Suicide Prevention in High-Risk Communities
Summary
In 2024, The Defensive Line (TDL) committed to educate more than 40,000 youth-serving adults in Black and Brown communities across the United States in suicide prevention by 2028. Through its network of trained English and Spanish-speaking facilitators with shared lived experience, TDL will use its curriculum that humanizes mental health challenges through storytelling to inspire and equip communities with the knowledge, tools and resources, including connection to mental health care, to support Black and Brown youth and prevent suicide. In partnership with Stanford University and the University of Nevada, Las Vegas, TDL will conduct randomized control trials to evaluate the program’s impact and make data-driven improvements. To further support its training founded on proven social behavior change models, TDL will roll out a media campaign to further address the top barriers to adopting mental health practices, including shifting norms to support care-seeking behavior.
Approach
The Defensive Line (TDL) will build on proven social behavior change models and combine story-telling and stigma reduction strategies with subject matter expertise to shift the discussion around mental health challenges in the United States. TDL will reach more than 1,000,000 people in Texas and Nevada communities with behavior change messaging while simultaneously designing, creating, and rolling out evidence-informed suicide prevention training in English and Spanish that will reach 40,000 youth-serving adults by 2028.
TDL’s two-hour training will be scalable and delivered through a network of trained facilitators with subject matter expertise and shared lived experience who use storytelling to humanize mental health challenges. Facilitators will be certified at a two-day program conducted by experienced instructors, ensuring empathetic and expert delivery. This diverse, community-based network will allow the program to reach an equally diverse range of communities and youth-serving organizations. TDL facilitators will roll out training in three different modalities, facilitator led in-person and virtual as well as asynchronously online.
The training will cover critical topics such as recognizing symptoms of distress, increasing one’s comfort level to discuss issues with youth, and how to execute practical intervention strategies through the creation of a personal action plan. Through its partnerships with Vibrant and other local mental health service organizations, trainees will also receive information on local resources to help connect those in crisis to life-saving care. To ensure effectiveness, TDL will conduct randomized control trials in partnership with Stanford University and the University of Nevada, Las Vegas, to rigorously evaluate the program’s impact and make data-driven improvements.
Finally, to further reinforce training content, TDL will conduct a digital stigma reduction campaign to facilitate adult engagement in protecting youth. This media campaign will be designed to address the top barriers to adoption for mental health practices outlined in the training.
Action Plan
Year 1 (2025) :
Q1:
Recruit and hire training facilitators, new TDL staff, and a film production team. Source a filming location.
Q2:
Write the training framework with the Mental Health Advisory Group.
Develop and implement a communications strategy based on Darkness to Light’s Prevention Paradigm.
Q3:
Collaborate with diverse parenting experts to expand TDL’s Parent University.
Develop evaluation instruments,
Q4:
Produce facilitator materials for year two training.
Finalize English Training production.
Year 2 (2026) :
Q1:
Begin English training facilitator certification.
Start production of the Spanish version of the mental health training program and hire Spanish facilitators.
Q2:
Launch a mental health awareness and suicide prevention campaign in Black and Brown communities.
Continue English training facilitator certification.
Seek input from Spanish-speaking communities and experts.
Q3:
Launch online learning platform and in-person/virtual English mental health training program.
Begin research on the effectiveness of English Training.
Conduct 250 initial facilitator trainings with pilot communities.
Adapt communications based on campaign interaction.
Q4:
Refine the English training program based on feedback.
Finalize Spanish training facilitator materials.
Expand the behavior change campaign through various channels.
Year 3 (2027) :
Q1:
Develop supplementary materials for English training.
Certify Spanish-speaking facilitators.
Expand the campaign to Spanish-speaking communities.
Q2:
Continue Spanish facilitator certification.
Assess the English behavior change campaigns.
Q3:
Pilot the Spanish training program and gather feedback.
Evaluate the Spanish training program and campaign effectiveness.
Q4:
Continue training sessions and gather feedback.
Adapt campaign strategies based on engagement data.
Monitor and evaluate both training programs and campaigns.
Year 4 – 2028:
Q1:
Continue roll-out of English and Spanish training curriculums.
Strengthen partnerships and explore new collaborations.
Q2:
Evaluate the long-term impact of the training programs.
Q3:
Plan for financial sustainability and increased presence across the US.
Q4:
Publish English RCT results with a comprehensive report on outcomes and impact.
Background
The Surgeon General has labeled mental health a public health crisis, costing taxpayers millions and causing widespread harm. In communities of color, access to mental health services and stigma reduction is particularly dire.
In April 2024, the Pew Research Center reported that the suicide rate among Black youth aged 10 to 19 surpassed that of their White peers for the first time in 2022, reflecting a 54% increase since 2018, while simultaneously, the rate for White youth decreased by 17% (CDC, 2024) . From 2007 to 2020, the suicide rate among Black adolescents aged 10 to 17 rose by 144% (Congressional Black Caucus, 2024) . These alarming statistics highlight the urgent need for mental health care in Black and Brown communities.
Current intervention services are insufficient; a shift toward holistic prevention is crucial. To combat this crisis, it’s important to reframe societal norms, combining research, advocacy, education, and funding for a multifaceted approach to suicide prevention. Social behavior change, a model that targets audiences to shift beliefs and attitudes about any societal “norm,” so they may adopt a healthier behavior, has been shown to drastically reduce maternal and child mortality, improve malaria prevention, and shift norms and behaviors around HIV/AIDS prevention. There is also promise in shaping mental health with social behavior change (NIH, 2021) .
The Thomas family, who lost their daughter to suicide, founded The Defensive Line (TDL) after recognizing the widespread experience of shame and silence surrounding mental health. The Thomas’ found that through sharing their personal story, many individuals expressed their own new comfort with vulnerability about their mental health struggles. Using learnings from The Prevention Paradigm for Child Sexual Abuse (Nguyen, et al., 2022) TDL aims to shift the focus from suicide intervention to prevention, particularly for Black and Brown communities.
Progress Update
Partnership Opportunities
The Defensive Line (TDL) is seeking collaborations with both funders and implementing organizations working with youth ages 10-25, particularly in communities of color. TDL is also seeking financial resources and connections to organizations and individuals with expertise in social behavior change communication strategies with a focus on prevention., Through this project, The Defensive Line (TDL) will offer collaborators, including schools and community organizations working with parents/caregivers, evidence-based resources and practices for promoting caregivers’ mental health and equipping caregivers to support teens’ mental health. TDL also aims to utilize its extensive media connections to highlight effective community organizations addressing caregivers’ mental health.