Suicide is the second leading cause of death among American Indian youth. In some communities, the suicide rate is as high as ten times the rate of the general U.S. population, requiring immediate attention. Like many public health issues, suicide is complex and influenced by multiple factors, including parental conflict, academic problems, substance abuse, and socioeconomic status. Although limited research exists on protective factors for American Indians, studies have found that positive school experience, supportive tribal leaders, and commitment to cultural spirituality were protective against suicidal thoughts. . While these factors provide a good starting point for program development, suicide prevention programs must be flexible to account for differences between tribes, such as social structure, gender roles and conceptualization of death. 
The Indian Health Service (IHS) is committed to improving the health of American Indians and Alaska Natives and recently launched a Suicide Prevention Website to provide culturally appropriate information about suicide prevention. Other organizations are also joining the fight, including the Center for Native American Youth. States have recognized the need to address youth suicide in Indian country and include tribes in their state suicide plans. Finally, many tribes have developed tribal programs aimed at reducing youth suicide rates within their communities.
Despite these efforts, more is needed. We need additional funding for American Indian youth suicide prevention programs. Early research shows that suicide prevention programs can be effective. Now, we simply need the funding to implement these programs. It is a matter of life and death for our children, our communities, and our future.
 Balis, T. and Postolache, T. (2008). Ethnic Differences in Adolescent Suicide in the United States. International Journal of Child Health and Human Development, 1(3), 281-296.