American Indian and Alaska Native youth have the highest rate of suicide in the nation. The following report outlines the factors that contribute to these rates. These factors include barriers to mental health care and the unique risk factors. Barriers to mental health care that American Indians and Alaska Natives face include isolation of tribes, cultural values, limitations of Indian Health Services, and a lack of qualified providers. Unique risk factors faced by these groups include isolation, oppression, tribal characteristics, and high rates of alcohol abuse. Two prominent theories in suicide research are examined to help explain the epidemic of American Indian and Alaska Native youth suicide. These theories include the Interpersonal Theory of Suicide as well as Strain Theory of Suicide. A close look at current interventions is also provided. Limitations of these interventions are discussed. Implications for community and college counselors are given, which include being sensitive to the unique needs of these clients and designing interventions targeted specifically at these groups. Suggestions for future research are also included. / text