Tribal Health – Reaching out InVolves Everyone (THRIVE)

The suicide prevention project at the NPAIHB is THRIVE which stands for Tribal Health: Reaching out InVolves Everyone. THRIVE works to reduce suicide rates among American Indians and Alaska Natives living in the Pacific Northwest by increasing tribal capacity to prevent suicide and by improving regional collaborations. Staff provide programmatic technical assistance, suicide prevention training and resources to the Northwest Tribes. Specific project activities include:

Zero Suicide Model (ZS) “The Zero Suicide Model relies on a system-wide approach to improve outcomes and close gaps. Success is achieved when clinical teams embrace the understanding that suicide deaths are preventable in their organization; and when patients feel comfortable disclosing suicide risk and work with clinic staff to lower that risk. The Model is based on the realization that suicidal individuals often fall through multiple cracks in a fragmented and sometimes distracted health care system, and on the premise that a systematic approach to quality improvement is necessary” ( THRIVE currently has three tribal pilot clinics implementing the ZS model and are recruiting additional sites to receive a site specific ZS training in 2016.

Training and Presentations – Project staff can facilitate trainings and presentations around the topic of suicide and are trainers of a couple popular suicide intervention gatekeeper trainings. The two trainings we currently can offer at low- or no-cost are QPR (Question Persuade Refer) and ASIST (Applied Suicide Intervention Skills Training). To request a training or presentation please contact project staff, Colbie Caughlan at  or Celena McCray at

Preventing Injury through Social Marketing – Several learning and health communication theories support the use of culturally-tailored media to increase behavior change. Tailored information is more likely to be read, understood, perceived as personally relevant, and remembered. Cultural tailoring is particularly important when addressing sensitive health topics, like suicide and sexual health. To view the social marketing campaigns please check out the Social Marketing Campaigns webpage.

Annual THRIVE Conference – This annual summer conference is for Native youth ages 13-19 from all over Indian Country. The conference brings youth together to learn about health promotion and disease prevention with a strong focus on suicide prevention and mental health. To learn more about the 2019 THRIVE Conference please click here.

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1. Increase knowledge and awareness about suicide among tribal community members, and in doing so, take steps to address the silence and fear that exists in many of our communities preventing use of available prevention and treatment services.

2. Improve intertribal and interagency communication about suicide prevention and treatment in order to share and maximize limited resources, by working collaboratively with the Northwest Native Adolescent Health Alliance and other regional partners.

3. Increase the capacity of tribal health programs to track, prevent, and treat suicide.


Funded by the Indian Health Service (IHS) and Substance Abuse and Mental Health Services Administration (SAMHSA)

Project activities are funded by the Substance Abuse and Suicide Prevention (SASP) grant awarded by the IHS, Division of Behavioral Health in September 2015 and SAMHSA’s Garrett Lee Smith youth suicide prevention grant awarded in October 2014.

THRIVE does not currently have funding for Tribal Cooperative Grants but please check back every couple of months to see if there is an update. If you need assistance with honoraria, incentives, training materials, etc. please contact Colbie Caughlan ( or 503-416-3284) to ask if THRIVE can help provide smaller materials for your event(s). Thank you!

Suicide is a sensitive issue, but one that is of great concern to many American Indian and Alaska Native (AI/AN) communities. Data suggest that suicide is a significant problem throughout Indian Country, particularly among Native youth, males, veterans, and elders. From 2002-2006, the average suicide death rate was highest among AI/AN aged 10-24 years at 27.72 cases per 100,000. In the Northwest (ID, OR, and WA), suicide is the 8th leading cause of death for AI/AN people and the 2nd leading cause of death for AI/ANs ages 15-24 years (this is the same for AI/AN youth throughout the U.S.).

The Portland Area has one of the higher suicide death rates for AI/AN among the IHS service areas.  The IHS reported that, from 1996-1998, the age-adjusted suicide death rate for the Portland Area was 22.0 per 100,000, a rate that was exceeded only by Aberdeen, Alaska, Bemidji, and Tucson.

At the state level, annual suicide rates for AI/AN tend to fluctuate widely because the actual number of deaths each year is relatively small.  For example, an average of 20 AI/AN suicides occur in Washington each year, 6 in Oregon, and 4 in Idaho. While males typically complete suicide more often than women, studies suggest that women actually attempt suicide more frequently than men. This pattern is also present among AI/ANs in the Pacific Northwest.

Data on suicide risk factors and attempts, as opposed to mortality, are available from a variety of sources, including the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) and the Youth Risk Behavior Survey (YRBS).  Data from these sources and other studies have found that several factors can put a person at higher risk for attempting suicide, including: – Previous suicide attempt(s) – History of depression – Alcohol or drug abuse – Family history of suicide or violence – Physical illness – Feeling alone. Additional research is needed to identify and explore the culturally unique factors that affect AI/ANs.

There are also protective factors against suicide attempts among AI/ANs. They include:

  • Connectedness to family and/or friends
  • Connectedness to culture and/or spirituality
  • Good emotional and physical health
  • Positive Communication with family or friends
  • Restricted access to lethal means
  • Access to mental health care
  • Problem solving skills
  • Engagement in positive activities i.e. extracurricular sports, clubs, community center groups, cultural activities, etc.


Data Collection Tools:

Oregon Native Youth Risk Survey. The Oregon Native Youth Survey (ONYS) is based upon the Oregon Healthy Teen survey (which is made up of the Youth Risk Behavior Survey and the Student Drug Use Survey), the Communities That Care (CTC) survey (developed by Hawkins and Catalano at UW Seattle), and the Voices of Indian Teens survey (Dr. Spero Manson, PI). Native American Rehabilitation Association (NARA), which has been using the survey tool, added a peer suicide knowledge section from the Lifelines PreTest Questionnaire and additional questions about protective factors based on the concept of resiliency. The survey was also reviewed for cultural appropriateness by a cultural advisory team at NARA-NW. NARA has been granted permission to use parts/all of these surveys and/or they are public domain. The second to last question (#108) is meant to be tailored to the particular Tribe or community it will be implemented in. The ONYS is also designed to be used along with focus groups for a better understanding of how the actual intervention activities are experienced by the youth. Folks are welcome to tweak and perfect (and share their tweaking with us, please!). Please contact Tamara Perkins, of NPC Research, with any questions. NPC Research would be most interested in contracting with interested communities to work on implementation and analysis. Tamara Perkins – –

Native Youth Survey. Washington State 2008 Healthy Youth Survey Sixth, eighth, tenth, and twelfth graders were surveyed. The survey included questions about safety and violence, alcohol, tobacco and other drug use, physical activity and diet, and related risk and protective factors.


Resource and Patient Management System (RPMS) RPMS is a computerized Health Information System that has been used by most Indian health care programs since the 1980s. RPMS is a comprehensive suite of packages with many outstanding features that are useful for the daily management of patients. Although RPMS has a vast amount of data on the health status of individual patients, a detailed analysis of its usefulness and accuracy for surveillance has not been done. The EpiCenter has recently been invited by the national IHS Epidemiology Program to enter into a contract to do such an analysis. IHS’s suicide surveillance tool and measure, available through the RPMS Information on IHS ‘s Suicide RPMS package

Request a Suicide Prevention Training! If you would like to request a suicide prevention training for your Tribe or Tribal staff in WA, OR, or ID, please contact Celena McCray at or 503-416-3270. Three different trainings are available as well as suicide prevention presentations or awareness activities:

  • QPR (Question, Persuade, Refer) – This is a 1.5 – 2 hour training for anyone who may come in contact with a person thinking about suicide.
  • safeTALK (Suicide Awareness for Everyone) – This is a 3 – 3.5 hour training that is similar to QPR in that it is for anyone who may come in contact with a person thinking about suicide. For QPR & safeTALK, participants become suicide prevention gatekeepers and learn what the signs of suicide may be and how to link a person to proper resources or to a person with intervention skills training.
  • ASIST (Applied Suicide Intervention Skills Training) – This is a full two day workshop that focuses on teaching participants intervention skills that they may need to be a caregiver of someone thinking about suicide. This is not a counseling treatment model but can be a wonderful supplement to skills that counselors and mental health professionals already possess. It is also a very effective workshop for those who may already understand the signs of suicide but who would like a little bit more training on how to really review a person’s risk of suicide and how to help them get more help.o QPR (Question, Persuade, Refer) – This is a 1.5 – 2 hour training for anyone who may come in contact with a person thinking about suicide.  o safeTALK (Suicide Awareness for Everyone) – This is a 3 – 3.5 hour training that is similar to QPR in that it is for anyone who may come in contact with a person thinking about suicide. For QPR & safeTALK, participants become suicide prevention gatekeepers and learn what the signs of suicide may be and how to link a person to proper resources or to a person with intervention skills training.

Online Suicide Prevention Trainings and Courses:

9th Annual THRIVE Conference



THRIVE reached the capacity of 84 youth participants. Registration for 9th Annual THRIVE Conference is now closed.

If you would like to be placed on the waitlist, contact THRIVE project coordinator Celena McCray at or 503-416-3270. The waitlist is still a first come, first basis.

Draft Agenda

Conference Flyer

Presented to you by THRIVE, with funding from the Garrett Lee Smith youth suicide prevention grant from SAMHSA and the MSPI grant from the Indian Health Service.

What:             9th Annual THRIVE Conference

When:             June 24-28, 2019

Where:           Portland, Oregon at the Native American Student and Community Center at Portland State University 710 SW Jackson St, Portland, OR 97201

Who:               American Indian and Alaska Native Youth 13-19 years old *Background checks are required for all adults 18+

Join us this summer and spend a week in the city of roses! This conference will focus on building protective factors and help Native youth to strengthen their nation through culture, prevention, connections, and empowerment! Participants will learn about healthy lifestyle choices like healthy behaviors, suicide prevention, healthy relationships, and building new friendships through FIVE (5) interactive workshop tracks.


Sessions will incorporate American Indian/Alaska Native culture, traditional learning strategies, and skill-building activities that educate youth about healthy behaviors.

  • Creative Design w/OXDX – The aim is to help the youth generate and disseminate a youth-driven social marketing campaign. This workshop will provide youth with hands-on activities with founder and owner of OXDX clothing line Jared Yazzie and his talented team by creating their own logo using digital design to develop meaningful campaigns around the environment, cultural, body and mind. These custom shirts, stickers, and patches will be shown off by creating a social media plan to spread these positive messages. Space is limited and you don’t want to miss out on this awesome experience.
  • Beats Lyrics Leaders (songwriting and production) – Explore your way through cultures and heritage with music! BLL offers a hands-on approach to learning as they teach each participant, young and old, the ins-and-outs of beat making, lyric/songwriting, and recording.
  • Science and Medical Track (Oregon Health and Science University) – Meet Native professionals working in health and science fields, explore the amazing technology of the Oregon Health & Science University, learn how translational research impacts health, learn how alcohol impacts the brain, and more. Join us to see this work in action and learn about many aspects of healthy living.
  • Traditional Foods Workshop (culture & nutrition) – What are your favorite traditional foods? Why are they important to you? We will learn how our traditional foods have sustained us over the years and discuss how they keep us healthy. This workshop is all about keeping our bodies and spirits nourished. We will learn to prepare a healthy snack using traditional foods, hike through an urban forest and learn how it is connected to salmon runs, and participate in a service learning project to remove invasive species and protect biodiversity and water quality. Be prepared to move, explore, and eat!
  • Storytelling in Graphic Novels (culture as prevention) – In this workshop, we will use Indigenous storytelling to develop a graphic novel. We will use the Trickster story to talk about the impact of addiction on NativeAddiction can impact anyone and as a community, we can look towards the story of the Trickster or “The Tricky One” to learn how addiction can impact Native communities in similarly sneaky ways. In oral tradition, Trickster is a sacred being that take on many forms.  To mention just a few, he can be old-man coyote among some tribes, raven in Northwestern tribes, or, more generically, “The Tricky One” (such as Wakdjunkaga among the Winnebago or Manabozho among the Menomini).

Chaperones Workshops (optional):

Sessions will provide chaperones with culturally-appropriate programs and resources, interactive activities for those working with Native youth, and opportunities to collaborate to promote adolescent health.

  • Question Persuade Refer Training (QPR)
  • Youth Engagement Session
  • Healthy Native Youth Brainstorm Session
  • Northwest Tribal Juvenile Justice Alliance
  • Northwest Native Adolescent Health Alliance Meeting



THRIVE reached its capacity of 84 youth participants. Registration for 9th Annual THRIVE Conference is now closed. If you would like to be placed on the waitlist, contact THRIVE project coordinator Celena McCray at or 503-416-3270. The waitlist is still a first come, first basis.

REGISTRATION IS FREE and ends on June 10thorwhen we reach 84 youth participants. 1 chaperone for every 4 youth attending *Space is limited, 8 youth per tribe maximum. Additional youth will be added to the waitlist on a first come first serve basis. Tribes on the waitlist will be notified by May 31st. 


Submit forms by June 10th to Celena McCray by fax (503-228-4801) or email (

Adults 18+ must complete a background check (paid for by NPAIHB) – or – submit a letter from your organization/tribe which states that you have completed a background check.

  • Background check (paid for by NPAIHB): Fill out a chaperone consent form and send to Celena McCray.
  • Letter: Click here to download the template letter to submit from your organization/tribe.

*** Background checks MUST be completed & results (or letters from organizations/tribes) received by the NPAIHB by June 14th for admittance to the conference.

Lodging and Travel Logistics:

There is a group rate at the Radisson Red Portland Downtown (Closing on May 22, 2019) $179/night + tax
Reserve online using this like, 9TH THRIVE YOUTH CONF or call 503-334-2167 ask for “9th THRIVE YOUTH CONF”

Additional accommodations at The Hotel Zags Reservations, ( Closing on May 31, 2019) $184.00/night + tax
Reserve online using this link, The Hotel Zags Reservation  The Group Code, “235190623NPAIHB” or call 877-484-1084 ask for the “NPAIHB June Group Rate”

  • Lunch and snacks will be provided Monday-Thursday. Breakfast and dinners are not included.
  • Travel, parking, lodging, breakfast, and dinners are not included.

Click here for a copy of sample expense budget for THRIVE.

Welcome to Portland! Visitor Guide Links Below:

Conference Deadlines:

  • June 10th Registration deadline – or – when we reach 84 youth participants
  • June 10th Participant/Chaperone forms due to Celena McCray
  • May 22nd and May 31st Room block deadline
  • June 14th Background Checks completed with results – or – received letters from organization or tribe.

Don’t Forget:

  • Please bring cultural games, regalia, music, and activities to share during the cultural night on Tuesday.

Conference Contact:

If you have any questions, contact Celena McCray at 503-416-3270 or by email


Funding for this conference was made possible, in part, by grant number SM61780 from SAMHSA and IHS grants BH16IHS0016 and BH16IHS0021. The views expressed in written conference materials or publication and by speakers and moderators do not necessarily reflect the views, opinions, or policies of CMHS, SAMHSA, or HHS; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

What is the Alliance? The NW Native Adolescent Health Alliance is an inclusive, multi-functional group that meets quarterly in OR, WA, and ID to discuss cross-cutting planning and prevention strategies targeting AI/AN teens and young adults (addressing tobacco, substance abuse, STD/HIV, teen pregnancy, and suicide topics). Our goal is to support regional action planning, resource development, and sharing.

Who Should Attend? All interested parties are invited to attend, including tribal health and prevention staff, IHS, State Health Department personnel, MSPI funding recipients, and University and Community partners from ID, OR, and WA.Check out the new Adolescent Health Tribal Action Plan here! Project Red Talon and THRIVE have developed this plan with NW tribal professionals and tribal organizations in hopes that the plan will be used by the NW Tribes and partner agencies to guide program planning, and foster a coordinated response to adolescent health and well-being in our tribal communities.

Upcoming Meetings:
June 27, 2019, at NPAIHB office Portland, OR or online video chat

For more information contact Celena McCray at or call 503.416.3270.

Past Meetings:
December 2009 in Salem, OR Meeting Minutes
February 2010 in Shelton, WA Meeting Minutes
May 2010 in Spokane, WA
June 2010 in Klamath Falls, OR Meeting Minutes
October 2010 in Tulalip, WA Meeting Minutes
January 2011 in Portland, OR Meeting Minutes
April 2011 in Ocean Shores, WA
May 2011 in Coeur D’Alene, ID Meeting Minutes
May 9, 2012 in Bellingham, WA
May 16, 2012 in Portland, OR
April 9, 2013 in Florence, OR
May, 15, 2013 in Spokane, WA
May 22, 2013 in Portland, OR
March 19, 2015 in Portland, Oregon Meeting Minutes
May 21, 2015 in Bow, Washington
August 21, 2015 in Suquamish, Washington Meeting Minutes
September 22, 2015 in Coos Bay, Oregon
March 16, 2016 in Seattle, Washington
May 11, 2016 in Portland, Oregon Meeting Minutes
May 18, 2017 in Portland, Oregon
June 27, 2018 in Portland, Oregon.
September 21, 2018 in Portland, Oregon Meeting Agenda
January 11, 2019 in Portland, Oregon & Virtually (Zoom) Meeting Agenda 

Travel scholarships for tribal representatives may be available for the Alliance meetings. For more information about the NW Native Adolescent Health Alliance meetings dates, travel scholarships, or general info, please contact Celena McCray at or 503-416-3270.