Attempted Suicide in American Indian and Alaska Native Populations: A Systematic Review of Research on Protective Factors

American Indian and Alaska Native (AIAN) populations contend with disproportionately high rates of suicide. The study of protective factors is essential for highlighting resilience and formulating potential interventions for suicide. We systematically review factors that are posited to protect against suicide attempts for AIAN peoples. Seventeen (12 journal articles, five theses/dissertations) articles met inclusion criteria. Results indicate that protective factors are typically situated at one of four levels of analysis: individual (e.g., self-esteem), family (e.g., parent caring), community (e.g., positive adult relationships), and cultural (e.g., cultural spiritual orientation). Notably, there were trends in protective factors across age, sex, and geographic region. Based on these findings, we propose recommendations for moving the field forward in future identification of protective factors as a means of AIAN suicide prevention. Public Health Significance Statement It is incredibly important that research move forward in efforts to understand factors that protect American Indian and Alaska Native (AIAN) peoples from attempting suicide, given that they are at great risk for suicide death. These factors that might promote wellness come from many places (self, family, community, cultural, societal), though historically we have primarily focused on the individual. A more thorough understanding of protective factors as they relate to individuals from a variety of backgrounds is critical to AIAN suicide prevention.