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By Elyse Wild
February 28, 2026
Native youth die by suicide at rates 91% higher than the general population. Tribal communities are turning to culturally centered treatment — combining ceremony, traditional practices and mental health care — to address a crisis rooted in generations of historical trauma.
Growing up on the Navajo Nation, Diedra Yellowhair heard only whispers of people in her community dying by suicide. In traditional Diné beliefs, speaking about the deceased is thought to beckon more death, and dying by suicide was taboo.
“In my generation, when I was younger, middle school, high school, suicide wasn’t something that was openly talked about,” said Yellowhair, an assistant professor and research faculty member in psychiatry and behavioral health at the University of New Mexico.
That silence masked a growing crisis. Today, Native youth die by suicide at rates 91% higher than the general population — the highest of any demographic — according to the Centers for Disease Control and Prevention. It’s the second leading cause of death for American Indians and Alaska Natives aged 10-34.
But tribal communities are breaking that silence by turning to culturally centered treatment that blends ceremony, traditional practices and clinical care. The White Mountain Apache Tribe cut its suicide rate by 38% using a model built by tribal elders that makes every resident a mandated reporter and deploys emergency response teams alongside cultural teachings.
Today, tribal communities have developed culturally appropriate ways to discuss suicide without violating traditional laws around honoring life, Yellowhair said.
“I think that the reason we’re hearing more about suicide today is that many of our tribal communities have found culturally appropriate ways to talk about it, without inviting that sense of violating those natural, traditional laws around honoring life and celebrating life,” Yellowhair said.
Underfunded Federal System Leaves Gaps
An October 2024 study found that Native adolescents have the highest suicide rates of any group, and they may have the least access to resources to help them.
The Indian Health Service — the federal agency responsible for providing health care to American Indians and Alaska Natives — is underfunded by tens of billions and chronically understaffed, leaving Native youth without mental health care they are entitled to under treaty rights.
From 2000 to 2018, suicide rates climbed steadily across the United States before rising again in recent years. Studies suggest contributing factors: the opioid crisis, dwindling social safety nets, economic downturns and the rapid expansion of social media use among youth.
Several tribal nations are suing social media giants for their roles in harming the mental health of youth in their communities.
Private messaging channels on social media or burner accounts can create isolated spaces where bullying thrives, Yellowhair said.
“I’ve heard kids come in (for therapy sessions), talking about what happened on Snapchat, or what happened in direct messages on Instagram,” Yellowhair said. “It’s not public, per se, but it happens in these back-channel rooms of social media, and kids just don’t always have the tools to recognize social media bullying, how to stop or disengage from that content.”
For Native youth, many bearing generations of historical trauma, social media is an accelerant.
Dr. Mark Standing Bear Baez (Coahuiltecan Tribe) is the president of the Society of Indian Psychologists and an associate professor at Bemidji State University.
“Our youth carry the weight of historical harms,” Baez told Native News Online. “It’s looking at how we navigate modern pressures, what is happening on social media, isolation and even racism.”
Historical Trauma Creates Intergenerational Risk
From 1995 to 1997, more than 17,000 patients in a Southern California health care system were surveyed about their childhoods during their annual physical exams. Called the Adverse Childhood Experiences study — ACEs for short — it is now the gold standard in linking childhood experiences with health outcomes, both physical and mental.
The ACEs survey is made up of 10 yes or no questions addressing abuse, neglect and household dysfunction. Every “yes” equates to one point, resulting in a score along a scale that can tell us someone’s risk of developing certain chronic diseases, social, emotional and mental health disorders. A score of four or higher is associated with a higher risk of suicide, and Native youth score four or higher more often than any other demographic.
In many cases, ACEs are intergenerational. Parents with ACEs have poorer mental health outcomes that result in negative parenting behaviors, creating a cycle that passes on ACEs from generation to generation.
The flipside of ACEs are protective factors — social connection, community engagement and resilient parents — long embedded in Native cultures.
“Extended family and tribal kinship networks were essential, but it’s important to know that it also buffers despair,” Baez said.
The boarding school era violently disrupted those protective factors, removing generations of Native people from their communities and severing kinship networks. The widespread abuse that took place at the boarding schools has been the subject of national investigations.
“Children were being raised in boarding schools by strangers with no understanding of kinship systems or language or traditions and culture, and really introduced a different type of upbringing and discipline,” Baez said. “Those parents raised a whole new generation of parents, then those parents had children, and you see how it begins to impact generation after generation.”
That historical trauma, paired with cultural beliefs that often reject the notion of dying by suicide, can make mainstream treatment that may be successful in other communities miss the mark in Indian Country — similar to trying to fit a square peg in a round hole, Yellowhair said.
“Professionals have come into communities thinking they have the solution for us without fully understanding our culture, our ways, why suicide might be so taboo, and it just doesn’t work,” Yellowhair said.
Pushing for Indigenous-Centered Care
A few years ago, Baez was speaking in Arizona about incorporating Indigenous practices into evidence-based mental health care, and he was surprised to see that a renowned psychiatrist he admired was in the crowd.
“I was blown away,” Baez told Native News Online. “He’s well known globally, and he liked what I was talking about.
But when he had the chance to speak to the psychiatrist, Baez’s elation turned to disappointment. Perhaps the issue was less that evidence-based practice needed to be culturally competent for Native people, and more that Native people didn’t want to heal, the psychiatrist told Baez.
“He said, ‘I’ve been doing this before you were born. I’ve kind of been around the block — it could be maybe that your people are not ready,’” Baez recalled.
That attitude is exactly what Baez and his peers are trying to change. In 2008, Baez created the Sweetgrass method, which combines evidence-based practices with Indigenous methodology.
“Who loves to sit in pain, who loves to embrace all of the hardships?” Baez said. “Quite the contrary. We know joy. We know happiness, we know the importance of healing, but maybe it’s just the way it’s being delivered.”
Dr. Mark Standing Bear Baez (Photo/BSU)
Reconnecting Culture and Prevention
Shelby Rowe (Chickasaw) spent her early adolescence in a school in Oklahoma with a large Native population. Her mother was a weaver who took her to events where she reveled in being surrounded by Native artists and their wares. She was a good student, involved in school, and communicated openly with her family. But, when she was 15, something shifted.
Rowe was staying with her great-grandmother when the matriarch went into heart failure. It was the middle of the night in rural Oklahoma, and the volunteer ambulance in the area didn’t run from midnight to 5 a.m., so Rowe called neighbors to bring them to Seminole, the nearest town with a hospital. That night, her great-grandmother died.
In her grief, Rowe felt crushed by guilt that she didn’t act fast enough, that her great-grandmother’s death was somehow her fault. While her family mourned their loss, Rowe hid her suffering.
“We joke in tribal communities about being stoic,” Rowe said. “But sometimes the feelings are so deep you just don’t have the capacity to process them.”
One night, Rowe made a plan to end her life.
“I was overwhelmed with depression and grief and guilt,” Rowe said. “I was like, ‘Well, I don’t know how to fix this, I don’t know how to make this pain end. So I’m going to take my life.’ At the root, I wanted help more than I wanted to die.”
While Rowe did not act on her plan, untreated depression and guilt festered in her. By the time she was 19, she had two young children and had lost her husband to an accidental shooting. In the following years, she grappled with suicidal ideation and survived one suicide attempt. She emphasizes that not getting treatment as a teenager led to those challenges that persisted into her adulthood.
Shelby Rowe. (photo/courtesy)
“I was still alive,” she said. “But I developed self-destructive habits and had just no self-worth.”
Today, Rowe is the program manager for the Suicide Prevention Resource Center at the OU Health Science Center and serves on several boards focused on supporting mental health services in Native communities.
“I think we’re getting better, and there are so many incredible programs happening across Indian Country right now to help save lives,” Rowe said, noting that equipping tribes with the tools they need is more sustainable than the federal government “swooping in to save the day.”
“Tribes have kept our communities and families safe and healthy and thriving for millennia,” she said. “It’s about helping us to reconnect with the things we did to help everyone feel like they had a purpose and that they belonged. There are some real systemic factors that contribute to making someone feel like they don’t belong, that their life is a burden, and we’ve seen in communities where they’re embracing culture and that everyone has a place, that suicide risk is going down, but it’s hard work.”
Rowe points to the Celebrating Life Suicide Prevention model, established by the White Mountain Apache tribe in 2002 after a spike in youth suicides. The model uses sovereignty via tribal law that designates all people living on the tribe’s Fort Apache Indian Reservation in Arizona, as mandated reporters — meaning any individual who recognizes suicidal behaviors and substance abuse must report it to the tribe’s suicide task force. The task force follows up with emergency response and individual case management.
The program was built from the ground up with guidance from elders to incorporate cultural teachings and practices, Francene Sinquah (White Mountain Apache Tribe), an assistant scientist at the Center for Indigenous Health, told Native News Online last year. Celebrating Life is credited with lowering the community’s suicide rate by 38%.
“I think a lot of that [success] is when you are struggling and feeling that you don’t belong, you’re feeling hopelessness and despair, having other people in your community show up and say, ‘Hey, we care about you. We’re not going to give up on you.’ That connection is huge,” Rowe said.
The science backs that up. A 2025 study that surveyed 197 Native youth to examine protective and risk factors showed that communities with cultural programming that facilitated strong familial and social connections were likely to see lower rates of suicide.
“Working with youth, ceremony, prayer, smudging, they’re not add-ons, they’re core systems of care, it’s medicine,” Baez said. “Our culture is prevention.”
Years ago, Baez was contracted by the Bureau of Indian Education to work at a tribal school struggling with behavioral issues among its students. The community endured several suicides during his tenure.
Most of the faculty were non-Native, Baez said, and the absence of culture was apparent. In the fall, the school board asked Baez to help the students put on a summer solstice ceremony.
The tribal council enthusiastically approved the idea, and the youth were excited to perform, but there was a major challenge: no one knew the dances, no one had the regalia, and no one knew the traditional songs.
“But someone did know — the elders knew,” Baez said. “A lot of the elders felt that no one needed them anymore. I wanted our elders to know that you are sacred and you hold our knowledge, and I wanted our children to know how much power and knowledge and how many paved roads the elders created for them.”
Over the course of months, elders in the community worked with the youth to make regalia, build instruments, learn songs and dances and language. By spring, the entire community showed up for the ceremony, where their songs and dances filled the air for the first time in decades.
“I took a step back, and I just looked at what was happening,” Baez said. “And it was bigger than a performance; there was healing that took place that day. I’ll never forget it. Even months after, the students kept asking, ‘When are we going to do this again?’”
Elyse Wild reported this story while participating in the USC Annenberg Center for Health Journalism’s 2025 National Fellowship.
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About The Author
Author: Elyse WildEmail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Senior Health Editor
Elyse Wild is Senior Health Editor for Native News Online, where she leads coverage of health equity issues including mental health, environmental health, maternal mortality, and the overdose crisis in Indian Country. Her award-winning journalism has appeared in The Guardian, McClatchy newspapers, and NPR affiliates. In 2024, she received the inaugural Excellence in Recovery Journalism Award for her solutions-focused reporting on addiction and recovery in Native communities. She is currently working on a Pulitzer Center-funded series exploring cultural approaches to addiction treatment.