Alaska Native youth at highest risk for suicide, depression

One family has battled their daughter’s mental illness her entire life
Alaska Native youth at highest risk for suicide and depression
Published: May. 18, 2023 at 8:20 PM AKDT
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ANCHORAGE, Alaska (KTUU) - Alaska is number one in the country for youth suicide, according to numbers compiled by Alaska Public Health Analytics and Providence Hospital, and Alaska Natives are at highest risk according to a recent CDC study.

That study shows Alaska Natives and American Indians suffer more depression and cases of mental illness than any other group. Alaska Natives have long dealt with generational trauma, trauma that can begin before a person is even born and can be made worse through cultural influences or long periods of exposure to difficult home situations. Experts point out that difficult family situations are not unique to Alaska Native youth.

The Farrally family says they know this all too well, as raising their daughter hasn’t been easy.

“The anxiety, depression and then just the anger that she just doesn’t know how to control or deal with,” said Sonia Farrally, when speaking about her adopted daughter, Twilla. “She has scars up and down her arm from cutting.”

Farrally has been battling her daughter’s mental illness for years. Twilla was actually her niece and she adopted the child when she was just a baby. Born to alcoholic parents, Twilla was diagnosed with fetal alcohol syndrome.

“Body weight, height, all the things doctors look at for her growth, she was below the chart lines,” Farrally said. “She wasn’t even on the graph.”

Twilla’s odds were stacked against her from the start. As she grew, even the simplest things seemed like major obstacles.

“Try to get her to take a shower, she would go two or three weeks,” Farrally said. “Or try to get a change of clothes and she’d wear the same clothes for two to three weeks.”

Twilla’s biological family lived in the village of Crooked Creek. Farrally, half Alaska Native herself, says she turned to Native hospitals for help with Twilla, but had little luck.

“She is Alaska Native and then we still can’t get into any of those programs that are Alaska Native based,” Farrally said. “The waitlist, because you just don’t have enough people.”

A study recently released by the Centers for Disease Control found the need is there. In 2021, Alaska Native and American Indian high school students registered the worst on key mental health markers including seriously considering suicide, making a suicide plan and attempting suicide.

By junior high, Twilla’s therapists feared for her safety as well. Farrally says Twilla kept most of her rage bottled up, choosing to hurt herself instead.

“She would find anything and everything to use to cut and she would, she would slice on her right arm mostly, and sometimes on one of her thighs,” Farrally said.

By 2020, Twilla was in her teens, had been kicked out of high school and was sent to a mental health facility in Texas for 11 months.

“One of the hardest things I’ve ever done,” Farrally said. “You don’t ever want to leave your kid behind at a facility you don’t know, and a state you don’t know.”

When Twilla returned home her parents say she also returned to her old ways. During a violent episode, she threw a hammer at her father.

“She needs to learn her actions are having a major consequence,” Farrally said.

Twilla was sent to a juvenile detention facility. On April 27, 2023, she spent her 18th birthday there. Her parents don’t know what will happen to her next.

“It does hurt,” Farrally said. “I mean the only thing we know; we can say is that she’s in a safe place, she can’t hurt herself.”

Experts say trauma and mental health issues, such as those suffered by Twilla, are common in Alaska Native communities.

“In terms of substance abuse and mental health, it’s going to be a multi-factorial story and trauma’s certainly a piece of it, the response to trauma, the desire to numb,” psychiatrist Lisa Alexia said.

Alexia previously worked with the Southcentral Foundation for over 10 years. She’s now in private practice. She has experience helping children throughout Southcentral and Western Alaska villages.

“Schools theoretically teach skills to help you survive in an urban setting but they don’t do that adequately in most village schools,” Alexia said.

Alexia says children in Alaska, and particularly in western villages, are also uniquely affected by the changes in sunlight through the seasons and school days that fail to match the body’s natural rhythms.

“Alaskan students and Alaskan youth are the most sleep deprived in the nation,” Alexia said. “This is an artificial structure that we’ve imposed, it’s an unconsented public health experiment and we have enough evidence to say sleep deprivation causes mental health issues, it increases risks of suicide.”

Every child with mental illness struggles with their own form of darkness. Twilla’s parents hope she’ll see the light before it’s too late.

“There is hope,” Farrally said. “That’s all we can keep hoping for is to give her everything that she needs and know that we love her unconditionally.”

Farrelly said though Twilla is still in a juvenile detention center, she is doing better. Presbyterian Hospitality House has completed Twilla’s intake process and she has been accepted. She is now at the top of the waitlist and hopes to have a bed available sometime in June.

If you or someone you know is struggling or needs immediate support, contact Careline at 1-877-266-HELP, call or text 988, or chat at You are not alone. Please visit for additional 988 resources. For more information on the Alaska Suicide Prevention Council and suicide in Alaska, visit