Boulder Crest Retreat Foundation

PATHH: A Transformative Approach to Hopelessness, Despair, and Suicide

Lead Organization

Boulder Crest Retreat Foundation

Bluemont, Virginia, United States

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Our nation is in the midst of a mental health epidemic. Since 1999, the rate has gone up by 33%, and is largely responsible for American life expectancy going down for each of the past three years. At the core of suicide, and related diseases of despair - including drug and alcohol addiction and overdoses - is trauma. For the past six years, we have worked with a community that battles a suicide rate that is 50% higher than the national average: veterans. Leveraging our two wellness centers - Boulder Crest Retreat Arizona and Virginia - and our Institute for Posttraumatic Growth, we have developed a proven approach, PATHH, that allows those to struggle not simply to survive, but to live great lives, filled with passion, purpose, service, growth, and connection. We plan to scale our PATHH prevention and intervention approach nationally - focused on communities of greatest need.

Problem Statement

In 2017, 1.4 million Americans attempted suicide. 3,836 people — every single day — believed that tomorrow would be worse than yesterday, and that their best option was to end their life. These suicide numbers are merely the tip of the iceberg;. In communities across America, whether urban or rural, we are witnessing diseases of despair spiraling out of control, manifesting in suicides, overdoses, and miserable lives. Unfortunately, the group primarily responsible for addressing this epidemic — our mental health system — has proven ill-equipped and inadequate. That is largely because most people who struggle find our current mainstream approaches inaccessible (only 50% of those who might benefit will seek treatment) or ineffective (a tiny fraction will experience remission from their struggle). At the core of the system's failure are three truths. First, by outsourcing mental health to a select group of people who are not part of the fabric of communities, we increase barriers to access and stigma. Second. a major reason people won't seek out help is their fear they may be broken; the system's ubiquitous use of diagnoses and labels confirms this fear. Third, by focusing nearly exclusively on symptom reduction, the current approach codifies the problematic notion that times of struggle and traumatic experiences are permanently diminishing.In short, our solution to the epidemic is in fact worsening the problems. As Tom Insel, the former head of the National Institute of Mental Health asked, "Are we somehow causing increased morbidity and mortality with our interventions?”

Solution Overview

We have spent the past six years developing a comprehensive and transformative solution to the epidemic of struggle amongst veterans of war. This solution focuses on prevention via our Struggle Well training program, engaging mental health professionals (through training in Posttraumatic Growth principles and clinical application), and delivering scalable programs for those struggling acutely (PATHH). We have leveraged our training expertise to build peer-based, train-the-trainer models that ensure scale with quality, and through our expansions in Arizona and Florida, feasibility. Our 18-month program evaluation, combined with qualitative feedback from prevention-based approaches, demonstrates that our approach is not only effective but sustained. Our proposal calls for completing our efforts in the active duty and veterans space - completing our expansion of PATHH programs to 6 more states, as well as deploying a comprehensive training program for mental health professionals. We would then translate those successful efforts into the first responder community. We would then move beyond the "Warrior community" and translate our approach into different at-risk communities; starting with high schools, training students, teachers, parents, and mental health professionals; then colleges with the same stakeholders; rural communities; those in and departing the prison system; those struggling with drug and alcohol abuse; and so forth. Our vision would be to leverage all we have learned to deliver compelling and effective programming to all communities that struggle with trauma and diseases of despair. In short, we anticipate the impact would be broad and deep.

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