Coming Home: The Reintegration of Native Yup'ik Soldiers/Veterans into their rural communities

该奖项是根据2009年美国复苏和再投资法案（公法111-5）资助的。本研究探讨了阿拉斯加土著（Yup'ik）士兵和退伍军人从中东战场返回后，重新融入阿拉斯加西南部育空-库斯科温三角洲偏远的农村社区的潜在和多重自杀风险。总的来说，阿拉斯加土著社区，特别是Yup'ik社区，是美国自杀率最高的地区之一，年轻的土著男性面临的风险最大（Perkins 2006）。就中东战场的退伍军人自杀率而言，这些本土士兵/退伍军人正在回到一个双重紧张的社会和情感环境中（Tanielian, 2008）。此外，可能阻碍士兵和退伍军人获得所需的行为和心理健康服务的两个主要因素是获得护理和寻求护理的意愿。探索性研究有三个主要目标；首先，调查本土士兵和退伍军人在这种双重风险环境中使用的多种策略。其次，研究这些年轻的土著男子所面临的斗争如何影响他们的日常生活经历，即他们与家庭、同龄人和社区的社会关系。最后，探讨在什么情况下，这些年轻的土著成年人可能会或可能不会选择寻求帮助，以被描述为“无形的战争创伤”（Tanielian, 2008）。研究人员的假设是，如果没有一种对文化敏感的、以社区为基础的护理模式——一种中间立场——它可以作为不寻求任何护理之间的桥梁，即。，“独自行动”，积极参与以证据为基础的医疗护理，以治疗自杀念头和相关的抑郁症、创伤后应激障碍、药物滥用等问题，这些农村社区的土著士兵/退伍军人自杀的风险加倍，因为他们不仅与他们的军事同伴（Messinger 2008）隔绝，而且与他们的家庭和社区隔绝（Lifton, 1973；附录C）。这项研究试图理解在社会、文化和历史背景下，中间地带的参数可能是什么样子。这一阶段的研究有助于我们以新的方式了解这些年轻的阿拉斯加原住民士兵/退伍军人所面临的社会和情感问题的复杂性，从而获得更深入的见解，这些见解通常被更平淡的社区研究方法所错过。虽然现在许多社区研究已将人种学的组成部分纳入其研究设计中，但它通常受到快速反应技术的限制，通常涉及在村庄停留一周左右，从而减轻了对当地历史中嵌入的当地生活社会生活的理解。这项研究不仅探讨了有自杀风险的个人的生活经历，而且将他们置于他们的家庭、历史、社区和文化的背景下。在这样做的过程中，这些人的优势和弱点都会显现出来，这可能会为在这种情况下接触和伸出援助之手找到新的途径。

This award is funded under the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).This research explores the potential and multiple risks of suicide for Native (Yup'ik) Alaskan soldiers and veterans returning from the Middle East war theatre as they reintegrate into their rural isolated communities located in the Yukon - Kuskokwim Delta of southwest Alaska. Native Alaskan communities in general - and Yup'ik communities in particular - have some of the highest suicide rates of anywhere in the United States and young Native men are at the greatest risk (Perkins 2006). Insofar as veterans from the Middle East war theatre are committing suicide at an alarming rate these Native soldiers/ veterans are returning to a doubly charged social and emotional landscape (Tanielian, 2008). Moreover, two of the primary factors that can inhibit soldiers and veterans from obtaining the needed behavioral and mental health services are access to care and willingness to seek care. The exploratory study has three key objectives; first, to investigate the multiple strategies utilized by Native soldiers and veterans to negotiate this dual risk environment. Secondly, to examine the particular ways in which the struggles that some of these young Native men face affect their everyday lived experience, that is social relations with their families, their peers and their community. Lastly, to explore under what circumstances these young Native adults may or may not choose to seek help for what has been characterized as the "invisible wounds of war" (Tanielian, 2008). The researcher's hypothesis is that without a culturally - sensitive, community - based modality of care - a middle ground - that can serve as a bridge between not seeking any care at all, ie., "going it alone" and actively engaging with evidenced based medical care for suicide ideation and associated problems of depression, PTSD, substance abuse, these Native soldiers/veterans in rural communities are doubly at risk for suicide as they are isolated - not only from their military peers ( Messinger 2008) - but also from their families and their community (Lifton, 1973; Appendix C). This study seeks to understand what the parameters of that middle ground might look like that is at once socially, culturally and historically contextualized.This phase of the research contributes to our understanding of the complexity of the social and emotional problems faced by these young Native Alaska soldier/veterans in new ways that allows for more in depth insights usually missed by more prosaic community research methods. Although many community studies have now incorporated an ethnographic component into their research design, it is usually delimited by rapid response techniques, which usually involved a stay in village a week or so, thus mitigating an understanding of a locally lived social lives embedded within local history. This study not only explores the lived experiences of individuals at risk for suicide, but places them within the context of their families, their history, their community and their culture. In doing so both the strengths as well as the vulnerabilities of such emerge that may map new ways to reach and reach out to people in such circumstances.