Thread by @TracyWesterman

1/How 2 get Indigenous Suicide Prevention Right-A thread from (Westerman& Sheridan,2020).
STEP 1.Define causal pathways: We estab a unique set of risk & protective factors exist 4 Indigenous suicide @ a pop'n level via unique psychometrics (WASCY &WASCA) authorservices.wiley.com/api/pdf/fullAr…

2/ We Developed unique, intervention programs based on pop'n, evidence of difference in risk & protective factors spec 2 Aboriginal people. Some findings from Westerman (2003): 42% of youth (N=323) had suicide ideation; 23% considered @ suicide risk. 20% had made previous attempt

3/ Depression was linked with ideation (corr 0.2), BUT impulsivity had the strongest r'ship with suicide risk (youth correlation 0.80; adults 0.63). THIS IS A SIGNIFICANT FINDING with non-Indigenous suicide causally linked with depression. It informed our unique program content

4/Impulsivity was assoc with a lack of coping mechanisms, specific 2 a proximal trigger (mostly r'ship conflict) & often linked with either alcohol /drugs as an enabler 2 suicidal behaviours or other lack of self-soothing strategies. Distress tolerance skills were there4 taught

5/A high % @ risk had knowledge of some1 who had died by suicide (29.3% of youth & 48.1% of adults). This r'ship was further explored. Findings indicated there needed 2b established impairment as a direct result of exposure 2 suicide. Exposure alone was not enough 2 increase risk

6/The need 2 assess impacts of suicide exposure & respond is possible with the WASC-Y/WASC-A. Just as trauma becomes a central organising principle in the psychological structure of individuals, trauma has become a central organising principle in whole community suicide clusters

7/Known as ‘repetition compulsion’ -meaning individuals with previous trauma r @ incr risk 4 future trauma. Suicide ‘clusters’ r an obvious & common consequence of trauma repetition compulsion. Left unaddressed this can b inherited in2 future generations via disrupted attachment

8/The WASCY/A cultural resilience subscale had a negative r'ship with risk-demonstrating CULTURAL RESILIENCE MODERATES SUICIDE RISK 4 THE 1ST TIME! This provides a better opport'y 4 prevention as not all risk factors (e.g racism) r alterable. This also informed our unique content

9/STEP 2: Get your PROCESS right. Consult on specific community needs & adjust content but risk & protective factors r core content; Deliver across whole communities. Deliver 3 phases min. Deliver across language groups & geo locations. Interpreter's r often used in workshops

10/Outcome evaluate programs 2 test skills uptake; deliver over phases 2 test skills retention between workshops; Deliver content in visual spatial learning pref (acting, videos, mirroring applic'n of skills; invivo coping skills application). Deliver progs in Aboriginal English

11/Separate groups by gender; facilitators match participant gender. Network service providers with community 2 ensure referral pathways r established & cultural supervision of new skills application occurs. Develop service delivery model 2 ensure ongoing service uptake & impact

12/ This is a unique program developed by Aboriginal people 4 Aboriginal people. Its been tested across language groups; outcome eval over time & empirically determined. Its responsive 2 unique needs of each community all of which makes it truly 'community led' & self determined