title: Outcome evaluation of a public health approach to suicide prevention in an american Indian tribal nation.
abstract: OBJECTIVE
  We evaluated the efficacy of 15 years of a public health-oriented suicidal-behavior prevention program among youths living on an American Indian reservation.
  
  
  METHODS
  All suicides, suicide attempts, and suicidal gestures were monitored. Age-specific analyses over time were used to assess outcomes.
  
  
  RESULTS
  Both descriptive and linear regression analyses indicated that a substantial drop occurred in suicidal gestures and attempts. Suicide deaths neither declined significantly nor increased, although the total number of self-destructive acts declined by 73% (P=.001).
  
  
  CONCLUSIONS
  Data from this community-based approach document a remarkable downward trend-measured by both magnitude and temporal trends in the specifically targeted age cohorts-in suicidal acts. The sequential decrease in age-specific rates of suicide attempts and gestures is indicative of the program's success.
authors.affiliation: Department of Sociology, University of New Mexico, 2650 Yale Blvd, Albuquerque, NM 87106, USA. pmay@unm.edu
authors.forename: Philip A
authors.initials: PA
authors.lastname: May
authors.forename: Patricia
authors.initials: P
authors.lastname: Serna
authors.forename: Lance
authors.initials: L
authors.lastname: Hurt
authors.forename: Lemyra M
authors.initials: LM
authors.lastname: Debruyn
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D005260:Female; D006801:Humans; D007198:Indians, North American; D016014:Linear Models; D008297:Male; D009516:New Mexico; D011634:Public Health; D016728:Self-Injurious Behavior / Q000453:epidemiology* / Q000517:prevention & control; D013405:Suicide / Q000706:statistics & numerical data; D000092864:Suicide Prevention