Background and Problem Scope
Case Study Written by Stacy Rasmus Ph.D., Jim Allen Ph.D. Simeon John (Yup'ik Elder), and Billy Charles (Yup'ik Elder)
The indigenous peoples of Alaska’s Bering Sea Coast and Yukon Kuskokwim Delta have for centuries survived in harsh climates and through periods of scarcity and intertribal territorial disputes. They did this through their Yup’ik ways of life, which kept them strong, providing the tools, teachings, and strategies needed to live with purpose and overcome hardship. When newcomers began coming in to the region from places far away, the Yup’ik world began to change, often in ways unprecedented to the Elders who had come before and had survived so much. Suddenly, these Yup’ik ways of life seemed no longer enough to protect the young people from threats and dangers. At the same time, some communities began to experience disturbing losses of their young people to suicide and alcohol.
Finding Resolve Within the Community
In one small Yup’ik community, a spirit of suicide and alcohol and alcohol misuse seemed to move freely among its members, manifest in a closely paced cluster of youth suicides. It had just claimed two more victims and was looking for more. Sheltered inside the community’s tribal hall, Elders, youth and parents huddled in a circle. Some in the circle hunched down, faces void of tears, tense bodies pressed against unyielding metal chairs. Others let tears quietly slide down their cheeks. The two recent deaths were newest heartaches in a long line of many.
The group knew too well the spirit’s easy reach into their community. They’d carried many to the cemetery, dug many graves. They intimately knew how alcohol and drugs dull the pain, but deceitfully bring more tragedy and sorrow.
From time to time, outsiders had come to the village to help, but nothing they brought seemed to last. Despite disappointments and heartbreak, the people gathered this day because they still believed things could change. This time the solutions and answers would come from their community, from the Yup’ik people themselves.
What is Qungasvik?
The Qungasvik story describes how Yup’ik communities have worked to cast out of the spirit of suicide and alcohol abuse through a community-driven and cultural process based in Yup’ik theory and Indigenous knowledge. This community was joined by other Yup’ik communities in the development and expansion of the Qungasvik (ph. kung-as-vik: Toolbox) model to increase youth reasons for life and reasons for sobriety while reducing risk for youth suicide and alcohol misuse.
Qungasvik, in the Yup’ik language, refers to a container that carried important items for survival, such as hunting tools, or a sewing kit to maintain clothing and essential equipment.
The project is called Qungasvik because it contains tools to assist Yup’ik communities in finding their own answers and approaches to the challenges that young people face today, including suicide and alcohol misuse. Each community will look to its own strengths, local knowledge, leadership and teachings to provide protective experiences and culturally-based activities to prepare youth to thrive in an ever-changing world.
Qungasvik is a strengths-based approach to protecting youth ages 12 to 18 from suicide and alcohol misuse.
Strengths-based means the focus is on the good, and on supporting people and practices for doing well, and for building strength and resilience, instead of focusing on identifying, and then stopping or reducing what is wrong in a community. In contrast to risk reduction approaches, Qungasvik works with individual youth, their family, and their community to build protection.
The key role of community Elders
Early on in the development of the Qungasvik approach, the Elders advised the coordinating team and the researchers to teach the young people about their historical and inherited strengths as Yup’ik. The community spent their first year engaged in a process of collective self-reflection and self-inventory in order to understand youth suicide and alcohol misuse within an historical context.
The Elders stressed the importance for young people to create a healthy relationship to their past and to their ancestors. The Elders guiding the development of what became the Qungasvik approach made a critical decision to develop its teachings around those aspects of Yup’ik culture that have persisted through times of enforced change and colonization, and to provide as much exposure to the Yup’ik language as they could through the teachings.
The Elders chose to combat current adversity and problems resulting from these disruptions through a singular emphasis on the culture, and its emphasis on love and the power of love to protect young people even through the darkest and most difficult of times. Ultimately, the culture is the intervention in the Qungasvik approach.
The Qungasvik prevention program mobilizes community, cultural and historical strengths to build protection against suicide and alcohol misuse. When communities come together around their youth in loving and positive ways, there is no space for the spirit of suicide and alcohol abuse; it is shamed and it leaves.
Using Qungasvik in Your Community
Qungasvik is more than a collection of activities for youth. The Qungasvik prevention approach is at its heart a community-driven process. The process engages Elders, parents, other adults, and youth in delivery of a set of culturally centered activities that protect the young person from suicide and alcohol misuse.
In Qungasvik, each community selects teachings for the youths, for the youths with their families, and for the youths with their community. Then, and this is critically important, as it was the vision of the elders who developed Qungasvik, each community must adapt the teachings in their own way. This way must show respect and reflect the local cultural practices, as well as other important considerations, such as the season of the year, and what the local land gives and provides in its offerings. Delivery of a core set of the teachings over an annual seasonal round provides protective experiences to young people. Through this, they grow skills to survive, and to grow up strong and connected.
For a more complete overview of the Qungasvik community-driven service model, go to the new online preview version of the Qungasvik Training and Teachings Manual.
To date, six Yup’ik communities have developed or adapted their own Qungasvik Project. Each community comes up with its own project name as part of the community-driven and community-owned process. More than 600 youth have been enrolled in the prevention research projects across six communities in studies of outcomes. Many more youth have been served as part of the community-level, universal prevention strategies promoted by these communities.
The Qungasvik prevention approach is organized around the Qasgiq Model (ph. kuz-gik: Men’s/Communal House). The Qasgiq Model describes the underlying Yup’ik theory and organizing principles guiding the intervention management and implementation.
The Qasgiq Model is a Yup’ik Indigenous Logic Model. The Qasgiq Model is at its heart is a traditional Yup’ik way of coming together as a community to do important things. Through Qasgiq, the community gets to the desired outcomes identified by Yup’ik elders and other cultural knowledge bearers. Every community has a Qasgiq, and fidelity to this local process is, in the view of the Qungasvik program, the most essential part of effective prevention for suicide and alcohol misuse in Indigenous communities.
The Qasgiq Model provides the process steps for each community to follow in the implementation of their own Qungasvik Project.
- Each community will have their own Qasgiq.
- Each community will determine which activities will be their own teachings.
- Each community will determine which of the protective factors these teachings will emphasize and will gift to their youth.
While the Qasgiq Model is specific to Yup’ik Alaska Native communities, every community has its own way to Qasgiq. The Qungasvik process is flexible and adaptable to each community’s way. Qungasvik is not a cookbook. The teachings are examples, not rigid recipes. It is not the specific content of activities, or the form of the Qungasvik prevention that leads to its effectiveness. Instead, it is the underlying process, or the function of the teachings to build specific protections, that makes Qungasvik work in communities.
Or, in the words of Yup’ik Elders, “every community has at its center a Qasgiq,” a way of organizing and working together towards a shared goal.
The Role of Evaluation
An important part of healing includes telling your own community’s story of strength. Evaluation can provide a powerful tool for communities to tell their stories
At the time that the Qungasvik prevention approach was being developed by Yup’ik communities, no existing tools or measures existed to assess the outcomes that Yup’ik communities had identified as most desired for their youth. Communities wanted to achieve two primary outcomes for youth:
1) In the short-term, they wanted to grow protective strengths in the community, the family, and the individual youth using Yup’ik cultural teachings and practices.
2) Over the longer-term, through these protective cultural experiences, they wanted to ultimately instill in young people reasons for life and reasons for sobriety (reflective processes about alcohol).
Inspired by the People Awakening Protective Factors Model, researchers developed tools to help communities understand and document the impacts of their community-driven cultural strategies for prevention.
Implementing and Scaling-Up Qungasavik
The primary challenge to implementing the Qungasvik approach and Qasgiq Model in Yup’ik communities involves access to resources and supports that have contributed to past successes of the project. Extremely limited resources are available for prevention in the tribal, state and federal health systems that Yup’ik communities can access. Funds that are available most often come in the form of grants that often include timeline and design restrictions that do not always allow for communities to follow their own local processes and practices. Additionally, many Alaska Native tribes face challenges in terms of their capacity to apply for and administer grants, and therefore are required to seek out partnerships with regional systems or agencies outside of the community to access them.
The Qungasvik represents a unique, long-term partnership between Alaska Native tribal communities and university researchers. The relationship is unique in that it was initiated by Alaska Native Tribal leaders and community members and has sustained over a several decades long time period. This community-initiated and tribally-controlled research partnership has been essential to the development and expansion of the Qungasvik preventive intervention, and a key component in its sustainability as a model providing services.
A primary challenge has emerged in scaling-up Qungasvik to reach throughout the Yup’ik region and the state of Alaska. The Qungasvik is a community-level and cultural approach to prevention. These distinct features provide great benefits, facilitating increased ownership and durability of services created by and for community members. Scaling-up continues to require a careful balance of local control and local adaptation of the intervention both within and outside Yup’ik Alaska Native communities. One key aspect of this balance is the need for implementation of an approach to fidelity that allows for local adaptation while also not diluting crucial elements of the Qasgiq Model for organizing the community.
Sustainability of the approach contributes another set of challenges to expanding the practices or scaling-up.
The Qungasvik approach does not introduce anything particularly ‘new’ to communities. Rather, as one key member of the Qungasvik team has said, “it’s time we try something old.”
The approach deals with the new problems faced by youth today, using the traditional structures of organizing that the community has used for thousands of years. So while Qungasvik uses local expertise and local staff to implement the intervention, local capacity to execute the program varies in each community, and developing this capacity in settings where it is not yet fully formed becomes an important part of the intervention's long-term and enduring sustainability in the community.
The Role of a Research Partnership
The research partnership has been a key component in this sustainability plan for communities to continue to deliver prevention activities and services utilizing the Qungasvik approach and Qasgiq Model. Researchers from the University of Alaska and the University of Minnesota Medical School have been working for the past two decades to establish an evidence base showing the effectiveness of the approach for reducing Alaska Native youth risk for suicide and alcohol misuse.
While Qungasvik uses local expertise, local staff, and a locally adaptive framework for intervention, challenges to its sustainability continue to include development of community capacity and modest funding for these efforts. Therefore, Qungasvik is ultimately sustained by communities having the support and self-determination to continue to live their Yup’ik ways of life, allowing them to pass on their teachings to protect and strengthen their youth today.
The Story Continues…
Back in the tribal hall, the Elder woman rose from the group to speak. “Musk oxen circle their young to protect them from harm,” she said. She had the young people stand in a tight group.
“Elders, find a youth and say something nice about him or her.” The Elders surrounded the knot of young people. The adults praised them one by one.
“You always help your mother,” one said. “You are going to be a good hunter,” another said.
The youth were surprised to hear the praise because they didn’t realize so much was known about them. The Elders had always seemed to be strangers to them.
When they were done, an Elder man told the youths to stand in the center of the room while the adults held hands in a circle around them. He began to pray.
“Lord, bring healing, strength and power so we can overcome the hardships we face,” he said. “Now everyone, pray for the same thing as hard as you can.” Murmurs of petitions turned into earnest crescendos.
“When I count to three, everybody stomp, stomp, stomp!” he said. “One, two, THREE!”
The echo of snow boots and tennis shoes reverberated across the wooden floor.
“Now laugh hysterically, as loud as you can, as if you are laughing at someone,” he said.
And they did.
The spirit of suicide and abuse heard the prayers, the stomping of feet, and the community members' defiant laughter. The spirit was made to feel so ashamed that it was driven from and banished by the community. The spirit's presence and grip was lifted from this small community.
The Elder explained, “Just as a woman needs both of her hands to knit, we humans need each other to be able to fulfill our needs—emotionally and physically.”