The research review reveals that low socioeconomic status along with substance abuse, barriers to mental health services, and acculturation are risk factors for suicide among American Indians. Recent data from the late 1990s indicates that the overall age-adjusted suicide rate for American Indian populations is approximately 1.5 times higher than the rate for the general U.S. population. The lack of recognition of the problem and funding for suicide prevention in American Indian communities also plays a part in the high occurrence of suicide among American Indians. The authors recommend that suicide prevention efforts in tribal communities focus on overall empowerment and greater access to resources in order to mobilize the traditional strengths of tribal communities toward the prevention of suicide and other social ills including substance abuse and mental health problems. Funding and research approaches are also recommended, including the advice to explore novel funding approaches, such as using Medicaid funding to support tribal mental health programming. Implications for practice, policy, and research are considered and include the directive to establish and utilize culturally appropriate operational definitions of suicide, help-seeking behavior, healing, medicine, and healer. Future research in this area should focus on how religion and the use of traditional healers can help tribal communities deal with acculturation and other influences that affect suicide and other social problems among American Indians. Note, references