Symposium Summary:

Sources of Strength is an upstream suicide prevention program that was developed in high schools in North Dakota by Mark LoMurray and his team, using positive psychology, active learning, and social network theory. The aim was to take a proactive and positive approach to preventing suicide using multiple protective factors, instead of the prevalent reactive, risk-focused, and crisis-focused approaches available. The program has now been adopted by high schools and middle schools across the USA, as well as in Australia, and has recently expanded to elementary schools and college campuses. Through fun gatherings and collaborative campaigns, the program brings messages of hope, health, and strength to as many students as possible, with peer leaders primarily spreading the message to influence their schools’ culture. The foundation of the program is the “Strengths Wheel”—a collection of eight sources of strength that people can turn to when life gets difficult (https://sourcesofstrength.org/wheel/), including positive friends, supportive family, spirituality, healthy activities, mentors, generosity, physical health and mental health. Research to date has shown that peer leaders trained in the program demonstrate more school engagement, connection with adults, and likelihood to refer a suicidal friend to help (Wyman et al., 2010; Petrova et al., 2015). Sources of Strength has also been promoted or supported by the CDC, SAMHSA, and NIMH. 

Despite the success of the program in high schools, application in college settings is not easy. This symposium will discuss some of the latest research on the common challenges and best practices translating the program onto college campuses, describe what the program can look like from a peer leader’s perspective, and present preliminary findings from the development of a Sources of Strength college course using a mixed-methods, Human-Centered Design approach.

Symposium Presentation 1: Adapting Sources of Strength to college campuses

Presenter: Kelly B.T. Chang and Grace Emhoff, George Fox University

Adopting a high school program in higher education is complex and uneven. However, there is increasing demand for mental health services on campus, and the treatment gap is getting wider (Lipson et al., 2022). Positive mental health programs can help meet this need, if they are applied effectively. Staff and students at colleges and universities in the United States who have begun implementing the Sources of Strength program were interviewed about their experiences. Data collection is ongoing, and preliminary results will be presented. The program has been implemented in a variety of ways, from student clubs to dedicated college classes. Campuses differed in the amount of funding they had to start the program and whether or not they had dedicated staff for running the program or relied mostly on volunteers. Interviewees appreciated the energy, positivity, and resources the program provided through training and materials, the evidence-based approach, and the face validity of the Sources model. There were also some common challenges, including confusing terminology, since the roles established in the high school setting do not fit the college setting. More college-specific guidance was requested. Campuses with more funding, dedicated classes, and dedicated staff reached more of their students and felt that their methods were sustainable. The program is valued for multiple reasons, but adaptation of the model, college-specific guidance, and sharing of best practices is needed. Further results about common challenges and best practices will be presented, implications will be discussed, and recommendations for adopting the program in higher education will be presented.

Symposium Presentation 2: Positive messaging on college campuses: Suicide prevention and peer-leadership through a student organization

Presenter: Ashlen A. Wright and Graceson Clements, UNC Chapel Hill

Introduction: In the United States, suicide-related behavior is a growing public health concern for colleges and universities. Suicide is the second leading cause of death for individuals aged 10-24 (Heron et al., 2019). Specifically, 24% of undergraduate students have reported suicidal ideation, and 9% attempted suicide in 2018 (Liu et al., 2018). Research continues to indicate that the pandemic increased depression, anxiety, and psychiatric illness rates in the young adult population and the consequences are predicted to last long after the pandemic peak (Sher, 2020). To reduce suicide rates in the college population, it is imperative that prevention measures be developed. The purpose of this presentation is to examine the process of delivering a positive-themed suicide prevention program on a college campus. Methods: An evidence-based approach to suicide prevention was developed through a campus organization, Sources of Strength, at a large public university in the Southern U.S. Current club participants (N =54) interact in wellness focus groups, positive-psychology based activities, and mental health training. Future evaluation is needed on the campus organization, as a mode of positive modeling and suicide prevention. Results: The difficulties and benefits of a Sources of Strength college club will be discussed from the perspective of peer leaders to illustrate the application of the model in a real world setting. Examples of  positive messaging and classroom interactions will be provided. Future results will guide further direction and implementation of the campus organization. Conclusion: The Sources of Strength campus organization is grounded in extensive research on adolescent peer leadership and positive modeling as a strategy to modify help-seeking behaviors (Wyman et al. 2010) and awareness of natural protective factors and increase trust in adults for suicidal youth (Petrova et al. 2015). The program shows promise but needs further adjustment. 

Symposium Presentation 3: Evaluation of a university suicide prevention course using Human Centered Design

Presenter: Anne Drescher

Background: Improving the mental health and wellbeing of college students is a pressing and urgent matter of public health. Psychoeducational courses rooted in positive psychology offer an innovative and promising approach to promoting university student wellbeing and, ultimately, preventing suicide. Human Centered Design (HCD) is an approach to problem-solving that centers the voices and experiences of involved community members, in this case, university students. Using HCD, an innovative university course based on the Sources of Strength suicide prevention program was created and a pilot of the course was evaluated. Method: In the Fall semester of 2022, baseline data was collected on 57 students, including measures of depression, anxiety, social isolation, help-seeking behaviors, and overall wellbeing. Using a quasi-experimental repeated measures design, students will complete measures 5 more times throughout the semester. This analysis is complemented by a qualitative analysis of student focus groups. Preliminary focus groups on student needs (n=22) were conducted in May of 2022, with follow-up focus groups conducted in November of 2022. Results: Preliminary results of student focus groups suggest that the Sources of Strength course is a viable means of increasing student coping strategies and social connection. We hypothesize that empirical data will support increases in student wellbeing over the course of the semester. In line with HCD, these results are used to further refine the course structure and content. Conclusion: Results indicate that Sources of Strength is a promising option for universities for improving student mental health. Furthermore, these results are strengthened by the use of a HCD framework, which involves students as co-designers in developing and refining the course.