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 2020 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 June 2019.

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.

Recorded 1/8/2020 Introduction to Zero Suicide & Examples from Indian Country: Recently the THRIVE team hosted a webinar to introduce the Zero Suicide model to new staff at the clinics we are assisting with Zero Suicide implementation. Feel free to check this webinar out and learn about the model!

Online Suicide Prevention Trainings and Courses:

10th Annual Conference Updates (3/24/20)

The health and safety of our staff, tribes, and communities is of the utmost importance to the Northwest Portland Area Indian Health Board (NPAIHB).  We have heard from many of you about the precautionary efforts you have taken as you respond to the COVID-19 pandemic and the needs of your community members. We believe that taking every precaution to protect your community members and loved ones is critical to reducing transmission of COVID-19. We support your efforts and initiatives.

THRIVE will be monitoring COVID-19 and all the recommendations for continued social distancing & safe practices and as we move closer to the conference dates we will continue to update our Tribal communities what our plans are to move forward with the THRIVE conference or not. At this time, we will make a decision about the conference by April 30th. Because COVID-19 circumstances are changing rapidly, again, we will continue to provide regular updates to you.

Please visit if you have any questions specific to COVID-19. In regards to the THRIVE project, please direct any questions to the THRIVE project director, Colbie Caughlan, at 503-416-3284 or by email at

Celebrating 10 years of the THRIVE Youth Conference!

When:           June 22-26, 2020

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 in the city of roses in June 2020 for the 10th anniversary of the THRIVE youth conference!

Our goal of this conference is to provide youth with positive protective factors (i.e. creative self-expression, healthy coping skills) that builds culture pride/resilience in themselves and learn new skills to take back to their communities. Participants positively express themselves through 4-5 interactive workshop tracks that incorporate AI/AN culture, traditional learning strategies, and skill-building activites the educate youth about healthy decisions-making.

We believe a safe and family-like environment can give youth a sense of purpose, belonging, and pride of their culture as a means to address youth suicide. We also believe in having fun, making new friends, and enhance the creativity that youth already have instilled in them!

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.

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


  • TBD on April 30th 
  • Registration is FREE
  • 4 youth per tribe, 65 youth maximum.
  • 1 chaperone for every 4 youth attending
  • Background checks are require for all adults ages 18+



Coming soon!

Conference Location

9th Annual THRIVE Conference Recap

THRIVE staff would like to say ‘thank you’ to PSU NASCC and their staff for hosting the 9th Annual Conference. Thank you also to all the partners, facilitators, presenters, volunteers, staff, and chaperones who took the time to invest in these talented youth!

Participants have positively expressed themselves through 5 interactive workshops that incorporated AI/AN culture, traditional learning strategies, skill-building activities, and tips on healthy decision making.

Creative Design with OXDX workshop

Beats Lyrics Leaders workshop

  • Creative Design w/OXDX

    Special guest – Native artist Jared Yazzie, OXDX

    Youth created four meaningful social marketing campaigns by creating their own logos using digital designs inspired by the environment, culture, body and mind. Native youth amplified the advocacy for Missing and Murdered Indigenous Women, honoring tribal elders and sharing teaching passed down to them, reclaiming tribal identity through their ancestors, and being mindful of the environment and mother earth.


  • The Beats, Lyrics, Leaders (BLL)

    The Beats, Lyrics, Leaders (BLL)

    The Beats, Lyrics, Leaders (BLL) music track lead by recording artist J Ross Parrelli and a team of talented mentors guided youth to share their powerful voices and stories. Each participant created their own musical lyrics, created their own beats and rhythms, engaged in public speaking, and collaborate in developing an electrifying music video called “So Native.” This unified video is very powerful in sharing their culture pride and resiliency.


  • Storytelling in Graphic Novels (culture as prevention)

    Storytelling in Graphic Novels (culture as prevention)

    Youth developed a graphic novel using indigenous storytelling, the Trickster story to discuss and learn the impact of substance abuse disorder and addiction in Native communities. Each story represented oral teachings from their respective communities passed from generation to generation.


  • Traditional Foods (culture & nutrition)

    Traditional Foods (culture & nutrition)

    Youth prepared a healthy snack using traditional foods, hike through an urban forest making connection with indigenous plants, and participate in a service learning project to remove invasive species and protect biodiversity and water quality.

  • Science and Medical Track (Oregon Health and Science University)

    Science and Medical Track (Oregon Health and Science University)

    The science and health track with Oregon Health and Science University (OHSU) exposed youth to different health and science fields at OHSU campus. The workshop provides a connection for youth who are interested in health professions and becoming future healers. Youth expressed interest in the respective fields, pharmacy, dentistry, medicine, ophthalmology, pediatrics, nursing, research, chemist, therapist, nutritionist, psychiatry, and public health!

Conference Guest Speakers

9th annual conference guest speakers included:

  • StrongHearts Native Hotline, Mallory Black (Navajo) who lead an interactive session on health relationships and the connection with cultures and traditions.
  • Jared Yazzie, OXDX, shared his journey on becoming a native artist and using his work to bring light of indigenous issues.
  • Dyami Thomas & Rebecca Kirk, provided hopeful messages for Native youth on being prideful of their identity and helpful tips for dealing with depression.
  • N7 Youth Movement Jesse Schwarz & Tyler Hogan provide youth with an inspiring activity in brainstorming ideas on creating stronger communities and ways to apply for the N7 youth movement grant.
  • Dove Spector from We Are Healers encourage Native youth to keep ahold of their vision in becoming health professionals.

Chaperone Workshop Tracks

THRIVE also incorporated chaperone workshop tracks that provided chaperones with culturally-appropriate programs and resources, interactive activities for those working with Native youth, and opportunities to collaborate to promote adolescent health. Workshops included:

  • Question Persuade Refer (QPR) Training
  • Youth Engagement Session, Healthy Native Youth Brainstorming Session
  • NW Native Adolescent Health Alliance meeting
  • Northwest Tribal Juvenile Justice Alliance to learn and understand the needs of AI/AN youth involved in the juvenile justice system.

Meeting minutes and resources can be found here

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:
TBD. Meeting dates, times, and locations are updated periodically. Please check back at a later date for more detailed information.

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
June 27, 2019 in Portland, Oregon Meeting Minutes

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.