1

Youth As GatekeepersMental Health Literacy and Suicide Prevention Program

Fred Chou

Youth as Gatekeepers Coordinator

Fred.Chou@gov.bc.ca

778-883-6632

2

What is Youth As Gatekeepers?

Suicide awareness and mental health literacy prevention program Supported by and in partnership with

The FORCE Society for Kids’ Mental Health and Chilliwack Ministry of Children and Family Development Based on the idea of community gatekeepers

Community gatekeepers – efforts aimed at increasing awareness of warning signs and risk factors for suicide and mental health among those who live, work, and play in close proximity with youth (White, 2013)

With Youth as Gatekeepers, youth are trained to be and serve as Gatekeepers

3

Youth AsGatekeepers Purpose and Goals

Purpose

To train all senior students in the Chilliwack area to prepare them for difficult conversations as they spontaneously arise; to become literate in suicide awareness and mental health matters, recognize signs and symptoms, assist in reducing stigma, and be aware of who to talk to when these concerns present themselves.

Goal

Our goal is that every young person be equipped to know what to do and who to go to if someone they know is struggling

4

Rationale:Prevention-focused

“would you rather invest in ambulances at the bottom of the hill to take people to hospital when they fall or fences at the

top of the hill to stop them from falling?”

Many youth suicides are preventable (White, 2013)

Primary Prevention• Goal of preventing

disordered onset

Secondary Prevention• Prevent future onset of a

problem among populations at elevated risk

Tertiary Prevention• Aimed at individuals

who are already experiencing symptoms of a disease, with the goal of preventing further onset of pathology

• Often times it is management

• Often most costly Continuum of prevention work (Marchand et al., 2011, p. 32)

Youth as Gatekeepers

5

Rationale:Statistics

56% of youth who experienced a mental or emotional health condition did not access mental health services

18% of females and 7% of males did not access services despite feeling like they needed it

Reasons for not accessing services: Hoping that the problem would go away (56%) Not wanting their parents to know (43%) Not knowing where to go (30%)

Only 59% felt they could talk to an adult outside their family about serious concerns

In Canada, 1 out of 5 children and youth who need mental health services receives them

For serious concerns and suicidality, 81% of students ask their friends for help

*Statistics taken from Smith, Poon, Stewart, Saewyc, & the McCreary Centre Society (2009, 2011)

6

Rationale:Statistics Continued…

Suicide Second leading cause of death for youth

Canadians Suicide rates have tripled since 1950s to 1980s 7% of BC teenagers shared they attempted suicide

in the past year 60-80% of youths have sought help within the

previous month before their suicide

Mental health Most mental illness begins at around teenage

years to young adults 1 in 5 Canadians will develop a mental illness Estimates of 60% to 90% of young people who

commit suicide have depression

Systemic impact Mental disorders in youth are ranked as the second highest hospital expenditure in Canada

*Statistics taken from www.heretohelp.bc.ca/factsheet/suicide and White (2013)

7

Program Overview3 Stage Process

Presentations and action planning

Youth action groups

Mental health literacy and suicide prevention presentations

• Presentation material reflect youth personalities and passion

• Presentations to peers and youth in middle school

• Action-planning

• Youth-led action groups• Youth serve as Gatekeepers• Create presentation material• Facilitators help educate,

equip, support, and foster leadership skills

• YAG facilitators work with respective schools

• Facilitators provide presentations to: (1) provide education about mental health and suicidality and (2) recruit youth gatekeepers

8

RolesYouth as

Gatekeepers

Coordinator

Group Facilitators

Youth Gatekeepe

rs

Community Supports

School Advocates

School Administrati

on

The FORCE Society

Ministry of Children

and Family Developme

nt

9

Action Groups:Friere’s (1970) Critical Pedagogy – Process of Praxis

Critical Reflexivity• Reflection about how the social system has affects ones own well-being• Discussing about lived experience

• Researching about suicidality and mental health

• Learning from peers

Social Action• Actions that promote change in the social system

• Can include:• Presentations• Supporting one another

• Serving as gatekeepers

• Reducing stigma

10

Integration with SchoolsFramework for School Mental Health Programs (World Health Organization, 1994)

Promoting psychosocial competence

Mental health education

Psychosocial

intervention

Professional

treatment

(I) Integrated into school curriculum

(II) Part of general health curriculum

(III) Students needing additional help in school(IV) Students needing additional mental health intervention

Youth asGatekeepers

11

Youth As Gatekeepers in Chilliwack School DistrictPamphlet

12

Youth As Gatekeepers in Chilliwack School DistrictPamphlet

13

Youth As Gatekeepers in Chilliwack School DistrictPictures

14

Youth As Gatekeepers in Chilliwack School DistrictPictures

15

Evaluation:Chelsea Ohlmann’s (2012) Thesis Study

Voices of Resilience: A Group of Adolescents’ Experiences with a Suicide Prevention Program

Qualitative study examining how participation in YAG as student leaders impacted their resiliency

Utilized the method “the Listening Guide” How would you describe your life before the group? What was your experience of participating in the

group? Have there been any changes in your life? Can you share about your experiences with

suicidality?

Voices shifted from vulnerability (not knowing, silence, disconnection) to resiliency (knowing, connection, altruism, and protection)

In taking part in the group, youth experienced healing and a desire to help others based on what they have learned

16

Evaluation: Sources of Strength Suicide Prevention Program

Outcome evaluation of Sources of Strength suicide prevention program (Wyman et al., 2010)

Similar program to Youth as Gatekeepers

Survey of 2675 students and 453 peer leaders (18 schools)

Training improved peer leaders connectedness to adults and school engagement

Had the most positive impact on peer leaders who were most at-risk

Trained peer leaders were 4 times more likely to refer a suicidal friend to an adult than an untrained peer

Among students, the program increased perception of adult supports for suicidal youth and acceptability of seeking help

Perception of adult support increased the most in students with history of suicidal ideation

17

References

Cross, W., Matthieu, M., Lezine, D. & Knox, K. (2010). Does a brief suicide prevention gatekeeper training program enhance observed skills? Crisis, 31(3), 149-159.

Freire, P. (1970). Pedagogy of the oppressed. Continuum International Publishing Group.

Hendren, R., Weisen, R. B., & Orley, J. (1994). Mental health programmes in schools. World Health Organization, Division of Mental Health.

Marchand, E., Stice, E., Rohde, P., & Becker, C. B. (2011). Moving from efficacy to effectiveness trials in prevention research. Behaviour research and therapy, 49(1), 32-41.

Ohlmann, C. (2012). Voices of Resilience: A Group of Adolescents’ Experiences with a Suicide Prevention Program (Master’s thesis, Trinity Western University)

Smith, A., Poon, C., Stewart, D., Hoogeveen, C., Saewyc, E., and the McCreary Centre Society (2011). Making the right connections: Promoting positive mental health among BC youth. Vancouver, BC: McCreary Centre Society.

Smith, A., Stewart D., Peled, M., Poon, C., Saewyc, E. and the McCreary Centre Society (2009). A Picture of Health: Highlights from the 2008 BC Adolescent Health Survey. Vancouver, BC: McCreary Centre Society.

White, J. (2013). Preventing youth suicide: A guide for practitioners. Ministry of Children and Family Development

Wyman, P. A., Hendricks Brown, C., Lo, M. M., Schmeelk-Cone, K., Petrova, M., Yu, Q., …. Wang, W. (2010). Outcome evaluation of sources of strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health, 100, 1653-1661