Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could better evaluate suicide risk in AI/AN youth?

Method: A rigorous literature search was conducted from November 4, 2020 to January 27, 2021. This review sought to develop a further understanding of key risk and protective factors for suicide risk in native youth, the characteristics of youth at risk, and suicide prevention efforts along with efforts to develop a culturally appropriate suicide risk assessment survey to potentially decrease the incidence of suicide in AI/AN youth.

Key findings: Barriers to mental health resources related to stigma, location, and AI/AN culture contribute to increased suicide risk. Factors and characteristics found to increase suicide risk include: altered family structure, substance use, violence, racism/discrimination, historical trauma, and suicide exposure. Features that buffer against suicide include: cultural practices and identity, and healthy relationships with family and community. Existing scales have been utilized to study ways to influence risk and protective factors that could prove beneficial to developing a culturally sensitive risk assessment instrument.


Patricia Young

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing


Rights Statement

In Copyright