Mind4Health is an online training for caring adults that will prepare them to support and refer youth when they see or post concerning messages online. The 90-minute gatekeeper training is perfect for teachers, parents, counselors, coaches, and other caring adults.
The training was designed by the THRIVE Suicide Prevention Project at the Northwest Portland Area Indian Health Board (NPAIHB), to help community gatekeepers identify youth in need of support and connect them to appropriate services.
Mind4Health also includes a text message series that walks participants through three steps to fill their mental health toolbox. To join, text “Mind4Health” to 65664.
Audience: Perfect for teachers, parents, health educators, coaches, and other caring adults.
The Mind4Health training’s videos and handouts are also available on Healthy Native Youth’s website: https://www.healthynativeyouth.org/resources/mind4health
Trigger Warning: This webinar will share tips and examples that depict caring adults and youth talking about suicide.
The training is broken down into three parts that work together as a whole. They are the: Respond, Heal, and Grow Phases. The majority of the training is spent on Respond phase, which is designed to help build skills around how to support youth with their mental health, including three simple steps for letting youth know they are an askable adult that can walk them through tough times and connect them to support. The three steps are: Step 1: Start the Convo, Step 2: Listen & Ask Questions, and Step 3: Connect to Support.
In the Heal and Grow phases we use our Indigenous lens to process how we will Heal and Grow together and focus on how we can break the cycles of trauma that are so uniquely ours, as Tribal people.
This 90-minute training webinar is for caring adults who work with Native youth (ages 13-24). It includes:
The “lesson plans” tab has handouts that accompany the training, and the “supporting materials” tab has additional suicide prevention resources for Native youth.
*Please note the webinar’s “Resources tab” is only available when viewing the training on your desktop. The tab is not available when viewing the training on a mobile device. When viewing the training on a mobile platform for the first time you will be prompted to download the Articulate Mobile Player app on both iOS or Android devices. You can follow prompts, or go to app store to install for free.
Below is a list of resources for Native youth, Crisis Call & Text Services, and Suicide Prevention Trainings.
Concerning posts include those that express depression or intent to hurt oneself or others, posted on social media. These disclosures may provide new opportunities to identify youth at-risk and connect them to appropriate resources and support.
In 2015, a team from Seattle Children’s Research Institute and the Northwest Portland Area Indian Health Board conducted focus groups with 32 AI/AN youth (14-22 years old) to better understand their perspectives on concerning social media posts. Adults who work with Native youth were also surveyed on their experience with and comfort responding to such posts.
Two major themes emerged from the youth focus groups: First, AI/AN youth felt a sense of personal responsibility to help peers but would grow progressively frustrated and “burned out” if their efforts to help did not change the observed behavior; many described “giving up on the situation.” Second, youth requested support from trusted adults, but only 5% of adults surveyed felt adequately prepared to intervene, revealing the need for additional training.
The updated Mind4Health training builds on the original suicide prevention gatekeeping skills (described in the evaluation tab) and incorporates Indigenous Ways of Knowing and Healing to support youth’s mental health.
Current Research and Evaluation
Updates: In 2022, the NPAIHB’s THRIVE suicide prevention project and its Behavioral Health projects teamed up to update and improve the original Responding To Concerning Post training. The team made several improvements, based on user feedback from the pilot study, including:
Evaluation: The evaluation of the Mind4Health intervention was a multi-phase, single-arm, pre-and post-test study of users enrolled in the intervention that is available via text message (SMS) or via a 90 min online, self-paced training. From 2022 to 2024, 280 people enrolled in the Mind4Health text message training, and 250 completed the 8-week intervention. Participants included parents, family members, educators, and outreach specialists.
Results: Post-survey data demonstrated changes in knowledge, beliefs, comfort talking about mental health, and self-efficacy among participants. Mind4Health improved participant skills to have mental health conversations with youth and refer youth to resources in their community (see Figure 2). After completing the series, 75% of participants felt more prepared to be an askable adult and 42% found the videos very helpful, and 52% found the articles and resources very helpful.
Discussion: Outcomes from this study show several benefits from the Mind4Health training among intervention participants. Participants felt more prepared to have mental health conversations after the training. Resources, links, and articles were helpful and utilized by participants. Notably, participants reported they shared information and resources from the Mind4Health resource page with youth and other family members. Participants increased their knowledge, confidence, and skills to recognize a person in mental health distress and are better able to link those people to appropriate resources.
Findings from this evaluation are unique; no other studies cite the use of a decolonized gatekeeper training to address suicide in AI/AN populations. The results of this study support the continued use of decolonized gatekeeper trainings to address the suicide epidemic by building community-based knowledge, addressing stigma that often surrounds mental health help-seeking, and growing the self-efficacy of trusted, askable adults.
Past Research and Evaluation
To evaluate the impact of the original Responding To Concerning Post training, our team conducted a pilot study with two study arms: Arm 1 watched the 30-minute training video and reviewed accompanying training handouts. Arm 2 watched the 30-minute training video, reviewed accompanying training handouts, and participated in an interactive role-play scenario with a coach, that took place via text message.
Objective: In 2017, AI/AN adults who work with Native youth were recruited to test the training and provide feedback on its usability, appeal, and impact.
Methods: A sample of 70 adults were recruited to participate in the pilot, which included two study arms. Altogether, 35 participants finished the training over a 3-month period and completed pre- and post-surveys; 22 participants completed the 6-month follow-up survey. Participants provided qualitative and quantitative feedback on the training’s relevance, appeal, and utility. Qualitative analysis of the role-play transcripts were used to assess the quality and completion of the coached role-plays, in relation to a recommended Viewer Care Plan.
Results: Pre-post analyses of differences in means found significant improvement across several efficacy measures, including confidence starting a conversation about social media (p=0.003), confidence contacting the person who posted something concerning (p=0.0001), and confidence recommending support services to youth who witness (p=0.0014) or youth who post concerning messages (p=0.0001). Similarly, pre- to 6-month analyses found significant positive improvement across multiple measures, including confidence contacting the youth who posted (p=0.0004), confidence starting a conversation about social media with youth (p=0.0029), and an increase in the number of experiences recommending resources for youth who witnessed concerning social media posts (p=0.0196).
Evaluation of the interactive coached role-play scripts found that, on the whole, participants followed some of the Viewer Care Plan (VCP) guidelines more than others. For example, 89% (N=16) of participants completed the “Clarify Your Role” step, while only 44% (N=8) shared VCP tools and resources. Three main response styles emerged: Collaborative (61%), Directive (44%), and Non-Inclusive (22%), with 22% of health educators using more than one approach. Approximately half (N=9) of participants provided additional resources or advice beyond those included in the VCP.
Conclusions: Findings from the pilot study indicate that the Responding to Concerning Posts on Social Media training is a promising tool to better prepare adults to intervene and complete the three steps outlined in the Viewer Care Plan: (1) Start the Conversation; (2) Listen, Gather information, and Assess Viewer Experience; and (3) Plan and Act. To our knowledge, this is the first gatekeeper training for adults that provides guidance for responding to concerning posts on social media. Given the frequency of posts by teens and young adults that express suicidality and self-harm, this training may serve as a helpful blueprint for designing similar trainings for other high-risk populations.
I thought it was really good and would like to be able to use it for trainings with others and as a referral for people. I am a mental health practitioner working in suicide prevention, intervention, and post-vention, and I think it would be a valuable tool for me. Good job!
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