Need: Union Parish, a rural county in Louisiana, was experiencing higher than average suicide rates among youth.
Intervention: Union General Hospital, a Critical Access Hospital, started a program to educate students grade 4 through 12 on the negative effects of bullying and how to model positive social behavior.
Results: The 3,000+ students trained have learned how to recognize, report, and react to bullying.
Louisianans ages 10 to 34, suicide is the third leading cause of
death. Suicide was
responsible for 704 deaths in 2019, putting Louisiana
slightly above the national average suicide rate.
In 2014, 12 youth suicide cases were reported in Union
Parish, Louisiana. Increasing bullying and suicide rates
were a growing concern noted in Community Health Needs
Assessments. Union General
Hospital, a Critical Access Hospital (CAH) in Union
Parish, Louisiana, was averaging 9 teen suicide attempts
per month. It was the suicide of a local fifth grade
bully victim that drove hospital administration to take
Together We Can Be Bully Free is a part of Union General
Hospital's Drug and Suicide Prevention Program. Because
bullying often starts in elementary school, the program
was originally created for younger students and has since
expanded to high schoolers. In 3 sessions a year,
parents, teachers, and students learn the dangers of
bullying and how to help students who are at risk of
committing suicide. Because
research indicates a strong link between the suicide
and bullying, it became the goal of the program to
educate, identify, and overcome physical, mental, and
Together We Can Be Bully Free holds 3 sessions per year
at participating schools. The planning team formulates
session content around issues students are facing
expressed by parents and teachers at school board
meetings. Topics covered by a mental health and
psychiatric nurse from Union General Hospital and a
detective from Crime Stoppers of Union Parish include:
Different types of bullying and their physical,
mental, and emotional effects
Reasons why someone might engage in bullying
Identifying the roles that bystanders and those who
participate in bullying
Modeling positive social behavior
How social media spreads bullying and escalates
Brainstorming student-initiated solutions to reduce
Creating concrete action plans in the classroom
Constructing social rules for behavior based upon
Personal testimonies from
children who have addressed personal bully attacks
In addition to the sessions, the program also offers
referrals to local mental health providers for students
who need extra help.
Over 3,000 students have participated in the
anti-bullying program: 500 students the first year, 600
the second year, and over 1,900 the following years.
Students have learned how to recognize, report, and react
to bullying. As a result, reports of bullying incidents
to the Union Parish Sheriff's Office has decreased. The
number of suicide attempts has also decreased. Four
resource officers have also been assigned to partnering
schools to prevent and mediate bullying incidents.
Together We Can Be Bully Free received the 2014
Outstanding Rural Health Program of the Year Award from
the Louisiana Rural Health Association, for its
contribution to the healthcare system in Union Parish and
for its efforts in improving the quality of rural
healthcare through educational outreach efforts.
In 2015, the program was recognized as a "Program
of Promise" by Jackson Healthcare's National Hospital
Charitable Services Awards. It was selected from a pool
of 101 nominees as a high-impact community health program
and a model for replication.
One of the biggest challenges when first approaching
schools was hesitancy or denial that bullying was an
ongoing occurrence. Once the program explained their
intention, there was more receptivity. Educating
administrators and school staff on the reality of
bullying and its long-term effects has remained an
ongoing mission of the program.
When approached by school administrators about some of
the information presented (for example, stories about
suicide or effects of bullying), the program organizers
explain the importance of talking honestly with the kids
in order to prevent bullying and suicides.
To replicate this program, organizers suggest inviting
partners who have a stake in anti-bullying efforts.
Cultural diversity among the project's team has helped
build culturally relevant messages in order to reach all
demographics of children.
Provide age-appropriate material for the youth. Speak to
them at their level without sugar-coating the
information. Because students respond better to other
students teaching, engage the audience in demonstrations
and show videos that feature students.
When speaking of bullying, encourage the students to keep
their eyes forward and not embarrass the bullies in the
room by pointing to them. Include education about why
someone might be a bully (for example difficult
circumstances at home). Provide time for public
confession, a gesture that is the start of emotional
healing for many bullies.
After the presentation, allow time for students to
approach the leaders one-on-one, perpetrators and victims
alike. Invite the school counselor to be present as well.
The Together We Can Be Bully Free
brochure has more information about bullying and
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.