suicide prevention programs. An effective school-based suicide prevention program was developed and implemented among the people of the Zuni Pueblo Tribe in western New Mexico (LaFramboise, 1996). This approach arose from the concern of the indigenous administrators of the Zuni Tribal School District over a 20-year pattern of 2 suicides per year in their high school. American Indian psychology and counseling researchers were brought into the community from Stanford University, the University of Oklahoma, and the University of Wisconsin to examine and define the situation among the youth and to develop strategies for the prevention of suicide. A number of risk factors and possible solutions were identified from survey research among the students, teachers, tribal leaders, and others within the community. The research at Zuni pin-pointed correlates of suicide specific to this community that identified high risk youths as having experience similar to that of other populations (e.g., suicide ideation, depression, poor social support, and hopelessness, among others), but also identified variables of help-seeking behavior, communication, and cultural resources that were specific to this particular tribal community and clearly differentiated those Zuni youths that were high risk and those that were not (Bee-Gates et al., 1996; Howard-Pitney et al., 1992). The research and the school collaboration led to the development of a comprehensive school curriculum that covered everything from building self-esteem, dealing with emotions and stress, and communication, to recognizing self-destructive behavior and helping those who may be suicidal (LaFramboise, 1996). The program was integrated into the language arts classes of the school rather than presented as a stand-alone course. Detailed research analysis indicated that students who were exposed to the program scored better than a no-intervention group at post test in hopelessness, problem-solving ability, and suicide intervention skills, with nonsignificant yet encouraging declines in suicide probability, as well (LaFramboise and Howard-Pitney, 1995). Though no formal evaluation of post-program suicide completions has been conducted, the school has experienced a reversal of its 20-year suicide rate, with zero completions noted since the program was taught in the late 1980s (P. May, University of New Mexico, and H. Lewis, past superintendent of the Zuni Public School District, personal communication, February 2002).

The fourth and final program discussed in this section on rural American Indian communities was implemented in Canada. After a suicide cluster of eight young adults in 1974–1975 on an Ottawa reserve in northern Canada, risk factors were identified by case control research within the community (Ward and Fox, 1977). Social isolation, family disruption, and poor coping skills were identified, in addition to acute and chronic misuse of alcohol (Ward and Fox, 1977). Because of the link of suicide