Resource Types: Program/Practice

Pathways to Purpose and Hope

Pathways to Purpose and Hope is a guide to creating a sustainable suicide bereavement support program that offers a variety of services on a long-term basis to meet the complicated needs of survivors. The guide is designed so that any lay person can use it to start a new program or enhance an existing one. It provides detailed instructions and tips for developing an agency brochure, database, and website; welcoming new families, facilitating support meetings, and compiling a newsletter; and developing optional services such as lending libraries, memorial quilts, birthday and anniversary notes, retreats and conferences, speakers bureaus, and mentoring programs. It also includes chapters on communications, finances and fundraising, governance and structure, evaluation, and training. Sections of the guide can be implemented as an organization develops, grows, and customizes its services to meet the needs of survivors in their area. Included are sample forms and handouts that can be customized by users.

Pathways to Purpose and Hope is based on a comprehensive program developed by more than 50 survivors over a period of 30 years to provide multiple services to meet the complex needs of survivors after a suicide loss. The guide was written collaboratively by Friends for Survival (a suicide bereavement support program that has been based in Sacramento for over 30 years) and 14 contributors, including survivors and experts in the field of survivor support.

Program Objectives

Readers of Pathways to Purpose and Hope will have increased:

  1. Knowledge of the steps to establish and/or expand a sustainable survivor support program.
  2. Understanding of the critical elements and services for a sustainable program.
  3. Knowledge of training and other resources available to support their efforts.

Implementation Essentials

  • Those who implement or conduct suicide bereavement support groups should be familiar with local referral points for those who may require additional services. 

2012 NSSP Objectives Addressed: 

Objective 10.1: Develop guidelines for effective comprehensive support programs for individuals bereaved by suicide and promote the full implementation of these guidelines at the state/territorial, tribal, and community levels.

Creating Suicide Safety in Schools

Creating Suicide Safety in Schools (CSSS) is a one-day workshop designed for school-based interdisciplinary teams, empowering them to establish realistic short-term plans for effective suicide prevention and response planning. Participants spend time planning and problem solving for specific actions needed for suicide-safer schools. The workshop’s format includes didactic presentations coupled with small workgroup discussions, checklists, group planning documents, and exposure to free and low-cost resources that meet best practice recommendations and/or evidence-based practice standards. Creating Suicide Safety in Schools incorporates key aspects of the Social-Ecological Prevention Model, public health perspectives, and recommendations for school-based suicide prevention practices (e.g.. Berman, Jobes, & Silverman, 2006; Miller, 2011). Further, the workshop explores six broad categories of school-based suicide safety: (1) policies, procedures, and standardized protocols; (2) staff training; (3) promotion of student protective factors; (4) identification and reduction of student risk factors: (5) postvention planning; and (6) engagement of family and community.

To accompany the workshop, the Suicide Prevention Center of New York developed a resource binder that included public domain materials using two criteria: (1) well-researched and well-aligned with principles of the Best Practices Registry; (2) usable by school personnel for suicide prevention planning. Original material was added to introduce and organize existing materials and to fill in missing information. Evaluations of early workshops guided the refinement of materials in the binder and led to added planning worksheets, checklists, and structured activities.

Program Objectives

School personnel that attend the Creating Suicide Safety in Schools workshop will be able to: 1. Review, refine, and implement school-based suicide prevention, intervention and postvention activities. 2. Create a school-specific comprehensive suicide prevention and response plan. 3. Assess suicide program and training needs. 4. Access available local and national resources for school-based suicide prevention.

Implementation Essentials

Before the implementation of school-based suicide prevention programs, protocols for response to students who may be at risk of suicide should be developed and disseminated.

2012 NSSP Objectives Addressed: 

Objective 5.2: Encourage community-based settings to implement effective programs and provide education that promote wellness and prevent suicide and related behaviors.

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

Journey to Wellness

Journey to Wellness (J2W) is an eight-week wellness program for American Indian youth 12-18 years of age. Participants receive a sequenced set of eight one-hour sessions that are framed positively toward healthy living styles while at the same time exploring risk factors, suicide prevention, and other suicide-related issues. The sessions are activity-oriented and designed to engage youth. Sessions topics include: relationship building, problem solving, self-esteem building, facts and myths of suicide, networking, life planning, emergency planning, and finally, a celebratory event to close out the sessions. J2W is delivered along gender and age group divisions to promote comfort and safety.

J2W was developed by BTC Indian Health Services staff. An initial literature review of best practices was conducted. Input was sought from youth in the communities.  The initial program was piloted to female students in two communities. After pilot, focus groups were conducted with the participants. In addition, focus groups were held with male students to review the program and the potential effectiveness with this population. 

Program Objectives

Students who complete the Journey to Wellness program will have:

  1. Closer relationships to peers and adults in their schools.
  2. Greater problem-solving skills.
  3. Greater understanding of how to seek help for suicide.
  4. Greater knowledge of helping resources.

Implementation Essentials

  • Schools that use Journey to Wellness should have established protocols for how to respond to you youth who may be at risk for suicide.

2012 NSSP Objectives Addressed: 

Objective 5.3: Intervene to reduce suicidal thoughts and behaviors in populations with suicide risk.

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

Kognito At-Risk in Primary Care

Kognito At-Risk in Primary Care is a one-hour, online training simulation that teaches primary care providers to: 1) Screen patients using evidence-based tools to assess substance use and mental health (including suicidal ideation, depression, post-traumatic stress, and generalized anxiety disorder); 2) Engage in collaborative treatment planning with patients and build treatment plans that integrate mental health services; 3) apply motivational interviewing techniques to build trust and increase patient adherence to treatment plans; and 4) apply best practices in follow-up care. Training includes interactive role-plays with animated virtual patient avatars that act and respond like real patients in distress. The program is divided into 5 modules of 6-18 minutes. Successful completion of the training results in 1.50 nationally recognized CME /CNE credits.

Designation as a “Program with Evidence of Effectiveness”

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP). 

Outcome(s) Reviewed (Evidence Rating)*

  • Knowledge, Attitudes, and Beliefs About Mental Health (Effective)

A posttest immediately following the training found a statistically significant improvement in primary care clinician’s knowledge and skills about how to screen and address mental health issues among patient populations, compared with control group participants. Longer-term changes (e.g., changes in practice, improved patient outcomes) were not assessed.

Read more about this program’s ratings.

———————

* NREPP changed its review criteria in 2015. This program was reviewed under the post-2015 criteria. To help practitioners find programs that fit their needs, NREPP reviews the evidence for specific outcomes, not overall programs. Each outcome was assigned an evidence rating of Effective, Promising, or Ineffective. A single program may have multiple outcomes with different ratings. When considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome.

Implementation Essentials

  • Primary care settings that use Kognito At-Risk in Primary Care should have established protocols for managing patients who may be at risk for suicide.

2012 NSSP Objectives Addressed: 

Objective 7.2: Provide training to mental health and substance abuse providers on the recognition, assessment, and management of at-risk behavior, and the delivery of effective clinical care for people with suicide risk.

Objective 9.3: Promote the safe disclosure of suicidal thoughts and behaviors by all patients.

The FIRE Within: Youth Entrepreneurs Preventing Suicide

The FIRE Within: Youth Entrepreneurs Preventing Suicide is a 30-hour, classroom-based program for high school students that applies entrepreneurial strategies to suicide prevention. This program was created by the Carson J. Spencer Foundation (CJSF-no longer in operation) and as of June 2017 is operated by SPHERE Education. Co-curricular instruction (combining the talents of classroom teachers and local business leaders) using a hands-on approach helps students develop and use business, entrepreneurship, and leadership skills to advance suicide prevention and awareness. The FIRE Within is delivered to students using a combination of Junior Achievement’s Be Entrepreneurial and CJSF’s The FIRE Within curricula.  Students learn facts about teen suicide, research and identify the root causes of suicidal ideation among their peers, explore possible prevention strategies, and develop and execute a business plan to prevent suicide within their own community. The program includes a  business plan competition in which students develop sustainable businesses that raise revenue and achieve market-based solutions that address the root causes of suicide in their communities.  Students compete for varying levels of seed money to implement their plans.

From 2006-2009, CJSF’s CEO and Co-Founder Dr. Sally Spencer-Thomas piloted The FIRE Within at Regis University in Colorado. In 2009 CJSF started implementation in high schools in partnership with Junior Achievement and the Second Wind Fund. While scaling the program statewide, external evaluators and standardized materials/training ensured quality control. The program’s goals are to promote student-driven suicide prevention (students are trained as QPR Gatekeepers and taught best practices in safe messaging); increase student engagement; and develop socially responsible business leaders.

Program Objectives

By the end of the academic year, students who participate in The FIRE Within will be able to demonstrate:

  1. Improved knowledge and attitudes about mental health issues in the school community.
  2. Increased knowledge of how to increase help-seeking behavior via referrals and helplines
  3. Improved ability to connect students and caring adults.
  4. Improved sense of purpose and connection to community.
  5. Expanded social networks. (Additional business/entrepreneurship goals also exist, but are not listed here)

Implementation Essentials

Schools that implement The FIRE Within should ensure the following prior to implementation:

  • Instructors should be knowledgeable about the safe messaging guidelines found in the training manual and ensure that student discussions and products adhere to those guidelines.
  • Teachers, administrators, and staff should be familiar with school protocols for identifying and referring students at risk of suicide.
  • Communities should be prepared to treat students who are identified as “at-risk.”

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.

ASK about Suicide to Save a Life

ASK about Suicide to Save a Life is a 1.5 to 4-hour workshop for adults who interact with youth or adults at risk for suicide. The program provides participants with an overview of the basic epidemiology of suicide and suicidal behavior, including risk and protective factors. Participants are trained to recognize warning signs—behaviors and characteristics that might indicate elevated risk for suicidal behavior—and how to intervene with a person they think might be at risk for suicide. Using role-playing, participants practice asking other participants about suicidal thoughts, feelings, and intentions. Participants are trained to respond to someone expressing direct suicidal communication by seeking emergency care. Participants are also trained to gather more information about a person’s risk and take action consistent with that risk if they identify a person who is not acutely suicidal. In longer workshops, participants are given Texas laws related to suicide and trained to access best practice suicide prevention information online.  Length of the training depends on which training modules are used.

The workshop was developed by reviewing existing gatekeeper training programs, research findings on gatekeeper training, and effective strategies for adult learning. Pilot testing of ASK about Suicide to Save a Life workshops was conducted, and results from the pilot testing were used to refine the workshop. 

Program Objectives

At the completion of the ASK about Suicide to Save a Life workshop, participants will have: 

  1. Increased knowledge about suicide.
  2. Increased knowledge of basic suicide intervention skills.
  3. Increased confidence to ask and respond to someone in a suicidal crisis.
  4. Increased knowledge of appropriate ways to refer a person in suicidal crisis to a mental health professional.
  5. Increased knowledge of how to assist in the aftermath of a suicide.
  6. Demonstrated that they have added the National Suicide Prevention Lifeline to their cell phones and know how to access local Texas crisis lines.

Implementation Essentials

  • Participants should be aware of the suicide prevention protocols for their particular setting along with local referral points for those who may be at risk for suicide. 

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.

Step In, Speak Up!: Supporting LGBTQ Students

Kognito Step In, Speak Up!:Supporting LGBTQ Students is a 25-minute, online, interactive training simulation intended for use by teachers and school staff. In the training, users assume the role of an educator and engage in three simulated experiences that address common challenges affecting educators and their students who may be struggling with psychological distress and suicidal ideation related to harassment or exclusion related to sexual identity, sexual orientation or other differences. During the simulations users learn about the challenges facing lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth and how to (1) address harassment and homophobic language in the classroom, (2) broach topics such as bullying, harassment and sexual identity with a student, (3) ask a student about suicidal thoughts or plans, and (4) make appropriate referrals, including referrals to supportive adults and mental health or crisis services, on and off school grounds. By addressing the common challenges facing LGBTQ or other vulnerable students, teachers and staff will create a more supportive academic environment for all students and support prevention and early intervention through effective referrals.

The program was developed by Kognito Interactive with input from mental health experts and staff from not-for-profit, LGBTQ youth-serving organizations. Kognito also conducted several face-to-face focus groups with LGBTQ students and educators as part of the development process.

Program Objectives

  1. Increase knowledge about the common challenges facing LGBTQ students, including verbal and physical abuse, compromised school attendance/performance, and higher rates of suicidal thoughts and behaviors.
  2. Increase knowledge of best practice techniques for creating a safe learning environment and addressing harassment and bullying when it is observed.
  3. Increase motivation and likelihood to approach a student to discuss their struggles with psychological distress and suicidal and refer them to on- or off-campus support services.
  4. Increase motivation and likelihood to ask a student if they are considering suicide.

Implementation Essentials

  • Educators who use Kognito Step In, Speak Up! should be aware of their school’s referral policies and protocols for students who may be at risk for suicide.
  • Kognito Step In, Speak Up! is most effective when used as part of a school’s larger strategic plan to identify and help at-risk students.

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.

Saving Our Lives: Preventing Suicide in Transgender Communities Video and Discussion Guide

Saving Our Lives: Preventing Suicide in Transgender Communities Video and Discussion Guide provides simple but important recommendations for recognizing and intervening with members of the transgender community who may be at risk for suicide. As such, it is appropriate for both caregivers and the general public. The video guide provides background on transgender suicide, definitions of transgender-related terms, and recommendations for addressing those who are transgender. It also lists six discussion questions that can help facilitate discussion of the important topics found in the video. The 10-minute video includes practical examples of how to recognize possible warning signs of suicide, how to ask directly about suicide, and how to help those who may be at risk for suicide.  

Saving Our Lives: Preventing Suicide in Transgender Communities Video and Discussion Guide was created by the Massachusetts Transgender Suicide Prevention Working Group, a collaboration of the Massachusetts Department of Public Health, the Massachusetts Transgender Political Coalition, Fenway Health, Samaritans, Inc., and the Massachusetts Coalition for Suicide Prevention. The working group was formed in 2008 to address the issue of transgender suicide by working to make communities safer and healthier for transgender people.

Information in the video and discussion guide is based on a literature review and feedback from the transgender community and service providers. The related brochure was adapted from a similar brochure produced by Samaritans, Inc. 

Program Objectives

Those who view the video will have greater:

  1. Knowledge of how individuals at risk for suicide may act.
  2. Knowledge of how to ask about suicide.
  3. Knowledge of how to seek help for someone who may be at risk for suicide.
  4. Knowledge of how to seek support as a helper.

Implementation Essentials

  • Those who sponsor viewing and discussion of the video should be aware of local helping resources and let participants know how to contact these resources.
  • It would be helpful to have a mental health professional attend presentations of the video.

2012 NSSP Objectives Addressed: 

Objective 5.3: Intervene to reduce suicidal thoughts and behaviors in populations with suicide risk.

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

Real Teenagers Talking about Depression: A Video-Based Study Guide

Developed by Erika’s Lighthouse, Real Teenagers Talking about Depression: A Video-Based Study Guide is a 1-hour universal intervention for middle–school and high-school classrooms that focuses on depression education. The purpose of the video and study guide is to increase student knowledge about depression, reduce stigma surrounding depression and increase the likelihood that students with depression will receive help. In addition to the video and study guide, there are a number of optional exercises, including understanding depression, the science of the brain and depression, exploring stigma, how to help a friend, coping with stress and resiliency, and bullying and depression. The study guide was developed by the board and staff of Erika’s Lighthouse that includes mental health professionals and was reviewed by the Erika’s Lighthouse board, mental health professionals and educators.

Program content is based on research that shows that: depression is common among adolescents; it is a major risk factor for youth suicide; it is a diagnosable mental disorder with specific symptoms; it is treatable and friends are often the first to know about a friend’s depression. 

Program Objectives

Students who view the video and receive the accompanying lesson will have increased understanding of:

  1. Depression and its symptoms.
  2. Warning signs of suicide.
  3. Stigma and how it affects help-seeking behavior.
  4. Effective treatments for depression.
  5. How to get help for themselves or their friends.

Implementation Essentials

  • Schools that use Real Teenagers Talking about Adolescent Depression should have established protocols for addressing students who may be at risk for suicide. School administrators, faculty, and staff should be aware of the protocols.
  • Real Teenagers Talking about Adolescent Depression is most effective when used as part of school’s larger strategic plan to promote student wellbeing and safety.

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.

Trevor Lifeguard Workshop

Trevor Lifeguard Workshop is a 1-hour interactive workshop for middle school, high school and college-age youth that describes the mental health, suicide, and self-care resources provided by The Trevor Project. There are two versions of the workshop: one for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth and one for general youth audiences. Workshops are given by volunteer facilitators who have completed the 2-day Trevor Lifeguard Workshop training for trainers. The workshop guides youth and young adults in a conversation about how to recognize the warning signs of suicide and how to respond in a way that will keep their peers safe. In addition, the workshop guides participants in a conversation about self-care strategies and helps participants identify their own personal strategies for self-care. The workshop concludes by helping the participants identify sources of support in their own environment and includes a discussion of each of the resources available through The Trevor Project, including The Trevor Lifeline, TrevorSpace, TrevorChat, and Ask Trevor.

The Lifeguard Workshop was developed by reviewing the current literature regarding suicide prevention awareness and education programs for youth and young adults, as well as current research regarding LGBTQ youth mental health issues. Through an examination of existing curricula it became evident that there was a need for an educational resource that was specifically designed to address the mental health needs of the LGBTQ community and make resources for LGBTQ youth both visible and available. 

Program Objectives

After completing Trevor Lifeguard Workshop, youth will be able to:

  1. Examine the impact of their language and actions on the experiences and mental health of their LGBTQ peers (for general youth audiences only).
  2. Identify the warning signs of depression and suicide.
  3. Describe three personal self-care strategies.
  4. Explain the ways to respond to the warning signs of suicide to keep their peers safe.
  5. Identify one supportive adult in their environment to turn to for help.
  6. Describe the services offered by The Trevor Project and how to access them.

Implementation Essentials

  • Schools that host the Lifeguard Workshop should have established protocols for addressing students who may be at risk for suicide. Teachers and staff should be aware of the protocols.
  • The Lifeguard Workshop should only be administered by trained Lifeguard Workshop Facilitators.

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.