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Youth Suicide Prevention in Rural America National Webinar: SPRC and STIPDA Sources of Strength Mark LoMurray Director 7

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Youth Suicide Prevention in Rural America National Webinar: SPRC and STIPDA Sources of Strength Mark LoMurray Director 701-471-7186 marklomurray@gmail.com. Network Positions. Peripherals. Bridges. Group Members. Central Members. Isolate. 2. Sources of Strength Description.

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Youth Suicide Prevention in Rural America

National Webinar: SPRC and STIPDA

Sources of Strength

Mark LoMurray

Director

701-471-7186

marklomurray@gmail.com

network positions
Network Positions

Peripherals

Bridges

Group

Members

Central Members

Isolate

2

sources of strength description
Sources of Strength Description

A program that trains both adult advisors and diverse peer leaders – with five follow-up action steps that take peer leaders/adult advisor teams three to four months to complete

Usually school-based, but faith, community, cultural is used.

The purpose is to reduce codes of silence and promote help seeking by teens to caring adults in their local school and community.

Started in ND in 1998, used extensively in a statewide campaign from 2000-2004. In 2005 the project received the national APHA Public Health Practice Award – epidemiology section

Rigorous randomized research is underway in 18 schools in GA, upstate NY, and ND through the University of Rochester, NY and University of South Florida.

a singular focus on mental health referrals
A Singular Focus on Mental Health Referrals

Leaves rural and tribal communities feeling disempowered

Rural communities are often mental health shortage regions

A one way model that requests referrals to medical and mental health services, but generally does not refer back to village-based supports and strengths.

a connections model sources of strength
A Connections Model Sources of Strength

A focus on developing multiple sources of support

A strength-focused approach

Bring peers and adults together for prevention power

Use peer connections to change peer social norms about adult help seeking, strengths

Spread Hope, Help, Strength messages, not stories of trauma – local faces and voices

basic process
Basic Process

Awareness Phase -Engage leaders/ administrators

Review protocol

Identify and train key adult advisors (2-6 hr)

Train school or community staff (20 m – 1.5 hr)

Recruit peer leaders

Train peer leaders with adult advisors (3-4 hr)

Peer leaders with adult support begin 5 action steps (3-4 months)

sources of strength
Sources of Strength

Access to Mental Health

Family Support

Positive Friends

Access to Medical

Spirituality

Caring Adults

Positive Activities

Generosity/Leadership

early results impact of training on 176 teen peer leaders in 6 schools ga
Early ResultsImpact of training on 176 Teen Peer Leaders in 6 Schools (GA)
  • 6 high schools in Cobb County that already received staff gatekeeper training
  • Randomized design – to immediate training or wait-list
  • More than 50% of peer leaders aware of suicidal peers
  • Positive training effect (at school-level (4 d.f.) on:
    • Help-seeking Norms p< 0.05
    • Coping Using Sources of Strength p< 0.05
    • Knowledge of helping Suicidal Peers p< 0.01
    • Referral of Suicidal Peers to Adults p< 0.05
referred a suicidal peer to adults 2 fold increase by training p 05
Referred a Suicidal Peer to Adults: 2-fold increase by training (p<.05)

Control Schools

Sources of Strength Schools

initial conclusions for peer leader training sources of strength
Initial Conclusions for Peer Leader Training (Sources of Strength)

In high schools with adult staff training (QPR), peer leaders can be trained and implement ‘peer to peer’ messaging

Training increases Peer Leaders’ positive help-seeking attitudes, reduces ‘codes of silence’

Trained Peer Leaders refer more suicidal peers to adults for help (self-reported), unlike adult training which did not increase referral behaviors in high schools

promoting help seeking behaviors
Promoting Help-seeking Behaviors

A model that values village-based supports as highly as institutional services.

Intentional and strategic about using peer and rural connections to change social norms

Localize – create names, faces, of local supports on a small town, village, housing project level.

Move from just help seeking around suicide to include strength building behaviors, early emotional distress = caring conversations

data and surveillance
Data and Surveillance
  • North Dakota experience of needing to look at a fuller picture
    • raw numbers of suicide fatalities
    • rates of suicide fatalities – gender, age, ethnicity
    • Breakdown into state regions and counties
    • Use ten year averages – recent and long-term trends
    • Compare to national rates and to surrounding states
    • Use YRBS, lack of injury data – ambulance trips
  • Surveillance system needed – contagion response
clinical care one example
Clinical Care – one example
  • Mental Health – Faith-based Partnerships
  • Many pastors and spiritual leaders provide a bulk of rural counseling
    • Many lack training
    • Almost all lack support and consultation services
  • Be intentional about bringing ministerial- spiritual leaders in regular meetings with mental health providers.
  • Encourage cross system referrals
screening and identification
Screening and Identification
  • First do no harm
  • Make sure adequate resources are in place to handle youth identified
  • Universal school-based screening – 20% identification of students is not uncommon
  • Tiered system
    • Hospital, outpatient, small support groups, mentors
supporting attempters
Supporting Attempters

Oniyape – home tracker model

Maniilaq Association, Alaska – letter writing

Hotlines – phone follow-up support

Sponsors – Mentors to provide ongoing support