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Nobody to call: the plight of indigenous suicide in Alaska

Indigenous people in the US die by suicide at a far higher rate than other Americans. In the remote Native Alaskan village of Buckland, one family’s painful losses have exemplified a public health emergency.

 

If you didn’t know any better, you might have thought it was three or four in the afternoon – not 10pm. It was still beautiful outside. The navy blue water of Eschscholtz Bay was calm. There wasn’t a cloud to be seen. The sun still hung high in the sky. Depending on where you are in Alaska in the summer you can get near-constant daylight, and that’s what Nathan Hadley Jr. and his family got that night on 28 July 2018. 

After a long day of hunting for beluga whale in the bay and some berry-picking, it was time for a bonfire, dinner and, for some, a chance to swim before heading home. At one point, the low rumble of a plane could be heard as it cut southeast through the sky. Soon, the twin-propeller craft came into view, the night-time sun reflecting off its white paint. Instantly, Nathan knew what it was: a medevac (a medical evacuation aircraft). That kind of plane wasn’t new to him; for one emergency or another, he had seen it time and time again. 

Around the toasty bonfire on the beach of Choris Peninusla, the adults started talking about the medevac. “I wonder who they’re going to Buckland for?” Nathan wondered aloud in between bites of smoked salmon.

Buckland was Nathan’s village, about 30 miles away, and, sure enough, where the patient was. There was a chance to save her. But with every second that passed, time was running out. 

It would be hours until Nathan found out what was going on. The patient was his daughter, Rosie. She had fallen victim to a rising public health issue for indigenous people that, for years, has claimed life after life after life and has hurt countless families and loved ones around the country, but especially in Alaska: suicide.

***

Nathan Hadley Jr’s voice is soft. His words come slowly. He has dark brown hair and broad shoulders. At around 5’11”, he stands a good inch or two taller than most of the other men in Buckland. He wears glasses – finding the right pair that fit his wide face is hard – and flannel plaid long-sleeve shirts. 

Buckland has been Nathan’s home pretty much all his life. He was born on 16 April 1968, and picked up the nickname Jughead from a babysitter before Nathan could even toddle. The nickname has stuck to this day.

 “With young kids today, I can go out and tell ‘em – certain kids – ‘My name is Nathan,’ and they will not believe me,” Nathan says. He also goes by Juggie. “Even the elders that know my nickname, prefers calling me by my nickname – even when we’re in public.”

For many reasons, Alaska is unlike any other state in the US. The country’s 49th member, Alaska is big – really big. At 665,384.04 square miles in total size, according to 2010 US Census Bureau area data, Alaska is the country’s largest state. The next largest is Texas, at 268,596.46 square miles. In fact, you can fit the three next-largest states – Texas, California (163,694.74 square miles) and Montana (147,039.71 square miles) – inside Alaska, and still have enough space to comfortably fit Utah (84,896.88 square miles) in too.

Despite its vast size, Alaska’s population is small and isolated – just 710,231 people, according to the 2010 US Census, revised to 710,235 in 2013. That was larger than Vermont’s (625,741) by only 84,494 people, or about the size of a suburban city.

Alaska’s internal remoteness is stark. Take the Northwest Arctic Borough, for example. It’s located in the northwest corner of the state that faces Russia, and is one of the state’s 29 county equivalents consisting of boroughs and census areas. In the Northwest Arctic Borough, you’ll find Buckland – and a little more than 400 people who call the village home – nestled up against the Buckland River, which feeds into Kotzebue Sound and the Chukchi Sea.

There aren’t any roads that leave Buckland. Options are limited if people want to travel outside the village. In the warmer months once the ice melts, and if it’s not too windy, villagers can take a boat up the river. To get to nearby villages by land – like Deering, which is about 45 miles to the west – depending on the time of year and if weather allows, they can use an all-terrain vehicle or snowmobile.

Or they can fly to somewhere. Buckland has an airport for smaller planes, though a flight from the village to Kotzebue – the borough’s hub, or county seat, located about 75 miles north – can cost $180 one-way for the 30-or-so-minute trip. But even a flight out of Buckland isn’t guaranteed; wind and snow can wreak havoc on air travel plans.

There are 573 federally-recognised American Indian and Alaska Native tribes and villages in the United States, according to the US Department of the Interior’s Bureau of Indian Affairs. Nearly half, 229, are in Alaska. For at least 10,000 years, the Iñupiaq – pronounced In-you-pack – also known as Iñupiat, have called the area now known as the Northwest Arctic Borough home. Almost everyone in Buckland is a member of the Iñupiaq, including Nathan. And life for him and the rest of Buckland’s villagers, Alaska Native or not, is vastly different compared to what most of their fellow Americans experience in the contiguous US.

For starters, Buckland has two governments. Under the Indian Reorganisation Act, which president Franklin Roosevelt signed into law in 1934, and a 1936 amendment, known as Alaska IRA, for the then-Territory of Alaska, the Native Village of Buckland has a tribal government. The city of Buckland has a municipal one.

Health care is also different. Local health aides provide care at the village’s clinic. Specialists, like doctors, dental care providers and counsellors, travel to the village. If something serious happens, a patient goes to the hospital in Kotzebue; however, if weather doesn’t allow safe travel to the borough’s hub, the patient is forced to go somewhere else like Nome. There’s a catch, though: If you need surgery, your only option is to fly about 475 miles – about the distance from New York to Detroit – to Anchorage.

And language, too. “They don’t get to see a lot of written print, like, when you’re a child growing up in the Lower 48,” – the contiguous US – “you get in the car and you drive with your parents [to] places; and you see billboards and you see when you go to Walmart to get groceries, you see lots of magazines,” Nathan’s wife, Alison Hadley, says. Originally from Texas and not indigenous, Alison taught in the contiguous US as well as internationally before she moved to Buckland. In Buckland, she teaches at the village’s only school, which serves students in pre-kindergarten through 12th grade. “There is no printed language, really, anywhere other than at the school building.”

The Iñupiaq in Buckland have a non-verbal culture. They’ll show you how to cut something instead of telling you. Raised eyebrows mean “yes”. A scrunched nose means “no”. They observe, and speak when necessary. Their subsistence lifestyle plays into why: If noise is made, it could scare away what they’re hunting and potentially go without whatever it is they’re going after until the following year’s hunting season.

People in Buckland, including high schoolers, will switch between the Iñupiaq’s own language and an Engish dialect. At the same time, the Iñupiaq’s language is nearly extinct in the village. Alison says missionaries, the first teachers that arrived, used to hit students at school when they spoke their own language. Nowadays, only the village’s tribal elders speak it fluently. 

Then there are things most Americans take for granted that are relatively new, altogether nonexistent or hard to come by in the village. For example, running water was installed throughout Buckland only in the past few years. The same applies to the 3G service, which allowed villagers to start doing more with their mobile phones than just make calls and text when they weren’t connected to Wi-Fi. You won’t find paved roads in the village – they’re gravel. Nor will you find stoplights. Or school busses.

It’s expensive to live in Buckland. Very expensive. A gallon of milk can cost you anything from $9 to $19. A loaf of bread can cost more than $6. A dozen eggs can go for $6. It’ll usually set you back more than $6 if you want a gallon of gas. Everything has to get flown or shipped into the village. Food gets brought in regularly; gas comes once a year.

Subsistence living is important in the region because of the high food prices. People hunt for caribou, moose, seal and whale. They also fish. Eggs are collected from waterfowl, like puffins.

Jobs are scarce in Buckland, which can make money tight. Poverty is high. The median household income in the village is $41,932, according to the US Census Bureau’s 2013-2017 American Community Survey five-year estimates. At 22.5 per cent, just under a quarter of Buckland lives in poverty. By comparison, the US Census Bureau reported the 2017 median household income in the United States was $61,372. The country’s poverty rate that year was 12.3 per cent. 

“There’s a big number that hasn’t worked or isn’t working,” Nathan says. “People are always hurting for jobs here.” 

Nathan graduated from high school in Buckland in 1986. He completed a nine-month industrial mechanics program at a technical school in Kotzebue the following year. He started working up north at Red Dog Mine in his 20s, and spent several years working there on a rotational schedule. In his 30s, he was a truck driver, hauling ore away from the mine 52 miles to a port where it would be stored and shipped.

He then started working for a handful of years for Maniilaq Association – pronounced Man-ee-lick – a non-profit corporation that provides health care as well as tribal and social services to residents in the Northwest Arctic Borough plus the village of Point Hope, the latter being a part of the North Slope Borough. With Maniilaq, Nathan worked as a liaison, traveling to villages and listening to people’s needs.

When Nathan was 42, he began his political career. Working as a liaison got Nathan interested in leadership and serving on the borough’s assembly, so, when a seat opened up, he wrote a letter of interest and got selected to fill it. He’s held onto his seat representing Buckland and Deering ever since. Nathan, now 51 years old, was the assembly’s president last year. Serving as president is a one-year term; it was his first time in the top role. 

In 2015, Alison was in her second year of teaching at Buckland School when she met Nathan. It was at a parent teacher conference – or maybe an open house, she can’t quite remember. They were married in February 2017. Alison is 33 years old and a twin. Even her little sister, nine years Alison’s junior, has the same birthday: May 28. Alison’s hair is brown, but also what she calls “glitter hair.” 

“I have more grey hair than my husband does,” Alison says. She starts chuckling while adding: “He’s 17 years older than I am.”

Alison has a big personality and lots of energy. A competitive side comes out when she dives into a board game. And there’s an artistic side, too. She loves to paint, but hasn’t done it much since moving to Alaska.

Moving is something she’s done a fair amount of over the past 10 or so years. In 2010, Alison’s second husband died by suicide in front of her at the home they were renting in a suburb of Dallas, Texas, just a few months after they got married. After that, Alison decided to get away.

Dubai was her destination. There, she taught for a short while at an Emirates school in 2012. When she returned to the US, she taught in Texas for half a year in 2013 before moving to Kansas, where a friend of hers was living. Following a year of teaching in Kansas, Alison moved again: This time, to Buckland. 

Her second husband’s death was one of the reasons Alison moved to Alaska in 2014. She knew rural Alaska had a high rate of suicide, and she wanted to turn what had happened into something good. And growing up, she always wanted to live out west. 

During her time in Buckland, Alison taught three of the five children Nathan had from his relationship with his first wife. One of them was Rosaline, or Rosie. 

Rosie Hadley was born on 28 March 1998. At 5’8”, Rosie was tall – around the same height as many men in the village. She used her height and muscular build to stand out on the school basketball team. A four-year starter, she and her teammates went to the state tournament every year. Colleges down in Washington state and Montana offered her athletic scholarships.

She wasn’t just a standout on the hardwood. Rosie excelled in the classroom, too. By the time she graduated from high school in 2016, she finished with the third-best grade point average in her class.

In her freshman year of high school, she found her passion for helping others. During her final years at Buckland School, Rosie helped siblings and other students with their school work. She also volunteered as part of a program that strove to help prevent suicide in the region. 

“I would like to get my degree in Social Services to help the [Iñupiaq] people,” Rosie wrote in a 2016 college scholarship application letter. “I know that I am really good at working with people and feel blessed to know what I want to do with my life so young.” 

Goofy and a jokester, Rosie made everyone laugh. She was hard-working, selfless, close to her siblings. She had an outgoing personality and loved children. When Rosie was young, she would get her little brother Martin dressed when he was just starting to go to school. 

Rosie was also independent, so much so that she reminded Nathan of himself. 

***

On 29 August 2016, the fall semester started at the University of Alaska Anchorage. It was Rosie’s freshman year. She’d soon drop out. Then, on the night of Wednesday 7 September, within days of dropping out, she was medically evacuated from Buckland to Kotzebue. Rosie had intentionally overdosed. After being involuntarily admitted into Maniilaq’s hospital in Kotzebue, Rosie was discharged the next day and headed back to Buckland. According to the hospital report, Rosie “was trying to hurt herself, but not kill herself.”

Nathan and Alison didn’t know why Rosie overdosed. They also didn’t know if she went to counseling in Buckland after getting out of the hospital in Kotzebue even though someone at the hospital arranged it for her. She never went.

Before heading off to college, Rosie was reserved. The only person in her family that she shared a sliver of her emotions and feelings with was Martin. Martin thinks the reason his sister opened up to him, even just a little bit, was because of their strong relationship. “Ever since I was little, she took care of me,” Martin explains. “She knew that I would understand how she is and what she was going through.”

During the summer in between graduating from high school and leaving for college, Rosie turned to Martin with a secret. Don’t tell anybody, she requested.

She had been molested as a child, Rosie told him.

Martin doesn’t know who molested his sister, but he does know it scarred her. He could tell by her voice when she told him. As promised, Martin kept the secret for years.

It was late into the morning one day around the middle of July of 2019, about three years after Rosie had told him, when Martin finally spoke out about the molestation while answering some questions for this story regarding how private his sister had been over the years. Just about to head off to work, Martin was in Nathan and Alison’s living room. Some of the rest of the family was there, too.

The news was a bombshell. Nobody in the room had known except for Martin. Alison, who was sitting on the long couch next to the loveseat, started looking around to see if anybody else was as surprised as she was. Nearby, Nathan’s eyes grew big. Everybody in the room was stunned.

“I don’t know why she didn’t think she could tell me because when the kids were growing up, I would always talk to them and tell them that ‘If anyone ever touches you, you need to tell me, you need to tell someone, you need to – if I’m not home, tell someone, have them tell me,’” Nathan says the day after hearing about Rosie’s molestation. “And, you know, I remember those conversations when they were kids when I would have to travel for work all the time.”

When Rosie came home after dropping out of college, she stayed with family – for years, Buckland has had a housing shortage. Over the next two years, she worked seasonally doing manual labor during warmer-weather months. She liked working with her hands. 

In the colder months from 2016 till 2018 after dropping out, Rosie spent time hunting, helping family and volunteering at the airport in Buckland – where Nathan’s father worked at the time. She also visited her older sister Karstin, who was living in Anchorage. Karstin has lupus and occasionally needs help, so Rosie pitched in by assisting with taking care of Karstin’s daughter. Rosie also went to women-only open gym nights in Buckland.

Alison and Nathan weren’t worried about Rosie potentially harming herself again after she checked out of the hospital in September of 2016. In their mind, whatever had happened was over. On the surface, everything did seem fine.

“There’s a lot of cases where people take pills to harm themselves around here, but they are okay, and a lot of them don’t do it again. Because when I was growing up, I saw – when I was, like, a little girl – I saw people in high school do it,” Karstin says. “In high school, I took pills, too, and got medevac’d.” Her voice falters with emotion so it’s hard to understand what she says next, except that she says that she’s “still here.” She adds: “So when people take pills around here, people assume that they will be okay then, I guess, because most everyone is okay after they do it.” 

In fact, Rosie even opened up a little bit to Nathan and Alison, telling them she was a lesbian. Her aunt Ethel already knew. And after Rosie told Ethel that she was tired of keeping that secret from Nathan, Ethel encouraged her to open up to her father. So, Rosie did.

It was sometime around Christmas and the end of 2016 – a few months since dropping out of college and overdosing – when Rosie went to Nathan’s bedroom and told him she needed to talk. They went to the living room; Alison joined. Not only was Rosie into women, she told them, the real reason why she dropped out of college was because she was in love with one in particular and wanted to be close to her.

The news that Rosie was gay caught Nathan by surprise. He was completely fine with it, though. He told Rosie he loved her.

Alison, too, told Rosie she loved her. Unlike Nathan, Alison wasn’t surprised. She had a hunch back when Rosie was in high school that Rosie liked girls. Alison also diverged when it came to reacting to the reason why Rosie dropped out of college. Alison was disappointed that Rosie felt like she couldn’t continue pursuing her education and that Rosie had let a relationship get in the way of her dreams.

The new year brought joy to the Hadleys – at least, at first. In February of 2017, Nathan and Alison got married. Rosie got a new baby brother a couple of months later when Alison gave birth to Alison and Nathan’s first child together: Patrick. 

Their happiness was soon overtaken by sorrow. In November, Rosie’s granduncle Rudy passed away. Two days after Rudy was buried, Rosie’s then one-year-old cousin Meadow died. Then, in January of 2018, Rosie’s cousin – but practically her brother – Jacob died. Three months, three deaths. 

“No one was normal in the family during that time,” Alison says. “You couldn’t even heal from the first trauma, and then the next trauma happened, and then the next trauma happened.” Rosie helped dig graves for all three.

Despite all the trauma, Rosie continued to seem fine. Yes, she was grieving – everyone was grieving. However, she didn’t appear upset. Didn’t appear depressed. Didn’t appear angry. 

That summer, on 26 July, a bunch of Rosie’s family – immediate and extended – decided to grill at the sandbar, a mile or so down the river from Buckland. Fifteen or 20 people piled into a couple of boats to get there. From around 7pm till roughly midnight, everybody hung out in the summer heat. Nathan manned the grill, slinging hamburgers and hot dogs. There was also soda, chips, smoked salmon and an indigenous food made of beluga whale called muktuk. 

Kids swam. Rosie went out into the river on a tube with her older brother Nathan III; there, they chilled, just the two of them. That night on the sandbar, flames from a driftwood bonfire danced. Marshmallows would get roasted. “I thought it was a perfect day,” Nathan remembers. “We all had a good time. We all, you know, we laughed a lot.” 

***

On July 28 2018, the night of the beluga hunt and berry-picking up north, and two nights after the grill at the sandbar, Alison was in the smokehouse behind Ethel’s house working on some salmon and keeping one-year-old Patrick out of the fire. After finally finishing, Alison started heading home. Turning the corner with Patrick in a stroller, Alison saw a couple of all-terrain vehicles out front of Ethel’s house, and a man standing on her sister-in-law’s front steps. The man was a village police officer. 

“It’s not good,” he told her moments later. 

Nobody would answer Alison’s questions. Not the village police officer. Not the health aides on the scene. Nobody would tell her that Rosie had killed herself. 

Alison grew frustrated. And she couldn’t get a hold of Nathan. She knew the radio on his boat wasn’t turned on. 

At long last, Alison got her first bit of info. It came from Esther, one of Nathan’s sisters, as the two women were out front of Ethel’s house. Esther was visibly distraught; her hand shook while she smoked and tried to relay news to Alison. Alison doesn’t remember what Esther said, except that it was about Rosie.

Helpless, a thought crept into Alison’s head. I can’t believe this is happening again. I can’t believe we’re outside of Ethel’s house again. About six months earlier, Jacob, who was 16 years old, had shot himself inside Ethel’s house. He later died at the clinic in Buckland. A few months later, a young woman from Buckland took her own life in Kotzebue.

Just as the medevac from Kotzebue was landing in Buckland, Rosie died at her aunt’s house aged 20 years old. In just a handful of months, Buckland had been affected by indigenous suicide three times.

Eventually, a state trooper showed up. She had flown in from Kotzebue. Once finished with her work inside the house, the state trooper came outside and asked Alison and others waiting if they wanted to come inside and see Rosie. It was Alison’s first chance to see her.

Sometime between midnight and 1am, the village’s ambulance arrived. It wasn’t really an ambulance, though – a real ambulance is a medical luxury that the small, remote village of Buckland doesn’t have. Instead, a truck with a canopy attached on the back showed up. The state trooper needed to get Rosie to Kotzebue for an autopsy. Alison begged her not to take Rosie away just yet – Nathan and the others hadn’t gotten back from the hunting and berry-picking trip.

As Nathan was pulling his boat into the sand-gravel beach in Buckland, he saw his father racing toward the shoreline in an ATV. It was about 1AM. Nathan wondered why his father was up so late.

“I have bad news,” his father said.

 “What do you mean, you have bad news?” Nathan asked.

 “Rosie’s gone,” his father replied.

“What do you mean ‘Rosie’s gone’?” Nathan questioned. 

“Rosie killed herself.” 

***

Indigenous suicide is a serious public health issue across the US. According to the Suicide Prevention Resource Centre, in 2017, the combined suicide rate for US indigenous peoples was 22.15 per 100,000 people, compared to a national average across all races of 16.3 per 100,000 people. In Alaska, the difference is even more stark. The overall suicide rate in the state is higher: from 2010 to 2018 for all Alaskans – Alaska Native and non-indigenous – was 23.92 per 100,000 people. 

But the rate for Alaska’s indigenous population is nearly double the state average, and more than three times the national average. In 2017, the Substance Abuse and Mental Health Services Administration, a federal agency under the umbrella of the Department of Health and Human Services, published a report which included data indicating Alaska had an indigenous suicide rate of 42.5 per 100,000 people from 1999 to 2009, the highest rate in the country in that time span.

If you want to drill down deeper, you can look at the indigenous suicide rate in each of Alaska’s 12 tribal health regions, the health care service areas in the state that are responsible for both Alaska Natives and non-natives. The Alaska Native Epidemiology Center reported that from 2012 to 2015, the Northwest Arctic tribal health region – comprising of the Northwest Arctic Borough, where Buckland is, and the village of Point Hope – had an indigenous suicide rate of 65.5 per 100,000 people, the highest in that span of time. Two other tribal health regions in Alaska, Norton Sound and Yukon-Kuskokwim, also had an indigenous suicide rate above 60.0 per 100,000 people.

Eric Reimers – currently a policy coordinator for the Alaska Native Health Board, a non-profit advocacy organisation, and a former congressional staffer for Lisa Murkowski, one of Alaska’s two senators – says indigenous suicide in Alaska is at “crisis-level, by far”.

“Whenever you talk to – especially a native person from rural Alaska – if you talk to anyone my age that are in a professional setting, if you ask them ‘Do you know anyone that has committed suicide?’ it’s not uncommon for people to know multiple people within the past couple years,” Reimers says, adding that one of his own friends died by suicide earlier this year. 

Reimers is 25 years old. He’s from Iliamna, a remote village in southwest Alaska. Reimers is biracial – his mother is Alaska Native, his father is white – and is part of the Native Village of Iliamna. His Alaska Native heritage is split between the Yupik people, on the side of his mother’s grandfather, and Dena’ina Athabascan, on the side of his mother’s grandmother. 

Why have Alaskan Natives died by suicide at such a significantly higher rate than the country as a whole? Bree Swanson – a social services administrator at Maniilaq and a board member of the Alaska Association of Developmental Disabilities – doesn’t have the answer. Nor does she know why the Northwest Arctic tribal health region was the worst region for indigenous suicide in Alaska from 2012 to 2015.

One risk factor, she says, that is different for Alaska Natives compared to American Indians in the Lower 48, is generational trauma. “In the Lower 48 in the reservations … colonisation is hundreds of years old. In the state of Alaska … it’s more recent. We’re talking grandparent generation,” Swanson says. Russia sold Alaska to the United States in 1867. It wasn’t until 1959 that Alaska became a US state. “There’s a lot of loss of culture, loss of what family means, family ties.” 

Almost every day, Swanson says, someone comes into Maniilaq’s emergency room in Kotzebue feeling suicidal. Swanson says mental health only plays a partial role in indigenous suicide in Alaska. There’s also housing. Education. Poverty. Childhood abuse. But even when looking exclusively at mental health, she says Alaska is facing a dire situation. 

At the local level, Swanson says resources are always a concern. Maniilaq is faced with providing more behavioral health care – the practice of “helping people with mental illnesses or substance use disorders,” as defined by the federal Substance Abuse and Mental Health Services Administration – with less money. This past year, Maniilaq’s state grant funding was cut by $350,000.

Maniilaq doesn’t offer a lot of preventative care. As of October 2019, it didn’t have any case managers to assist people outside of therapy sessions and help people make sure their basic needs are met, that patients have a job, that patients have a place to live, that patients attend their medical appointments. Why didn’t Maniilaq have case managers? Funding. If money is tight and a behavioral health care provider has to pick between offering patients therapy and case management, Swanson says, the decision is therapy. 

Maniilaq also doesn’t offer a substance abuse program, except for intensive outpatient services. A lack of funding caused Maniilaq to close its residential facility for substance abuse around 2009. 

At the state level, Swanson says Alaska’s behavioral health system is broken. There aren’t assisted-living or peer-support services in the state for people who have a chronic mental illness. If someone in the Northwest Arctic tribal health region has a chronic mental health issue and needs a higher level of care, that person can be held in Maniilaq’s hospital in Kotzebue. If an even higher level of care than that is needed, that person is then sent to a facility like Alaska Psychiatric Institute (API) in Anchorage.

Swanson compares API to “a revolving door.” People will repeatedly bounce from API back to their respective communities and back again to API without getting the service they need, she says. “They’re not given any therapy where they can deal with their mental illness and learn how to take their medication appropriately,” she says. “We always operate in a crisis mode, and there’s not a lot of prevention services that go on, nor services that continue to help people to be successful outside of a mental health psychiatric ward.”

But this is only if someone is lucky and can get admitted into API. According to a court case in October 2019, API itself is in crisis. API has a total of 80 beds; but its actual capacity fluctuates daily because of staffing. More people need beds at API than there are available. Alaska’s Department of Health and Social Services even has an online tracker that shows the estimated wait time, in days, until the next available bed opens up. 

So what happens when people all over Alaska have to wait for a bed at API? Sometimes, they’ve been put in hospital emergency rooms. Others were sent to a Department of Corrections (DOC) facility even though their criminal charge or charges have been dismissed. Some were sent to a DOC facility without criminal charges at all simply because they needed to go to API but there weren’t beds available.

“Every single day, I would get an email when I was a magistrate judge for over eight years that API is at full capacity,” Chris McLain says. “Every. Single. Day. For eight years.” McLain is 39 and from Nenana, Alaska. From 2008 to 2016, McLain worked as a magistrate judge in Alaska’s fourth judicial district. Now, he works as president of First Alaskans First, LLC, which he founded in 2016, an organisation which works to help tribes build their own tribal courts as well as with trauma assistance. 

Two months after Rosie’s death, upon the request of Buckland’s tribal government, First Alaskans First came to the village. There, McLain helped run three days of native healing circle activities. McLain echoes Swanson: Behavioral health resources in the state fall short. “How are we going to respond to the crisis that our people are dealing with at record numbers in suicide rates in the villages when we don’t even have the resources, the state doesn’t have the resources, the non-profits don’t have the resources to deal with it in the urban areas in Anchorage, in Juno, in Fairbanks?”

A big factor, Reimers of the Alaska Native Health Board believes, is the state’s remoteness. Eighty two per cent of communities across Alaska aren’t accessible by road. Another part of access is technology. While Buckland received 3G cell phone service within the past three years, Iliamna, where Reimers still sometimes resides, doesn’t have it. 

“If people are in a crisis situation and they’re considering suicide, who do they turn to?” Reimers asks. “If there’s no one within the community, there’s no 911 service available. I mean, there’s, you know, suicide hotline, like 211, but what if you’re in a community that doesn’t have access to cellular service?”

***

The first few days after Rosie’s death were a blur. Nathan was in shock. He couldn’t believe what had happened. He couldn’t understand why Rosie took her own life. “No more Rosie,” he kept saying. 

Alison was in shock, too. And disbelief – she couldn’t believe another suicide had happened in her life. It had been about six months since Jacob’s suicide, and a sense of safety or normalcy had been returning in Alison’s life. Then Rosie died, and that safety, that normalcy was gone. 

There were talks with the state trooper. Talks with family. Getting arrangements in order. And visitors; lots and lots of people dropped by Nathan and Alison’s house: People brought food, one person came and took little Patrick on a walk.

Within days, Rosie’s body was in Anchorage for an autopsy. Nathan and Alison went down, too, with Patrick and Rosie’s biological mother.

Nathan had been anxious to get to Anchorage to go shopping for Rosie’s final clothes. Preparing for his daughter’s funeral, though, felt like a dream. It just didn’t seem real. A very nice pair of black tennis shoes were picked out. Same with a watch, a necklace and a new hat. Rosie would have loved that hat, he thought. There were other aspects of the funeral to arrange while down in Anchorage, too, including pictures and flowers. Financial donations paid for most of Nathan and Alison’s funeral-related costs.

The trip was a whirlwind. Soon, they were headed to Buckland. The trek was broken up into two legs: Anchorage to Kotzebue, and Kotzebue to Buckland. Rosie’s body was on both flights with them.

The last flight was aboard a tiny chartered jet. Taking up the left side and most of the aisle in the jet’s cabin sat a big, white transportation box. Inside it was Rosie and her casket, white with gold trim. The right side of the cabin consisted of a single-file row of passenger seats. Nathan sat up front nearest the cockpit. 

The thought I’m on the same flight with my daughter, but she’s dead played in his mind during the flight; Nathan just couldn’t believe it. 

Through all those first days after Rosie’s suicide, Nathan never cried. It always had been hard for him to cry in front of people. Yes, he was hurt after his daughter’s passing. He was really hurt. But Nathan wanted to show leadership. He wanted to make sure everything got done.

After landing in Buckland, Rosie went home to Nathan and Alison’s house one last time. There, family assembled for a short private viewing in the couple’s open-concept living-dining area. There isn’t a mortician in the village to prepare a body for a funeral. There isn’t even a funeral home. So, on the morning of Rosie’s funeral, Alison and a group of others showed up in the trauma room in the village clinic to finish getting Rosie ready. 

“Even preparing her body was not something that I was mentally realising I was going to have to do,” Alison says. “There’s lots of things you don’t realise that people and there are services for you that take care of that that they don’t happen when you’re in a village.” 

Alison cried most of the time she worked on Rosie that morning. When she couldn’t take it anymore, someone else jumped in and picked up the work. “It was just a very – surreal experience,” Alison explains. “Because you know that it’s your loved one that you’re working on, and you’re trying to not cry, and then you lose it and you start crying, and then you try to regain your composure – just a lot of emotions going on.” 

At the time, Buckland had a church. It wasn’t big – just one room – but, for Buckland, it was one of the village’s bigger buildings for the community to gather at. That afternoon, it was packed for Rosie’s funeral. Almost everybody in attendance wore plaid. The idea came to Nathan and Alison while they were in Anchorage just days earlier as they were getting things ready for the funeral. Rosie loved plaid. 

The funeral lasted about three hours. In Buckland, longer funerals are tradition. Nathan’s family sat in the front row, about five feet or so away from Rosie’s casket. Nathan didn’t cry. Just before it ended, Rosie’s casket was opened, and Patrick saw his big sister. He wanted to go to her, but Alison and Nathan wouldn’t let him. Patrick reached for Rosie from Alison’s lap. Crying, he called to her, using the nickname Rosie and Nathan had been teaching him. “Sissy!” 

After the funeral, a majority of those who showed attended made their way across the river to the cemetery for Rosie’s burial. It was getting to be dinnertime as the burial ceremony finished. Folks were hungry, worn out, emotionally drained. So, they headed back across the river and over to the cafeteria at Buckland’s school for a potluck. With the night coming to an end, Alison and Nathan found themselves asking new questions.

Now what?

What comes next?

How do you move on?

***

The first time Nathan cried after Rosie’s death was a week after the funeral. It was around 10 in the morning. He was sitting on his bed. Tiny Patrick was asleep next to him. Alison was at work. After bottling up his grief, Nathan couldn’t hold back the tears any longer. 

Over the next year, Nathan often played the role of family consoler. Whether over the phone or in person, he tried to comfort his children. Then there was Nathan’s mother. Oftentimes, she was crying, asking why Rosie had killed herself. One time, Nathan’s mother told him that she herself was ready to die, that she didn’t want to see her children or grandchildren go through these suicides. She didn’t have a choice, Nathan told her. 

Despite being there for his family, Nathan refused to open up to them. Not even Alison. Why? Nathan was the oldest of ten siblings. He was a leader in his family and had been since he was young.

That first year after Rosie’s death was up and down for Nathan. What made him the happiest was being around family as well as the work he was doing on the Northwest Arctic Borough’s assembly. But there wasn’t a day that went by that Nathan didn’t think about Rosie and her suicide. Those thoughts brought a cloud of sadness that washed away his joy. 

Often, in his mind, Nathan played back the conversation he had with Rosie on the day of her death. Rosie was getting a boat ready for the beluga hunt and berry-picking up north. At one point that day, Nathan asked her if she wanted to come with everybody. “No, Dad,” Rosie replied. “I love you, Dad.” Nathan thought obsessively how he wished he would have forced Rosie to come with him that day.

Sometimes at night during that first year, when the room was dark and everyone else was fast asleep, Nathan would have a panic attack. Nathan felt isolated during the panic attacks, as if he was alone in his grief. For a while early on, the panic attacks happened once a week. Eventually, though, they grew more spaced out before disappearing for good around 11 months later.

Alison did a lot of thinking as the months went by. “After someone dies by suicide, I think you play the ‘what if’ a lot in your head: ‘What if this?’, ‘What if that?’, and you spend a long time thinking about that and replaying the day in your head over and over and over again,” she explains. “You know it’s not going to change the outcome, but you want to be able to change the outcome in your head, like, ‘If I had just done this,’ or ‘If I had just known this one thing,’ and I think you mull over that a lot in your head.”

“What if” questions weren’t new for Alison. She asked herself questions after Jacob’s suicide six months prior to Rosie’s as well as after her second husband took his own life in 2010 back in Texas. Alison tried to deal with emotions as they came and not block them out. If something reminded her of Rosie and it made Alison happy, she tried to treasure it. If something made Alison sad, she tried to recognise the sadness, but in a way that wouldn’t sweep her up in its undertow. 

Both Nathan and Alison say there’s another part to the public health issue of indigenous suicide in Alaska: trying to help people heal after losing someone close. Maniilaq sent at least one counsellor, specialising in crisis response, to Buckland after Jacob’s death, and again after Rosie’s. “She was here for, like, a couple of days, and then we didn’t see her again from Jacob till Rosie’s death,” Alison says. “There’s no follow-up.”

Nathan, a few moments later, adds: “Their attitude is, like, ‘Well, I came and talked to ‘em, and they seem to be okay, why should I, you know, come back to them and talk to ‘em more?’” 

In Nathan and Alison’s opinion, Nathan’s participation in this story was, in a way, the therapy that Maniilaq should have provided him. Nathan did 27 interviews for this story over the span of four months. 

Alison participated in nearly every interview, too. “It’s been helpful for me, too, to talk with you and put things into words,” she says. “We don’t get to talk to people about it, and I think that that’s part of the problem … suicide is different than death by another means because it’s a taboo topic. So it’s already harder to talk about than just someone who dies of cancer or something, and not having anyone to verbalise those feelings and thoughts and to talk to them is very hard. It’s hard to process all that when it’s all bottled up inside.”

Maniilaq knows, Swanson says, that it needs to come up with a plan for what she calls “post-vention” – helping people after losing a loved one to suicide. People need support for a long time afterwards. Currently, Maniilaq mainly leaves it up to an individual to seek post-vention service, though it reaches out to family members as best as possible. It’s also training local facilitators to have monthly conversations in a talking circle, an indigenous form of talk therapy, in which people can talk about challenges. 

Nathan and Alison both say it isn’t enough.

***

Light snow had fallen overnight in Buckland, but nothing measurable. Alison was sitting at a round table near a giant window in her principal’s office on a frigid Tuesday morning in late November 2018. The office was medium-sized and oddly shaped. Cluttered with furniture, things felt cramped. Joining her at the table were two students, parents and the principal. It was a big moment. They were calling into the Northwest Arctic Borough assembly’s monthly regular meeting.

A few months after Rosie’s death, another member of the Iñupiaq in Buckland attempted suicide. Afterwards, in October, Alison called Nathan while he was in Anchorage for work. Kids at school were tired of suicide, she told her husband. Nathan had an idea: If Alison could get permission from the school’s principal and parents, Nathan would get them on the agenda at an upcoming assembly meeting. This way, they could have their voices heard. That same month, Nathan was installed as the assembly’s interim president. The following month, he shed the interim designation and became president permanently, a role that carried a one-year term. 

Immediately, Alison went to her principal. At first, he was hesitant. Alison didn’t back down, though. After the principal didn’t say yes, Nathan called the principal himself and gave him an earful. Finally, Alison got the answer she was looking for: Yes. 

For weeks, the students outlined, wrote, edited and practiced what they would say during the assembly meeting. The work was student-led, with Alison guiding them along the way.

The call probably lasted no more than 30 minutes or so. Alison sat with her back to the window. The two students were both visibly jittery before anybody in the room started talking. Many children in the village struggle with public speaking. Alison was a little jumpy, too. Not only was she going to be on the radio, her husband was on the call up in Kotzebue, where the assembly’s meeting was taking place. She didn’t want to make him look bad. And she wanted the kids to do well.

One by one, everyone in the principal’s office spoke. They talked about what was going on in the village: alcohol, drugs, bullying, mental health and suicide, according to the assembly’s meeting minutes. Bit by bit, the collective butterflies in the room subsided after each person finished. By the end, the students felt confident they had been heard. 

“They spent a really long time, like, almost – I think every assembly member made a comment,” Alison says of the feedback given during the meeting. One assembly member even responded in the Iñupiaq’s native language. “They were impressed with the kids.”

In January 2019 the assembly had a three-day retreat, in which a number of topics pertinent to the borough were discussed. Among them was suicide prevention. During the retreat, Nathan says Maniilaq gave an informational presentation about suicide and talked about what it was planning to do going forward to fight the public health issue. At the time, Nathan thought the presentation was good. However, his enthusiasm for the behavioral health care provider’s approach vanished after the retreat. Maniilaq, he contends, hasn’t followed through. 

Before Rosie’s death, Nathan, as a member of the assembly, had heard talk about the rising indigenous suicide rate in Alaska and that things needed to be done to combat it. The assembly hadn’t done anything. Why? Because its hands have been tied. Although the assembly is the governing body of the borough, health care and behavioral health care is outside of its purview. Those things are up to Maniilaq.

***

Even though it was hunting season, the big herd of migrating caribou hadn’t come through Buckland yet. It was the second Saturday in October 2019, and, on that below-freezing, cloudy morning, Alison is tired. Patrick and Hunter had gone to bed late the night before and then woke up at 5am to start the weekend.

Alison had made an extra-big pot of coffee for her and Nathan to sip on that morning during our final interview. Parked over on the brown three-cushioned couch in the living room at their house, Alison is wearing a grey and peach shirt with blue, white and pink shorts. Wearing a black shirt and jeans, Nathan sits on the brown loveseat, diagonally opposite his wife.

For a while as we talk before he fell asleep and was whisked away to bed, Patrick – now two years old – lay in Alison’s lap, playing with her phone. Hunter, not even two months old yet, was in a baby swing and wrapped in a blanket in front of the wood-fired stove for some of the morning.

The week had been eventful. Maternity leave had come and gone, and it was Alison’s second week back teaching at the village’s school. Mid-term grades had been due Friday. On Monday, the general election results had been certified in the borough. Nathan had run unopposed for another three-year term on the borough’s assembly. His eyes were on another year sitting as the assembly’s president, too, but whether or not that would become reality would be decided by the assembly later in the month.

At home, the week had been stressful. The couple’s refrigerator stopped working Wednesday, sending the Hadleys into a mad scramble to get as much of the food out as possible. Some things were sent to the freezer outside. A bunch was eaten: breakfast-for-dinner was whipped up Wednesday night from breakfast meat and eggs, veggies were thrown into a soup Friday. The new fridge wasn’t expected to arrive till next week. They got it on sale, but, even so, the cost of shipping from Anchorage to Buckland with a stop in Kotzebue was basically the same as the appliance. 

Fourteen months had passed since Rosie’s death. Her presence was still felt, though. Hats of hers hung on hooks in the dining room. Rosie had been on Alison’s mind Friday during fifth period at school. That’s when Alison was on her breastfeeding pump break. What was that like? As soon Alison begins to explain, her voice started to give out.

“Just really sad because she helped with her brother because Patrick wouldn’t take a bottle, and Hunter won’t take a bottle right now. So, if Rosie was here” – on the couch with his mother still, Patrick yells “Stop!” at Alison amid her tears – “I wouldn’t be so stressed about the baby not wanting to eat when I’m not around because she would bring him up to me.”

 Patrick speaks up again: “You be happy.”

“I am happy, Baby,” Alison replies. 

A short while later, Alison adds: “You just don’t realise how insignificant that that little thing was that she would do that, but it made such a big difference for Patrick. And now that Hunter is here and I don’t have that and her brothers don’t have that, it’s just sad.”

Rosie had been on Nathan’s mind recently, too. For Nathan, it had been about hunting. His daughter always wanted to take part in the hunting. While Alison had been to Rosie’s grave a couple times since the funeral, Nathan hadn’t yet. The thought of visiting Rosie at the cemetery was still too hard.

As the conversation starts to near its end, the topic changes again. Both Nathan and Alison say they think Maniilaq will get better at treating overall mental health. Alison feels the US as a whole is trying to come up with a plan to better treat it. Maybe she wasn’t aware of it back in the early 2000s when she was in high school, Alison says, but, to her, it seemed like the country had been talking more about the topic nowadays.

Nobody should die because they’re hurting inside, because they feel like they can’t take it anymore. Help is available. And if access to beds at API increases and if behavioral health care in the state improves, things might get better. However, those improvements probably won’t be enough on their own. The Northwest Arctic Borough, like so many other boroughs and areas in the state, arguably would still face a steep challenge in fighting indigenous suicide.

Nathan says he is hopeful things will improve. Alison’s response was just four words. “God, I hope so.”

Three days later, on 15 October, Alison unexpectedly calls me. There had been another indigenous suicide – Nathan’s nephew up in Kotzebue. “I just – I don’t understand. I don’t understand,” Alison says. I asked her what she means. “Why people feel like this is their only way out, and when they know it’s not the only way out and they’ve seen the family struggle and they do it anyways. I just don’t understand.” 

The phone call didn’t last long, less than 15 minutes. At least twice during it, Alison says she didn’t know why she was calling me. After what was probably the first time, she said she just wanted me to know that indigenous suicide was still happening, that it was still happening to their family.

There was no mistaking how upset she was. She doesn’t want to answer her phone anymore, she tells me. She is afraid that if someone called her, news of another suicide in the Hadleys’ family would be waiting on the other end of the line.

It was a little before 9am. Alison was calling me from her classroom. She had to work that day. After maternity leave with Hunter, she didn’t have any days off left. Alison’s first-period class was just minutes away from starting, and she was trying to compose herself. She didn’t want to look like a wreck.

At one point during our conversation, she said she wanted to talk to somebody, but there was no one to talk to. Alison had already tried calling her mother in the Lower 48; she didn’t answer. Talking with Nathan right then wasn’t really an option. Already out of town, he was en route to be with the bereaved. Alison didn’t want to keep bugging him. And Alison didn’t know a lot of the new people at work just yet. 

I guess that’s why she called me.

Devon Heinen is journalist living in Seattle, Washington. His work has appeared in the Atlantic, VICE, Sports Illustrated, ESPN and others. He tweets @DevonHeinen.

Images courtesy of the Hadley family and the Native Village of Buckland (IRA).