Collective discussion of ACYRN evidence helps Alberta Métis communities draw up action plans to prevent youth suicide

Elders, elected council members, youth, and frontline workers from community social and health services discussed the evidence from a baseline survey carried out by community-based researchers (CBRs), with technical assistance from CIET. Using this information, more than 80 participants from seven communities outlined action plans and identified common challenges and available resources. The “all in” strategy, bringing together people from different Métis settlements, created strong momentum for working in the communities.

Carrielynn Lamouche, a Métis researcher who coordinates ACYRN in Alberta, accurately captured the nature and outcome of the event in a few words. “We managed to link the findings with the lived experience of the communities,” she said, “not only because many of the participants had been personally touched by suicide in their communities, but mostly because they were able to channel their emotions into collective energy and ideas for interventions.”

Looking for locally relevant ways of discussing evidence for action

The Alberta “all in” strategy illustrates CIET’s approach to communication for health and development. Our SEPA model of socialising evidence for participatory action revolves around participatory research and action-oriented, collective discussion of research findings –first in focus groups and then in a variety of settings, from workshops to community meetings-, strategically adapted to local circumstances.

In socialising evidence, CIET keeps the focus on problem solving and decision-making. Researchers gather information from households on topics that communities see as a priority, they analyse it and later bring it back for collective discussion in local settings. We try to do this taking into account local culture and mores and including all relevant stakeholders.

In Alberta, our Métis research coordinator saw the “all in” approach as the most suitable way to make communities aware of their common challenges and resources, to learn from others, and to gain momentum for immediate action. This was also in line with the networking nature of ACYRN.

But collective discussion of the evidence needs careful planning in order to be truly productive. In this case, we presented the findings in a way that showed the connections among risk factors and invited those present to reflect on the data in terms of community action. “There was nothing really surprising in the numbers from the survey,” explained Carrielynn Lamouche. “Everyone knew suicide was a problem in their communities. What was new was seeing how the risk factors are connected and how they build up towards crisis. Even more helpful was turning the risks into action entry points for interventions.”

During the second and third days, community-specific discussion groups outlined immediate action plans, including how to overcome possible roadblocks. Some formed working groups to spearhead the evidence-based initiatives in their own communities.

All breakout and community groups had input from youth whose ages ranged from 15 to 25 years. A couple of youth-only sessions provided a safe environment for younger participants to voice their views and concerns.

Turning risks into opportunities for action

The analysis of data from the participating settlements revealed different risk factors, directly or indirectly linked with risk of suicide (See Chart 1). High distress, for instance, had a direct connection with immediate suicide risk. Low self-esteem and low sense of mastery –understood as feeling powerless, without control, with low problem solving skills and little ability to change things- had, in turn, an impact on high distress. On a more indirect path to suicide risk, bullying was linked with low sense of mastery, while low support bore upon low self-esteem. Lack of pride and perceiving lack of parental knowledge and caring had an impact on self-esteem and therefore, indirectly, on suicide risk.

Chart 1

By turning these risks into potential action points (See Chart 2), community members found themselves thinking in terms of opportunities to tackle risks along the path to suicide. Each inter-community group worked on a given risk factor, now viewed as an opportunity for preventive action. People began to realize they could actually do something about youth suicide –and they began talking in very concrete terms.

Chart 2

Thinking in terms of concrete actions, available resources and potential challenges led community groups to draft action plans around leverage points, that is, those initiatives that would give the most mileage, as they cut across risk factors. They also ran a reality check by taking into account local circumstances that could either bolster or undermine these plans.

One community group worked around the idea of giving more voice and space to their youth. Group members agreed that a youth centre would give the physical and institutional foundation for different preventive actions based on the ACYRN evidence. The group developed an action plan and members took on different responsibilities. A member of the community council said he would ask for permission from the council to use and old church for setting up the youth centre. The group discussed practical issues, such as who would have control over the structure of the centre, and possible obstacles, like the need to provide transportation, to remove junk from the church, to deal with smoking issues, and to provide washrooms and running water. They proposed youth take the lead in working plans and activities such as fund raising, inviting parents to help out at the centre, and reaching out to community youth “wherever they are”, so no one would be left out. In this regard, the group pointed to the convenience of an inclusive marketing strategy that would “remove the stigma from those who participate and convey the idea that this program is for everyone, not only for those who have problems”. In an effort to make the centre a key reference to address interlinked risk factors, group members planned to integrate youth counselors, school staff, and workers from social and health agencies; they also proposed to use the facilities for meetings between youth and Elders. All the participants volunteered to write letters of support to the community council. Youth in the working group proposed hosting a memorial round dance and slide show in memory of those who committed suicide and began planning for the event. Related to this activity, they also made provisions for a grieving workshop with assistance from both community and external agencies.

All community groups agreed there was much room for improving and linking existing programs catered to youth and their parents, based on youth input, evidence from the study, and the situation in each community. Many groups felt they needed to establish trust within the community before they could work on more specific issues. Problems around “clan wars” and community fractions came up in all group discussions. As a result of these concerns, some community groups planned for inter-agency and community meetings to start addressing these issues. One group made plans to set up a community development committee, post a community family tree to point to common roots and give youth a sense of belonging and unity; establish a voluntary peer support group for in-school youth; and start a community garden using community resources, run by Elders and qualified community members teaching traditional agricultural skills. Another group laid out a detailed work plan for a community potluck meeting in June 2007, where they would share the results of the youth survey and the proposals from evidence-based group discussions in Edmonton. The group members decided to keep on working as a unit in the organization of the event, listed all community agencies that should be present and volunteered to make contacts to bring them on board. They also developed a draft agenda for the meeting and proposed a “marketing” strategy, including word of mouth, talking to family pillars to reach high-risk youth, and rewarding attendance with points towards a draw.

All these initiatives were meant as starting points for community action and an opportunity to bring families together, as they engage in common tasks to build on youth resilience.

One of the working groups came to the conclusion that their community already had many programs in place, but not always well advertised. They proposed to create contact lists to send out to schools with descriptions of each service, to post advertisements, and to make personal invitations. In order to harness existing resources, they planned to promote dialogue and permanent links between the local youth centre and Elder groups. Embracing an idea from participating community youth, they outlined a working plan to create a crisis support committee.

People agreed that youth had to participate from the onset and be actively involved throughout the program. One woman said, “we have to start trusting our youth to take responsibility and run things for themselves by themselves”. Another person stated, “we start many of these things for youth, and then we realize we’ve been doing it for ourselves”.

Over the next few months, communities will discuss and implement their action plans. To raise awareness and sustain the momentum from the Edmonton gathering, the CBRs will disseminate the findings from the study in their own communities and assist key stakeholders as they implement the proposed actions. In 12-18 months, they will evaluate the outcomes, during the next phase of ACYRN.