Youth Suicide Prevention Efforts in Southwest Phoenix, Arizona

Background: Project Aware intended to improve the quantity and quality of life for adolescents between the age of 12 and 18 years through the deployment of a cadre of individuals trained in Youth Mental Health First Aid (YMHFA). The project geographic are (SouthWest Valley) included areas of West Phoenix, Tolleson, Avondale and Goodyear in Maricopa County, Arizona. Over 12% of the total population in the project area are 12-18, and 51% are Hispanic. This area was chosen because over 35% of youth living there felt sad or hopeless one or more times during the past 12 months (as compared to 30% in the U.S.), 14% have attempted suicide (compared to 8% in the U.S.) and 6% of the attempts resulted in serious injuries (compared to 3% in the U.S.) (YRBS 2014).  The program raised awareness about youth mental health and suicide prevention, and trained teachers, community members, school psychologists, counselors, social workers, and security resource officers to spot the signs of mental health issues and/or suicidal thoughts. The YMHFA program also provided Mental Health Aiders with the tools to refer youth to appropriate community resources, and mental health and behavioral health providers for follow up. The curriculum used was the Youth Mental Health Fist Aid USA from the National Mental Health First Aid Council.

Methods: The Bruno Anthony survey was used pre- and post- training to evaluate Mental Health First Aiders knowledge, attitudes and expected behaviors changes. Paired sample t-test were used to analyze the results of the Bruno Anthony survey. First Aiders submitted youth referrals’ information to the evaluators for tracking. The Youth Risk Behavior Surveillance System was used to track suicide attempts, youth sad and hopeless feelings and other indicators of suicidal thoughts.

Results: Over 700 Mental Health First Aiders were trained in the program. Only 44% of participants had previously participated in a mental health training of any kind (not First Aid). Results of analysis showed statistically significant increases across participant’s knowledge about mental health problems, positive changes in attitudes concerning providing mental health first aid, and confidence providing first aid services to youth. Most importantly, over 1100 youth were referred to community resources, and/or mental and behavioral health clinics for further assessment and follow up.

Conclusions and Implications: The evaluation results indicate the high need for mental health services for youth in the project area, and the need for Mental Health First Aid training for professionals, paraprofessionals and community members. Policy changes concerning mandatory mental health first aid for all school personnel would increase the chances to provide more timely assistance to youth in need of mental health care, and specially to those who are considering suicide.