One day, Jamie Tworkowski might hear from someone who decided not to commit suicide after seeking help from his nonprofit, To Write Love on Her Arms (TWLOHA). The next day, he might speak at a memorial for a girl who took her own life, even after reaching out. “We never get used to stuff like that,” says Tworkowski, “but I don’t think we’re supposed to. That stuff just breaks our hearts and reminds us what’s at stake.”

Tworkowski, 30, founded TWLOHA in early 2006 while helping a 19-year-old friend, Renee, who was struggling with addiction, depression, self-injury (she had written “F—Up” with a razor on her forearm), and attempted suicide. While Renee debated getting treatment, Tworkowski and other friends offered support; in the meantime, he wrote an essay, “To Write Love on Her Arms,” addressing Renee’s situation. The name stuck, T-shirts started selling, Christian bands (including Switchfoot) started spreading the word, and a movement was born. Since then, TWLOHA—partnering with the likes of Teen Challenge, S.A.F.E. Alternatives, and others—has responded to more than 150,000 people (many in crisis) and donated over $700,000 to treatment and recovery centers.

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