After conducting research for the Kiowa Tribe’s Injury Prevention program five years ago, Amy Cozad made a startling discovery about Caddo County, Oklahoma youth in the 15-to-24-year-old age range. “I found that youth suicide had been high—the second-leading cause of death for close to 20 years,” she says.
It was from this research that the Kiowa Teen Suicide Prevention (KTSP) program began as an effort to decrease suicides of not only American Indian teens, but all youths in southwest Oklahoma. It began as an official resolution of the Kiowa Business Committee in 2005, and was placed under the Kiowa Tribe’s Injury Prevention Program. By 2007, KTSP became a stand-alone program. Cozad now serves as the KTSP Director and as the Kiowa Tribe’s injury-prevention specialist. “When I started to do research and collecting data not only for our area but for the state as well, I found that Caddo County had ‘suicide clusters,’?” she says, explaining that a cluster is when many suicides occur within a small population and create an increased risk for more suicides in that group. For this reason, one of KTSP’s functions is to offer group-counseling sessions for the family and friends dealing with a suicide. “A lot of people forget about the survivors, because suicide is one of those hush-hush situations,” she says. “It leaves the survivors hurting and alone. It’s really important for us to get together as a community and try to help, try to make them feel they have support and resources.”
Some of the contributing factors in Caddo County’s high suicide rate KTSP has identified thus far include substance abuse, high levels of poverty and the breakdown of the family structure in many homes. Another important factor mentioned by Cozad is “historical trauma,” psychological trauma occurring over generations that can have negative, far-reaching effects on present and future generations. Applying the concept of historical trauma to American Indians was first done by Lakota psychologist Maria Yellow Horse Braveheart in the 1980s.
One of the primary components of the KTSP program, which offers classes in the Fort Cobb-Broxton and Boone-Apache Consolidated School Districts, is teaching life skills and coping mechanisms as alternatives to suicide. These include improved communication, problem-solving skills, depression and stress management, and finding positive outlets for anger.
Their model is adapted from American Indian Life Skills Development Curriculum created by Dr. Teresa D. LaFromboise. KTSP Community Liaison Glenn Beaver says this curriculum prepares students for challenges they face in real life. “From the time I was a teenager to now, kids are dealing with so much more,” he says. “It’s a ‘right-now’ society. You get your news right now. You get information right now. They’re so bombarded with a lot more. The Life Skills program allows a person to handle situations a lot better, because they’ve already had practice and already had examples of how to would handle that situation.”
The KTSP Life Skills classes were implemented in 2008 in the Fort Cobb-Broxton School District after a murder-suicide in that community. KTSP screened students using Columbia University’s TeenScreen testing system and found that at least 30 percent of the tested students had potential suicide risk factors that included ideation—the detailed thoughts and contemplation of a suicide act. This year, the ideation risk factors have decreased in Fort Cobb-Broxton high school students to two percent to three percent.
KTSP focuses its efforts not just on teens, nor only on Kiowa tribal members. With Caddo County being a part of six other tribal jurisdictions—Comanche, Apache, Fort Sill Apache, Wichita, Caddo and Delaware—KTSP works with all ethnicities represented in southwest Oklahoma. Cozad, whose background includes work as a critical-care nurse, says it is not within her training to be selective when helping others in a crisis situation, and when the Kiowa Business Committee created this program, it stressed the importance of helping all people. “If somebody came into the ER, I couldn’t say, ‘I can’t work on them. They’re not Native,’?” explains Cozad. “It just didn’t make sense to me. My children go to school with other races of children. If they’re friends with that child and they are having depression—cutting or any kind of issues—it is going to affect my child as well. We have to really come out of that old mind-set of only just helping our people by helping everyone around us.”
Other efforts by the program include a public relations campaign that includes a large billboard with the program’s contact information on Mission Street in Anadarko and television commercials on ABC affiliates in Lawton, Oklahoma City and Tulsa. KTSP also hosts an annual contest pow wow centered on suicide awareness, with PowerPoint presentations and counselors on hand to help those directly or indirectly affected by suicide.
Other methods of creating suicide awareness by KTSP include the holding of youth and adult trainings in “QPR”—Question, Persuade, Refer—as a method of identifying those who may be suicide risks.
Part of the initial funding for the program was through a sub-grantee award from the Oklahoma Department of Mental Health and Substance Abuse Services. KTSP recently created its own sub-grantees through receiving a Garrett Lee Smith Grant as part of the federal Substance Abuse and Mental Health Services Administration. Smith, the son of U.S. Senator Gordon Smith (D-Oregon), took his own life shortly before his 22nd birthday after a long battle with depression.
“The sub-grantee awards were basically to help further the services,” said Cozad. “We understand that we can’t touch everyone. These other organizations have been involved or are interested or work with that target population or with adults who work with those youth that could benefit from this grant as well.”
The recipients of these awards include 4 the People, Inc. counseling services; Agape Faith Worship Center; Apache Tribe of Oklahoma; Fort Cobb-Broxton Junior High School; and Riverside Indian School. Each recipient receives $20,000 for the first year and $40,000 for the second year to promote suicide awareness.
Both Cozad and Beaver believe that one of the strongest deterrents to suicide is a stronger extended-family structure, not only within the confines of Caddo County, but throughout Indian country. “We used to have societies and different organizations hundreds of years ago that we could go to for help or guidance,” Cozad says. “I think if we start to bring that back and start caring for one another again, that will help the situation.”