How Not To Keep A Secret


(For resources, this is the publication date. For programs, this is the date posted.)


Youth Health Connection

The How Not To Keep A Secret manual is available for $50 plus shipping and handling. Contact Karin Farrell for more information (781-794-7849, The Break Free from Depression DVD is available for $75. Contact Dr. Nadja Reilly for more information (617-919-3203,


Developed by Youth Health Connection (YHC), How Not To Keep A Secret (HNTKAS) is a peer leader training program designed to provide education to teens about depression and suicide, increase help-seeking behaviors, and decrease stigma associated with mental illness. The day-long HNTKAS training includes a clinical presentation, the documentary Break Free from Depression, and interactive activities. Students create and perform skits highlighting risk factors and warning signs of depression and suicide, as well as how to reach out for help. The skits are then presented by the peer leaders to their home schools. The day-long HNTKAS training and follow-up implementation are part of a comprehensive recommended program that includes: consultation on policy and procedure for addressing mental health issues in schools; educator gatekeeper training; use of advisory groups in schools; parent education and training; primary care and nurse training; community partnership, including clergy and law enforcement representatives; and an e-newsletter.

HNTKAS was developed over a period of 15 years and incorporates the power of peer to peer relationships, the interactive dynamic process of drama and discussion, and connection to a trusted adult. The manual, clinical presentation and DVD have been piloted and revised after implementation across public, charter, independent, and parochial schools, including multicultural populations. The manual represents the work of mental health professionals who have been on the YHC Mental Health Advisory Board. The DVD, Break Free from Depression, is the work of the Swensrud Depression Prevention Initiative, Children’s Hospital, Boston, MA.

Program Objectives

At the end of training, participants will be able to:

  1. State that depression is a treatable illness and that suicide is preventable.
  2. List a minimum of four symptoms of adolescent depression.
  3. List a minimum of three warning signs of suicide.
  4. Identify a minimum of three adults, inside and outside the school setting, with whom they would connect and talk if they are concerned about their own mental health and safety or that of relevant others.

Implementation Essentials

  • Schools that participate in the How Not To Keep A Secret program should have policies and procedures in place to respond to students who are at risk for depression and suicide.
  • It is strongly recommended that schools provide gatekeeper training to all faculty prior to implementing How Not To Keep A Secret with their peer leaders.

2012 NSSP Objectives Addressed: 

Objective 7.1: Provide training on suicide prevention to community groups that have a role in the prevention of suicide and related behaviors.