Talking Circle for Native American Youth Living Well (A Yo Li)

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Abstract/Summary The ongoing mental health crisis among Native Americans manifests in extraordinarily high rates mental, emotional, and behavioral health disorders such as anxiety, stress, depression, substance use, and suicide in Native American youth as young as 10. The virulence of COVID-19 for older people has hit Native American communities particularly hard, and the loss of Tribal Elders and Native speakers has taken an incalculable toll on the cultural ties of language and tradition that flow from Elder Native American generations to the young. The COVID-19 pandemic has exacerbated the suffering of Native American people of all ages, who reported some of the highest rates of psychological distress that include depression, anxiety, life stressors, substance use (alcohol, drugs, commercial tobacco use), and suicide long before the pandemic. The devastation of Native American communities from COVID-19, coupled with both a recent and long history of racism and crimes against Native American people, has had an alarming effect on the mental health of Native American youth. Even before the pandemic, suicide fatalities for Native American youth between the ages of 15–19 was more than double that of non-Hispanic whites. For some Native American communities, suicide is the leading cause of death for youth ages 10-14. Moreover, Native American youth begin to use alcohol, other substances and commercial tobacco at younger ages (around the age of 11), and at higher rates, than all other ethnic groups. For a population already struggling, the COVID-19 pandemic is calamitous, increasing the already high risk for suicide and other mental health disorders of Native American youth. Thus, interventions to improve Native American youth mental, emotional, and behavioral health outcomes are urgently needed. To meet this urgent need, our overarching objective is to leverage the empirically proven, highly effective, school based, Talking Circle Intervention to promote the mental, emotional, and behavioral health of geographically diverse (rural vs. urban) Native American youth. This study, “Talking Circle for Native American Youth Living Well (A Yo Li)” uses a Community Based Participatory Research (CBPR) approach to evaluate Talking Circle effectiveness, partnering with the United Keetoowah Band (UKB) of Cherokee Tribe in Oklahoma, with members living in two geographically diverse areas, rural and urban. “A Yo Li” in the UKB tribal language means “youth”. The Talking Circle Intervention will be implemented as an after-school program in each of the participating schools. After-school programs are an ideal setting for the Talking Circle intervention. After-school programs are preferred by parents, students, and teachers in many Native American communities, as they provide structured, educational opportunities and activities for youth after regular school hours, while parents/guardians are still busy with work or other responsibilities. Based upon the preference of our UKB tribal partners, and ethical considerations, all students will eventually receive the intervention, thus the control condition is waitlist-control.