WOLFPUNKT, Mont. – Fallen pine cones covered the fresh grave of 16-year-old Leslie Keizer on the outskirts of Wolf Point, a small community on the Fort Peck Indian Reservation on the eastern plains of Montana.
Leslie, whose father is a member of the Fort Peck Assiniboine and Sioux tribes, is one of at least two teenagers on the reservation who died of suicide this summer. The death of a third teenager is being investigated, authorities said.
Leslie’s mother, Natalie Keizer, was recently standing next to the grave when she received text with a photo of the tombstone she had ordered.
She looked at her cell phone and then back to the grave of the girl who had committed suicide in September.
“I wish she had reached us and let us know what was going on,” she said.
In a typical year, Native American youths die from suicide nearly twice as often as their white counterparts in the United States. Mental health experts fear the isolations and shutdowns caused by the COVID-19 pandemic could make the situation worse.
“It gave them a very heavy spirit to be isolated and depressed and be at home and have nothing to do,” said Carrie Manning, project coordinator at the Spotted Bull Recovery Resource Center at the Fort Peck Tribes.
It’s not clear how the pandemic is related to youth suicides on the Fort Peck reservation. Leslie had attempted suicide a few years ago, but she had been in counseling and seemed to be feeling better, her mother said.
Keizer noted that Leslie’s therapist had canceled her counseling sessions before the pandemic broke out.
“It would probably have been discontinued with the virus anyway,” said Keizer. “It seems like important things have been neglected.”
Tribal members usually lean on each other in times of crisis, but this time it’s different. The reservation is a COVID hotspot. In remote Roosevelt County, which covers most of the reservation, more than 10% of the population is infected with the coronavirus. The resulting social distancing has caused tribal officials to worry the community may fail to spot warning signs among vulnerable youth.
Hence, tribal officials in their suicide prevention efforts focus on finding ways to help these children remotely.
“Our people have been through trouble and are still here, and will still be here after this,” said Don Wetzel, Tribal Liaison member of the Montana Office of Public Instruction and a member of the Blackfeet Nation. “I think if you want to look at resilience in this country, look at our Native Americans.”
Poverty, high rates of drug abuse, limited health care and overcrowded households all increase both physical and mental health risks for reservation residents.
“In these conditions, things like suicide and pandemics like COVID can only decimate tribesmen,” said Teresa Brockie, a public health researcher at Johns Hopkins University and a member of the White Clay Nation from Fort Belknap, Montana.
Montana recorded 231 suicides that year, with the highest rates recorded in rural counties. These numbers are little different from a typical year, said Karl Rosston, suicide prevention coordinator for the state Department of Public Health and Human Services. The state has had one of the highest suicide rates in the country every year for decades.
Rosston said the death toll is rising and the economic impact of the pandemic is gripping families, Rosston said, and he expected more suicide attempts in December and January.
“We hope, of course, that we are wrong about that,” he said.
For rural youth in particular, the isolation caused by school closings and shortened or canceled sports seasons can put a strain on their mental health.
“Peers are a big factor for children. If they’re cut off, they’re more at risk, ”said Rosston.
In addition, teenage suicides are becoming more common, especially in rural areas. Every suicide triples the risk of a surviving loved one following suit, Rosston said.
On average, each person who dies from suicide has six survivors. “When it comes to small tribal communities, that jumps to 25-30,” he said.
Maria Vega, a 22-year-old member of the Fort Peck Tribes, knows this type of contagious heartache. After finding the body of a close friend who died by suicide in 2015, Vega also attempted suicide. She is now the youth representative on a state suicide prevention committee that organizes conferences and other events for young people.
Vega is a nursing student who lives six hours away from her family, making it difficult to travel home. She contracted COVID-19 in October and was forced to isolate, which increased her sense of distance from her family. While in isolation, Vega was able to attend therapy sessions through a telemedicine system set up by her university.
“I really think therapy is something that would help people when they are alone,” she said.
However, Vega points out that this is not an option for many people on rural reservations who do not have a computer or reliable internet access. The therapists who provide telehealth services have long waiting lists.
Frederick Lee presents a suicide prevention program called QPR (Question, Persuade, Refer) in Scobey, Montana. Organizations that offer youth suicide intervention and prevention initiatives are struggling to maintain the same level of service during the pandemic. (Sara Reardon)
Other prevention programs are struggling during the pandemic. Brockie, who studies health care in disadvantaged populations, had to postpone the start of an experimental training program for native parents of young children twice. She hopes the program will lower the risk of substance abuse and suicide by teaching resilience and parenting skills.
At Fort Peck, the reserve’s mental health center has had to cut down on youth events that teach leadership skills and traditional practices like horse riding and archery, as well as workshops on topics like dealing with grief. The events, which Manning said typically attract 200 people or more, are intended to distract teenagers from depression and allow them to have conversations about suicide, a taboo subject in many native cultures. The few events that can go forward are now limited to a handful of people at a time.
Tribes, rural states, and other organizations running suicide intervention and prevention initiatives for youth struggle to maintain the same level of service. Using funds from federal CARES and other sources, the Montana Public Education Office expanded online preventive training for teachers, while the Rosston office enhanced counseling resources that people can access over the phone.
Nationally, the Washington, DC Native American Youth Center hosts bi-weekly webinars where young people can share their hopes and concerns. According to Executive Director Nikki Pitre, an average of around 10,000 young people sign up each week. Under the CARES Act, the federal government allocated $ 425 million to mental health programs, of which $ 15 million was earmarked for local health organizations.
Pitre hopes the pandemic will draw attention to the historical inequalities that have led to a lack of health care and reserves for reserves, and how they enable the twin epidemics of COVID-19 and suicide.
“This pandemic really opened those wounds,” she said. “We’re holding on to the resilience of culture even more.”
At Wolf Point, Natalie Keizer experienced this resilience and support firsthand. The Fort Peck Community has teamed up to pay for Leslie’s funeral.
“That is a miracle in itself,” she said.