Across Colorado and in La Plata County, coalitions are working on new efforts to reduce underage drinking, drug use, violence and other problem behavior among teens. It’s work that could also help prevent suicide.
About 50 Communities That Care coalitions in the state are following a model developed at the University of Washington that is scientifically proven to reduce problem behaviors over time, said Kate Jones, Thriving Youth Programs supervisor at San Juan Basin Public Health.
The efforts are funded through marijuana taxes, and the state set aside $9 million in 2017-18 to fund the coalitions, according to the state health department.
A study of 24 small towns across seven states found that students from communities with active coalitions were 25 percent less likely to have participated in delinquent behavior, according to the Center for Communities that Care.
The study, started in 2002, tracked students in the fifth grade and showed results by the time students reached eighth grade. The study is ongoing, and it has shown children from those communities were less likely to participate in substance abuse, violence and other behaviors into adulthood, according to a study published in the American Journal of Public Health. There are now 118 Communities That Care coalitions operating in 15 states
While studies haven’t directly proved the model reduces youth suicide rates, a Communities That Care coalition in the city of Tooele, Utah, successfully employed the model to prevent suicide in recent years, said Heidi Peterson, who oversaw the coalition.
About five years ago, four teenagers died by suicide in Tooele, a town of about 33,000 people 40 miles west of Salt Lake City. Around the same time, survey data showed an increase in depression and thoughts of suicide among teenagers.
The deaths and data prompted the Communities That Care coalition to make suicide prevention a priority, Peterson said.
The effort started in 2015, and Tooele County, home to about 63,000 people, was the only county in the state to see its suicide rates decline in 2017, Peterson said.
The 2017 suicide rate data is not yet publicly available. But Tooele County’s suicide rate for those older than 9 dropped from 43 deaths per 100,000 in 2014 to 15.3 per 100,000 in 2016, according to data provided by the state of Utah. State officials caution the population of the county is small, so the rates can vary dramatically when the difference in the total number of deaths each year is not significant.
The group set out to train 1,500 people per year in Question Persuade Refer, which is designed to be similar to CPR for those experiencing suicidal thoughts. The coalition started by training every high school sophomore in the county and offering free monthly trainings to the public.
“It was our goal to saturate our community,” Peterson said.
In three years, the community trained about 7,000 people, far outstripping its goal because residents continued to request sessions.
QPR teaches participants to recognize statements and behaviors people may exhibit when they are feeling suicidal. For example, those at risk of suicide may allude to their feelings by saying: “Everyone would be better off if I wasn’t around,” according to the QPR Institute.
Trainees are also taught to take three steps laid out in the name of the program. They learn how to question suicidal people about their feelings, persuade them to seek professional help and refer them to local providers.
The sessions also require participates to practice asking direct questions about thoughts of suicide, according the QPR Institute.
A study of about 400 people who work in child welfare, education, the juvenile justice system and similar professions found QPR training tended to fade a bit from participants’ memories after six months. The study completed in Tennessee recommended annual trainings be required for teachers and principals.
The coalition found of all the different people in teenagers’ lives that they could talk to about suicidal thoughts, members of the clergy were last on the list, Peterson said.
So the coalition worked closely with the Mormon church and other faith-based organizations to train their leaders in QPR. It was warmly received by those faith leaders, who put the training into practice.
“They could talk to these people that they were concerned about and trust they were using the correct steps to bring them help,” Peterson said.
The coalition had 75 faith leaders come to the first training and 150 attend the second.
The group also introduced efforts at local schools to train teachers and administrators on the best steps to take after a suicide to prevent additional deaths, she said.
“The objective of postvention is to help process that grief in a way that turns it to healing and hope and prevention for others,” she said.
The coalition had been working in the community since the early 2000s and had already built partnerships with key groups, including the health department and the mental health authority, which allowed it to work efficiently, she said.
The local Communities That Care coalition plans to help young people understand that underage drinking and drug use is harmful. The group chose those goals based on Healthy Kids Colorado Survey data, said Jones with San Juan Basin Public Health, who started work in 2016.
The coalition is not focused on suicide intervention, such as QPR, but on prevention work that will keep teens from becoming suicidal at all, Jones said.
The coalition’s work is built on a positive youth development strategy developed by the Center for Communities That Care that involves teens as equal partners, Jones said.
The model requires adults to provide quality extracurricular activities, teach teens the skills to succeed and praise them for specific achievements.
The strategy also encourages building strong relationships between adults and teens to motivate teens to meet clear standards for behavior, according to the center.
To help build relationships between adults and teens, the coalition is educating coaches, parents, law enforcement, business owners and others about what to expect from youths, she said.
“The biggest thing positive youth development brings to a community is really getting adults to see the opportunities that are available in each stage of (teen) development,” Jones said.
While some adults might say that teens are frustrating to work with because they are unpredictable, the model helps adults see difficult moments as opportunities for growth, she said.
Communities That Care is also promoting groups that may not be as well-known as sports, such as comic book or gaming clubs.
If a student can’t find a group that interests them, the coalition will encourage the student to start one, Jones said.
“We don’t ever want to tell them what to do. We empower them to come up with some of these ideas and then we help them implement them,” she said.
Communities That Care is collaborating with Celebrating Healthy Communities, another countywide coalition, to encourage healthy relationships between adults and teens and involve teens in prevention work.
After seeking input from at least 150 teens in La Plata County, the coalitions found that young people want the community to listen to their ideas and give them opportunities to participate in promoting a healthy community.
Adults must trust that teenagers are the experts in what it means to be a young person and not limit their involvement to one-time projects, said Breeah Kinsella, interim director of Celebrating Healthy Communities.
“Kids are fully capable of not only telling you what they need, but also getting what they need and accomplishing tasks if we give them the right guidance and leadership,” she said.
Building relationships takes commitment, vulnerability, honesty and trust, she said.
“Real, honest connection does not come in the form of a ding from your phone. And so it takes time, relationship building is not easy,” she said.
The two coalitions developed the Youth-Adult Partnership Series to empower teens to advocate for themselves and teach teens and adults to work together.
During one workshop, adults and teens discussed the positive impact an adult had on their lives and the qualities that person possessed. The teens also gave presentations to adults about how they can better show they value and listen to youths, Jones said. Two workshops had been held as of September and more are in development.
The two coalitions are designing a survey to follow up with those participating in the workshops to see if the workshops helped improve their community engagement, she said.
Communities That Care wants to ensure teens can advocate for themselves, identify and talk to a trusted adult and talk to peers they might be concerned about, she said, in an email.
The coalition also provides teens information about brain development and how it affects what teens experience throughout their adolescent years, Jones said.
The model can be expected to bring about change in the next five to 10 years, Jones said.
She expects to see substance use among teens decline and their participation in the community increase.
She wants teens to feel as through their time, energy and effort is not only valuable but necessary for the community’s health and future.
The coalition in La Plata County has completed the first three steps of the Communities That Care model. The first step is to get community stakeholders involved. Once coalition members are recruited, they must learn about how to prevent risky behaviors among teens and write a vision statement. In the third phase, coalitions must review data from youth surveys and decide how they plan to encourage healthy behavior.
This month, the coalition planned to review a community action plan about how to achieve its goals, and it will likely start implementing the plan shortly, Jones said.
“I believe a coalition, such as this one, is successful when we have built it to a place where youth feel like they are the ‘captains of the ship,’” Jones said.
mshinn@durangoherald.com
