Grantee Categories: Garrett Lee Smith State

Oregon

The Oregon Garrett Lee Smith Youth Suicide Intervention and Prevention Initiative, managed by the Oregon Health Authority Injury and Violence Prevention Program (IVP), will focus on youth age 10-24 in at least 4 counties with youth suicide rates higher than the national average (Deschutes, Jackson, Josephine, Umatilla). The population of youth served is estimated at 206,545, which comprises 27.3% of the youth population in Oregon and accounted for 26.9% of deaths by suicide among youth from 2015-2017. Oregon’s rate of youth suicides almost doubled from 7.2/100,000 in 2010 to 14.1/100,000 in 2017 (OPHAT, 2019). In response, IVP will build on successes and lessons learned from three previous GLS grants to sustainably implement youth suicide prevention and early intervention strategies in schools, educational institutions, and a variety of child- and youth-serving organizations. Project goals are to (1) Increase capacity of counties with higher than average rates of youth suicide to implement sustainable, evidence-based youth suicide prevention strategies; (2) Increase the number of youth-serving organizations able to identify and refer youth at risk of suicide; (3) Increase capacity of clinical service providers to assess, manage, and treat youth at risk of suicide; and (4) Improve the continuity of care and follow-up of youth identified to be at risk for suicide. Objectives to be achieved by project conclusion in 2024 include the following: In support of Goal 1, IVP will subcontract with up to 10 direct service provider organizations to expand or establish local initiatives to undertake evidence-based youth suicide prevention, intervention and postvention. IVP and Lines for Life will develop new content pages for the Oregon Suicide Prevention website and track page views. A youth suicide prevention track will be incorporated into the annual statewide suicide prevention conference, and local prevention coordinators will have supported youth suicide coalitions in up to 10 counties. In support of Goal 2, 120 child welfare personnel will become suicide prevention gatekeeper trainers and provide training to 3,000 CW staff and foster parents. An additional 8,450 staff in youth serving organizations will receive training in QPR, ASIST, and safeTALK and ongoing training for students and staff will be established in selected middle and high schools. In support of Goal 3, 500 clinicians will receive training evidence-based suicide risk assessment, management and treatment; all 76 school-based health centers will implement evidence-based suicide risk assessment; and up to 16 health systems will participate in a Zero Suicide (ZS) Academy. In support of Goal 4, selected communities will develop and implement continuity of care and follow-up plans for youth identified to be at risk for suicide. Up to 32 healthcare systems will actively implement ZS and 100% of youth discharged from ED and inpatient psychiatric units identified in those systems will receive referrals to a mental health provider, safety planning (including lethal means counseling), and one or more caring contacts from the health system.

Old Dominion University

This proposal, entitled Implementing a Social-Ecological Suicide Prevention Program (SESPP) at Old Dominion University (ODU), adopts a public health approach to suicide prevention among 24,000 college students. The program seeks to build sustainable infrastructure at ODU to enhance mental health service provision, improve campus-wide mental health-related attitudes, and reduce college student stress, suicide risk and substance abuse. Populations Served: The following specific groups are served across SESPP program components:

  1. faculty, staff, and administration;
  2. at-risk student groups (e.g., military, LGBTQ, students with disabilities);
  3. students experiencing stress, mental health and/or substance use concerns;
  4. police officers, and;
  5. a range of Norfolk, VA area community partners (e.g., VA Medical Center, LGBT Center).

Strategies/Interventions: A number of programs will be implemented to serve ODU stakeholders. First, an integrated Campus-Community Suicide Prevention Taskforce will be assembled to formulate a strategic plan, establish a regional campus-community referral network, and provide other project guidance. Second, a campus awareness program will be instituted, including weekly emails, campus flyers, a mental health resources website, and free on-campus mental health screenings. Third, Counseling Services and Student Health service providers will receive a series of trainings in evidence-based practices (e.g., brief psychotherapies). An annual undergraduate suicide prevention course for health professions students will augment training efforts. Fourth, QPR and Safe Talk gate-keeper trainings will be implemented for all stakeholder groups. Finally, a series of campus outreach programs (i.e., LGBTQ Safe Space, military Green Zone, and Life Skills Training) will be conducted on campus.

Project Goals & Objectives:

  • Goal 1 holds the objectives to enhance suicide prevention skills among 20 health service providers and 75 total undergraduate health professions students.
  • Goal 2 features the objective to provider gate-keeping training for a total of 480 students, staff, faculty, administrators, and police officers.
  • For Goal 3, the awareness campaign holds objectives to reach 6,000 students, family members, staff and faculty through electronic means, as well as 300 students via free on-campus mental health screenings. Goal 4 addressing at-risk groups possesses the objectives to educate 100 students, faculty and staff via outreach programming each on LGBTQ concerns and military student needs.
  • Goal 5 holds the objectives to add a total of 9 community members to the Campus-Community Taskforce, and implement a referral resource network.
  • Goal 6 seeks the following student well-being objectives: 5% reduction in financial stress, 10% reduction in mental/emotional difficulties impacting academic work, 3% decrease in 12-month self-harm prevalence, 2% reduction in 12-month prevalence of suicidal ideation, 5% reduction of binge drinking, 10% increase in student willingness to use health services, and 10% reduction in suicide-related stigma beliefs. Goal 7 holds the objective to establish a campus-wide suicide prevention strategic plan.

Oklahoma

Healthy Connections for OK Youth, an enhanced continuation of the Oklahoma Youth Suicide Prevention and Early Intervention Initiative, improves our ability to ensure that once a young person is at risk for suicide, they are compassionately and promptly connected with the appropriate level of care. The target population for Health Connections will be Oklahomans ages 10-24, with a special focus on students served by schools partnering with OK Systems of Care for Behavioral Interventions and Support Services (BISS). As a Cohort I, IV, VI and IX grantee of SAMSHA’s Garrett Lee Smith initiative, the State of Oklahoma has been able to take important steps toward the development of a public health infrastructure to promote the prevention of suicide. Through improved connections between our state’s strong prevention efforts and robust youth mental health care system, Health Connections will streamline the process of linking a young person in distress to the appropriate lifesaving level of care and support for themselves and their families by linking a comprehensive approach to school based suicide prevention with personalized wrap around behavioral interventions and timely access to mental health care. Project goals are to: 1) Increase the capacity of school personnel and staff from youth serving entities to identify a young person in distress and compassionately connect them with the appropriate level of assistance. 2) Increase the number of youth at risk for suicide who receive the appropriate level of care in a timely manner. 3) Increase access to healing supports and resources for those impacted by suicide. Initiatives to achieve project goals include providing online evidence-based suicide prevention gatekeeper training to k-12 school personnel statewide, then working closely with selected school sites to implement comprehensive suicide prevention, intervention and postvention training to create effective policies and protocol for the identification and referral of students at risk as well as a “return to learn” protocol for assisting students and their families with a smooth transition back to school following a hospitalization. Combined training initiatives will enable this project to provide training to behavioral health staff serving Oklahoma’s most at risk youth for mental or emotional disorders, including those in foster care, juvenile justice and allow us to reach their families with healing resources following a suicide attempt or death. This project will impact the lives of 350,000 Oklahomans over the next five years.

Ohio Northern University

ONU is requesting funds to enhance infrastructure, awareness, and education related to mental health and substance use disorders on the ONU campus. These disorders can cause serious consequences including suicidal behavior, injury, or school failure. This project will enhance services in an effort to prevent mental and substance use disorders and increase help-seeking behaviors to protect ONU students and help students successfully complete their studies. ONU’s students, faculty, and staff is the population to be served, with an emphasis on LGBTQ, racial/ethnic minority, veteran, and athlete students. ONU has 3,088 students, 2,312 of whom are undergraduates. Of all students, 5% are international, 77% are white, 4% are African-American, 9% are of unknown race, and students of other races comprise under 3% each. ONU has 489 first-generation college students and 10 veterans receiving benefits, and the university hosts degree-seeking and exchange students from 23 countries. Unfortunately, ONU has seen an increase in

  1. Student of- concern referrals,
  2. the percentage of students presenting for counseling with suicidal ideations, and
  3. the number of ER visits and hospitalizations for suicide ideation, attempts, or substance use crises.

In 2016-17, 11% of the student body requested counseling services on campus. ONU’s GLS Project has three goals with nine objectives, in summary:

Goals:

  1.  equip the campus to assist students at risk for mental health problems and/or suicidal behavior;
  2.  Increase protective factors in students;
  3.  increase collaborations with local behavioral health care providers and community stakeholders.

Objectives: increase awareness of mental and substance use disorders by 20%; increase the percentage of faculty and staff trained to respond effectively to students at risk of mental and/or substance use disorders over years two and three by 10% and 25%, respectively; increase the percentage of Residence Life student staff trained to respond effectively to students at risk of mental and/or substance use disorders by 75% and 100%, respectively; increase the number of outreach efforts on mental and substance use disorders by 10%; increase the percentage of students who complete mental and substance use disorder screenings by 25%; increase involvement with student organizations/groups by 25%; increase the number of activities on campus to educate students and reduce negative attitudes about mental and behavioral health disorders by 15%; increase student satisfaction rate of behavioral health care providers by 25%; and increase involvement with public and private entities trained in behavioral health care by 10%. It is estimated that 770 students will be reached each year.

Notre Dame College of Ohio

The Notre Dame College Counseling Center is requesting support to implement a comprehensive suicide prevention strategy for the benefit of its students, faculty, and staff called iThrive@NDC. This will be implemented with the collaboration of local partners and include suicide prevention and mental health promotion training, voluntary annual mental health and substance use screenings, and provide students with more options to encourage help seeking behavior. iThrive@NDC will take place in South Euclid, Ohio and will target its efforts towards the mental health challenges facing minority students, first generation college students, and students with learning differences.

New York

The New Yorkers Advancing Suicide Safer Care (NYASSC) project will reduce suicide attempts and deaths by implementing Zero Suicide (ZS) in health systems across all five mental health service regions in New York. The project will also create a Suicide Safer Care Network in a high-risk county by linking emergency departments, inpatient psychiatric units, outpatient mental health and substance use disorder treatment settings, and primary care practices to create a local zero suicide safety net. The project anticipates assessing 281,596 individuals served by the project sites for suicide risk over five years, and projects that of those assessed, 197,116 will receive suicide-specific interventions. The Office of Mental Health will partner with the Center for Practice Innovations at Columbia University and the University of Rochester to advance implementation of Zero Suicide across the state. Providers will develop competency in the NYS Suicide Safer Care Model which includes screening and assessing for suicide risk, developing a prevention-oriented risk formulation, suicide care management plan, providing suicide specific evidence-based treatment and brief interventions, and protocols for transition of care and follow up when patients move to a different level of care.

The four goals of the project are to:
1) implement Zero Suicide in health systems in each of the five regions of NYS,
2) develop a Suicide Safer Care Network across all health systems in one high risk county,
3) disseminate statewide implementation of Zero Suicide based on lessons learned at project sites in the first 3 years of the grant, and
4) evaluate the project’s impact on clinical service delivery and utilization and on suicide attempts and deaths.

With input and guidance from individuals with lived experience and members of the NYS Suicide Prevention Council, project goals will be accomplished by accomplishing the following objectives: engaging health systems leadership, conducting learning collaboratives, training providers, developing and implementing site specific protocols, developing and conducting fidelity checks for clinical components, developing and disseminating materials and trainings, creating a robust suicide surveillance infrastructure, and by conducting an outcome evaluation to assess impact of the project on suicide attempts and deaths. In Year 4, the NYS Suicide Prevention Conference will be devoted to introducing health systems, county leadership, and providers across the state to Zero Suicide, to the NYS Suicide Safer Care Model, and to lessons learned from a county’s development of a Suicide Safer Care Network of Health Systems to create a local zero suicide safety net.

New Mexico

Cross-Sector Coordination to Ensure Life (XSCEL) aims to decrease the rate of suicide attempts and completions among 10-24 year olds in New Mexico through a continuum of local and statewide strategies. These strategies will coordinate and align multiple intervention levels across sectors including schools, communities, and healthcare settings. This project is urgent because New Mexico’s suicide rate rose to 32.3 per 100,000 for 15-24 year olds in 2017 after already being about double the national rate for the past decade. Geographically-focused strategies will be implemented in five counties with higher rates of suicide and/or risk factors compared to the rest of the state. One focus county is urban and the rest are predominantly rural; three have a high percentage of American Indian/Alaska Native populations and four have a high concentration of military members. XSCEL’s partner organizations have experience reaching and serving Native and military populations with accessible and culturally-appropriate strategies. XSCEL’s primary goals and objectives are: Goal #1: Improve coordination and alignment of suicide prevention and treatment activities across sectors at the local and statewide levels. Objectives: Engagement of individuals with lived experience; alliance-building activities; statewide suicide prevention coalition; changes in systems, policies, and practices. Goal #2: Improve multi-level suicide prevention practices in schools. Objectives: Gatekeeper train-the-trainer; screening, referral, and follow-up by School-Based Health Centers and school nurses/counselors; school safety plans. Goal #3: Improve multi-level suicide prevention practices in communities. Objectives: Gatekeeper training with community members; media campaign; non-clinical support by Navigators for referral completion; non-clinical EBP training for suicide prevention. Goal #4: Improve multi-level suicide prevention practices in healthcare settings. Objectives: Postvention services; screening and referrals in emergency departments; clinical EBP training for suicide prevention. When all project strategies are being implemented, XSCEL will serve the following number of people annually: Gatekeeper training (560); school crisis prevention and intervention training (130); screening (10,100); referrals for those with suicide risk (2,550); Navigator services (250); behavioral health services (917). Some strategies will not be implemented all five years because they require development work, and some of the annual numbers will include some of same individuals in multiple years. Therefore, over the course of the project, we expect to serve: Gatekeeper training (2,800); school crisis prevention and intervention training (650); screening (22,000); referrals for those with suicide risk (6,000); Navigator services (1,000); behavioral health services (2,000). Thus, XSCEL will have a broad enough reach and intensity of services that we expect to positively impact rates of suicide attempts and completions in the focus communities and impact systems, policies, and practices for suicide prevention throughout the state.

New Hampshire

Leveraging the innovative Integrated Delivery Networks (IDNs) created through New Hampshire’s 1115 Waiver Project and the corresponding Regional Public Health Networks (RPHNs), NAMI New Hampshire and its project partners have designed New Hampshire Nexus Project 2.0 (NHNP2), a cross-systems, collaborative approach to reduce suicide incidents among youth by improving pathways to care and offering comprehensive training to provide youth-serving organizations with the resources to identify, screen, refer, and treat at-risk youth. Population to be served: Based upon the most recent NH youth suicide data, NHNP2 will focus on youth/young adults ages 10-24 in IDN 2 (Capital) and IDN 7 (North Country/Carroll County). IDN 2 reported 14.5 youth suicides per 100,000, while IDN 7 reported 12.3 per 100,000. Both regions are higher than the US rate of 10.57 per 100,000. These 2017 rates indicate a 67% increase in Region 2, and a 50% increase in Region 7 since 2016. Strategies: 1. Leverage the infrastructure of NH’s IDNs to enhance functional inter-agency care systems and improve care coordination, continuity of care, and provider communication. 2. Enhance the ability of child and youth-serving organizations to recognize and engage youth at risk of suicide; establish referral pathways and cohesive procedures that connect high risk youth with appropriate services; and increase the capacity of communities to respond to suicide risk in a timely manner. 3. Build upon existing public/private partnerships to enhance the statewide capacity to recognize and respond rapidly and appropriately to suicide risk among youth/young adults. Goal: Reduce suicide incidents among youth/young adults by strengthening cross-systems collaboration, improving pathways to care, and offering comprehensive training opportunities that provide youth-serving organizations with the resources to identify, assess, refer, and treat at-risk youth. Measurable objectives: 1. Develop a Care Liaison role in each region to facilitate pathways to care for high-risk youth/young adults. 2. Leverage technology to advance screening and assessment and improve care coordination and cross-systems communication. 3. Convene and train regional implementation teams comprised of providers serving high-risk youth in suicide prevention/intervention/postvention. 4. Engage regional teams in planning to build infrastructure around best practices for suicide prevention/postvention. 5. Develop youth/young adult leadership in regional youth suicide prevention efforts. 6. Engage statewide organizations that interface with at-risk youth/young adults in suicide prevention/postvention training and planning. 7. Promote safe messaging in accordance with the NAASP framework. 8. Enhance and expand NSPL Lifeline follow up calls. Number to be served: The project will train an estimated 10,456 stakeholders and providers working in child and youth-serving organizations in suicide prevention, intervention, and postvention. The Care Liaison will work with approximately 60 high-risk youth/young adults annually. Approximately 10,756 individuals will be served over 5 years (Yr. 1 = 2,106; Yr. 2 = 2,302; Yr. 3 = 2,159; Yr. 4 = 2,038; Yr. 5 = 2,151).

Nebraska

The purpose of Nebraska’s proposed project is to reduce the number of suicides and attempts for youth ages 10-24 with a focus on outreach to15-24 year olds because their suicide rate is increasing in Nebraska, exceeding the US rate. Prevention activities are concentrated in southeast Nebraska because the youth suicide rate for this area is over the state and US rate. We reach the entire state by including suicide prevention in coordinated school health plans for K-12 schools and workforce development for clinicians serving youth in crisis. Nebraska will promote the zero suicide approach for health and behavioral health organizations along with evidence based strategies and practices to prevent youth suicide. The project has four goals. 1) Decrease the youth suicide rate 80% in Region 5 by 2024. 2) 100% of Nebraska public school districts will have policies and protocols in place for suicide prevention, post-suicide intervention, and transition back to school after a suicide crisis by 2024. 3) Twenty (20) Nebraska providers or healthcare systems will implement the zero suicide approach by 2024. 4) 100% of Nebraska’s child serving systems will adopt evidence-based practices to follow-up with youth after a suicide attempt or hospitalization by 2024. During the course of the grant we will reach 70,000 15to 24-year-olds in Region 5, and embed suicide prevention practices in 244 school districts reaching 187,000 public school students in grades 5-12 statewide. We will train at least 200 clinicians by introducing 30 organizations to the zero-suicide initiative, embed suicide screening with school psychologist services in 17 educational service units and 12 treatment organizations, We will implement evidence based follow-up after youth experience a suicide crisis in five child serving systems and two healthcare systems, and implement evidence based post-suicide intervention practices on five post-secondary campuses impacting lives of 40,000 college age students.