"If you do not birget [manage] then you don't belong here": a qualitative focus group study on the cultural meanings of suicide among Indigenous Sami in arctic Norway

Suicide is a major public health issue across the Arctic, especially among Indigenous Peoples. The aim of this study was to explore and describe cultural meanings of suicide among Sami in Norway. Five open-ended focus group discussions (FGDs) were conducted with 22 Sami (20) and non-Sami (2) participants in South, Lule, Marka, coastal and North Sami communities in Norway. FGDs were recorded, transcribed verbatim and analysed employing thematic analysis. Six themes were developed from the analysis: "Sami are treated negatively by the majority society", "Some Sami face negative treatment from other Sami", "The historic losses of the Sami have turned into a void", "Sami are not provided with equal mental health care", "The strong Sami networks have both positive and negative impacts" and "'Birgetkultuvvra' might be a problem". The findings indicate that the participants understand suicide among Sami in relation to increased problem load for Sami (difficulties in life not encountered by non-Sami) and inadequate problem-solving mechanisms on different levels, including lack of equal mental health care for Sami and cultural values of managing by oneself ("ies birget"). The findings are important when designing suicide prevention initiatives specifically targeting Sami.