OVERALL PROJECT SUMMARY Suicide is the second leading cause of death for American Indian and Alaska Natives (AI/AN) ages 18-34, and is up to 6 times higher than for their White counterparts. AIAN also suffer a disproportionate burden of suicide risk factors, including mental health disorders, traumatic life events, and substance abuse. These challenges contribute to the notably greater risk of urban young AI/AN adults compared to their non-AI/AN counterparts for attempted suicide (21% vs. 7%), as well as for depression and substance abuse. This application responds to NOT-DA-20-033 and seeks an administrative supplement to 5U19MH113135, one of 3 NIMH’s Suicide Prevention Hubs focused on AI/ANs ages 18-34. Our supplement emphasizes the twin aspects of personal social network dynamics and behavioral health risks (BHRs) in this special population. Social network theory, methods, and analyses will be used, first, to understand the role of personal ties in the etiology of suicide, mental illness, and substance abuse; and second, to provide novel directions to improve uptake of clinical and community interventions among urban AI/ANs. Our aims and example hypotheses are as follows: Aim 1: Identify baseline associations between social network characteristics and current levels of behavioral health status and risk. We will conduct face-to-face interviews of 400 AI/ANs, 18-34 years of age, who visit All Nations Wellness and Healing Center (ANWHC), a cultural and social services program operated by the First Nations Community HealthSource (FNCH), a FQHC in Albuquerque, NM. FNCH receives nearly 80% of patient referrals from ANWHC. We will collect data about BHRs, including mental illness (depression, anxiety), suicide (ideation, attempts), alcohol use, and drug use (opioids, other psychostimulants). We will also describe the structure (size, density), function (support resources), strength (closeness), and content (leadership) of participants’ personal networks. Sample hypothesis: Larger, less dense networks composed of a mix of strong (kin) and weak (neighbors or acquaintances) ties will be associated with lower BHRs. Aim 2: Examine the health influence structure of individuals’ networks to identify effective potential points and pathways for BHR prevention and treatment intervention among AI populations. Social network data from the same cohort will be used to describe the composition and function of social networks and analyze how these patterns relate to health communication. Social network analysis and random graph techniques will be used to identify the potential for health interventions. Sample hypothesis: Individuals with greater “prestige” in a social network (i.e., greater cohesion, leadership, and lack of conflict) will be more likely to have shaped individuals’ help-seeking response, including program participation. The proposed line of inquiry promises to yield important scientific and programmatic insights into this critical area consistent...