Suicide among American Indian adolescents has increased by almost 1000% over the past 20 years to become, as in Anglo society, the second most frequent cause of death in the 10 to 20 year old age group. The two major causes of adolescent suicide are acute stress and chronic depression. Environmental factors contributing to American Indian suicides include breakdown of tribal tradition, lack of effective role models, having alcoholic parents, coming from a broken home, too early marriage, failure to learn in school, unemployment, group contagion phenomenon, and anniversary reaction phenomenon (following the example of a parent or relative who has suicided). Where suicide rates remain low, particularly in the Southwest, tribes tend to be more traditional in their daily living, and opportunities for employment and education exist within the tribal community. Effective efforts to reduce the American Indian adolescent suicide rate require tribal sanction, involvement of tribal elders, and recognition of each tribe's particular traditional attitudes. Measures that have been successful include use of elders to stay with arrested adolescents, suicide prevention centers, high school programs for pregnant adolescents, first offender programs, early intervention prevention programs, identifying at-risk adolescents, and at-risk adolescents trained as counselors. A list of resources and programs available to American Indian tribes is provided. (NEC)