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Assessing Suicide and Risk Behaviors in an Incarcerated American Indian Population: Investigating Culturally Sensitive Risk Assessment Instruments and Procedures in a Border Jail, Final Report

NCJ Number
199363
Date Published
Agencies
NIJ-Sponsored
Grant Number(s)
1999-IJ-CX-0016
Annotation
This study determined whether a popular contemporary suicide risk assessment tool is culturally appropriate for use with American Indians admitted into a county jail facility that borders Indian reservations, as well as whether the use of different suicide screening protocols results in a difference in the reliability of detainees' reports of suicide ideation and related risk factors.
Abstract
Two self-report surveys and jail documents were used to ascertain validation data as well as honesty and comfort-level of screening protocols. During the sampling period from October 1999 through January 2000, all new prisoners who gave their informed consent were given a self-report survey after they had been interviewed using the New York Suicide Prevention Screening Guidelines. The sampling period for the second year of research was initiated in October 2000 and continued through May 2001. Additionally, focus groups were convened to review item-level responses to the jail's current risk-assessment tool and to assess process issues. The study found that the prevalence of suicide ideation was the same across Indian and non-Indian groups, a rate lower than anticipated. Validity concordance was low in sensitivity for the suicide risk-assessment screening tool, especially with American Indians. Focus group results suggest the nondisclosure of suicide ideation and other risk factors due to both the wording of the question and procedural and culturally specific issues. The timing of the assessment, the wording of the assessment tool, the establishment of a trusting relationship, and a concerned demeanor were found to increase honesty as well as comfort levels for full disclosure. Indian-specific concepts of community, mental health, loss, respect, "ghost" illness, and direct questioning of negatively framed concepts were found to be influential. The study advises that a "one size fits all" screening tool used in a detached manner will not adequately assess suicide ideation among people of any culture, particularly American Indians. Further research is needed to explore the impact of the timing of risk assessments in the jail environment on a person's likelihood of answering truthfully about their thoughts and intentions. Further, research must assist in the development of rigorously tested assessment tools and procedures that address the specific cultural and social factors identified in this report. 31 tables, 45 references, and appended study instruments and supplementary information
Date Created: November 7, 2003