A Strength-Based and Youth-Driven Approach to Suicide Prevention in Rural and Minority Communities

Introduction: Hawai‘i has one of the highest percentages of youth reporting suicide risk, and adolescents who are Native Hawaiian and Pacific Islander and live in rural communities are more likely to engage in suicidal behaviors. Effective interventions should address these unique ethnic and geographic disparities, as well as strengths and resources within rural communities. This qualitative study examined the impact of a statewide program called Hawai‘i’s Caring Communities Initiative (HCCI), which utilized a youth leadership model to partner and engage with youth and community organizations in youth suicide prevention and awareness efforts.

Methods: HCCI partnered with six community organizations who primarily serve Native Hawaiian and Pacific Islander youth in rural communities across the State of Hawai‘i. The goal was to integrate evidence-based practices into youth-led community awareness activities that are grounded in each community’s strengths and needs. Four focus groups with 17 youth leaders and interviews with nine adult community partners were conducted towards the end of the program. The semi-structured focus group and interview guides were designed to identify the impact of HCCI on multiple levels of the social-ecological model. The focus groups and interviews were audio-recorded, transcribed, coded, and analyzed using NVivo software.

Results: Preliminary analyses indicated that youth and adults gained knowledge and skills on community mobilization, particularly related to suicide prevention awareness. HCCI also provided an opportunity for the youth leaders to build positive relationships among their peers and supportive adults within the community. The adult partners also felt that they expanded their social and professional network through HCCI. Being involved in HCCI also instilled a sense of purpose among the youth and broadened their future career and educational goals. The organizations also received positive attention from the wider community for their youth-driven efforts, although direct involvement in HCCI activities with agency staff was limited. Both youth and adult participants noted that youth involvement in suicide prevention activities seemed to help decrease the stigma of suicide among the wider community.

Conclusion: Increasing evidence is emerging regarding the effectiveness of community-based prevention programs, especially in minority and marginalized communities. The findings from this study suggest that HCCI has been successful in building protective factors among the youth and adult partners as well as the wider community to promote mental health wellness. This study demonstrates that interventions centered on a strengths-based model of positive youth development can enhance resiliency across multiple levels.