Sources of Strength

Coalitions that Adopted

Healthy Teen Minds – Calumet, Outagamie, and Winnebago Counties

Strategy Type

School-based

Strategy Goal

Reduce the rate of depression among teens by implementing population-level strategies that focus on prevention, including promoting social-connectedness, resiliency and help-seeking behavior among youth; intervention for struggling teens; and improving access to care.

Intended Population

Students and youth-serving staff in middle and high schools across Calumet, Outagamie, and Winnebago Counties.

Strategy Background

In 2016, the Healthy Teen Minds initiative made the strategic decision to invest in a region-wide implementation of Sources of Strength, a best practice youth mental health promotion and suicide prevention program.

This project was informed by alarming youth mental health data and community concern over a growing youth mental health crisis. At the time, the community was reeling from a cluster of teen suicides in Kaukauna and several other unrelated teen suicides throughout the Fox Cities. 2015 data from the Youth Risk Behavior Survey (YRBS) across Calumet, Outagamie, and Winnebago Counties revealed that about one-fourth of local teens reported feeling “sad or hopeless” on the survey, which was used as a proxy for teen depression. Students in the region were also attempting suicide at a higher rate than the state and national averages.

Sources of Strength in Schools Color Wheel Sources of Strength uses an upstream approach to suicide prevention and moves beyond singular risk factors to focus on multiple sources of support. The program incorporates teams of Peer Leaders mentored by Adult Advisors to change social norms and encourage students to individually assess and develop strengths in their lives. Sources of Strength is rooted in eight "strengths" – research-backed support factors that protect against suicide risk. The strengths include family support, positive friends, mentors, healthy activities, generosity, spirituality, physical and mental health.

Sources of Strength is radically positive and uses Peer Leaders to spread messages of “hope, help, and strength” that change school culture by growing help-seeking behavior, breaking down codes of silence around mental health struggles, and improving perceptions of adult support. The program involves strategically designed strength-based messaging campaigns developed by local peer teams to improve school culture and positively impact their peers throughout the school and community.

Appleton North Sources students The Healthy Teen Minds team chose the Sources program as a means to improve the mental health of teens in the tri-county region, with the goal of implementing it at all local high schools, along with a middle school “pilot program” in three schools. The coalition used AHW funding to dramatically reduce the program’s cost by 75% for schools and create a regional trainer certification program, further reducing costs. Participating schools committed to three years of annual trainings. Ultimately, the coalition was able to successfully embed Sources of Strength in 22 local schools and certify 14 regional trainers to carry the program forward.

In addition to embedding the program in local middle and high schools, Healthy Teen Minds worked to ensure a sustainable model for Sources of Strength in the community. One of the coalition’s partners, ThedaCare, used Healthy Teen Minds’ business and training model to duplicate the project within their service area, which includes six adjacent counties to the north and west of the coalition’s footprint, leading to implementation in 12 additional high schools. Further, the coalition held conversations with the local Cooperative Educational Service Agency, CESA 6, to increase collaboration and discuss options for further program sustainability. After sending their own staff to the coalition’s training event, CESA 6 ultimately agreed to take over the program under their Allies in Mental Health Education (AMHE) initiative, creating a path for additional schools in the region to implement and sustain Sources of Strength for years to come.

Did you know: Sources of Strength is considered the first suicide prevention program to demonstrate effectiveness using peer leaders to enhance protective factors associated with reducing suicide in a school.

Strategy: Creating a Reduced Cost Model

Growing a region-wide implementation of Sources of Strength at middle schools and high schools in the requires several key steps. Though Sources is a very popular school-based mental health promotion program, its cost to implement and sustain is a barrier for many schools, particularly for small, rural districts with limited budgets. What helped make Healthy Teen Minds’ project successful was their ability to create a business model that dramatically reduced the cost for schools to implement the program by 75 percent through investing in the certification of regional trainers.

Twenty-two schools that joined the project committed to three years of consecutive trainings to allow the program to take hold, grow and positively influence school culture. Twelve school-based trainers were trained across eight schools.

all

Consult with the National Sources of Strength Program

To begin your work implementing Sources of Strength in local school districts, start by building your relationship with the National Sources of Strength team. The national team can support your vision for a regional implementation of Sources and intention to recruit, hire, and certify regional trainers.

Generate Awareness and Buy-in

Spend time calling, emailing, and meeting with local school administrators to generate awareness of your efforts to implement Sources in your community and get school districts on board. This can include a presentation and overview of the program to school stakeholders, such as school boards, district administrators, and school staff.

Tip: Once the program has been successfully implemented, work with local media to build public awareness of the program and garner further buy-in from additional school districts.

Sources of Strength FAQ (PDF)

Review and Sign Memorandum of Agreement (MOA)

Once schools have decided to implement the program, work with them to review and sign the MOA, which outlines the requirements and responsibilities of each party, including a three-year training/implementation schedule and cost requirements.

Sources of Strength MOA Template (PDF)

Develop Local Cohorts

During the early stages of implementation, work with schools eager to adopt the program and those that may already be working on school-based mental health. Identifying willing leaders from these early adopters helps build momentum and support of the program and helps create a contagion effect. As other schools become increasingly aware of the program and the success experienced by a first cohort of schools, others will likely want to follow suit, and adopt the program.

Strategy: Localizing Trainers

Sources of Strength involves recruiting and training a diverse group of students and staff to hold the respective positions of Peer Leaders and Adult Advisors. The training model is broken into two foundational trainings. First, school staff attend the Adult Advisor training for three-to-four hours in late summer or early fall. Once school begins, the Adult Advisors nominate a group of Peer Leaders they believe would be good leaders and role models, to participate in the day-long Peer Leader training. While the National Sources of Strength office’s certified trainers typically lead these trainings, Healthy Teen Minds invested in the training and certification of local, regional trainers, reducing costs and providing the additional benefit of having local trainers who can build relationships with schools, offer ongoing support, and remain in the community to offer trainings long-term.

all

Investing in Local Trainer(s)

The first step to creating a localized trainer model involves identifying community member(s) with a passion and dedication to improving mental health to attend the weeklong “Train the Trainer” (or T4T) skills session hosted by the National Sources of Strength Training Team to become a “provisional trainer.” Following this training, the provisional trainer must then co-train with national trainers at two Adult Advisor trainings and two Peer Leader trainings.

Train First Cohort of Schools

The second step to creating a localized training model is to bring in the National Sources of Strength Training Team to conduct the Adult Advisor and Peer Leader trainings with the first cohort of schools. The local trainer participates in these training sessions alongside the national trainers to complete their certification requirements.

Note: The Health Teen Minds project invested in training and certifying two regional trainers who both had training experience and a background in youth mental health.

Consider Hosting a Local Train the Trainer Skills Session

After establishing the foundation for Sources in the community, consider hosting a local T4T to re-certify the regional trainers. Certified trainers must attend a T4T every three years to maintain their certification. Not only does this process allow for recertification, but also provides an opportunity to certify additional school-based trainers who can sustain the program in their own school districts.

Note: Of those who attended Healthy Teen Minds' local T4T, 14 went on to train alongside the regional trainers and become official school-based trainers in their respective districts.

Strategy: Creating a System for Evaluation

To be successful in implementing Sources of Strength, schools must work to continuously improve the program through evaluation. However, most schools do not have the capacity to analyze program data, so Healthy Teen Minds took over that responsibility, ultimately allowing schools to focus on creating effective campaigns with guidance and direction from the coalition. Their evaluation model is as follows:

all

Conduct Surveys

After the first year of implementation and at the start of each consecutive school year, administer the online evaluation surveys for all Adult Advisors and Peer Leaders to gauge the quality of the program by recording changes in the school’s level of student social connectedness, connections between students and trusted adults, access to resources, protective factors, and help-seeking.

Peer Leader Survey (PDF)
Adult Advisor Survey (PDF)

Administer Fidelity Check/Assess Activity Log Forms

As you approach the close of the school year, continue reminding school staff of the deadlines to submit Activity Log Forms. You should use these documents to assess a school’s fidelity to the program and provide a score.

Activity Log Form (PDF)

Hold Cohort Data Meetings

After data is collected from the annual evaluations and activity log forms have been returned, schedule meetings with schools to review findings from the surveys and discuss fidelity scores. These meetings create the opportunity to coach and support Adult Advisor teams as they work to troubleshoot challenges and make improvements for the coming school year.

Challenges and Tactics to Address Them

Navigating successful strategy implementation can be complex, and obstacles may arise that set your plan back. Read about strategies you can use to run a successful workshop:

List of Challenges & Tactics

From managing a large network of school cohorts to ensuring deadlines are met, the path forward is often challenging. The following section includes common challenges faced when coordinating Sources of Strength and tactics recommended by Healthy Teen Minds to address them and pave the way for successful implementation.

all

Cost of Implementation

Implementing Sources of Strength can be an expensive endeavor in a school, especially for smaller districts. To reduce the cost-burden, consider developing cost-sharing options with schools if funding allows.

Cost-Sharing Model (PDF)

Fidelity to Documentation Report-outs

Not every school will report out on their campaigns on time for a number of reasons. To address this, ensure that you are continuously reaching out and making contact with school staff and Adult Advisors ahead of time. Additionally, regular contact throughout the lifetime of the program will aid in relationship building and garnering further buy-in, increasing the likelihood of fidelity.

Enforcing MOAs

MOAs are detailed documents that require school administrators to understand all aspects of the Sources of Strength program. This includes information regarding training site requirements, including room type and setup. To help remind schools what was required of them, send key staff reminder emails in the weeks leading up to trainings with clear instructions on room setup and what to expect on training day. Contacting key staff over the phone days in advance will further ensure a school is prepared for the trainings.

Generating Buy-in

Creating initial buy-in to recruit new schools into the program can be a difficult process in districts where school staff – teachers and administrators alike – feel overwhelmed by existing responsibilities. Leading a Sources team takes time, commitment, and resources. Throughout the project, school teams are likely well aware of the youth mental health crisis and the sense of urgency to address it. However, they may feel overwhelmed by the enormity of “school-based mental health” and finding a place to start. Taking time to schedule informational meetings with an overview of Sources can be valuable, as it gives administrators and teachers a solid understanding of Sources as a universal mental health promotion program that complements other school-based mental health efforts.

Trainer Unavailability

When a trainer is unavailable for a scheduled training, you should have a backup plan to replace them. In the early years of implementation, consider contracting with the National Sources training team as necessary to conduct makeup trainings in the event your trainers are unavailable.

Pop-out: In year three, Health Teen Minds invested in the certification of a third regional trainer, and thanks to the good working relationship they had developed with ThedaCare, were able to rely on two additional certified trainers from there as needed.

A testament to their success in sustaining the program, Health Teen Minds worked with CESA 6 to oversee implementation of Sources of Strength, ultimately folding it into its “Allies in Mental Health Education” (AMHE) program.

Best Practices

Through the process of implementing their respective behavioral health strategies, each AHW-funded coalition recorded its lessons learned to help other organizations implement similar strategies in the future. Tried-and-true best practices also enhance the likelihood of achieving desired outcomes. The following section includes an insightful list of learned best practices Healthy Teen Minds recommends other organizations employ to steer their strategy towards successful implementation.

all

Maintain Close Contact with Schools

Developing deep relationships with participating schools will aid in creating a successful program. Conduct school visits for listening sessions to identify challenges and workshop solutions. Maintaining regular contact with participating schools to offer coaching support, set clear expectations, provide tools and technical assistance will allow you to guide them through challenges.

Note: Some engagement tactics include:

Monthly Sources e-newsletter
Monthly “Ask the Trainer” phone conferences
Check-ins at the beginning of each semester
Regional planning meetings with schools

Encourage Participation in the Adult Advisor Training

Ahead of the first year of implementation, strongly encourage all school staff to attend the “Adult Advisor” training to familiarize them with the program. This event will also serve as an opportunity to recruit key volunteers to become “Adult Advisors.”

Develop a Learning Community

Further aiding in the success of Sources of Strength is the creation of a regional Learning Community to bring together lead Adult Advisors from each school that has adopted the program. The Learning Community meetings allow participants to build relationships, share successes and challenges, share campaign ideas, and receive technical and coaching support from the project’s certified trainers. They can also be used as a regular touchpoint for you to check in and remind participating schools to stay on track with necessary documentation and fidelity expectations.

Learning Community Agenda Example (PDF)

Engage Individuals Embedded in the Community

Having the right trainers involved helps develop the project’s reputation as engaging, high-quality, and impactful. By recruiting and training individuals already embedded in the community to become trainers, those who are passionate about mental health and have experience working with teens are able to improve the program through their expertise.

Tip: Reach out to your local Boys and Girls Club to find and train individuals outside of school districts.

Engage Schools Early

Reaching out to school districts at the end of the school year or early into the summer break allows you to develop relationships early, before the next school year begins. This will aid in garnering buy-in and can even lead to early engagement, allowing you to build out cohorts intentionally and increase the likelihood of a smooth start to the program.

Offer Availability for Community Events

To reinforce and expand the message of Sources beyond the schools and into the broader community, assist participating school districts in holding public events by volunteering your services. These events not only extend the reach of a messaging campaign but also garner additional buy-in from the community.

“When there is unilateral support throughout the school and everyone in the building is able to ‘speak the same language’ around Sources… the campaigns are more successful.”

– Project Coordinator Wendy Harris

Resources Needed

An understanding of the broad time and financial costs involved in embedding Sources of Strength in local schools can assist in planning and prevent unexpected delays or shortages that hinder progress. Adopting and implementing Sources of Strength can be a costly endeavor for a school, both in terms of money and staff time. The Healthy Teen Minds project made a large investment on the front end to certify two regional trainers. Additionally, the Project Coordinator, whose position was funded by the AHW grant, devoted two-thirds of her time toward the management and coordination of the Sources implementation project.

all

School Implementation Costs

This investment dramatically reduced the cost of training fees for schools. The following is a breakdown of the costs that can generally be expected when implementing Sources of Strength based on the Healthy Teen Minds’ cost-sharing model:

Sources of Strength Cost Model 2016-2023

50% of annual licensing fee for first year schools: $375 of $750
50% of annual licensing fee for sustaining schools: $250 of $500
50% of annual Sources of Strength Training Fee per pair of Adult Advisor/Peer Leader trainings: $1,000 of $2,000
Annual Adult Advisor Stipend: $1,000-$3,000
T4T registration fee: $500

Note: Optional training for schools that wish to certify school-based trainer.

Healthy Teen Minds encouraged schools to pay lead Adult Advisors a stipend for their time and efforts, much like they do coaches and extracurricular leaders.

Organization-Covered Training Costs

Local Trainer Certification with National Sources Team: $19,000
50% of annual licensing fee for first year schools: $375 of $750
50% of annual licensing fee for sustaining schools: $250 of $500
50% of annual Sources of Strength Training Fee per pair of Adult Advisor/Peer Leader trainings: $1,000 of $2,000
Host National T4T Skill Session: $35,000

Project Coordination

Project Coordinator 0.75 FTE Salary: $46-50,000

Time Commitment for Schools

Adult Advisors spend 40 hours over a four-to-six-month period.
- Adult Advisor Training: 3-5 hours
Peer Leaders spend 15 to 50 hours over a four-to-six-month period.
- Peer Leader Training: 4-6 hours

Sources of Strength Statistics

200

adult advisors trained in year one

350

pear leaders trained in year one

427

school staff trained across 22 schools by year five

961

students trained across 22 schools by year five

Highlights/Select Work Product

Sources E-News: