Suicide prevention model relies on local adaptation

Village-based coordinators from the Bering Strait Region gather in Nome for a P.C. CARES information session in 2019. (Davis Hovey/KNOM)

A new prevention model aims to make a dent in Western Alaska’s high suicide rate by providing the region with research and strategies, and letting each village decide for itself how to use the information.

The model is called Promoting Community Conversations About Research to End Suicide, or P.C. CARES.

“Suicide has always been a really hard issue to talk about…even for myself personally,” says Emily Murray of Elim. She’s on the local steering committee P.C. CARES. As Murray describes it, suicide isn’t discussed openly in local communities, but it damages communities all over Western Alaska.

“It took me a long time to talk about my parents, but to me it was a very long and difficult road,” Murray said. “I carried a lot of false guilt – that’s what I’m calling it now, thinking I could have done something, maybe if I was there then it wouldn’t have happened…People, without meaning to, they said ‘Oh if you were there then it wouldn’t have happened.’ And so (they) tell somebody it was your fault, and it wasn’t your fault.”

Facilitators with P.C. CARES are hosting five “learning circles” in communities from the Bering Strait Region, Yukon-Kuskokwim Delta, and Northwest Arctic Borough this winter.

Lisa Wexler, a primary investigator with P.C. Cares, says they work with village-based coordinators and local health aides.

“The whole process is all about self-determination and about people deciding for themselves what they want to do and how they want to do it,” Wexler said. “We’re here to sort of spark interest and maybe a few new ideas in the mix, to give people a chance to come together to learn and to take action to make their communities more well.”

The model debuted in the Northwest Arctic Borough from 2015 to 2017, with 64 learning circles hosted by local facilitators in ten communities. Now P.C. CARES has been adapted for the Bering Strait Region. The project seeks to hold five sessions in five regional communities per year for three years, giving all 15 Bering Strait villages the opportunity to participate.

According to Wexler, in each community that adopts P.C. CARES, the goal is to train four local facilitators so that the community can host its own conversations, which they refer to as learning circles.

“We were able to track what people did afterwards,” she said. “Not only did people learn new information, not only did people get new skills and feel like they had more people to work with to do wellness and prevention, but they also talked to their friends and family about it and those people, their friends and family, went on to do more prevention after.”

Diane McEachern has piloted some of these learning circles at the University of Alaska Fairbanks’ Kuskokwim Campus in Bethel, where she has created a course that gives college credit to P.C.CARES facilitators. She also works with P.C. CARES as a trainer and mentor for facilitators in the region.

McEachern says she has seen a strong response from participants as they learn about suicide research and decide how to use that locally.

“It’s really in the hands of the community, what they want to do with information,” she said. “(It) is different from the old days, or not so old days, where people would come in and tell people what they ought to do, and this model shies away from that completely.”

McEachern says individual suicide prevention skills for one-on-one scenarios are still needed. But those efforts are complemented by the P.C. CARES model, which encourages people to work together across sectors in their community to take action before a suicide crisis.

That’s one of the reasons Murray in Elim likes the P.C. CARES model, because local community members can take ownership of the healing process.

“In order for communities to heal, I believe it has to come from us,” Murray said. “It can’t come from outside. It has to come from us saying that we want to heal.”

And, as Murray goes on to say, now is the time for healing in Western Alaska.

The next P.C. CARES learning circle in the Bering Strait Region is scheduled for this Sunday, January 19, in Brevig Mission.

SUICIDE PREVENTION RESOURCES: If you are thinking about suicide, or are worried about someone who might be, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or Stop Suicide Alaska at 1-877-266-HELP.