Sharing What Works

North Dakota in 1998 as a grassroots effort to prevent suicide among the state’s adolescents. Its focus on what founder Mark LoMurray calls “strength-based approaches,” combined with peer leadership, resulted in a significant drop in deaths, he says.

The American Public Health Association took notice, and the program took off. Researchers at the Universities of Rochester and Miami carried out a large-scale, multi-school trial, expanding the program into other states.

“Now we’re in more than 30 states and several Canadian provinces, with more than 5,000 peer leaders and plans to expand internationally,” says LoMurray. “Our messaging is based on whole health and how teens can find sources of strength.”

Based on this success, Sources of Strength has been included in the Best Practices Registry, an online resource managed by the national Suicide Prevention Resource Center (SPRC) at EDC. The registry, a collaboration between SPRC and the American Foundation for Suicide Prevention (AFSP), identifies, reviews, and disseminates information about suicide prevention programs that address specific objectives of the National Strategy for Suicide Prevention.

Sources of Strength is listed among the registry’s evidence-based programs—interventions that have undergone evaluation and have demonstrated positive outcomes. Other promising programs are categorized according to their adherence to standards within the suicide prevention field. A separate section lists best knowledge in the form of expert and consensus statements.

The science of suicide prevention is an emerging field, says Phil Rodgers, an evaluation scientist with AFSP who helps manage the Best Practices Registry for EDC. “When we started doing this 10 years ago, there were few evidence-based suicide prevention programs,” he says. “It’s a challenging field to research, because there’s no one cause of suicide. But our knowledge of what works and what is important has grown tremendously in the past 10 years.”

Complex problem, complex solution 

More than 120 programs are listed in the registry. Some target specific groups such as youth, American Indians, or the elderly, while others are geared toward health care settings such as emergency departments and psychiatric facilities. The U.S. Air Force Suicide Prevention Program is also on the list.

EDC’s Jerry Reed, who directs SPRC, is a recognized leader in the national suicide prevention movement. “The problem of suicide is complex,” he says. “Therefore the solution to suicide is going to be equally complex. One program, one intervention, one approach is not going to solve the problem.”

SPRC offers training and technical assistance to users of the registry seeking to create, expand, or improve suicide prevention programs. Trainings are offered via webinars, bringing together experts and practitioners from all over the country.

“People come to us looking for a suicide prevention program, but what they really need is a suicide prevention strategy,” says Rodgers.

“We help people follow a public health model that helps them understand what the problem is in their community,” adds Reed. “Then we look for interventions. There should be more than one to help you get where you need to go. That’s a comprehensive approach.”

Promising programs may apply for inclusion in the registry, which is regularly updated.

LoMurray hopes others working in suicide prevention will be inspired by Sources of Strength. “It’s an honor to be in the registry,” he says. “I hope folks reading about us will take away the power of peer leadership. But it has to be done right. It takes training, it takes guidance from adults, it takes coordination among partners, and it takes time.”