“Kids usually sleep, listen to music and spend time on their phones, none of which, the evidence shows, makes them feel better,” said Elizabeth Koschmann, a psychologist and founder and executive director of TRAILS. Instead, students are taught skills grounded in cognitive behavioral and mindfulness practices, like reframing how they think about a situation or recognizing and stopping negative feelings and thoughts about themselves.
The program also offers professional development and coaching, a suicide risk management protocol and a library of resources teachers and counselors can use when working with students. About 750 schools have partnerships with TRAILS and about 8,000 teachers nationwide use its social and emotional learning curriculum. Materials in the program’s resource library are free for school mental health professionals and pulled from its website 2,500 times each day during the school year.
Students living in rural areas face significant challenges accessing mental health services, according to the Rural Health Information Hub, a national clearinghouse for information on rural health issues. Rural communities often lack local psychologists, psychiatrists or social workers and suicide among youth has historically been highest in rural areas.
The Rural Behavioral Health Institute, a nonprofit established in 2020, aims to reduce youth suicide in rural regions, starting with Montana, where young people commit suicide at more than twice the rate of young people nationwide, according to data from the Center for Children Families, and Workforce Development at the University of Montana.
In March 2021, the institute piloted its Screening Linked to Care program in one Montana high school to identify students at risk for suicide, quickly evaluate them and refer them to care. Janet Lindow, an associate professor of psychiatry at the University of Kansas Medical Center and executive director of the institute, has been a suicide researcher for six years.
“It used to be unheard-of to have a kid below age 12 being suicidal, but it is now not uncommon to have 10- and 11-year-olds,” she said.
This year, the program will offer psychiatric services, case management to help families connect to mental health providers and virtual group therapy for students in different schools with the same mental health needs. The institute screened 41 students in the 2020-21 academic year; last year, its program screened more than 1,000 children at 10 schools in five Montana counties. About 10 percent were identified as having a high risk of suicide, and about one-third needed mental health services.