Week 7- challenges.

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Health Problem is Teen Suicide in SWFL. 

My health promotion proposal about this topic is attached. 

Please read it and answer the following question. 

This week you will devote your time to work on your health promotion proposal. Please share what you consider a challenge for this activity. How did (or would) you approach the challenge?



Teen Suicide Health Promotion Program I

Description of Health Problem

Teen suicide is a serious problem adversely affecting families, communities, and governments. According to Busby et al. (2020), suicide is the second leading cause of death in the United States among young people aged 10-24 and 25-34 years. The study established that approximately 9% of high school students have made at least one attempt to commit suicide, whereas 20% had seriously considered taking their lives. In addition, the study estimated the cost of suicide in the United States at $926 billion in loss of productivity, medical costs, and the value of statistical life. Teen suicide could be reduced significantly by integrating a prevention program into the already existing school mental health resources or systems. The Yellow Ribbon Suicide Prevention intervention will be integrated with the mental health programs in Schools to promote help-seeking behaviors. Staff members will implement the “Ask for help” training among teens. The training will last for 30 minutes and will be conducted after every seven days. In addition, teens and teachers will wear a wrist bracelet written: “It is OK to Seek Help.” According to Gallo and Wachter (2022), teens are more likely to share suicidal thoughts with classmates and peers than teachers or adults. The proposed Yellow Ribbon Program (YRP) is designed to encourage and support teens’ help-seeking behaviors.

Vulnerable Population

The youth are more vulnerable to dying by suicide than adults. In the United States, estimates reveal that about 7% of teens (adolescents) attempt suicide yearly (Vaughn et al., 2020). It was also established that at least one suicide is completed for every 100 suicidal attempts. There is an increased risk for suicide attempts among teens with a history of abuse, family discord, and negative life events; adolescents with substance abuse, general health, and mental health problems; and girls. It is noteworthy that risk factors for suicide among teens seem to be consistent with the bodily developmental changes during adolescence. The risk of suicide among teens may be increased by factors such as distress, irritability, lack of a support network, feelings of hopelessness and struggle with sexuality or gender identity. Adolescence is a time of relationships, the need for independence, and relationships, which conflicts with the expectations and rules set by others. Busby et al. (2020) suggested that mental health systems should address additional objectives, such as supporting healthy youth development. Given the high risk for suicide among the adolescent population, schools are better placed to provide early interventions to address the problem.

Evidence-Based Interventions (Literature Review of Articles)

One of the teen suicide prevention programs is gatekeeper training, elucidated by an article titled ”
Preventing Adolescent Suicide,” authored by Torok et al. (2019). Gatekeeper training allows persons with high contact with teens, such as teachers and parents, to detect early signs of suicidal conduct, tendencies, or behaviors and intervene to prevent injury, disability, or mortality (Torok, Calear, Smart, Nicolopoulos, & Wong, 2019). The article suggests that parents and teachers reported improvements in perceived confidence and knowledge to intervene to prevent teen suicide. From this study, it is apparent that most teachers and parents have considerably low suicide literacy. School counsellors have more knowledge concerning suicide risks among teens and how to intervene, which means that gatekeeper training may have a null effect on this group. According to Gallo and Wachter (2022), gatekeeper training for teaching staff is an effective and safe strategy for increasing awareness of suicide risk among teens and reducing suicidal attempts or deaths in schools. As such, gatekeeper training programs should be reviewed and improved regularly to enhance their efficacy in facilitating suicide prevention.  

Another evidence-based intervention to prevent suicide among teens in schools is screening and mental health assessment. According to Vaughn et al. (2020), schools may focus screening exercises on selected teens (known to be at risk of suicide) or perform it universally with all teens. In the article by Singer et al. (2020) titled ”
School-based Suicide Prevention,” the authors contend that screening for suicide risk factors among teens in schools increases early detection of individuals at risk of committing suicide and enhances timely interventions to improve mental health. The students identified from the screening process as being at risk should be interviewed further to understand their problems and address them appropriately. However, there are no universal screening measures for behavioral health problems or suicide (Singer, Erbacher & Rosen, 2019). Nevertheless, screening encourages help-seeking behaviors’ and improves mental health among teens, ultimately reducing suicidal thoughts.

Strengths and Weaknesses of the Articles

The two articles reviewed have fundamental strengths and some weaknesses. According to Busby et al. (2020), a robust research methodology is essential for generating authoritative findings. A case in point is the systematic and rigorous analysis of various studies in Torok’s article. The comparative evaluation of more than five studies about gatekeeper training enables the authors to obtain reliable and broad sets of data, leading to valid conclusions. Similarly, the article “school-based suicide prevention” contains significant explanations on the efficacy of screening to detect and prevent teen suicide in schools. The authors highlight different screening approaches used by schools and draw useful conclusions about their efficacy. Despite the strengths, the methodologies used in the two articles lacked the use of validated scales to measure behavioral outcomes of suicide prevention programs. According to Gallo and Wachter (2022), lack of measurement standardization and variance in scientific quality complicate efforts to determine the efficacy of the suicide prevention programs discussed. Nevertheless, the articles highlight important information to support integrating suicide prevention programs with school mental health systems.

Theoretical Model (Yellow Ribbon Program of Suicide Prevention)

  The Yellow Ribbon Program (YRB) will focus on empowering teens through education, awareness, and leadership to prevent suicide. According to Vaughn et al. (2020), integrating youth suicide prevention programs with mental health programs in schools is crucial for encouraging help-seeking behaviors among teens. The YRB program also reduces the stigma associated with suicide, which often discourages adolescents from openly sharing suicidal thoughts with adults or teachers. More specifically, the YRB program entails two components: “Ask for help” and “Be the link.” The component of asking for help will be actualized by implementing an educational program to create awareness and provide teens with knowledge to encourage help-seeking behaviors as individuals or on behalf of peers. Also, the teens will be issued a Yellow Ribbon Card. The card will highlight the three steps of helping oneself and others and an appeal to dial hotline numbers to seek help when faced with suicidal thoughts, stress, anxiety, depression, or behavioral problems. Gallo and Wachter (2022) asserted that teens require quick help, especially by dialing hotlines, before they feel helpless and resort to suicide. Therefore, integrating the YRP with mental health systems in schools will increase the efficacy of preventing suicide among teens.


Busby, D. R., King, C. A., Brent, D., Grupp‐Phelan, J., Gould, M., Page, K., & Pediatric Emergency Care Applied Research Network (PECARN). (2020). Adolescents’ Engagement with Crisis Hotline Risk‐management Services: A Report from the Emergency Department Screen for Teen Suicide Risk (ED‐STARS) Study. 
Suicide and Life‐Threatening Behavior
50(1), 72-82. https://onlinelibrary.wiley.com/doi/abs/10.1111/sltb.12558

Gallo, L., & Wachter, M, C. A. (2022). Suicide Intervention in Schools: If Not School Counselors, Then Who? 
Teaching and Supervision in Counseling
4(2), 6. https://trace.tennessee.edu/tsc/vol4/iss2/6/

Singer, J. B., Erbacher, T. A., & Rosen, P. (2019). School-based suicide prevention: A framework for evidence-based practice. 
School Mental Health
11(1), 54-71. https://link.springer.com/article/10.1007/s12310-018-9245-8

Torok, M., Calear, A. L., Smart, A., Nicolopoulos, A., & Wong, Q. (2019). Preventing adolescent suicide: A systematic review of the effectiveness and change mechanisms of suicide prevention gatekeeping training programs for teachers and parents. 
Journal of adolescence
73, 100-112. https://www.sciencedirect.com/science/article/pii/S0140197119300715

Vaughn, L. M., Sunny, C. E., Lindquist-Grantz, R., King, C., Brent, D., Boyd, S., & Grupp-Phelan, J. (2020). Successful suicide screening in the pediatric emergency department: youth, parent, researcher, and clinician perspectives. 
Archives of suicide research
24(sup1), 124-141. https://www.tandfonline.com/doi/abs/10.1080/13811118.2018.1541034


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