There are two presiding theories undergirding the work of Hope Squad. First, Thomas Joiner’s Interpersonal Theory of Suicide (IPTS) is the dominant theory in suicide research and practice. In his book, Why People Die By Suicide, Joiner describes the three mechanisms that, in tandem, could identify those at highest risk for suicide death: perceived burdensomeness, thwarted belongingness, and capability for suicide.

Joiner argues that when a person assesses that their cost to their loved ones is more than they contribute, that may result in perceiving oneself as a burden. When that same person feels as though their primary tribe of support, such as friends and family, no longer want them or love them, and when they have lowered inhibitions about death, dying, pain, and injury, they are at the most vulnerable to suicide. In a 2007 publication, Joiner further argues that this theory can be applied to school-aged adolescents. Although adolescents may arrive at these three emotional states a different way than adults, these areas of concern align regardless of age. Complicating factors for youth could be family dynamics, pressures of peer relationships, academics, and other systems that young people require to thrive.

In practice, Hope Squad’s work addresses the elements of Joiner’s theory. First, Hope Squads use unconditional positive regard and intentional outreach to forward acceptance and belongingness to all students, regardless of mental state, emotional health, or suicide risk. Second, Hope Squads employ positive messaging to all students in order to highlight each student’s value, the importance of their life and contribution to the school and student body. Lastly, Hope Squads are trained to report lethality risk, including the possession of a lethal mean, such as a gun, poison, or other items or mechanisms by which a peer could harm or kill themselves.

A second important theory relevant to the work of Hope Squad is Kalafat’s sentinel research on peer-to-peer disclosure of suicide risk. Their findings suggest that young people tell each other of their risk as opposed to going to an adult for help. Hope Squads work to address concerns about students keeping “deadly secrets” when peers disclose suicidal thoughts to each other. Hope Squads advertise themselves as peers who, without judgment, will listen and shepherd someone to help, using a warm-handoff whenever possible. This may reduce the fear and angst young people have in seeking help.

Hope Squad is supported by several other strands of research. In a systematic review of suicide prevention programs, Surgenor, Quinn, and Hughes recommend that prevention efforts be long term, flexible, interactive, and have clearly defined learning outcomes. They suggest that successful programs focus on both protective and risk factors and engage multiple levels (e.g, individual, school environment, parents). Additionally, Marraccini and Brier report that programs focusing on improving school climate and promoting connectedness help reduce suicide risk. Doan suggests schools should create a comfortable group climate and train students to recognize potentially suicidal peers. According to Mazza and Reynolds, creating a sense of belonging can be challenging in a school setting but can be one of the best preventative measures within a school to help prevent suicide.

Finally, the Substance Abuse and Mental Health Services Administration (SAMHSA) supports the need for suicide prevention in schools for the following reasons:

• Maintaining a safe school environment is part of a school’s overall mission.
• Students’ mental health can affect their academic performance.
• A student suicide can significantly impact other students and the entire school community. 
• Schools have been sued for failure to get assistance for a student at risk of suicide and for failure to notify the student’s parents.

• Reducing Suicide-Related Stigma through Peer-to-Peer School-Based Suicide Prevention Programming
• Suicide gatekeeper training outcomes in educational and religious settings
• Peer-Assisted Learning in a High School Suicide Prevention Intervention: An Exploratory Qualitative Study by Sterling R. Morris
• Suicide Concern Reporting among Utah Youths Served by a School-Based Peer-to-Peer Prevention Program
• No-Suicide Contracts with Suicidal Youth

Hope4Utah 2020-21 Survey Results

One of the target outcomes for Hope4Utah is to provide suicide prevention training through the Hope Squad program in Utah schools. In a pre-survey given to Hope Squad members at secondary schools in Utah for the 2020-2021 school year:

• 47.73% of respondents selected “Strongly agree” when asked to what extent they agreed with the statement “I recognize the warning signs of suicide.”
• That number rose to 69.75% when the post-survey was given at the end of the 2020-2021 school year.

Similarly, when students in the same survey were asked to respond to the statement “I know where to get help for a friend who is thinking about suicide:”

• 68.61% selected “Strongly agree” in the pre-survey; and
• 82.28% selected this option in the post-survey.

These numbers indicate that students in secondary schools in Utah have shown an increase in ability to not only recognize the warning signs of suicide, but also know how to get help for someone who may be presenting these warning signs.

Hope4Utah has been successful in it’s outcome to provide suicide prevention training through the Hope Squad program.

Ohio Hope Squad Comparison Study (2020, under review)

Recent findings from year one of the Ohio Hope Squad Comparison Study reveal the following:

• Hope Squad schools have less suicide-related stigma than non-Hope Squad schools
• Stigma among males in Hope Squad schools showed a downward trend as compared to non-Hope Squad schools
• Hope Squad schools had significantly more referrals from all students compared to non-Hope Squad schools 
• Hope Squads had more referrals of high-risk students, and those students received support that was aligned with their risk status

Growing School-based Suicide Prevention Programming through Parent Engagement: Lessons Learned from Focus Groups and Gatekeeper Training (2020, under review)

A mixed methods study of Hope Squad parents showed that 1) “inclusivity” may be a primary reason their child makes a good Hope Squad member, 2) their child’s previous experience with, and openness to, people struggling with mental health also prepares them for Hope Squad work, and their 3) faith plays a central role in their helping attitudes. When these parents participated in a QPR training, their knowledge, skills, and self-efficacy significantly approved.

Hope Squads: Peer-to-Peer Suicide Prevention in Schools (2018)

Annual pre-and post-surveys indicate that Hope Squad curriculum is effective in improving the knowledge, skills, and self-efficacy of members. Hope Squad members experience low burnout and stress when assisting peers.

Suicide Concern Reporting among Utah Youths Served by a School-Based Peer-to-Peer Prevention Program (2018)

An analysis of suicide concern data shows that 25%-30% of all students seeing their counselors for suicide-related distress were referred by Hope Squad members, and that 14% of those referred are getting hospitalized. This supports the idea that Hope Squads are referring students in urgent and critical need. Additionally, current longitudinal trends in the data reveal that in subsequent years after implementation (year 1), student self-referrals and other student referrals of peers in distress increase, indicating that stigma is breaking down and comfort with help-seeking is increasing.

Exploring the Long-Term Impacts of Peer-Based Suicide Prevention Among Adolescents (2018)

This exploratory research study examines the experiences and perspectives of past Hope Squad members. Findings from this study provide support for the long-term benefits of peer-outreach suicide prevention programs. After participating in the Hope Squad program, students were shown to have greater access to knowledge and resources that contributed to emotional resilience, be more respectful and understanding of their peers’ needs, and be more comfortable being vulnerable about their own struggles. The study includes interview responses from Hope Squad members about the positive traits and skills they gained from the Hope Squad program.

2017 SHARP Survey: Help-Seeking Outcomes for Hope Squad Schools (under review)

Compared to students at non-Hope Squad schools, students at Hope Squad schools showed significantly more help-seeking behavior by talking to adults when feeling “sad, hopeless or suicidal.” This effect was evident for the entire population as well as for students who experienced suicidal ideation, suicide plans, and suicide attempts.

Educators’ Perspective of Suicide Prevention Program: Hope Squad (2021)

This study investigates the perspectives of educators involved in the Hope Squad program. A thematic analysis indicates a positive appraisal towards Hope Squad, focusing on trained and trusted peers, suicide training, mental health awareness, and change in the culture of the school.

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