Relationship between family history of mandatory boarding school experiences and suicide risk in US reservation-based Native American youth: a cross-sectional analysis

Introduction Suicide is a leading cause of death among Native American youth and adolescents in the USA. A myriad of factors have been correlated with risk for suicide ideation (SI)/suicide attempt (SA), including historical trauma; however, accurate measurement of historical trauma has been inconsistent. Objective To examine the association of family history of a negative mandatory boarding school experience with SI and SAs. Methods An anonymous online survey was conducted with 288 Native youth aged 15–24 years from the Fort Peck Reservation in Montana. Multinomial regression was applied adjusting for other known risk and protective factors of SI and SAs. Results Thirty-five percent reported past SAs and 15% reported ideation without prior attempt. Of the 129 (45%) reporting a family history of mandatory boarding school experiences, 28% perceived the experience as positive while 22% as negative. After adjusting for risk and protective factors, both SI and SAs were associated with a family history of negative mandatory boarding school experiences (adjusted OR (AOR)=4.8 and 4.3, respectively) and polydrug use (AOR=3.6 and 2.3). SAs were also associated with post-traumatic stress disorder (AOR=2.6) and depressive symptoms (AOR=3.6). Conclusion The association between family history of negative mandatory boarding school experiences and SI and SAs implies that culturally responsive interventions are needed to reduce the intergenerational impacts of historical trauma.