SYKESVILLE, Md. – When Celia Anthony was a high school sophomore, her fellow students nominated her to be a peer leader in her school’s student-led mental health support and suicide prevention program.
Anthony, now a junior at Century High School in Carroll County, said she initially joined the club because she thought it was a good cause and had friends who were already involved. She said her experience has been “eye-opening,” as she learned some of her peers were struggling in ways she did not know until they said so at a club meeting.
“We’re spreading a really positive message, and we’re helping increase positivity and supporting each other throughout our school,” Anthony said about her school’s Sources of Strength chapter.
Sources of Strength, a program in schools across the United States and Canada, is just one of many peer-based initiatives working to address rising mental health concerns among young people.
Peer support takes many forms. Some students get trained to help their fellow students. Other peer specialists can share their own experiences with mental health struggles. The latter programs feature certified peer recovery specialists who, under state law, must undergo training, work or volunteer in a peer support role and complete an application.
The roots of peer support stretch back decades, to the era when many mentally ill people were institutionalized and mistreated, said Kris Locus, transitional age youth coordinator for On Our Own Maryland, which provides peer support training.
“Those people came together and said, ‘We could probably help each other better than what the system at the time was providing,’” Locus said. “And so that’s how the movement was created.”
It’s one approach to mental health care that’s proven to work. Troubled youths who speak with peer support workers often experience increased self-esteem and are less likely to be hospitalized, according to the Substance Abuse and Mental Health Services Administration.
“Peer support workers can help break down barriers of experience and understanding, as well as power dynamics that may get in the way of working with other members of the treatment team,” according to the federal agency.
Here’s a look at three peer support efforts that aim to help young people in Maryland:
Sources of Strength
With youth spending much of their time in schools, many school-based peer programs empower young people to help each other while building a sense of community.
Sources of Strength, which is listed on the Suicide Prevention Resource Center’s National Best Practices Registry, works with young people to stress eight areas of strength: physical health, mental health, family support, positive friends, spirituality, generosity, healthy activities and mentors.
Christine Tobias, the assistant supervisor for health education at Carroll County Public Schools, helped start the local Sources of Strength program in 2018. The program stood out to the county for its peer model and empowerment of student voices, she said.
“Everybody has big emotions, everybody goes through worry, everybody probably experiences anger, and everybody can experience sadness. Those are human emotions,” said Tobias, now a program trainer for Sources of Strength. “But then how we deal with that and how we find health and strength through those struggles are how we build our strength as a human.”
Teachers nominate peer leaders at the county’s schools, with an emphasis on finding students with leadership skills and who represent students across all social groups. Students can also join if they are interested.
At Century High School in Sykesville, Anthony, 16, and the other peer leaders plan activities, decorate the building and manage social media pages to spread awareness about the club.
When students approach Anthony with struggles, she talks with them about their feelings and asks if they are seeking a listening ear or advice. She then recommends they speak to a trusted adult.
If a student is experiencing suicidal thoughts or discusses self-harm, peer leaders immediately tell an adult even if the student doesn’t want them to do so, Anthony said.
“My job as a peer leader is to be the bridge between someone who is struggling and the sources of strength that can help them,” Anthony said.
Tobias agreed.
“We’re not asking students to be counselors,” Tobias said. “We are asking them to notice, in their friends, any changes, anybody that might need help, and then link them to a trusted adult.”
Sources of Strength’s approach has proven to be successful. In a study published in the American Journal of Public Health in 2011, researchers found the program — in 18 high schools — made students contemplating suicide more likely to think it’s acceptable to seek help.
“Sources of Strength is the first suicide prevention program involving peer leaders to enhance protective factors associated with reducing suicide at the school population level,” the study’s authors concluded.
Through this program, Anthony said she has developed better communication skills regarding how to help those facing mental health issues, in addition to finding a community of peers who can support her.
“It’s just really important and kind of awesome to me that we have a good time while also connecting with each other, while also planning and developing our campaigns on a professional level,” she said. “We have fun, and we get deep, and we support each other.”
Hope Squad
Hope Squad, another program recognized by the Suicide Prevention Resource Center, has made its way into Maryland through Cecil County, according to Grace Babula, the organization’s director of marketing and communications.
Hope Squad, which operates in schools across the U.S. and Canada, also takes a peer-to-peer approach to mental health support and suicide prevention.
The state’s first program, at North East High School, was implemented with help from the #LiveforThomas Foundation, a nonprofit organization working on mental health awareness and suicide prevention. The organization, which often collaborates with the school’s Hope Squad, was started in honor of Thomas Ocasio III, a North East High student who died of suicide in 2019.
In 2024, Cecil County fared worse than the average Maryland county in health outcomes, which depict how long people live on average in a community, according to County Health Rankings & Roadmaps.
Melody Smith, a school social worker and Hope Squad advisor at North East High, said generational issues impact students, making them apprehensive about talking to social workers or other adults, which makes peer support helpful.
“By the child seeking help through the Hope Squad, I’m able to make contact and see what the family needs,” Smith said. “Because it’s never usually just a child issue. It’s something deeper going on.”
Smith said many students have a hard time trusting people or being vulnerable because of previous trauma, but word-of-mouth and being a presence around the school has helped more kids reach out and open up to her.
Other states have implemented this program years earlier. In Wisconsin, Ameera Hassan was nominated in eighth grade by her fellow students as a peer they could approach if they needed to talk to someone.
Hassan, who is now 17 and a high school junior, is a Hope Squad member trained to recognize signs of suicidal thoughts in students and to respond when a peer opens up to her about their mental health struggles.
“Knowing that I’m someone that people are comfortable in confiding in, that people are comfortable coming to if they have a hard time, it’s helped me self-reflect a lot on the type of person that I am and that I want to be,” said Hassan, a Hope Squad National Council member.
At Hassan’s high school, she hears doubts about the program’s effectiveness. But from her encounters with her peers, she has found the program means a lot to those who need support.
More than 98% of school administrators who have implemented Hope Squad said the program “promotes a positive school climate,” according to a survey from the program. The vast majority of students in schools with the program say they know how and where to get help for their peers, Babula said.
In his clinical work with youth, Noah Triplett, an assistant research professor in the University of Maryland’s psychology department, said he noticed young friends often serve to provide emotional support to each other.
School programs that provide early intervention and support to youth benefit those students as they grow older, Triplett said.
“Youth need robust support systems, and whether that comes from an immediate family or larger peer network or a trusted adult,” he said.
Preventing Black suicide
Peer-led support systems also consist of specialists who’ve themselves struggled with mental illness — who can support others through recovery from attempted suicide, substance abuse or other struggles.
T-Kea Blackman, executive director of Black People Die By Suicide Too and a Howard University alum, was hospitalized when she was 24 years old after surviving a suicide attempt.
There, she met Jordan Scott, and the pair soon became friends. As they got closer, they realized they supported each other by giving each other space to talk about issues they couldn’t talk about with anyone else, such as suicide.
This experience led them to co-found the peer-led organization Black People Die By Suicide Too in 2023. The organization, which is based in Charles County, says it is dedicated to “normalizing the conversation about suicide in the Black community.”
The organization serves people around the world through virtual peer-led support groups, which provide a community for people with suicidal thoughts or who have been affected by suicide.
“What I could not find was specific groups for Black people who struggled with suicidal thoughts,” Blackman said. “That often felt like that was the missing piece to the groups that I would attend.”
Having the space to talk about suicide has given people who are struggling hope and a community, Blackman said, adding the support groups are growing.
While the organization’s peer support groups are not meant for school-age children, they have helped young people in their early 20s, Blackman said. The group also hosts wellness workshops with middle and high schoolers to discuss mental health and self-care.
On its website, the organization makes clear that its peer support groups are not intended to replace clinical treatment for those that need it.
But Locus, of On Our Own Maryland, said her own previous experience providing peer support proved it can sometimes accomplish what some clinical treatments cannot.
“There were so many moments where there were young youth and young adults who would never talk to the doctors or the nurses, never came into their appointments, didn’t take their medicine, they weren’t involved in their recovery at all — and then a peer specialist like me came in and just kind of talked to them like a real person. And then everything shifted,” she said. “It really is something beautiful that can happen with peer support.”
If you or someone you know is having thoughts of suicide or self-harm, help is available. Call or text 988 to reach the confidential National Suicide Prevention Lifeline or view these resources from the American Foundation for Suicide Prevention.