Thankfulness Challenge


Studies have shown that practicing gratitude can have a huge impact on your life. The actual physical makeup of the brain changes and makes people more positive, joyful and content. One way to do this is as simple as writing down or journaling about 3 things you are thankful for every day for 21 days. A fun activity your Sources of Strength team can sponsor is a Thankfulness Campaign.

You can use our Thankfulness Journals, our Thankfulness Posters or create your own way to spread messages of gratitude in your school or community.

Watch this video for ideas to get started.


Social Media: Everyday for 21 days, post 1 thing you are thankful for and hashtag #thankfulnesschallenge and #sourcesofstrength. You can also take photos of people with their Thankfulness posters and share them on your school’s Sources of Strength account.


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Videos: Create a short video with as many people as possible naming things they are thankful for. Watch this video for tips on how to make a great video. 



Hallway Displays: Have as many students and staff as possible fill out Thankfulness posters. Use these posters to create a large wall display. Take a photo of your display and post it on your school’s Sources of Strength social media accounts. 

School-wide Activities: Brainstorm activities you can do to share messages of gratitude in your school. Use these activities as opportunities to pass out Thankfulness Posters and Thankfulness Journals. Collect the posters to use in a large wall display. Encourage students and staff to use the journals for a 21 day Thankfulness Challenge.


What Helps Me Campaign


The What Helps Me Campaign is a powerful way to share stories of strengths in your community. This campaign focuses people’s personal stories of what strengths help them when dealing with the big three emotions – anger, anxiety/worry, and depression or feeling sad or down. Everyone struggles with at least one of these emotions. This campaign is about identifying which emotions you wrestle with the most and which strengths help you through it.



 Watch this video for ideas on how to get started with a What Helps Me Campaign

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What gives this campaign power is if everyone in the school can get involved in a small group discussion, or a writing, art or video project. Getting everyone thinking about what are the things that help them with their emotions. Everyone wrestles with these emotions, and we want you to focus on collecting stories of help and strength. Here are some ideas of how to do that:

Video Project:

  • Get a number of the Peer Leaders and Adult Advisors to state “What Helps Me with ________ (emotion) is _________ (strength) and _________ (strength) and _________ (strength). Example: What helps me when I get too anxious or worried is playing my guitar, talking to my mom, and going for a run. Stories can be this simple or more detailed, as long as they remain strength focused and hopeful.
  • Link several of these video’s together (make sure to include adults), place some still pictures in the middle, layout some popular strength-based music in the background, and create a video.
  • See Sources of Strength website videos for instructions on how to make a video and for an example of a What Helps Me video.
  • This video can then be shown schoolwide, on social media, or as an introduction to a class or small group discussion.

School Newspaper,  Announcements & Social Media: Peer Leaders can write or interview others (students and adults) about the strengths that have helped them manage emotions. These stories can be posted in the school newspaper or shared over morning announcements. This will be used in promoting the activity schoolwide. These stories can also be shared on social media on your school’s Sources of Strength accounts. Post these stories and hashtag #sourcesofstrength and #whathelpsme. Have all the peer leaders to post their stories on their own accounts. Then encourage your friends to post their stories. Soon you will have created a social network filled with stories of strength. 

Small Group Discussions: During a classroom presentation, Peer Leaders and Adult Advisors can first share a few of their own What Helps Me stories. Be sure to practice with your Peer Leader group before presenting to a class. (For tips on giving presentations, watch this video) After you share your stories, pass out What Helps Me cards and ask the students to write their own stories of strength. Then divide into small groups and have everyone share what helps them when dealing with difficult emotions. You can use the Sources of Strength What Helps Me cards or design your own. It’s a good idea to have a large Sources of Strength wheel projected onto a screen, drawn on the whiteboard, or displayed on a poster to help students name which strengths help them.  

Wall Display: Create a wall display highlighting the stories, art, etc… that have been created throughout the course of the campaign, detailing ways students and staff have found help for regulating their emotions in healthy ways. Be creative. Take a photo of your finished display and post it on your school’s Sources of Strength social media accounts. 

Class Assignments: Teachers can get involved by incorporating the What Helps Me campaign into specific assignments. English teachers have given writing assignments interpreting strengths that might have helped literary characters manage difficult emotions or essay assignments asking students to tell their stories – What Helps Me with…. anger, anxiety, or depression… is…. Art teachers have assigned art projects that communicate the What Helps Me philosophy. Psychology teachers have assigned emotional regulation research and projects.    


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Trusted Adult Campaign


In your Peer Leader Training, you named adults in your community who you would go to for help if you or a friend were struggling. Be sure to deliver your Thank You cards to them and tell them that you appreciate them. 

Now your challenge is to involve the rest of your school. We want you to get at least 80% of students in your school to name their Trusted Adults and to display these names in a large, visual Wall of Trust. 

Here are some ideas to help you get started. 


As you are planning this campaign, think about what you want your final Wall of Trust display to look like. A tree, a pyramid, a mural, circles, rainbow, photos + names, . Once you pick an idea, get crafty and make your cards, bricks, leafs, triangles, circles, etc. Make sure you have enough cards for at least 80% of students to write at least one name each. Here are some examples from other Peer Leader teams. 


Also think about where the Wall of Trust will be displayed. Work with your Adult Advisors to find a large area in a prominent location so everyone can see it. 

Then work with your Peer Leader team to decide how you will gather the names. Here are some ideas for talking to other students about Trusted Adults and collecting names from them:

Cafeteria Contacts: A team of Peer Leaders can set up a table in the cafeteria or commons and hand out ‘trusted adult cards or ‘Post-Its’, asking students to write down their own name and the name of an adult they could go to about a problem (Trusted Adult). Give them a card to fill out with their name and their Trusted Adult’s name that you can add to a wall display. Have students place these cards or ‘Post-Its’ on a poster in the lunchroom. These cards or ‘Post-Its’ can then be transferred to a hallway mural or larger display for the whole school. Also give them a postcard, which they can give to their trusted adult that says, “Thank you for being a source of strength in my life.” On the back of the postcard they can write some personal words of thanks to their Trusted Adult. 

‘Tagging’ Students: A fun way that you as Peer Leaders can get other students talking about trusted adults is to go into the hallways and tag 5-10 of your friends by putting a sticker on them. You can make stickers or use Sources of Strength stickers. Tell them “You’ve been tagged – Sources of Strength” or “ You’ve been chosen – Sources of Strength” – and then give them directions to go to a specific location (room 101, the table set up in the commons, etc.)  for a mystery prize or mystery game. When the student arrives in the room, they are meet by Adult Advisors and Peer Leaders, given a prize (bottle of water, cookie, wristband, etc…) or engaged in a quick fun activity or game, and asked to name a trusted adult. Once the student writes this name down on a card, ‘Post-It,’ paper leaf, paper brick, etc…  they will then be given a sticker to go out and tag 1 or 2 of their own friends in the school. Be sure to also give them a Thank You postcard to share with their Trusted Adult. 

Classroom Presentation: As Peer Leaders you can plan a classroom presentation, in which you talk about Sources of Strength, share stories of your mentors/trusted adults, and then pass out cards and have the students fill out who their mentors/trusted adults are. Go around the room and have the whole class share the names of their trusted adults out loud. You can also write all the names on the whiteboard. Collect the cards to be used in your hallway display and be sure to give every student a  Thank You postcard to give to their mentors/trusted adults as well. 

Once you have collected all the names, build your Wall of Trust in a prominent location in the school. Take a photo of it and share on your team’s social media account and #sourcesofstrength.


As you are collecting names and handing out postcards, you can also encourage students to take a photo with their Trusted Adult and post it on social media tagging #sourcesofstrength and #trustedadult. 

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In addition to creating the Wall of Trust, you can also promote the campaign and spread the word about Sources of Strength and Trusted Adults through other outlets in your community. 

Video Project: Create a brief video where several Peer Leaders name different trusted adults both in the school and out of the school and give short stories about how they have been a strength in their lives. This video can be shown in the school or sent out via social media. 

Social Media: Create a Trusted Adult social media campaign. Start with your peer leader team. Have each Peer Leader post a photo with their Trusted Adult, explain why they are a source of strength in their life and #sourcesofstrength and #trustedadult. Encourage the whole school to post their own photos and stories. 

Newspaper Stories: Write about your  trusted adults and how they have been a strength for you in the school newspaper or community paper. This can help promote the school-wide activities your peer leader team is doing to collect names from other students.

School Announcements: Peer Leaders can also plan for a school announcement series of trusted adults stories – “this is Thank Your Mentor-Trusted Adult week and over the course of the week we will be sharing stories of Mentors/Adults who have been a strength for us and made a positive impact in our lives” – and then have three to four Peer Leaders talk about their trusted adults over the announcements every morning.

Be creative. Have fun. Involve the whole school. Let us know how it goes by sharing on social media or emailing 

I am Stronger Campaign


The I am Stronger Campaign focuses on strengths that you have increased in the last year. This campaign spreads the idea that the strengths on the wheel are not static. Just because one area on the wheel isn’t strong for you now, doesn’t mean you can’t strengthen it in the future. You are not stuck. You can grow stronger in each area of the wheel. The I Am Stronger Campaign is about collecting stories of strength from your community and sharing them through photos, videos, wall displays and social media. 


What gives this campaign power is if everyone in the school can get involved in  a writing, art or video project or small group discussion. These activities get everyone thinking about their strengths and the ways that they have grown stronger in these areas.  We want people to know they can grow in certain areas by working on new practices or activities that help develop these strengths. Likewise, we can help our school or community grow and develop these strengths by highlighting how others have gotten stronger.

Click here for a video about creating an I am Stronger campaign:

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Here are some tips to help you create a successful I am Stronger campaign in your school or community.

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Videos: Click here to watch an example of an I Am Stronger Video:



Hallway Displays You can make I am Stronger cards, take photos of students and adults, and create a wall display using the photos and stories of strength. 

 I am Stronger photo montage

School Newspaper & Announcements: Peer Leaders can write or interview others (students and adults) about areas they have grown stronger in. These stories can be posted in the school newspaper or shared over morning announcements. If the campaign is run over the course of a week, there could be one or two stories every morning. I Am Stronger stories can also be posted on bulletin boards.

Small Group Discussions: During a classroom presentation, Peer Leaders and Adult Advisors can first share a few of their own I Am Stronger stories. Then other students can be invited to share their stories of strengths in small groups. You can use the Sources of Strength I Am Stronger cards or design your own. The Sources of Strength Wheel can be projected onto a screen, drawn on the whiteboard, or displayed on a poster to help other students identify strengths that have become stronger in their lives.  

Social Media: You can also spread this campaign on social media by encouraging people to share their stories of strength and hashtag #IamStronger and #SourcesofStrength



Click here to download these I am Stronger cards



Sources of Strength Train the Trainer

Throughout 2015 Sources of Strength has continued to grow and expand. This is our seventh year of Training For Trainers/Advanced Coordinators across the US and Canada. These trainings are multi day sessions that teach local trainers how to implement the Sources of Strength program with fidelity to our best practice/evidence based standards.  This past spring we provided T4T’s sessions in Winnipeg, Ottawa, and New Jersey.  

Check out these photo’s from our Summer 2015 T4T/Advanced Coordinator sessions in Denver, Savannah, White Mountain Apache Arizona, and Fairbanks (Tanana Chiefs Conference).  Participants came from middle and high schools, colleges and universities, mental health and community programs, faith based and recreation-based programs all focused on expanding Sources of Strength. Our participants represented an incredible diversity of cultures and brought great spirit and skills to our efforts. We played lots of games, learned from our community partners about what is working in their areas, practiced and honed our training and facilitation skills, and were continually inspired and encouraged by the incredible people we get that privilege of partnering with across the world. 

We are excited about our expanding work with Latino/Hispanic communities, LGTBQ outreach, start of French-Canadian efforts and translations, faith-based efforts, school, village, urban, and of course with our ever expanding efforts in Native American, Alaskan, and Canada 1st Nation communities.  This Fall/Winter we’ll provide T4T’s with the California based United Indian Health, as well as Australia (Black Dog Institute) and New Zealand.  
It wouldn’t be Sources of Strength without laughter, fun, and learning that games aren’t
just games, but strategic and purposeful. 


A Key T4T component is to help make our trainers AUTHENTIC, by applying and using the strengths in their personal lives. 


Time is spent on teaching theory, method, and research behind the curriculum as well as the power of
positive norming in our peer messaging and how we use social network connections to spread Hope, Help, and Strength.  Trainers develop a deeper understanding the curriculum, intent of each module, and the why and purpose of the sequencing. 
Exciting things are happening at Sources of Strength as our great partners spread an Upstream prevention model that lights up their corners of the world.  

Sources of Strength adventures in Alaska

We recently returned from a 2-week trip to Alaska, training in Fairbanks with Tanana Chiefs and traveling to Fort Yukon and Venetie to work with peer leader teams and adult advisors in those villages. We were fortunate enough to be able to travel between the villages by boat on the Yukon and Chandalar Rivers. It was an amazing opportunity to be on the river and experience the beauty of the landscape. 


Here are some photos from our journey:

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Flying into Fairbanks


 Alaska T4T

Lots of games and lots of laughs at our training in Fairbanks. Such an honor to work with this amazing group of people and hear their stories of the great work they are doing. 

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Marianne Young, Doreen David, Katrina Gibson and Rowena Sam shared the work their peer leader teams have been doing in the villages of Tetlin, Huslia, Minto and Northway. Sources of Strength peer leader teams have woven Sources of Strength messages into anti-bullying campaigns, peer leader led water safety classes for younger kids, doing generosity activities like baking for elders in the community, swim parties, picnics, sledding, teaching cultural skills like drying meat, snowshoeing, fire building, berry picking and fishing. These adult leaders have been working with youth and adults in their communities to build positive relationships between teens and trusted adults  and to reduce bullying and suicide rates. 





We also had an opportunity to do a fun photo shoot in Fairbanks:



Then we were off …

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Flying to Fort Yukon 

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 Buddy/Constance Sources of Strength Alaska Tanana Chiefs youth suicide prevention 

Buddy our fearless boat driver and Constance our guide from Tanana Chiefs. 


Where the Yukon (brown) and Chandalar (green) Rivers meet. 


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We brought our media team to capture the journey and create images with peer leaders in the villages. 


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Peer leaders in Venetie write and draw the strengths in their lives. 

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Meeting with elders and adult advisors in Venetie. Special thanks to Myra Thumma for organizing the adult meeting as well as the peer leaders, for cooking for everyone and for taking great care of us while we were in Venetie!






Sources + CDPHE = Powerful Prevention in Colorado

Sources of Strength pilot program works “upstream” in seven schools to prevent the need for youth suicide intervention

By Jan Stapleman | Office of Communications
It’s an overused adjective, but well-earned by the Sources of Strength youth suicide-prevention program. It also applies to the way the program is being piloted by the Colorado Department of Public Health and Environment in seven middle and high schools across the state over the next two years.
Most youth suicide-prevention programs are designed to identify kids who are at risk of suicide and launch an intervention. In contrast, Sources of Strength works “upstream” to build a support system of connections to schools and caring adults that helps protect kids from needing such interventions. Suicide is the leading cause of death among Colorado children ages 10 to 17.
Research shows the program’s protective factors are effective against a range of problems, which is why the program is being piloted in an unusual way in Colorado, supported partially by CDC funds designated for rape prevention and education. 
“We know school connectedness is protective for suicide, sexual violence, substance abuse, bullying and more,” said Jarrod Hindman, director of the Office of Suicide Prevention. “It was unique and cool and innovative for the CDC to fund something that works across programs like this.”
The CDC funding, $70,000 over two years, will pay for implementing and supporting the program in the seven pilot schools: two in Adams County; one in Trinidad; and one each in Boulder, Denver, El Paso and Fremont counties. State funding from the Child Fatality Prevention System and the Office of Suicide Prevention paid for “train-the-trainer” sessions for personnel from the pilot schools and other Colorado schools that have local funding to pay for implementation. Having certified trainers in the schools significantly reduces the cost of implementation and can improve the program’s sustainability.
At the June 23-26 training, Sources of Strength founder Mark LoMurray led the Colorado educators, along with school counselors, local public health staffers and community youth group leaders from various states, through games they will use to prepare adult advisers and student leaders for their roles. The games, and the program, are designed to help teens identify and connect with their own sources of strength from eight possible realms: family support, positive friends, mentors, healthy activities, generosity, spirituality, medical access and mental health. LoMurray demonstrated a light and fun approach, using the games to introduce a quick lesson, not a heavy moral imperative.
“We ask our mental health professionals to scrub that mental health language,” he said. “We use teen language here.”
Participants took turns leading the games in small groups. They practiced asking questions and summarizing lessons learned in a quick, light-hearted way, then evaluated their success. LoMurray’s son Scott, who has taken up the mantle of his father’s work as deputy director of the program, helped lead the small group practice sessions. This fall, he and other Sources of Strength personnel will go into Colorado schools and help the newly trained participants implement the program.
Mark LoMurray developed the program over his 40-year career as a social worker working with teens and young adults in crisis intervention and suicide prevention. In 2009, Sources of Strength was listed on the National Best Practices Registry by the Suicide Prevention Resource Center and the American Foundation for Suicide Prevention. In 2011, the program gained listing on the Substance Abuse and Mental Health Services Administration’s National Registry of Evidence-based Programs and Practices. The program was the subject of one of the nation’s largest studies on peer leaders and their impact in suicide prevention, with results published in 2010 in the American Journal of Public Health. Among other results, the study found:
  • Peer leaders’ connectedness to adults increased.
  • Peer leaders’ school engagement increased.
  • Peer leaders in larger schools were four times more likely to refer a suicidal friend to an adult.
“We will be the first to evaluate the program for sexual violence outcomes,” said Tomei Kuehl, supervisor of the Sexual Violence Prevention Unit. “This is all about taking an innovative approach to work across programs.”
“We used our partnerships at the local level to recruit schools for the pilot,” explained Colleen Kapsimalis, unit supervisor of the Child Fatality Prevention System. Kapsimalis said connections with the state’s local child fatality prevention teams helped identify interested schools. One of three recommendations made in the 2015 Colorado Child Fatality Prevention System Annual Legislative Report, to prevent youth suicide, is “expand implementation and evaluation of school-based suicide-prevention programs that promote resilience and positive youth development as protective factors from suicide statewide.”
Hindman said Sources of Strength is a priority for his office. “There are a lot of good programs out there designed to identify kids at risk and intervene,” he said. “But Sources of Strength builds a support system to prevent kids from getting to that point. Our hope is that five years down the road Sources of Strength will be in 100 Colorado schools.”

Youth Today Article

Originally posted at Youth Today

What Three People Learned About Suicide and Kids

Students who take part in the suicide prevention program Sources of Strength identify trusted adults in their lives who can offer support. Here a teen writes down names of two such adults.

Rate in rural areas twice as high; innovative prevention program can work — and life can be good

When Cynthia Fontanella saw the numbers, she was surprised.

It wasn’t that almost 66,595 kids in the United States had killed themselves from 1996 to 2010, although that was bad enough.

It was that the suicide rate for rural kids was double that of urban kids — and the gap was getting wider.

The Ohio State University assistant professor and fellow researchers examined suicide data for youth ages 10 to 24 and published their results in March in the journal JAMA Pediatrics.

Males had a suicide rate of almost 20 per 100,000 in the countryside, compared with more than 10 per 100,000 in the city, according to the article “Widening Rural-Urban Disparities in Youth Suicides, United States, 1996-2010.” Among young women, the rural suicide rate was more than four per 100,000, compared with an urban rate of more than two.

Guns were the most widely used method, and more youth used guns in rural areas than in cities.

Suicide is the third-leading cause of death among young people ages 10 to 24, according to the Centers for Disease Control and Prevention (CDC). Only accidental injuries and homicides account for more deaths, according to the CDC.

Among young Native Americans, many of whom live in rural areas, suicide is the second-leading cause of death. It’s 2.5 times the national rate among ages 15 to 24, according to the Center for Native American Youth at the Aspen Institute.

Suicide is also the second-leading cause of death among lesbian, gay and transgender kids, according to the CDC.

Outside the cities

Fontanella, an assistant professor of psychiatry, is concerned with the mental health of children and how to best get services to kids who need them. She wanted a clear picture of the difference in suicide rates between rural and city kids in order to develop effective policies and programs.

So, what accounts for the higher rate of suicide among rural youth?

“The big factor is the greater access to and ownership of guns,” Fontanella said. Rural residents in many cases grow up around guns and use them for hunting. Gun ownership is more prevalent in rural areas, and, where there are more guns, there are more gun accidents and suicides, according to the Harvard Injury Control Research Center.

In addition, Fontanella said, rural areas have a chronic shortage of mental-health providers. More than half of U.S. counties — all rural — have no psychologist, psychiatrist or social worker, according to a 2012 book “Rural Mental Health.”

“Residents have to travel further for appointments and wait longer,” Fontanella said. As a result, they get treatment later and develop more severe symptoms.

They also are less likely to have health insurance.

Stigma also plays a role, too, she said. “There’s more of a culture of self-reliance” in rural communities. “People tend to believe they should solve their own problems and not turn to others for help,” Fontanella said.

Rural areas were hard hit by the recession and poverty has increased.

“Many residents out-migrate to get jobs,” she said. It changes the social structure when young people leave the area.

In rural areas gun ownership is stable or increasing, but the number of guns has dropped in urban areas, based on research in “Social Trends in American Life,” published in 2012 by Princeton University Press. Fontanella said these changes may help explain the widening gap between suicide rates among rural and urban teens.

Problems and solutions in North Dakota

For many years, North Dakota was among the states with the highest rates of youth suicide in the nation. Mark LoMurray had a front-row seat on the problem. As director of the Police Youth Bureau in Bismarck, N.D., which worked to keep kids out of trouble with the law, he often saw teens in crisis. Over a three-year period, LoMurray attended 30 teens’ funerals, many of which were suicides.

“He was filled with a sense that we could do more to get in front of this,” said his son, Scott LoMurray.

The senior LoMurray helped develop a mentoring program aimed at suicide prevention at Standing Rock and Turtle Mountain, tribal lands of the Sioux and Chippewa tribes, respectively.

His goal was to build resilience among rural and Native American teens.

“A lot of suicide-prevention programs weren’t training teens,” Scott LoMurray said. “To be effective, we have to have teens involved.”

Many programs focused on teaching the warning signs and risk factors for suicide. People could list the risk factors, but it didn’t help them get better, he said.

Today, Mark LoMurray’s program, Sources of Strength, trains teens to be peer leaders and teaches adults to work with them. Mark is executive director and Scott is deputy director.

Teen leaders learn to identify the sources of strength in their own lives. They then talk with five to 10 of their friends about the supports they have. The teen leaders create a series of messages for a wider audience. They determine the form of the message, ranging from bulletin boards to text messages to videos.

One powerful message is a list of each person’s “trusted adults” posted on a bulletin board.

Sources of Strength is based on the idea of spreading change through a social network. Just as suicide can be contagious, so can attitudes and behaviors that counter suicide, Scott said.

Sources of Strength trains a diverse group of peer leaders, encouraging them to identify where they gain strength to deal with adversity — whether from positive friendships, music, spirituality, family or other areas.

“We’re training peer leaders, not as counselors, but to be agents of change in their school and culture,” he said. “Adults can educate, but not change the underlying culture. Kids can, however.”

At first, teens may think it’s snitching to tell an adult about a friend’s suicidal thoughts. But the code of silence can shift.

The program is now in more than 300 schools in 20 states and 32 tribal communities, many of which are very remote, according to Sources of Strength.

Teens take part in a Sources of Strength training, which was developed initially in rural North Dakota. The program strengthens relationships, and evidence shows it has been successful in changing a “code of silence” around suicide.

The program, initially developed in a rural area, is adaptable to different groups of people, Scott said, and is used by youth and community organizations as well as schools.

Sources of Strength is one of the few prevention programs with evidence to show its impact, and it’s listed on the SAMHSA National Registry of Evidence-Based Programs and Practices.

Researchers, led by Peter Wyman at the University of Rochester in New York, studied the program

over three years at 18 schools in South Dakota, New York and Georgia. Six were urban schools and 12 were rural.

Researchers found the program increased students’ likelihood of referring a suicidal friend to an adult. Students were four times more likely to do so after they became peer leaders. Students who had been suicidal showed the biggest change in their willingness to seek help.

One teenager’s experience

Whitney Bischoff became a Sources of Strength peer leader her junior year at Rapid City., S.D., Central High School.

Two years before that, on the first day of ninth grade, she had faced a calamity: A childhood friend shot and killed herself.

“It was completely out of the blue,” Bischoff said. Only a few friends had had hints of trouble.

Bischoff took part in group counseling with other students who had been friends of the girl. “It never made me feel any better,” she said.

Bischoff also had problems within her family. Her father died when she was small, and her mother was an alcoholic with an abusive boyfriend.

Bischoff had never considered suicide before her friend died, but she began having suicidal thoughts. She even thought about a plan.

When the school introduced Sources of Strength, Bischoff expected “to sit around a table and be talked at,” she said. Instead, students were asked to name the things that gave them strength in their lives. The peer leaders began to feel connected to each other, she said.

To present the program to other students they created a skit. “We wanted to come up with a new approach,” she said.

She began to realize that although she lacked family support, she had other things that gave her strength, including good friends, adult mentors, church and her own interest in theater.

“[The program] just opened my eyes to things I didn’t know how to communicate before,” she said.

Since then, life has thrown some punches. Her mother died when she was a sophomore in college. But she’s felt resilient.

Now a senior at Black Hills State University in Spearfish, S.D., Bischoff studies psychology and theater, and recently directed a production of “The Breakfast Club,” based on the movie about five struggling teenagers.

Her plan is to attend graduate school and to use Sources of Strength as a suicide-prevention program among college students.

“People need to know about it,” she said. “I know it works.”

More change needed

In addition to school and community programs that reach youth, Fontanella wants to see mental-health services made more accessible in rural areas. Mental-health care could be integrated into primary medical care in rural communities, Fontanella said. Sixty-five percent of rural residents see a primary-care doctor, she said, and integrating mental-health care would make those services more acceptable.

She would also like to see the spread of video or Internet consultations with mental-health providers, known as telemedicine. The practice has been shown effective in dealing with mental-health disorders, she said.

And not least, she said, are education campaigns on the need to store guns safely.

The Role of Guns in Rural Suicides

More than half the young people in rural areas who kill themselves do so with guns, according to research published in JAMA Pediatrics in March.

Guns, which are more prevalent in rural areas, are a particularly effective way to commit suicide, compared with ingesting substances, according to the research.

And to compound the tragedy of suicide is the fact that it’s often an impulsive act, said Frederick P. Rivara, editor of JAMA Pediatrics and professor of pediatrics at the University of Washington. He noted in an editorial that one study found 48 percent of people who attempted suicide did so only 10 minutes after thinking about the action.

People who use a gun to commit suicide will be successful more than 90 percent of the time, Rivara said.

“So restricting youth access to guns is important,” he said.

While gun-control laws are controversial, locking up guns in homes with children should not be a contentious issue, he said.

A study of gun storage practices published in 2005 in JAMA Pediatrics concluded that trigger locks and lockboxes could reduce youth gun accidents and suicides by 70 percent.

Guns should be locked away in lockboxes or safes, Rivara asserted. Trigger locks should be used to stop the trigger from being pulled by anyone without the key or combination. Communities should have education campaigns to urge safe storage, he said.

Suicide prevention programs

A sample of evidence-based programs on the SAMHSA National Registry of Evidence-Based Programs and Practices

Preventing Suicide With A ‘Contagion Of Strength’

Reposted from NPR:
Suicide prevention

LA Johnson/NPR

For Whitney Bischoff, high school was tough. On the first day of her freshman year, a childhood friend committed suicide. Things weren’t any better at home — her father died when she was 7 and her mom was an alcoholic with an abusive boyfriend.

She had a hard time making friends.

And when all the stress threatened to overwhelm her, she, too, considered suicide.

“I thought family was everything,” Bischoff says. “I thought, if I didn’t have family support – what am I going to do? Suicide seemed like the only way out.”

As the thoughts persisted, Bischoff started going to group counseling sessions organized by her school in Rapid City, S.D.

But it didn’t help. “I felt like it was always so depressing every time we talked,” she says. “Having all that negative put to your face as a freshman – it was just a lot to take in.”

But then something changed. Rapid City Central High started using a suicide-prevention program called Sources of Strength. The 15-year-old effort is now in more than 250 schools and community centers in 20 states. Researchers and advocates point to it as one of few prevention programs that has research behind it showing it can work.

Strength Is Contagious

I first learned about Sources of Strength last month, when four high schools in the Washington, D.C., suburbs started the program. I headed to Thomas S. Wootton High School — a top performing school in Rockville, Md., with enrollment of just over 2,000 — to see the initial student training.

It’s a cold Friday morning in January. There are about 60 students sitting in folding chairs in the school’s gymnasium. They’re circled up, clustered around Dan Adams, a national trainer with the program. They’re talking about the many stresses of high school.

“The stress of boundaries in dating,” offers Shelby Ting, a sophomore. “Like what you’re willing to do in your first relationship.”

“I think we overlook the stress of being social,” says Noah Braunstein, a senior. “Finding that group you fit in with is hard, and it’s really taken me until senior year to find it.”

Adams, in a black T-shirt and jeans, shifts the conversation to strengths: “What are the strengths in your life that help you deal with stress?” he asks.

Music. Friends. Family. Mac and cheese.

This emphasis on strengths is what Sources of Strength is all about: promoting positive behaviors in teens.

The curriculum is rooted in eight “strengths” – factors that research has shown are protective against suicide risk.

Adams walks the Wootton students through these eight strengths — family support, positive friends, spirituality, healthy activities, medical access, mentors, mental health and generosity.

For each category, students offer up examples from their own lives. “I know my really good friends don’t put me under peer pressure,” says a student. Another shares about how her church family really helped her get through her grandmother’s passing.

“Not one of these pieces is enough to save someone from taking their own life,” says Adams. “But a bunch of them – now that can make a real difference.”

Jeff Brown, the acting principal of Wootton, is watching the training. He says that, like many schools, Wootton has faced issues with suicide. In 2014, the 154,000 student district lost five students to suicide.

And though national suicide rates have remained flat in recent years, it’s still the third most common cause of death for 15- to 19-year-olds. And nationwide, 17 percent of American high school students said they had seriously considered suicide, according to the Centers for Disease Control and Prevention’s 2013 Youth Risk Behavior Surveillance.

Teens are highly influenced by their peers – social development, peer acceptance and personal identity are all part of growing up. Researchers note that adolescents look to their peers to define acceptable ways to deal with problems.

“Kids learn from each other a great deal. So when peers are offering each other solutions, there is a greater chance kids are going to try them,” says Dr. Jill Harkavy-Friedman, who leads research for the American Foundation of Suicide Prevention. She praised the Sources of Strength program for its methods, naming it as one of the few comprehensive suicide prevention programs that’s based on research.

“We knew we had to have a peer component … to bring teens into the mix,” says Scott LoMurray, who runs the Sources of Strength program with his father. Mark LoMurray, Scott’s father, developed the program in the late 1990s after working with law enforcement as a crisis-response expert. In a three year period, he attended 30 funerals of teenagers — a number of them due to suicide.

“We couldn’t just train adults and expect that to be effective,” Scott LoMurry says.

But the peer mentors didn’t replace the role of adults. Instead, Sources of Strength uses adult advisers – teachers, parents and administrators – as resources for the peer-leaders.

Harkavy-Friedman says having this combination of peer-to-peer communication with adult backing makes the program stronger.

Dan Adams, a national trainer with Sources of Strength, leads a discussion with student peer-leaders at Wootton High School in Rockville, Md.

An Evidence-Based Approach

Over the next five months of school, Wooton High School’s newly trained peer leaders will meet with their adult advisers and other students. They’ll be talking about the power of positive support and sharing stories of how the eight pillars of strength play out in their own lives.

Administrators at the school are convinced Sources of Strength will have a strong impact on their school culture – and research tends to back that up.

“This is really the first peer-leader program that has shown impact on school-wide coping norms and influence on youth connectedness,” says Peter Wyman, a psychiatry professor at the University of Rochester in New York.

Wyman has been studying suicide prevention for the last 12 years. He was one of the authors of a three-year study in the American Journal of Public Health that looked at the effectiveness of Sources of Strength.

The researchers looked at 18 schools in Georgia, New York and South Dakota and found big changes in health-seeking behavior. Students, the study found, started to think that adults in school could be helpful, and peer leaders successfully encouraged friends to seek help from adults. The biggest changes in behavior occurred among students who were, or had been, suicidal.

“Telling their own life stories, about overcoming adversity and people who helped – that seems to be a very potent tool for having an impact on diverse teens, including teens that may not be receptive to other kinds of information,” Wyman says.

Schools are catching on — Sources of Strength is expanding programs in Palo Alto, Calif., Idaho and in a number of rural Alaskan villages north of Fairbanks. They’re also starting new programs in several communities in Washington state, including one in the Tulalip tribal community.

But the price tag can be a deterrent: It costs close to $5,000 to bring the program to a new school. If a school chooses to spend $4,000 to certify a staff member as an official trainer, then it will cost a school about $500 each year to maintain it.

And despite the research — school counselors sometimes find it difficult to convince schools to make it a priority. Mary Hines-Bone, a prevention specialist for the Cobb County school district, near Atlanta, says it can be tough getting schools to implement it properly. The biggest obstacle in making the program successful: the time commitment.

“It’s been a real challenge to get time during school days,” says Hines-Bone. “And programs where students meet before and after school don’t end up being as effective.”

And so schools may turn to less costly and less time-consuming approaches, like suicide-prevention assemblies or presentations that discuss the warning signs and risks of suicide.

Some prevention experts warn that programs emphasizing risks might not work as well, and researchers say there is little evidence that such one-time lectures have any effect. And they say any sustained effort must include adults talking with kids: making students part of the the intervention and not the target of it.

“The biggest prevention piece that’s out there is connection. When kids feel connected to somebody or their environment they’re going to make fewer risky decisions, ” says Tim McGowan, the school counselor who brought the Sources of Strength program to Rapid City Central High School.

After running the program there for seven years, he says he finally has a student body that has never experienced a fellow student who has died by suicide. He says he gets lots of calls asking for advice, asking how he turned his school around. His best advice: Listen to kids and trust them.

“Sometimes kids tell us things we don’t want to hear,” McGowan says. “But you have to be open to those – because if you’re not open to those, then you lose that opportunity for growth.”

Whitney Bischoff, now 21, says she’s grateful for that openness. The program gave her a space to feel supported and the ability to recognize that, while her family support wasn’t as strong, she had other strengths: her friends from theater, her spirituality and her school mentor — Mr. McGowan.

She says she’s come a long way since freshman year. She’s on track to graduate this spring from Black Hills State University in Spearfish, S.D., with a degree in Psychology.

“That program saved me,” she says, “and it gave me the passion and the confidence to want to pass it on to others.”


Elissa Nadworny/NPR

Reflections on Sources of Strength & NREPP

Greetings from Sources of Strength. In the past few weeks we have been accepted to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP). This is the highest tier a prevention program can achieve. It’s a great honor for our organization and for all the peer leader teams around the US and Canada that are impacting their schools and communities.

I found this to be an emotional moment for me as I immediately thought back to standing gravesite by many teens in the 1990’s and reflected on the first steps of creating the strength-based peer efforts in the late 90’s when most voices in the country were saying not to use peer leaders in suicide prevention. Our early work in rural and tribal communities led to the holistic model represented in the Sources of Strength wheel today.

I also thought back to a cold November day in 2005 when Peter Wyman from the University of Rochester, Hendricks Brown from the University of South Florida, and David Litts from SPRC flew into Bismarck to see what this Sources of Strength deal was all about. Peter and Hendricks had just finished one of the nation’s largest research trials on gatekeeper training and were conducting a national search of peer led efforts in their attempts to address some of the gaps in prevention their research had found. That trip was the start of a rich and dynamic community-research partnership that is in full swing to this day. I feel blessed, amazed, weary, and refreshed as I think through the many years leading up to the NREPP posting.

“Upstream” prevention is a trendy buzzword today, but my sincere hope is to contribute to how suicide prevention is conceptualized in some significant ways. Our goal is to empower local leaders, both young people and adults so they can truly create positive change. With many schools already having been rigorously evaluated and a large number in our present five-year National Peer Leadership Study we can possibly be one of the first efforts to statistically answer the question of whether we are truly reducing suicide fatalities and injuries.

This is not easy work. I was recently reading on how Community-Based Participatory Research is often spoken of, but how few programs are able to do this in reality, especially in large scale randomized trials. Putting together a large randomized trial while listening, respecting, and learning from our community partners is not a task for the faint of heart. It is the high wire act of prevention – balancing the rigors of research with the challenges of maintaining true partnerships in schools and communities. Being able to make strategic change to Sources of Strength from two equally important directions – research outcomes and from the community/school input and experience.

Not easy work at all and it takes some great researchers like Peter Wyman and Hendricks Brown, combined with key stakeholders with vision for states, regions, and tribes. Mix in some outstanding adults that will mentor and support peer leaders not just for a few months, but for a few years. Add groups of local peer leaders with energy, vision, diversity, passion, and creativity. Stir, support, train, support some more and something pretty special comes out.

What it means is that the NREPP posting is a great step in this process. We get to pause and raise our glasses to each other and say well done. So from across the country the Sources of Strength staff is raising our glasses to all of you and saying well done.

My vision of Sources of Strength is that after this powerful moment, we move back to work and continue to evaluate, research, and listen and continue to make an impact out in the real world. Implementing programs in schools, communities, and villages that are seriously challenged with limited resources, high fatality numbers, and day to day crisis threatening the ability to sustain prevention efforts. My vision is that Sources of Strength is never a finished product, but that we keep adapting, learning, marketing, and changing. While we have products, curriculum, manuals, and resources there is no “finished product” in Sources of Strength. We keep making changes in our efforts based upon ongoing and expanding research and on the stories and experiences from our grassroots partners.

So thank you. Thank you. Much peace and do know that your efforts are greatly appreciated. Let’s keep lighting up our corners of the world and keep walking forward with a humble, inquisitive, engaged, playful spirit of awe that we get to go to work each day and actually save some young lives. Pretty amazing.