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Seattle nurse’s mental health program empowers teens to help peers


In 2010, school nurse Robin Fleming, RN, PhD, NCSN, initiated a club to teach teens how to be peer counselors and educators. Quaker Teens Improving Health Problems, called Q-TIHP, enables teens to help classmates who are battling mental health issues, such as suicidal thoughts.

“About 25% of students have some diagnosable mental health concern,” said Fleming, who recently left her school nurse position at Franklin High School in Seattle. “While I was at Franklin High, I could identify students all day long who had mental health problems, but I didn’t have the infrastructure to care for them.”

According to the Washington State Department of Health, suicide is the second leading cause of death among 10- to 24-year-olds in the state. An average of two people between ages 10 and 24 die each week by suicide, according to the Youth Suicide Prevention Program, a local nonprofit.

Fleming said Franklin High’s student population comprises mostly low-income, minority teens. “I knew that we needed to be able to treat them, and make it free and available where they are,” she said.

Fleming received a grant from the Franklin High School Alumni Association and Foundation to address suicide prevention by teaching teens how to be peer educators.

About 10 students joined the club and learned about suicide prevention through the Youth Suicide Prevention Program. After weeks of classes, the students practiced their new skills in the classroom. The club averages 10 members a year.

No one is sure how many students’ lives have been saved, but more students have started to seek mental health services, Fleming said. “The student educators were seen as safe people to go to,” she said. “Their peers saw them as resources.”

Club members also benefit from the experience. Teachers said the members became more successful in school. The teens also had the opportunity to interact with other peer educators, including those at the University of Washington in Seattle. Fleming said this exposed Franklin High students to college life.

Q-TIHP founding member Lily Tesfaye said she joined the club because she wanted to help people. “I don’t want another generation to die,” she said.

As a senior, Tesfaye continues to serve as a peer educator and resource. She shares stories about real teens who took their own lives and how students can help friends by recognizing warning signs.

Fleming, who now is a nursing practice and education specialist for the Washington State Nurses Association, said she sees positive long-term outcomes for Franklin High students. “These [peer educators]have learned leadership skills and they understand public health roles,” Fleming said. “I think some of these students will go into health careers, which can really help reduce health disparities.”

For information on suicide prevention, visit


About Author

Karen Schmidt, RN, is a freelance writer. Send letters to

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