The school’s auditorium was empty. At five minutes before 7 o’clock, not a single person had shown up. Scheduled because of a recent upsurge of youth suicides in and around the Washington state city of Bellingham, this youth-driven and arranged meeting was meant to rally the community in support of a comprehensive youth suicide prevention strategy. But as the minutes passed by, organizers were getting discouraged.

“But then, at 7, over 200 people showed up,” laughed Lisa Moulds, who is a prevention manager and prevention coalition coordinator at Whatcom Family & Community Network. “That was really cool. From that, 100 people worked for an entire year in different workgroups to come up with the M.A.D.-H.O.P.E. program and said, ‘What’s one of the best things we could do with the resources we have and the energy we have to help young people?’”

That was in 2012. Today, M.A.D.-H.O.P.E. Youth Suicide Prevention and Wellness Program, which stands for Making A Difference — Helping Other People Everywhere, is a 1.5-hour suicide prevention training program. It is was created in collaboration with both youth and adults and remains youth-led and driven. Moulds, who has worked extensively alongside the organization, said that it was essential to changing the way the local community thought about youth suicide and instrumental in its ongoing prevention. But what pushed the program even further was its involvement with CONNECTED. A privately funded initiative coached by Change Matrix (CM).

Lasting Change
CONNECTED served to provide supports in five pilot communities that included Bellingham around the decrease of depression, anxiety, and suicide while increasing wellness and belonging in communities.

“I think that the CONNECTED project really changed how we looked at engaging with youth. It also changed [our goals],” she said.

Before the project, Whatcom Family & Community Network Executive Director Kristi Slette said that M.A.D.-H.O.P.E. “had started adapting versions of its curriculum for different audiences where data showed health disparity in suicidality.”

“We wanted to ensure we had the cultural and linguistic content to be well-received by youth who identified within LGBTQ+ , tribal. Latino/a/x and rural communities,” Slette continued. “Before Change Matrix’s coaching and connecting us with others, we were aimed to make multiple versions of our curriculum. Afterward, we realized that we needed to take an ‘inclusivity’ approach, where the one curriculum was inclusive of the cultural needs of all the youth we see in public school and community settings”

Moulds agreed.

“So, what we learned was that we were doing all this outreach to find LGBTQ+ youth, etc. that we needed to look at what we were already doing and make sure that our curriculum was responsive, socially responsive, and responsible for not alienating groups of young people,” Moulds said.

CONNECTED also helped reframe M.A.D.-H.O.P.E.’s view of suicide prevention as a social justice issue rather than a traditional mental health issue. This, Moulds said, resonated on a deeper level than what the program was doing before.

“We would talk about how a lot of young people died by suicide, but we would also talk about protective factors. Now we do just as much around building resiliency and protective factors and [asking questions like], ‘What do you do if you’re feeling down?’ and talking about coping mechanisms,” Moulds said. “We actually do somatic work in the training. So, we practice breathing together, we do mini trainings about ways to calm yourself. We also brought in animals as natural therapy. And before COVID hit, we had a connection with our local organization to bring animals into the classroom. But now we do some virtual animals as natural therapy.”

“CONNECTED helped us see that M.A.D.-H.O.P.E. could be a curriculum, but it could also be many other changing strategies envisioned by youth,” Slette added. “It could be a ‘Chalk Art for Mental Health event’; It could be ‘It’s Okay not to be Okay’ sticker campaign.  It could be a social media outreach effort.  So, M.A.D.-H.O.P.E reimagined is the container in our community for all types of youth engagement to promote mental wellbeing.  That was a huge shift.”

With the help of youth, a zine was also developed to provide resources, support, and even a worksheet to help readers assess their own support systems.

A screenshot of M.A.D.-H.O.P.E.’s zine, which features the community’s Whatcom County Young Influencer, a part of the CONNECTED program.

The program also includes video content with youth testimonials, like the story of two friends Alec and Daylin.

“It’s about how a friend saved his friend’s life,” Moulds said. “It’s very moving, and it’s put out through our office of public instruction. We’ll show that video and ask people, ‘What did you see? What did you notice from the friend noticing his friend was suicidal?’



Youth Suicide Misperceptions

In fact, it’s through the review of real-life scenarios like the video that allows for the program to provide answers to pertinent questions and dispel myths surrounding youth suicide. For instance, in the video, Alec’s friend, Daylin, leaves a note. While that does occur, Moulds said it’s not as common as people believe.

“Another misperception is, especially with middle schoolers, if your friend is saying, ‘I’m going to tell you this secret, but you can’t tell anybody,’ we always say, ‘It’s better to have a friend who is upset with you than a friend who has died by suicide. Never keep a deadly secret, and you need to go to a trusted adult,’” Moulds said.

She added that sometimes, it might seem like there were no signs of suicide at all. However, she advises to “never assume” that just because someone seems to have “the perfect life” that they aren’t experiencing mental health concerns of their own.

“The other thing we say to young people is that, ‘You have the power to help your friends.’ And a lot of it has come from listening from your heart and being compassionate and letting your friend know that they are important and matter in your life. That goes such a long way,” Moulds said. “And it is never, ever your fault if your friend dies by suicide. When we say, ‘Don’t keep a deadly secret,’ we always emphasize finding a trusted adult.”

Ongoing Goals
Unfortunately, as effective as programs like M.A.D.-H.O.P.E. and CONNECTED have been, national rates of youth suicide have increased during the course of the COVID-19 pandemic, which has had a significant impact on mental health. It’s also a grim reality that since 2007 suicide has been the leading cause of death for children and young adults ages 10 to 24. Currently, that number continues to grow.

However, Moulds said that the program has experience in building community resiliency and will continue to do so despite obstacles.

“The CONNECTED project has fundamentally changed how we view working with young people. That will stay with us always,” Moulds said. “… We have a long, long way to go, but we are in a better place to consider cultural factors in youth suicide prevention.”

She cited an example of outreach with a community member from the Punjabi American community being done to ensure that programmatic concepts resonate across cultures. M.A.D.-H.O.P.E. has also worked with the National Council for Behavioral Health (NCBH) and Northwest Indian College to better serve Native American populations.

Moulds also recognized that the COVID-19 pandemic provides a uniquely isolating situation for many students who no longer have in-person access to school staff who are trained in behavioral health. To combat this, she advises parents to “trust their gut” and connect with their child when possible.

“If you are concerned about your child and they’re not giving you any information when you ask, ‘Are you depressed? Do you need help?’ If you still think something is off then find the resources. I can’t emphasize enough that the 1-800 national suicide lifeline number is not just there for people thinking of suicide, it’s for family members,” Moulds said. “And so, I would really provide the text line, because a lot of people use the text line.”

Ultimately, she said, suicide prevention often boils down to just being present.

“We want young people to know that they’re beautiful as they are,” she said. “We want to help. There are resources out there. It is OK to not be OK. And I think that’s the heart of our work: youth matter.”

Learn more about M.A.D.-H.O.P.E. online at madhope.org or contact Danielle Humphreys, a youth suicide prevention and wellness specialist at the organization, directly at madhope@wfcn.org. For more information about CM and its projects, visit changematrix.org. The teen suicide prevention text line is 741741. The national Suicide Prevention Lifeline is 1-800-273-8255, which will change to 988 in 2022 for easier access.