When it comes to teenagers, one thing is pretty much a given: they usually listen more to their friends than to their parents, teachers, or other adult role models.
So in the effort to fight alarming rates of suicide and drug addiction in youth, why not cultivate programs that actually give students the most powerful voice?
This was the question that prompted University of Rochester Medical Center professor of Psychiatry Peter Wyman, Ph.D., and his team to refine and test two school-based prevention programs that empower teens to become change agents for promoting health.
Today, substantiated by more than a decade of Wyman’s research, the two interventions—called *Sources of Strength and Above the Influence, respectively—are being implemented at 60 high schools and middle schools across New York State, with the help of a $1.5M grant secured by Senator Rob Ortt, 62nd District (R, C, I-North Tonawanda). The grant will keep the programs active for three years.
“We’re proud to bring these valuable programs to dozens of schools across the state for the first time,” says Ortt, who chairs the Senate Committee on Mental Health. “The evidence we have seen makes it clear that they help young people build critical strengths and protective abilities, so that we can markedly reduce the number of our youth who are taking their own lives, or becoming dangerously addicted to drugs and alcohol.”
Within Monroe County, the programs are being implemented in Pittsford, Penfield, and East Bloomfield School Districts, with more to come. Other nearby beneficiaries include Holley High School in Orleans County, and Batavia Middle School.
Trained as a clinical psychologist, Wyman spent several years working with adolescents and families in private practice before pursuing a desire to make a larger impact through preventive, population-based approaches. With young people especially, he sees vast potential in using what he calls a “social network health diffusion model.”
“Research shows peers have enormous influence on adolescents’ choices and decisions, especially when it comes to things like substance use, risk-taking and sexual practices,” he says. “But rather than bemoaning this fact, it actually offers immense opportunity to capture and leverage peer group influence for prevention and health. Just as suicide can be contagious, so too can be the attitudes and behaviors that counter suicide, and help adolescents thrive.”
In a typical high school or middle school, students often gravitate to well-defined peer groups through activities such as sports, drama, or music, says Wyman, while others affiliate with groups less connected with school. The network health approach first identifies the most influential members or “key opinion leaders” from each of these varied groups, he says.
“By engaging peer leaders, and encouraging them to build healthy coping practices, better connections with adults, and the strengths to avoid problematic behaviors, we empower them to become effective change agents,” he says. “We then prepare adults in each school to be effective mentors for their peer leader teams. The final step is to help peer leaders employ strategies to get their friends on board, and promote a culture change through their school. These activities have included poster campaigns, cafeteria activities, and videos for social media.”
Over the past 10 years, with support from the NYS Office of Mental Health, Wyman and his team have focused on bringing the Sources of Strength program to predominantly rural schools in New York State where mental health resources are lacking and youth suicide rates are highest. Wyman’s research to date has shown that Sources of Strength increases peer leaders’ positive coping skills and connectedness to adults, and that their activities, in turn, strengthen the school-wide culture and behaviors surrounding help-seeking and suicide. The data acquired from his NIMH-funded evaluation of the program with 17,000 students in 40 schools will be published later this year as part of the largest youth suicide prevention study to date.
In addition to the Sources of Strength program, middle schools across the state will be taking part in the Above the Influence substance abuse prevention program, also implemented by Wyman’s team. Similar to Sources of Strength, the intervention—adapted by Wyman from a national media campaign—engages eighth graders to encourage their peers to overcome pressures to abuse drugs and alcohol. Peer leaders go through training to learn what motivates them to rise above negative influences, what they feel they have to gain by doing so, and what they feel they have to lose if they don’t.
“Research showed that the national Above the Influence campaign reduced substance use by helping teens focus on what keeps them in check and what keeps them from using,” he says, adding that many schools still use outdated, unproven drug prevention programs that may do more harm than good. “The goal of the school-based program is to help teens lead this process and show their peers that resisting substance use is something cool, and worthy of social status.”
Wyman adds that mobile technologies play an important role in both programs, and the ability to communicate through text messaging supports teens in their interactions with both peers and adults. For this, he is working in partnership with Anthony R. Pisani, PhD, an associate professor of Psychiatry at Pediatrics at the University of Rochester, who leads prevention technology on both projects. Wyman’s team also uses advanced data science techniques to anonymously map the thick web of student friendships, or social networks, to determine how healthy norms spread across a school.
The administration and students of Penfield High School—which experienced two student suicides earlier this year—have embraced the chance to be one of the first local schools selected to participate in the Sources of Strength program. In April, more than 50 student peer leaders, teachers and staff from the high school took part in their first day-long training session led by members of Wyman’s team. The diverse group of students—unlikely to share the same social circles at school—openly discussed varied perspectives, the challenges of growing up, and the “strengths” that keep them going through tough times: including friends, family, pets, sports, music, food, exercise, spirituality, books, and dreams of the future.
“One thing they comment on is that it can really mean a lot to learn that they share much more in common than they knew,” says Wyman, “including challenges and what is meaningful. It’s gratifying to see that process unfold.”
After the teen leaders learn to identify the sources of strength in their own lives, they are encouraged to talk with five to 10 of their friends about the supports they have and are growing. And, over the next several months, they are also supported in creating a series of messages for a wider audience—in the form of posters, text messages, videos, art and music. One powerful interactive activity has other students list their own “trusted adults” on a bulletin board.
“We’re committed to the concept that our training doesn’t tell, but shows,” says Wyman, adding that he and his team will be researching the implementation of the Senate program to determine best practices for sustainability. “It’s important that teens themselves lead it with adult mentoring, draw upon their strengths and learn from each other. That creates a lot more interest and motivation than a speaker giving them a big, charismatic lecture. We know people don’t retain that. So this is a very experiential model.”
*Sources of Strength was first developed by Mark LoMurray, director of the Police Youth Bureau in Bismarck, ND, to build resilience among rural and Native American teens and reduce North Dakota’s staggering rates of youth suicide in the 1990s. In 2006, Peter Wyman began working with LoMurray to further develop and refine the program, and published an NIH-funded study of 18 schools in 2010, which cited the program’s success at enhancing protective factors associated with reducing suicide. Now active in more than 25 states, the program is the recipient of a National Field Project award from the American Public Health Association and was entered into the National Registry of Evidence-Based Programs and Practices in 2012.