6 Suicidality among Aboriginal Youth in the Non-Aboriginal Child Protection Services System 1 Michael Boyle, Eman Leung, Harriet MacMillan, Nico Trocmé, Randall Waechter, and Christine Wekerle Introduction Worldwide, suicide is a leading cause of death among youth (WHO 2006), and is an especially insidious problem among individuals with a history of maltreatment (Giardino and Giardino 2002; Zoroglu et al. 2003). Beyond suicide, a history of childhood maltreatment increases the risk of experiencing a number of develop- mental challenges and negative behavioural health outcomes starting in adoles- cence and extending through adulthood (e.g., MacMillan et al. 2001; Wekerle, Miller, Wolfe, and Spindel 2006; Wekerle, Leung, Wall, MacMillan, Boyle, Trocmé, and Waechter 2009; Wekerle and Wolfe 2003; Widom 1999). These include associated behaviours such as depression, anxiety, self-harm, aggres- sion and delinquency, sexual risk-taking, and substance misuse. For example, youth involved with child welfare or child protection services (CPS) report two to fve times greater past-week proximal distress (i.e., depressive symptoms, low self-esteem, suicidal ideation) than their non-CPS involved peers (Wekerle, MacMillan, Leung, and Jamieson 2008). Often such distress can be expressed as increased thoughts of suicide and increased serious suicide attempts. While not all suicidal thinking or attempts co-occur with a clinical state of depression (i.e., diffculties feeling rewarded by people or activities, persistent sadness, restlessness/irritability, etc.), depression is a treatable condition. Service utilization shows that in states of high distress, individuals are only twice as likely to see a family/general physician, which may be related to treatment for other chronic health problems (i.e., they were already seeing a doctor regularly), and only slightly more likely to see a specialist/ psychiatrist for depressive symptoms specifcally (Rhodes, Jaakkimainen, Bondy, and Fung 2006). Among females who were on anti-depressant medications, self- poisonings, mainly with over-the-counter acetaminophen (e.g., Tylenol), were more often identifed as deliberate as compared to males. These results suggest that focusing on symptoms of distress among maltreated youth may reduce the impact of suicide in this population. Symptoms of distress, which may arise as a result of maltreatment-related traumatization, may become so persistent and pervasive that they impair future coping success. This is not — 79 — This is an excerpt from "Volume 9: Health and Well-Being" in the Aboriginal Policy Research Series, © Thompson Educational Publishing, Inc., 2013 To order copies of this volume, visit www.thompsonbooks.com or call 1-877-366-2763.