Touro University Nevada (TUN): Raising Resiliency Together is designed to provide TUN medical students with the knowledge and confidence to identify and overcome the stressors that contribute to substance abuse and mental health issues before they become debilitating and dangerous situations. Medical students face intense stress and experience both mental illness and suicide at a higher rate than their peers and the population as a whole. TUN will build campus capacity and infrastructure to help these students by forming a Behavioral Health Advisory Board and implementing activities including: 1) A coaching program directed primarily at students from underserved and underrepresented populations; 2) A long-term counseling model to increase access to campus counseling services; 3) A series of trainings and presentations for students, faculty, and staff; 3) Self-assessments that flag and refer students to needed services; and 4) Outreach activities that will promote awareness and action for students, faculty, and staff. The programs will reach and serve 1500 faculty, staff and students. TUN enrolls approximately 1,400 students in osteopathic medicine, physician assistant studies, nursing, occupational therapy, physical therapy, and education. The osteopathic medicine program is the largest medical school in Nevada. TUN’s student population demographics are: 53% white, 32% Asian, 6% Hispanic of any race, 4% two or more races, 3% black or African-American, 2% unknown, .5% native Hawaiian or other Pacific Islander, and .1% American Indian or Alaska native. Fifty-two percent of TUN students are female and 48% are male. Seventy-four percent of students are age 20-29, 19% are age 30-39, 5% are age 40-49, 3% are age 50-59. The average age of students is 28 years old. Veterans make up .6% of students and .3% are student dependents on VA benefits. The goals of TUN Raising Resiliency Together are to: 1) Grow and strengthen the institution’s infrastructure and network of mental-health and substance-abuse treatment resources and services; and 2) Increase the capacity of resiliency, emotional well-being, and mental health of all TUN students, including those traditionally underserved and underperforming student groups, in order to address the prevalence and severity of mental illness in medical students. The corresponding measurable objectives are to: 1) Increase the number of counseling hours available to students from 30 to 60; 2) Increase student self-awareness of alcohol, drug, and other risky behaviors; 3) Increase student knowledge and awareness of campus and community mental-health resources; 4) Serve 50 students per year (100 total) in a new coaching program to help create resiliency during years two and three; 5) Increase the frequency of campus awareness and prevention presentations to one per month by dean of students and Student Counseling Services, in addition to presentations given by the Drug and Alcohol Committee; 6) Increase student attendance at awareness and prevention trainings and presentations by 10%; and 7) Increase faculty and staff attendance at awareness and prevention trainings and presentations by 10%.
Grantee Categories: Garrett Lee Smith State
The Commonwealth of the Northern Mariana Islands
The Commonwealth of the Northern Mariana Islands, Commonwealth Healthcare Corporation Youth Suicide Prevention Program will utilize a system-wide, multi-strategy approach to reduce the incidence of suicide and increase access to appropriate suicide prevention and intervention services for youth and young adults in the CNMI between the ages of 10-24 years old.
The Youth Suicide Prevention goals include the following:
1) Promote awareness that suicidal and self-destructive behavior is a public mental health problem in order to reduce the stigma associated with being a consumer of suicide prevention or intervention services;
2) Increase system-wide capacity to deliver effective suicide prevention and intervention services;
3) Develop collaborations and networks that support common goals in suicide prevention;
4) Improve the usefulness of data surveillance systems to effectively inform suicide prevention and intervention efforts.
The Youth Suicide Prevention Program proposes to implement a multi-strategy approach to address youth suicide in the CNMI. The program will promote behavioral and mental health and wellness; provide suicide prevention education and outreach; provide intervention and treatment services for those at risk of suicide; and provide support for those in recovery from suicide behaviors.
The program’s measurable objectives include the following:
1) Increase community-wide support for the prevention of suicide and self-destructive behavior by promoting public awareness that these acts are a serious public health problem and that many of these acts are preventable;
2) Implement a state-wide campaign that promotes accurate and responsible reporting and portrayals of suicidal behavior and self-destructive behavior;
3) Implement a social marketing plan that promotes behavioral and mental wellness and reduces the stigma associated with accessing suicide prevention and intervention services;
4) Provide training for youth-serving agencies and key stakeholders (including educational institutions, foster care systems, juvenile justice systems, etc.) in recognizing the signs of persons at-risk for suicide and in accessing resources for prevention and treatment programs;
5) Provide training to increase the ability of healthcare professionals and staff to screen for at-risk indicators, identify protective factors, promote resiliency, and refer for appropriate services;
6) Provide training for clergy and community members in recognizing the signs of persons at-risk for suicide and in accessing resources for prevention and treatment programs;
7) Promote and support the presence of protective factors by improving clinical skills;
8) Provide comprehensive direct treatment to at-risk individuals including wrap-around and recovery support services;
9) Improve and expand comprehensive education programs and support services for survivors of suicide;
10) Implement a system of care linking youth-serving agencies, government and non-government partners, community members, peers and other appropriate stakeholders;
11) Increase collaboration with public and private nonprofit organizations;
12) Increase the number community-based support groups;
13) Develop and implement a comprehensive uniform system of data collection;
14) Develop a database that links and analyzes information on suicide and self-destructive behavior derived from separate data systems;
15) Measure the effectiveness of the implementation of the goals and objectives;
16) Utilize program evaluation data and analysis to develop a program sustainability plan.
The program goals and objectives will guide a data-driven process which will inform decision-making at all levels.
Texas Christian University
Texas Christian University (TCU) is an establishing a comprehensive program called the HOPE Collaborative, with the purpose of expanding current resources to enhance health-care services to better treat mental health and substance use disorders, as well as prevent suicides and suicidal behavior on campus. The HOPE Collaborative seeks to generate a campus climate change through nationally recognized trainings and workshops, voluntary screenings across campus
for mental health and substance use problems, creative outreaches, social marketing, and integrated clinical care. In addition to the campus population as a whole, the HOPE Collaborative will specifically target students at risk for suicide, depression, serious mental illness, and substance use disorders that can result in school failure. The project will further incorporate specialized preventive services for students who are military veterans, identify as a gender or sexual
minority, and/or are first-generational college students. TCU is a private, four-year teaching and research university located in Fort Worth, Texas.
There are 10,394 enrolled students, with an ethnically diverse population of about 30%. The need for the HOPE Collaborative is pressing as the number of critical mental health and substance use incidents on campus is escalating. For example, during the fall semester of 2017, 366 students presented to counseling with significant depression, 166 students reported thoughts of suicide, and 27 students visited an emergency room due to a substance abuse crisis. In some case, these numbers from the previous semester surpass the totals from previous academic years. Fortunately, the HOPE Collaborative is designed to reach approximately 4,000 people annually through the lifetime of this project. The HOPE Collaborative has 5 goals, founded in best practices, which will impact the university’s policy and processes, the utilization of mental health services, and campus knowledge/attitudes regarding mental health issues and substance use among TCU students. These goals are 1) Enhance mental health services for all college students and for those at risk (Employing a crisis care counselor and establish a “Let’s Talk” program); 2) Implement evidence-based trainings to teach responses to mental health and substance use disorders (utilizing Mental Health First Aid); 3) Provide suicide prevention training and resources to faculty (QPR and “Red Folders”); 4) Promote help-seeking and administer voluntary screenings (marketing campaigns, “Mood Check Days,” “Sober Tailgates” at athletic events); and 5) Create specialized preventive services for students of at-risk groups, (Training Symposium for veterans, certified more Safe Zone Allies instructors, “First Gen Days” for first generational students).
Texas A&M University – College Station
The Texas A&M University Department of Suicide Awareness and Prevention will develop a comprehensive, collaborative, well-coordinated approach to enhance efforts to reduce risk of suicide and substance-related death for over 63,000 Texas A&M students. Efforts include a mental health stigma-reduction campaign and training to improve the identification and referral of at-risk students so they can safely and successfully complete their studies. The project will serve the 63,000 Texas A&M students on the main campus, as well as an additional 5,000 distance learners located at special purpose campuses. Texas A&M is a Tier 1 research institution with a student population that is 57% White, 21% Hispanic, and 7% Asian. Texas A&M is consistently one of the top-ranking schools in the country for Veterans. A&M is also home to the Corps of Cadets, a leadership training program that commissions more military officers than any other institution with the exception of the nation’s service academies. The estimated rate of college student suicides is 7.5 per 100,000 students. This equates to between 4 and 5 deaths by suicide per year. With 9 deaths by suicide in calendar year 2017, the rate is nearly double the predicted number. The Student Counseling Service will take the lead in the creation of a campus-wide effort to collaborate in support of at-risk students. A comprehensive awareness campaign will focus on the availability of supportive resources to assist students both on and off campus. Existing Suicide Prevention Gatekeeper training will be provided with the goal of increasing capacity to train faculty, staff and students to identify and refer students that are in psychological distress. In addition, a 3-year license will be purchased for Kognito, an evidence-based computer simulation that teaches techniques to provide support to distressed students. This tool will be available for all faculty, staff and students. Project goals include the creation of a single point of coordination for campus-wide primary, secondary and tertiary response to reduce the risk of suicide on campus; to increase the capacity of students, faculty and staff to identify and support at-risk students; to increase the awareness of available services; and to form partnerships with student organizations that focus on student well-being. Objectives include holding meetings with community stakeholders, holding 2 general mental health and 2 suicide-specific awareness events, providing monthly promotion via email 100% of the Texas A&M faculty, and the provision of 5 trainings to the 180-member staff of Residence Life. Over the life of the grant, 100% of the student body and faculty will receive information about suicide prevention efforts and will have the opportunity to receive gatekeeper training. A projected 1,000 students will participate in suicide prevention events. Through this effort, the number of trained suicide prevention gatekeepers will double from 12,000 to 24,000.
Texas
Resilient Youth – Safer Environments (RYSE) will create comprehensive Suicide Safer Early Intervention and Prevention (SSIP) systems to support youth-serving organizations, including Texas (TX) schools, mental health (MH) programs, educational institutions, juvenile justice systems, substance abuse programs, and foster care systems. The target population, youth ages 10 to 24 years at elevated risk of suicide and suicide attempts, will receive enhanced services through best practice trainings, improved suicide care in clinical early intervention, treatments services as well as effective programs. TX will expand upon its previous success in the last GLS grant, Zero Suicide in Texas (ZEST) initiative which improved services for youth at risk of suicide through the development of Suicide Safer Care Centers (SSCCs) in the public MH system. With increased capacity to serve and recognize youth at risk, and enhanced infrastructure for strategy implementation, these SSIP systems will produce robust clinical and community services with collaborative networks to promote youth resiliency, recovery, and safety. In 2017, 3,488 individuals died by suicide in TX with 657 in the target population. Galveston County (GC) has been above the national average rate of suicide for the target population over the last 15 years, with a crude rate of 16.8 compared to the national rate of 9.6. Additionally, GC residents experienced the devastation of Hurricane Harvey in August 2017 and the Santa Fe (SF) school shooting in May 2018. The trauma associated with exposure to disasters and critical incidents can contribute to increased risks for depression, anxiety and suicidal ideation (SAMHSA, 2017; Usher, et al, 2016). Therefore, activities will begin with youth, ages 10 to 24, living in GC, and specifically in SF, attending schools in SF Independent School District. The goals of the grant are to: (1) improve SSIP systems with development of a Suicide Prevention Community Collaborative (SPCC) to support community planning, workforce development and oversight; (2) increase early identification and referral of youth ages 10 to 24 years at risk of suicide; (3) provide evidence-based interventions to enhance protective factors, promote mental health and reduce suicide risk; (4) enhance postvention strategies to reduce risk following exposure to suicide attempts or deaths in the community; and (5) continuously measure RYSE activities to improve quality and document lessons for expansion. There are numerous objectives for each of these goals; for example, Obj. 1.1: By January 2020, establish SPCC inclusive of community health agencies, BH agencies, schools, non-profits, juvenile justice, foster care, faith-based organizations, and individuals with lived experience, and Obj. 3.1: In year two, begin the Hope Squad youth peer model in a high school as a universal prevention strategy. There will be services and programs implemented to include the following strategies and interventions: screening and referrals, care transition services, suicide early intervention evidence-based practices (EBPs) trainings, and postvention services employed in all years of the grant. Services will be provided to the following numbers of individuals: year one (2,105), year two (3,000), year three (3,780), year four (4,375), and year five (5,200) with a total of 18,460 individuals served through the lifetime of the grant.
Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS)
The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) proposes “Tennessee Lives Count Connect2” to reduce suicidal ideation, suicide attempts, and suicide deaths among youth and young adults ages 10-24 by building on existing grant-funded suicide prevention and early intervention strategies to enhance and expand capacity statewide, including enhanced follow-up in 30 focus counties for 5,000 unduplicated individuals (Year 1: 750; Years 2-5: 1,063 annually). The focus area is the State of Tennessee, comprising urban and rural populations with multiple socioeconomic disparities (e.g., high poverty, unemployment) that contribute to high risk for suicidal ideation and behaviors among youth/young adults. Tennessee’s suicide rate for the state (16.8) exceeds the national rate (14.0), and 1,163 Tennesseans died by suicide in 2017. Among the focus population, 35% are enrolled in Supplemental Nutrition Assistance Program (SNAP) and 65% are enrolled in the state’s Medicaid program. Focus county schools serve over 6,200 students with an identified severe emotional disturbance/mental illness, with 31.5% of state high school youth reporting they felt so sad they stopped usual activities, 17% seriously considered suicide, and 14% made a suicide plan. Of the 128,000+ calls to the Statewide Crisis Line, 16% were made by youth under 17. TDMHSAS will partner with Tennessee Suicide Prevention Network and Centerstone of Tennessee to provide suicide prevention and postvention trainings for gatekeepers (schools, law enforcement, foster care, etc.) and training for primary/behavioral health professionals, screening/assessment, early intervention, follow-up, outreach/education, and linkages to treatment services, using the RELATE curriculum, based on evidence-based theory and incorporating evidence-based approaches, and the Columbia Suicide Severity Rating Scale (C-SSRS). Connect2 will also strengthen public/private collaborations and support higher learning institutions to train students in recognizing early signs of suicide and referring individuals needing help. Outcomes will include reduction in suicidal ideation and suicide attempts by 30% and suicide deaths by 10%. An existing Youth Advisory Leadership Council comprising stakeholders and focus population members will support Connect2’s goals/objectives: (1) increasing gatekeeper/stakeholder capacity to identify/refer youth at risk of suicide; (2) increasing stakeholder capacity to assess, manage, and treat youth/young adults at risk for suicide; (3) expanding provision of enhanced follow-up for youth experiencing suicidal ideation and/or a suicide attempt; (4) increasing risk identification, referral, and behavioral health services utilization; (5) increasing the promotion and utilization of crisis response services; (6) implementing key elements of the National Strategy for Suicide Prevention to reduce rates of suicidal ideation, attempts, and deaths for youths/young adults ages 10-24 in Tennessee; and (7) conducting a comprehensive evaluation and developing/disseminating a thoroughly documented service model for replication/adoption across the state and nation. Evaluation will report as required on participant outcomes and on progress and performance regarding infrastructure development.
St. Petersburg College
St. Petersburg College (SPC), representing eight campuses across Pinellas County, FL, proposes Project HEAL (Healthy Emotions and Lives) to build a collaborative infrastructure targeting mental health and substance abuse awareness. Project HEAL will strengthen a community-wide provider network, implement a comprehensive suicide prevention plan, and increase awareness of and access to resources for nearly 30,000 credit seeking students. Currently, no mental-health centered crisis response protocols or on-campus mental health services exist for SPC students, and in particular for vulnerable populations including minority students, veterans, and LGBT. Although students have access to a 24/7 free telephonic Student Assistance Plan, less than 1.08% of students (233) utilized this service in 2017. Faculty and staff indicate little knowledge of how to help a student experience a mental health crisis. In addition, community partner services vary widely across SPC’s large campuses and lack coordinated efforts. To bridge these service gaps, Project HEAL will achieve the following goals and objectives by the end of the project period:
- Establish a systematic infrastructure of SPC’s mental health referral and on-campus network, including the development of a Suicide Prevention Plan with Crisis Prevention Protocol and suicide tracking system, where 75% of College faculty and staff demonstrate knowledge of proper procedures and protocols;
- Offer a tiered system of Gatekeeper training for faculty, staff, and students on suicide prevention, substance abuse, and mental health promotion, where 80% of those trained indicate an increased ability to recognize students at risk;
- Promote access to mental health and substance abuse counseling with network partners, including on-campus screenings, where the number of students accessing help increases by 75% each year; and
- Provide mental health and substance abuse resources, materials and events on campus and online to increase awareness and understanding of mental health issues, including promotion of the National Suicide Prevention Lifeline, where 75% of students, faculty, and staff indicate an awareness of community resources and where to turn for help.
Leading the program is a Project Taskforce of key College personnel experienced in mental health promotion and high-risk populations, students representing high-risk populations, and new and existing community mental health agency partners to ensure a robust network of providers and referral sources for students, These partners, along with former GLS grantees, will inform program planning, activities, and best practices in evidencebased care. Over a period of three years, Project HEAL will train approximately 845 faculty, staff, and students in a Gatekeeper model and SPC mental health resources to increase student utilization of community mental health resources and referrals. More than 3,000 students will be reached through on-campus awareness and screening events. Finally, over 2,370 students will seek help through the Student Assistance Plan and other community resources. SPC pursues these goals with the belief that supporting mental health is everyone’s charge, and that one death as a result of substance abuse, mental illness, or suicide is one too many.
Southern Arkansas University
The Southern Arkansas University (SAU) Suicide Prevention and Awareness Program will develop a more comprehensive suicide prevention and substance awareness program on the SAU campus. This plan will consist of a multifaceted approach to its Suicide Prevention and Awareness Program. It will encompass training for faculty, staff, and students; awareness and education activities; surveys and assessments; accreditation process for counseling professionals; establishment and dissemination of a suicide prevention plan for the campus; creation of a suicide support network, and reactivating the Crisis Response Team (CRT). Southern Arkansas University’s 2017 fall enrollment is more than 4,600 students, this includes approximately 900 graduate students. Nearly 2,000 students reside in campus housing. Students mainly come from within a 100 mile radius, and 70% originate from within the state. Forty-three percent of the student body comes from a family household earning less than $24,000 annually. Student population is comprised of 54% female and 46% male; 58% White, 23% African American, and less than 5% Hispanic, Asian and other ethnicities. Non U.S. Citizens represent 14% of the student body. The Suicide Prevention and Awareness Program has four main goals. Goal one is to develop infrastructure for support referrals to campus and community based services designed to prevent suicide while improving the efficiency by which follow up interventions are carried out. This goal will be accomplished by hiring a full time coordinator, developing and disseminating resources and creating a variety of specialized teams within the SAU system and local community. Goal two is to annually assess the campus needs concerning mental health, substance abuse, and suicide risk. This goal will be carried out by administering regular assessments, screenings and surveys on campus. Results will be utilized to assess campus needs and target education and awareness campaigns regarding those needs. Goal three is to improve the suicide prevention training practices among faculty, staff, students, and at risk populations on the SAU campus. Key students and personnel will receive specialized training in suicide prevention and substance abuse, approximately 510 people.* Goal four is to build a campus culture of consistent messaging around the issues of substance abuse prevention, mental health access and suicide prevention. Information will be distributed to over 4,000 students throughout the duration of the project to deliberately reduce stigmatization of behavioral health services and to provide information about available resources. Campus, local, regional, and national resources will be accessible in the Counseling Center, on the website and distributed to parents and students. On-campus activities will be planned in collaboration with student organizations, the Counseling Center, and the local community regarding suicide awareness, prevention and substance abuse education.
Southeast Community College
The SCC Community Suicide Prevention Project will allow Southeast Community College (SCC) to build a network of support for students. A Community Advocacy Council will bring together healthcare, higher education, and other key community resources with the goal of providing a safety net of services, including responding optimally to suicidal threats or attempts, coordination with medical care providers, aftercare and re-integration into college life. Training will be provided to SCC staff, faculty, and students with a goal of building a campus community of acceptance, inclusion, and support. The SCC Project will provide training and support to all Southeast Community College students at all three campuses (Lincoln, Milford, and Beatrice). The Project will build infrastructure by creating a network of supportive services for students who are experiencing emotional distress, which may lead to suicidal ideation and suicide attempts.
In addition, the project will train a select group of SCC leadership to conduct Question, Persuade, and Refer (QPR) training to staff, faculty, and students. The QPR training will be provided in conjunction with SCC’s Suicide Prevention Protocol training. Educational seminars will be provided to SCC’s CARE Team, which was developed to foster meaningful connections and emotional and psychological support to students. The seminars will assist the team in developing the knowledge, skills, and abilities needed to offer support to students regarding a variety of issues they may be experiencing. In addition, SCC will develop a process to select and train Safe Students, who will serve as an additional layer of support for students. They will receive training in the skills required to support students in a positive and inclusive manner.
This project will also develop prevention materials to share with parents regarding student wellness and the signs of suicidal ideation. Student wellness information will also be included on the SCC website, enhancing the Student Services page with prevention information, contacts for the CARE Team and Safe Students, and the SCC Counseling Assistance Program. All materials developed, including the website enhancement, will include promotion of the National Suicide Prevention Lifeline.
Finally, SCC will create a safe space on each campus for the LGBTQA+ community that will include networking and support information, as well as speaker and forum events.
Project goals include: increasing intra and extra collegiate collaboration; increasing training; providing information to parents; increasing the scope of work and training of the CARE Team; developing a Safe Student Program; increasing inclusiveness and support to the LGBTQA+ community specifically; and increasing the promotion of the National Suicide Prevention Lifeline. Measurable objectives include: number of staff, faculty, and students trained in QPR and the SCC Suicide Prevention Protocol; number of linkages/agreements with area health care providers through the work of the SCC Community Advocacy Council; number of students helped by improved community linkages; number of students who choose to become Safe Students; number of hits on the newly developed Student Wellness Support page; and number of parents and family members that receive information regarding suicide prevention and student wellness. This project has the potential to reach all SCC students, staff, and faculty. It is anticipated that 250 individuals will be directly served by the program in year 1; 540 individuals in year 2; and 540 in year 3; for a total of 1,330 directly served through the lifetime of the project.
South Carolina Department of Mental Health
The SC Department of Mental Health (SCDMH) will implement the Young Lives Matter Project to reduce deaths by suicide and nonfatal suicide attempts among SC youth and young adults age 10-24. The project will focus on increasing access to screening and mental health services, raising awareness through social media marketing, increasing protective factors through training across community domains, supporting clinicians and educators in implementing evidence-based interventions, utilizing safety plans in emergency departments, and strengthening statewide infrastructure. Within the overall focus population, SCDMH will focus on the subpopulations of those with Serious Mental Illness (SMI), justice system involved, and LGBT. Strategies and interventions include a marketing/outreach campaign as well as suicide prevention programming conducted in 80 school districts and on 5 college campuses; implementing the evidence-based Interactive Screening Program; provision of screening, assessment, and therapeutic services (utilizing the evidence-based Attachment-Based Family Therapy); improving state infrastructure through training, re-creation of the SC Suicide Prevention Coalition, improving discharge protocols in emergency departments, and development of a universal response protocol to respond when it is suspected that a YYA is suicidal.
Goals of Your Life Matters are:
- To strengthen statewide infrastructure that will support improved behavioral health services delivery to potentially suicidal YYAs, including formation of a statewide Suicide Prevention Coalition and regional youth suicide prevention task forces.
- To raise awareness and knowledge of YYAs and those who care about them (e.g., teachers, parents, counselors) regarding how to get help for depression and other mental health issues that may lead to suicidal ideation and suicide attempts.
- To educate parents, teachers, and other caring adults on the risk and resiliency factors that impact YYA mental health, suicidal ideation, and attempted suicide; on how to respond when they believe YYAs to be suicidal; and on how to access services.
- To increase screening of YYAs for suicide risk and their access to services.
- To implement evidence-based practices and successful intervention strategies to reduce suicide attempts and deaths by suicide.
- To develop an interagency response protocol to use in the event that a youth or young adult is determined to be at risk of suicide.
Primary project objectives (not an inclusive list) are:
- 300,000 individuals will be exposed to mental health awareness social media marketing and will be contacted through program outreach efforts
- 10,000 individuals will receive training in prevention or mental health promotion
- 30,000 individuals will be screened for mental health or related interventions
- 20,000 individuals will be referred to mental health or related services
- 25 organizations/communities will demonstrate improved readiness to change their systems
- All 46 SC counties will improve connection via a shared information technology system
- 90 contacts (at key agencies/institutions) will be made through program outreach efforts
- 131 programs/organizations will implement mental health-related practices/activities
It is estimated that at least 300,000 youth and young adults (60,000 annually) will be reached with social media marketing over the lifetime of the project and 30,000 (6,000 annually) youth and young adults will be screened for suicide risk and mental health needs.