandparent — can make a tiny tribe's future less certain. A cluster of two or more suicides can devastate a generation.
So few Indigenous people remain today, that every young person is precious, says Corrine Sanchez, who grew up in the Pueblo of San Ildefonso. Sanchez is the executive director of Tewa Women United, a nonprofit serving women and families in Española. The 2010 Census pegged San Ildefonso's population at 527 — and that number includes non-Native people who live at the pueblo. The pueblos of Picuris and Pojoaque are even smaller. Even the Navajo Nation, the largest tribe in the southwestern United States, has a population of only about 298,000. For years academics and public health professionals have used the term “historical trauma” to try to explain the plight of Native people when talking about issues like poverty and health care. Softening the hard truths that lie behind them, those two words can lose their effectiveness.
But Sanchez knows their burden — and she also knows how to explain historical trauma in a way that's hard to forget. At her office in Española, Sanchez moves from behind her desk and pulls out Ziplock bags full of stones.
Pebbles line the bottom of the first, snack-sized bag. She places it inside a larger bag with rocks the size of marbles. And on and on, each bag representing a generation. As the bags get bigger, so too, do the stones.
The rocks represent traumatic events, she says, ticking off the waves of conquest Native people suffered in New Mexico. First the Spanish conquest. Entire villages destroyed and some Native people enslaved. Then came the Mexican-American War; and later the U.S. Army.
Even well into the 20th century, the U.S. government relocated or reorganized tribes. Many Native people left their home reservations and settled in cities, removed from their culture and language. According to the 2010 Census, 25,600 Native Americans live in Albuquerque, away from their homelands and kin. And today, young Native Americans are still prey for the powerful — whether the Catholic priests who allegedly abused children within the Gallup diocese, the men who beat Natives in border towns such as Grants or Farmington, or the schoolyard bullies who tease kids for being different.
Each of these events — and so many more not recorded, often not even spoken of — has weighed down the hearts of generations upon generations of Native people in New Mexico, Sanchez says. And each has accelerated losses of culture and community connection.
When recounting the traumatic events — from enslavement and conquest four hundred years ago to child sexual abuse within the last century's boarding schools — Sanchez's voice remains steady and even.
Finally, she heaves a gallon-sized bag full of stones onto the table.
There's air within each of the sealed bags within sealed bags, Sanchez says. Those gases represent guilt, shame and anger. She explains that her parent's generation grew up with substance abuse and alcoholism. They lost their language. They also began losing memories of old stories and a sense of belonging. “As we pass the bags along, the gas is sealed in — more and more — in each bag,” she says. “People become overwhelmed. They have suicidal thoughts and problems like alcoholism.”
There is hope. But change requires hard work. People must work to heal themselves, she says. To open the bags. To release the anger, guilt, and shame. “We want to protect the most vulnerable, bring back the core values, and honor and strengthen women and children,” she says. “We are ourselves. But we're made up of our past, and the choices we make will affect future generations. We need to think about our responsibility.”
A concentration of risk factors
Over the course of almost two years, NMID reviewed OMI death investigation reports on 161 young Natives' suicides in New Mexico and on the Navajo Nation, including Navajo deaths that occurred across the Arizona border but were investigated by New Mexico OMI between 2000 and 2014.
We compiled data from OMI investigators' reports into spreadsheets for analysis — not to intrude on families' pain or to memorialize lost lives, but to search for clues about why rates are so high among these kids and to get a better sense of what might be done.
Those reports and interviews suggest a concentration of risk factors that lead to youth despair, traditions of silence, and unresolved grief that ripples through families and tight-knit communities, increasing the risk of additional suicide attempts and deaths.
One recent study by public health researchers reveals the concentration of risk factors some youth are confronting.
At a public health conference in Albuquerque last year, University of New Mexico researchers Dornell Pete and Kyle Smith presented a survey they'd administered to more than 1,300 Native Americans from seven New Mexico communities. The survey asked people about their exposure to adverse childhood experiences like problems with alcohol and physical violence at home, separated or divorced parents, a close family member serving time in jail, physical abuse, neglect, and sexual abuse.
The numbers were off the scale.
Twenty-nine percent of those surveyed had been exposed to four or more of those experiences as children.
But even that number might be low. Since the surveys were conducted face-to-face, researchers say they assumed that some were reluctant or embarrassed to keep answering “yes” to the questions.
The use of alcohol can't be overlooked as a possible contributor to the high rates of suicide. It lowers inhibitions, making impulsive behavior and risk-taking more likely. NMID's analysis of OMI records shows that alcohol was present in just under half of the youth suicides OMI investigated in Native communities. But investigators don't always order lab tests for alcohol, so that number may be artificially low.
Social isolation and alienation amplify alcohol abuse and other risk factors for suicide — including mental illness and readily-available firearms. Health care workers and psychologists call it “thwarted belongingness.” That is, feeling like you don't belong within your community, your peer group, or even your family.
It's clear from the OMI records that investigators consider social and family strife as common precipitating events for youth suicide. Those triggers can include a romantic break-up or an argument with parents or siblings. But those triggers don't tell the entire story, says Susan Casias, a social worker who has worked in suicide prevention for more than a decade.
“What was going on earlier?” asks Albuquerque resident Casias, a member of the Jicarilla Apache tribe in Northwestern New Mexico. “There are always additional issues: Was he in school? Did his family support him? And there are additional issues: domestic violence, child abuse and neglect, rapes, alcohol and drugs?”
To be clear, these risk factors occur in all communities and ethnic groups. But their concentration in some Native communities — coupled with the cumulative burdens of generational trauma — puts children there at particular risk.
Stigmatizing communities where people are already grappling with so many of life's challenges doesn't help. But addressing youth suicide demands acknowledging that there are pockets within New Mexico where children are routinely exposed to factors that increase the risk of suicide, including violence, abuse, poverty and alcohol and drug abuse.
Take the case of two close friends who died together on railroad tracks in western New Mexico. One was a victim of a sexual assault, according to the OMI investigator's report. The other had recently lost her remaining parent to an alcohol-related disease. Her foster parent was rarely home.
Initially, their deaths were considered an accident, a game of “chicken” turned tragic on the railroad tracks. But a persistent OMI investigator learned that one teen left behind a note. Videotape from a camera attached to the front of the 95-ton locomotive, along with interviews with the conductor, made it clear: The children's deaths were not accidental.
In another instance, one 14-year old, who was preceded in death by a brother, took his life at the family's trailer. He was found by another brother. The OMI investigator noted that, when asked, the mother “knew nothing about her son, his friends or how he was doing in school.”
Even vigilant and concerned parents can misunderstand what's happening in their children's lives. Or they may not know how to communicate with their teenagers.
After leaving home on foot and staying out until the early morning hours, a teen was chastised by her worried father, according to one OMI report. After her death by suicide, a cousin told an OMI investigator that the girl had been raped the previous evening.
The importance of listening
Listening is important for preventing suicide. Don't tell a child that his or her concerns are silly, advises Casias, the social worker. “Ask what they are feeling,” she says. “Parents need to understand what's important to their kids. A lot don't. Suicide prevention begins in the home.”
There is a lot to talk about.
In many OMI-investigated cases NMID examined, for example, other children and teens discovered youth suicide victims. Kids as young as two and four years old witnessed a father's or sibling's suicide.
Unresolved, chronic grief — including grief over the loss of loved ones to suicide — appears to play an important role in fueling the state's high suicide rates among Natives.
Within OMI records and obituaries, it's plain to see how pain and sadness diffuse through, and persist within, families and small or tight-knit communities, like waves and ripples from a stone heaved into a pool of water. Obituaries frequently note siblings, uncles, cousins, or parents who preceded young people in death.
And in their notes, many OMI investigators mention that the young people who died by suicide had been distraught or depressed since the deaths of fathers, step-fathers, uncles, cousins or friends.
Grief caused by another person's suicide is becoming more widely recognized among researchers as a risk factor for suicide. And it's compounded when grief cannot be discussed openly with others.
That's why Casias and other suicide-prevention workers want to confront longstanding traditions of silence surrounding death and suicide — traditions that can isolate people when they most need support.
Casias says she once saw villagers avoid the mother of a child who had died by suicide: “Some people who knew her came up the (supermarket) aisle behind her, and when they recognized her, they turned around and went the other way.” After a pause, Casias continues: “That's not right. People say it's tradition, but I say, well, can't you break tradition? Because the fact is, this person lost somebody. Would you do that if their grandmother had died?”