title: Decreases in Suicide Deaths and Attempts Linked to the White Mountain Apache Suicide Surveillance and Prevention System, 2001-2012.
abstract: OBJECTIVE
  We evaluated the impact of a comprehensive, multitiered youth suicide prevention program among the White Mountain Apache of Arizona since its implementation in 2006.
  
  
  METHODS
  Using data from the tribally mandated Celebrating Life surveillance system, we compared the rates, numbers, and characteristics of suicide deaths and attempts from 2007 to 2012 with those from 2001 to 2006.
  
  
  RESULTS
  The overall Apache suicide death rates dropped from 40.0 to 24.7 per 100 000 (38.3% decrease), and the rate among those aged 15 to 24 years dropped from 128.5 to 99.0 per 100 000 (23.0% decrease). The annual number of attempts also dropped from 75 (in 2007) to 35 individuals (in 2012). National rates remained relatively stable during this time, at 10 to 13 per 100 000.
  
  
  CONCLUSIONS
  Although national rates remained stable or increased slightly, the overall Apache suicide death rates dropped following the suicide prevention program. The community surveillance system served a critical role in providing a foundation for prevention programming and evaluation.
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Cwik
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Lauren
authors.initials: L
authors.lastname: Tingey
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Maschino
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Novalene
authors.initials: N
authors.lastname: Goklish
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Francene
authors.initials: F
authors.lastname: Larzelere-Hinton
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: John
authors.initials: J
authors.lastname: Walkup
authors.affiliation: Mary F. Cwik, Lauren Tingey, Alexandra Maschino, Novalene Goklish, Francene Larzelere-Hinton, and Allison Barlow are with the Department of International Health, Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, MD. John Walkup is with the Division of Child and Adolescent Psychiatry, Weill Cornell Medical College, New York, NY.
authors.forename: Allison
authors.initials: A
authors.lastname: Barlow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D013405:Suicide / Q000639:trends*; D013406:Suicide, Attempted / Q000639:trends*; D055815:Young Adult; D000092864:Suicide Prevention