Intuitive Solutions to Our Mental Health Crisis: Sources of Strength

 

America is experiencing a mental health crisis, with the most recent data (2022) showing a record high number of people who took their own lives. Drug overdose deaths also continue to rise, and are consistently related to problems with anxiety and depression. Worldwide, people report more "bad mental health" days and lower overall levels of happiness than they did 20 years ago, and the problem is particularly acute among young people. More people than ever are accessing psychotherapy, yet that hasn't fixed the problem. Standard approaches like cognitive-behavioral therapy, which encourage us to think our way out of our troubles, have not been successful against this challenge.

Sources of Strength began as a statewide suicide-prevention program for teens in North Dakota, which in 1998 was seeing many young people die from suicide, along with overdoses and car crashes (two types of death that are also potentially related to suicidal feelings). In pooled results from three cluster-randomized trials, the program did in fact reduce suicide deaths among high schoolers: Across 78 total schools, there were zero suicide deaths in the intervention schools compared to 4 at schools in the control group. A fair amount of press has focused on the program's use of peer leaders to disseminate the Sources of Strength curriculum to at-risk adolescents. In this blog post, though, I want to focus on the actual content of the Sources of Strength program, all of which attempt to improve mental health through mechanisms that target the Intuitive Mind.

The Sources of Strength program suggests a set of resources that can help people to get "unstuck" when they are feeling hopeless. The same resources are protective factors that can be strengthened to reduce the chance of future difficulties. And they also represent tools that friends can deploy to support someone they are concerned about (along with referrals to professional help when appropriate). The 8 sources of strength are listed below; it's interesting to me that none of these mechanisms rely on thinking your way out of your problems. Instead, they are about doing, connecting, and believing -- activities in which the Narrative Mind is not generally in the lead.

• Starting clockwise from the top, family support matters for young people in particular. Parents who notice their child's mental health problems and encourage them to get help are more likely to have children who actually receive mental health support. Parental support is especially important in the case of GLBTQ+ adolescents, who are at increased risk for negative mental health outcomes. Of course, parents can also be stressors for their teenage children: those who are more stressed, less available, parenting alone, are from a different culture, or who have their own mental health issues are all less likely to have a child who receives needed mental health support.
• Having positive friends is another potential strength, with effects that are just as protective as parental support for GLBTQ+ teens. Friends are also the most common resource that all teenagers rely on when they experience mental health challenges. The Sources of Strength framework of "positive friends" acknowledges that teenagers can to a certain extent change their peer environment by associating with or paying attention to different friend groups. 
• Mentors are the third identified source of strength, recognizing the role of teachers and other non-family adults in a young person's life. Many adults are very interested in mentoring young people, and mentorship is most effective when it centers around the younger person acquiring a specific set of skills. And lest we think of these relationships as one-sided, there's also value for an older person in having a younger mentor who opens them to new points of view. 

So far, all of these sources of strength have the common thread of social support. which capitalizes on people's inherent tendency to orient themselves toward groups of other people. Social support mechanisms are a key ingredient of why psychotherapy is effective, and they are highly effective in shaping behavior. And interpersonal relationships are also a key way in which we discover and deepen the values that affect our behaviors and experiences across the lifespan. More than one-third of the Sources of Strength wheel, then, focuses on relationships of one kind of another -- family, peer, and nonfamily adult. Relationships have powerful effects at the level of the Intuitive Mind.

• Healthy activities is the fourth slice of the pie, including activities such as gardening, playing games, listening to or playing music, spending time with animals, baking, taking a bath, painting, reading, journaling, or meditation. These activities involve various forms of coping (mostly distraction-related), some of which might also have a social component. A commonality might be that they all have the potential for opening the mind to flow states, in which the Intuitive Mind predominates and the Narrative Mind is at rest.
• Generosity is something that I haven't written much about here, but it has clear benefits for both the social and emotional domains of the Intuitive Mind. Giving to others is a way of building social capital, a situation in which others recognize your contributions and are more likely to help you in times of need. It's a way of connecting to both the recipients of help and to fellow givers, which taps into the social support mechanism once again. And as people reflect on their own generous actions (which is a rare Narrative-Mind mechanism on this list), it can have the effect of increasing self-worth and strengthening a positive identity. These aspects of emotional health can be particularly important to young people.
• Spirituality (usually viewed as a broad term that is inclusive of religion, but not limited to it) also involves connection, both to others and to the larger universe. Spirituality can provide a sense of purpose through a set of values. Some Sources of Strength literature identifies gratitude practices, which are common in some meditation traditions, as a particular type of spiritual activity that may be helpful in sustaining good mental health.
• Physical health is connected to mental health, and this slice of the pie encourages healthy behaviors like exercise and sleep. For young people who are generally healthy to begin with, the most immediate effects of a sedentary lifestyle and burning the candle at both ends are probably not going to involve a health crisis or the development of a chronic disease. Instead, they likely manifest as increased inflammation, greater susceptibility to infection, and worse mental health. Aerobic exercise alone is the single most effective antidepressant treatment currently available.
• Mental health is the final source of strength, which might seem strange for a list of factors that help to prevent suicide. The distinction here is that mental health isn't simply an absence of illness or serious problems like suicidality. Instead, it represents a sense of wellness, wholeness,  or joy, above and beyond the removal of symptoms like anxiety and depression. Including mental health on the wheel also facilitates discussion of professional help when needed, medication for mental health symptoms, and proactive mental health practices like meditating. 

It's interesting to me that this empirically supported tool doesn't include a single component that's about actively solving problems, structured logical thinking, or talking oneself down. Those are all Narrative-Mind interventions. The Sources of Strength wheel recognizes that Intuitive-Mind support is more likely to help with the types of strong emotions and dysregulated behaviors that adolescents often confront. A focus on the Intuitive Mind helps this successful program to appeal to its target audience, who often seem to latch on to the strengths-focused aspects of the wheel. The intuitive appeal of the sources themselves is what makes the peer-support component of this intervention successful.