Grantee Types: Garrett Lee Smith State

The overarching mission of the Wyoming Youth Suicide Prevention(WYSP) Initiative is the reduction of suicidal behaviors among the approximately 110,000 Wyoming youth aged 10-24. The WYSP Initiative employs a public-health approach to prevention, relying on evidence-based models, best practices, and strong program evaluation. Emphasis will be placed on stigma reduction, environmental change, and positive community norms. The strategies proposed are based on the State Suicide Prevention Plan and build on existing state and community youth suicide prevention efforts and partnerships. An innovative component of the instant proposal is a plan to utilize the five-step strategic framework model within targeted communities. This process will include local needs assessment, strategic planning, implementation, and program evaluation of comprehensive suicide prevention strategies.

The state agency responsible for the WYSP Initiative is the Wyoming Department of Health (WDH). Within WDH, the Mental Health and Substance Abuse Services Division has primary responsibility for implementation of program objectives and operational oversight of the initiative. The Division provides state-level leadership, funding through provider contracts and technical support for all suicide prevention and early intervention activities in Wyoming. The Division also is responsible for leading statewide media efforts and for providing training on suicide alertness and intervention skills training across Wyoming.

The WYSP Initiative comprises five key objectives that directly support the State of Wyoming Suicide Prevention Plan and the National Strategy for Suicide Prevention. These are (1) Statewide Coordination and Leadership; (2) School-Based Initiatives; (3) Community-Based Prevention and Early Intervention; (4) Programs for High-Risk Youth; and (5) Anti-Stigma and Public Awareness. The initiative is supported by an active Wyoming Suicide Prevention Advisory Council (WySPAC), which includes leaders and stakeholders from across the state with a special interest and/or expertise in areas related to youth suicide prevention. WySPAC provides advice and consultation in development, implementation and evaluation of the objectives and programs of the WYSP Initiative.

During the grant period, WDH will work closely with an outside evaluator from the University of Wyoming, Wyoming Survey & Analysis Center (WYSAC). WYSAC was created by executive order of the governor as Wyoming’s clearinghouse for policy studies and evaluation research and has a proven record evaluating state and federal prevention programs in Wyoming. This includes current evaluations of the Garrett Lee Smith Memorial Act Program at the University of Wyoming. Their evaluation of the State and Tribal Youth Suicide Prevention Grant will include three data/program performance assessment efforts. These efforts include data and performance measures to satisfy GPRA requirements, cooperation, and participation in a cross-site evaluation and an annual self-evaluation of outcomes and activities.

Wisconsin will utilize a mentoring and expert consultation approach to develop culturally sensitive, cross systems and consumer inclusive projects in 9 communities with elevated risk of youth suicide and then disseminate information on best practices through regional sharing sessions, a toolkit, and a list serve. This process will create an infrastructure and increased capacity to support the development of further projects. Wisconsin will educate all project sites on identifying at-risk groups in their communities but will focus particular attention on the following three target populations with elevated risk for suicide: Native American youth, youth who are deaf/hard of hearing, and youth in rural areas. Project sites will be required to include the major youth-serving systems as part of their local coalitions, as well as including parents, mental health consumers, public health and primary care, faith communities and other stakeholders. Involvement of survivors of suicide will be strongly encouraged.

Wisconsin will also support suicide prevention in other areas of the state through the following: providing consultation and training to other sites as requested; developing and disseminating best practice postvention guidelines for schools and communities; developing and disseminating a suicide prevention bulletin for school administrators to provide education about the role of schools in preventing suicide; and participating in planning for the annual Crisis Intervention Conference in order to utilize this highly attended event to disseminate information.

We will hold a summit of stakeholders from across the state in grant year three to identify how we can build on what we have learned to promote a sustainable infrastructure for future suicide prevention efforts.

Prevent Suicide Wisconsin: Strengthening the Infrastructure will build on Wisconsins accomplishments to date by creating comprehensive local systems to prevent youth suicide, embedding suicide prevention training capacity into our child welfare and public education systems, enhancing suicide prevention skills for mental health clinicians, expanding efforts to reach high-risk populations, supporting local coalitions, and increasing public awareness.

The grant will support goals developed at a statewide planning summit in 2009 and the resulting strategic plan developed by our state-level steering committee: maintain strong state-level leadership; develop and strengthen local leadership; raise public awareness; continue training and technical assistance, and; enhance access to mental health services.

Comprehensive projects in three model communities will implement at least one evidence-based practice consistent with their local needs assessment, partner with a qualified treatment provider to address access to services, incorporate evidence-based lethal means restriction, conduct outreach to a high-risk population, incorporate more youth and family members, and mentor two neighboring communities that are developing their own coalitions.

Contracts with the agencies responsible for training child welfare and school staffs will develop their capacity to provide sustainable suicide prevention training and result in training and education to 2500 child welfare staffs and over 5000 school staffs.

450 clinicians will increase core competencies in suicide prevention through Assessing and Managing Suicide Risk and Recognizing and Responding to Suicide Risk. 1050 civilian clinicians will be educated about veteran mental health through three Wisconsin Warrior summits and at least five additional trainings each year of the grant.

Three targeted efforts will outreach to high-risk populations. 50 youth will participate in piloting of American Sign Language adaption of the SOS video and 50 community providers will participate in piloting the Culturally Affirmative Services for the Deaf/Hard of Hearing program. We will create culturally appropriate materials and trainings for the LGBT population, providing training to 100-150 youth and 50 people working with the LGBT population. We will support 50 youth in military families each year through Camp Yellow Ribbon and support an additional 80 youth and their families through Nurturing Skills for Military Families.

We will continue outreach and education to local coalitions through our website, webinar, teleconferences, materials and statewide conferences. We will train an additional 90 people as QPR trainers. We will update data related to youth suicide and reissue the Burden of Suicide Report with the updated data.

Mental Health America of Wisconsin will administer the grant on behalf of the State. We will partner with the Injury Research Center at the Medical College of Wisconsin as the evaluator, with a number of state agencies and a host of private partners.

Acknowledging the promotion of life in our West Virginian Youth, the Adolescent Suicide Prevention and Early Intervention (ASPEN) project works vigorously toward creating a comprehensive recognition and referral network in West Virginia. Suicide is the SECOND leading cause of death in our West Virginian Youth ages 15-24, ranking our state at 11th in the nation for this age population. In order to combat the “silent epidemic” for adolescent suicide within our state, ASPEN provides comprehensive, multifaceted, protective measures of suicide prevention and early intervention for the adolescent population of West Virginia. Direct services of ASPEN are provided in a multitude of venues and populations in order to enhance adolescent suicide prevention by increasing awareness, screening, and access to clinical services for identified at-risk youth. Trainings are conducted to acknowledge the prevalence and significance of suicide in order to promote it as a public health concern as well as to provide for increased recognition, referral, and protective factors for both professionals and students. Education, communication, collaboration, and connections among the entities interacting with at risk youth are enhanced in order to rectify system gaps so as to facilitate a culturally competent, caring, comprehensive, sustainable suicide prevention, intervention, and postvention system of care.

West Virginia is building on its initial ASPEN experiences in expanding to additional populations of at-risk adolescents in Kanawha County, as well as new geographic regions consisting of five mostly rural counties with high incident rates. In the newly identified counties, the project proposes to serve youth in the secondary schools by increasing awareness and screening; ultimately facilitating a mobile quick response team to serve at-risk students.

Collaboration with key stakeholders has enhanced the implementation of the project as well as providing for increased efforts of sustainability. ASPEN will continue to work with the West Virginia Council for the Prevention of Suicide as a key stakeholder in the project. In addition, collaborative efforts with secondary and post-secondary school systems, child-serving agencies, non-profit menta1 health agencies, primary care clinics, and hospitals will facilitate cross-system identification, referral and response for at-risk individuals.

The evaluation component of the ASPEN project will enable progress monitoring in frequent measurement of goal and objective implementation. In addition, such measures will provide timely input of successfully carrying out project directives. Finally, results will be shared with other counties throughout West Virginia and Appalachia, as well as nationally, in order to achieve a comprehensive adolescent suicide prevention approach.

West Virginia’s Bureau for Behavioral Health and Health Facilities (BBHHF) in partnership with Regional Youth Services Centers, Educational Institutions and Premier Hospital Health Systems seeks to reduce the rate of youth suicidal ideation, suicide attempts and suicide deaths in WV through the development and implementation of a collaborative and coordinated statewide prevention and intervention strategy that is integrated into the existing public and private service delivery system. The State of West Virginia will build upon the success of the Adolescent Suicide Prevention and Early Intervention (ASPEN) project and use committed and collaborative partnerships to work across a wide array of agencies and disciplines in order to make suicide prevention a core priority. The project is in response to alarming data, which include: Suicide is the second leading cause of death for individuals aged 15 to 24. WV also has the nation’s highest rate of drug deaths, more than 9 out of 10, coming from prescription drugs with drug overdoses now killing more West Virginians than car accidents. About 19% of our state’s children have experienced abuse or neglect, nearly double the nationwide rate of just over 10%. Too many WV youth, 13%, have seriously considered attempting suicide in the last 12 months. Almost 10% actually made a plan about how they would attempt suicide during that year. Alarmingly, more than 5% report they had attempted suicide one or more times in the last year, and almost 2% made a suicide attempt that resulted in an injury, poisoning, or overdose that had to be treated by a doctor or nurse. Specifically, the project will: Increase access and availability of services in existing behavioral health centers by utilizing telehealth and satellite offices; provide for a referral system of preferential appointments for youth, subpopulations and their families; assist in acquiring health insurance; incorporate comprehensive evidence-based protective measures that expand universal prevention messages of hope and help at the regional level; improve identification, referral and engagement interventions for youth and transitioning youth aged 10-24 in increasing the number of youth and youth-serving agencies implementing screening and gatekeeper trainings; reduce the number of completed suicides and attempt survivors providing for protective, caring follow-up services for attempt survivors and their families; and build the capacity of organizations serving vulnerable sub-populations to effectively deliver coordinated care. The sub-populations recognized include: a) Lesbian Gay, Bi- Sexual, Transgendered and Questioning (LGBTQ) youth; b) Veterans; c) Military families; d) juvenile services; e) survivors; f) attempt survivors; g) youth with mental health and substance abuse issues; and h) individuals with disabilities. WV is committed to local systems of care that offer the right services, at the right place and at the right time for WV Youth and families. Service provision must be close to home with public and private organizations working together closely across systems to align and coordinate support to overcome significant barriers that youth and their families face in accessing and engaging help when experiencing crisis.

Acknowledging the promotion of life in our West Virginian Youth, the Adolescent Suicide Prevention and Early Intervention (ASPEN) project works vigorously toward creating a comprehensive recognition and referral network in West Virginia. Suicide is the SECOND leading cause of death in our West Virginian Youth ages 15-24, ranking our state at 11th in the nation for this age population. In order to combat the “silent epidemic” for adolescent suicide within our state, ASPEN provides comprehensive, multifaceted, protective measures of suicide prevention and early intervention for the adolescent population of West Virginia. Direct services of ASPEN are provided in a multitude of venues and populations in order to enhance adolescent suicide prevention by increasing awareness, screening, and access to clinical services for identified at-risk youth. Trainings are conducted to acknowledge the prevalence and significance of suicide in order to promote it as a public health concern as well as to provide for increased recognition, referral, and protective factors for both professionals and students. Education, communication, collaboration, and connections among the entities interacting with at risk youth are enhanced in order to rectify system gaps so as to facilitate a culturally competent, caring, comprehensive, sustainable suicide prevention, intervention, and postvention system of care.

West Virginia is building on its initial ASPEN experiences in expanding to additional populations of at-risk adolescents in Kanawha County, as well as new geographic regions consisting of five mostly rural counties with high incident rates. In the newly identified counties, the project proposes to serve youth in the secondary schools by increasing awareness and screening; ultimately facilitating a mobile quick response team to serve at-risk students.

Collaboration with key stakeholders has enhanced the implementation of the project as well as providing for increased efforts of sustainability. ASPEN will continue to work with the West Virginia Council for the Prevention of Suicide as a key stakeholder in the project. In addition, collaborative efforts with secondary and post-secondary school systems, child-serving agencies, non-profit menta1 health agencies, primary care clinics, and hospitals will facilitate cross-system identification, referral and response for at-risk individuals.

The evaluation component of the ASPEN project will enable progress monitoring in frequent measurement of goal and objective implementation. In addition, such measures will provide timely input of successfully carrying out project directives. Finally, results will be shared with other counties throughout West Virginia and Appalachia, as well as nationally, in order to achieve a comprehensive adolescent suicide prevention approach.

From Classroom to Community: A Team Approach to Youth Suicide Prevention

The purpose of this proposed project is to implement youth suicide prevention and early intervention strategies, grounded in public/private collaboration, in three regions of Washington State, where the local suicide rates are higher than federal rates; these include Lower Columbia College in Cowlitz County, Sunnyside, Mt. Adams, and Mabton School Districts in Yakima County and Bethel School District in south Pierce Counties.

We intend to increase the number of community mental health substance abuse providers and school personnel who are trained to assess, manage and treat youth at risk for suicide. We intend to increase the number of youth who are identified as at risk of suicide, and the number of youth who are referred for behavioral health services and finally, we intend to increase the number of youth at risk of suicide who receive behavioral health services.
 

One of the communities that we selected has a high percentage of Native American and Hispanic youth, another community that has a high percentage of military families and the third community that is experiencing dramatically high numbers of suicide attempts in their 20-24 year old young adults. We anticipate serving a total of 4,079 adults and youth throughout the grant period. In the first year we will reach 1,515 adults and youth primary through on-line and in-person training. We will recruit community organizations and private practitioners who will provide treatment for those youth who are screened and would benefit from a mental health or substance abuse referral. In the following two years we will increase the number of youth who are screened and referred to services.
 

Care Coordinators will work closely with school personnel-counselors, nurses and Prevention/Intervention Specialist to develop functional care teams that screen—using the GAIN-SS tool – and refer. Referrals will increase as a result of education in health classrooms – using HELP, a curriculum designated on the Best Practices Registry – so that students can recognize when a peer is distressed and k now what to do. Referrals will increase as more teachers are educated on the warning signs and strategies for getting the student to help through the on-line training, At-Risk, another curriculum that has been designated as a Best Practice. Training on youth suicide assessment and intervention – using the 2-day ASIST workshop (another Best Practices-designee) – will result in improved screening, a greater ability to disable a suicide plan and create a safe plan.

SUICIDE PREVENTION WORKS! is a multi-faceted youth suicide prevention program for areas with high rates of suicides and suicide attempts. The key program component is a suicide attempt surveillance approach that allows for follow-up after the emergency department (ED) discharge of a suicidal youth within 48 hours. This component is complemented by clinical services, gatekeeper training, and media campaigns.

The prompt ED follow-up is made possible by an order from the county public health officer, declaring a self-harm attempt coming to the attention of the hospital emergency department to be a notifiable condition, requiring a report to the public health department within 24 hours of the ED discharge.

During the ED stay, the patient and family will be provided with education about warning signs of suicide and means restriction. As part of a thorough discharge process, signed consents will be obtained. This will allow for the involvement of an outreach specialist to ensure continuity of care after discharge. This same process will be applied to discharges from inpatient hospitalizations. After discharge, the patient and family will engage in outpatient mental health and/or chemical dependency services.

These intensive community services are complemented by extensive coverage of the community with gatekeeper training. This training will be provided to schools, juvenile justice and foster care systems, law enforcement, EMS staff, entities serving LGBTQ-youth, and tribal elders. At the college/university level, we will build on existing gatekeeper training by holding conferences that expand the current training to counseling, faculty, and administrative staff. In order to possibly export this college-level suicide prevention program, staff from all public and private colleges/universities will be invited to the conferences.

Additional facets of SUICIDE PREVENTION WORKS! include crisis plans in partnering systems, promotion of the National Suicide Prevention Lifeline, public awareness campaigns, strengthening existing and developing new public/private prevention partnerships, and increasing access to clinical service providers via innovative means.

The Washington State Department of Health has led activities in suicide prevention since 1994, by providing epidemiological support, implementing best practices and promoting community based prevention programs throughout Washington. Initiatives, funded from the Washington State Legislature through the General Fund, have primarily focused on raising public awareness, training those who work directly with youth, and working with communities and schools to implement prevention programs. Our goal for this grant is to reduce suicide risk among high risk groups by expanding our efforts and building infrastructure to address the complex needs of these particular populations. Grant funding will be combined with the state support described above, allowing us to enhance our statewide presence and provide sustainable resources and tools to prevent suicide. Elements of this project include:

1. Establishing and maintaining a statewide coalition focused on suicide prevention to help coordinate prevention activities and to provide opportunities for traditional and nontraditional partners to collaborate on suicide prevention projects.
2. Convening college campus students, staff and faculty at 4 college campuses in Pierce County to implement effective or promising suicide prevention strategies;
3. Implementing evidence-based suicide prevention strategies with one community based organization that serves at-risk youth and two Native American organizations

The Department of Health is the lead agency, providing key programmatic and evaluation staff for this project. Contracts are in place with agencies, tribes, and institutions of higher education as noted above. A contract is established with the Youth Suicide Prevention Program (YSPP) to support activities of the local projects and of the coalition. Several trainings have occurred at local sites and two Assessment and Managing Suicide Risk trainings were sponsored under this grant. Local activities are under way, with several sites working with work groups and local coalitions to implement their activities.