Grantee Types: Garrett Lee Smith Tribal

The issue to be addressed in the Preserving Life: Nevada Tribal Youth Suicide Prevention Initiative is to address suicide among Nevada native youth. The project is designed to provide education, awareness of suicide risk indicators among community members, identification of community resources and, where none exists, assistance in the development of these resources, and finally to implement prevention programs that are culturally appropriate and relevant.

Nevada native youths live in a bi-cultural world:  Indian and non-Indian, with all the distractions that face all youths of the targeted age population.  In the recent Youth Summit held the University of Nevada – Reno in August 2009, it became apparent that youths want more than statistics, data, and education: they want meaning and knowing who they are, their history and worth in their existence. They were interested in the world around them and wanted to know that they are not alone.

It is the purpose of this project to explore and identify unique and innovative approaches to addressing this serious problem. The challenge is to develop and implement a unique approach that can be utilized by other communities to provide that meaning so desperately sought by youths. In order to accomplish this, the project must evolve and meet these challenges which might not have been foreseen at the beginning of the project  or when it was originally envisioned. While not discarding the traditional methodology envisioned by the project, the other part of the equation (the so what aspect) must be equally prioritized.

It has always been the premise of this project that not all communities are equally ready: facilities, staff, programs, and knowledge levels differ from community to community and it is in this realm, that custom made approaches be explored, assessed, and implemented. As communities are assessed and status determined, some will require beginning levels of education and awareness programs, while others are more advanced and will require a multitude of approaches. Times change, events change the environmental reality, people and communities change, and facts once considered impenetrable become more porous. This is the underlying philosophical construct upon which this project must be placed.  We must find the so what part of the equation and make the necessary changes and adaptations to ensure that the approaches we champion reduce life-ending events among Nevada tribal youth.

The Indian Center Youth Suicide Prevention Project aims to support Native American Youth and their families in seeking solutions to suicide ideation, to help Native people gain access to appropriate treatment services, and to reduce the suicide rate of youth in Lincoln, Omaha, and Scottsbluff.  The program will target Native American youth ages 10-18 through outreach, public awareness, and developing partnerships.

Project goals and objectives include:

1. Conduct outreach services to the Native American communities of Lincoln, Omaha, and Scottsbluff designed to prevent suicide.
2. Develop a collaboration of public-private agencies in each city to increase the network of services for Native American youth through Memoranda of Understanding

The purpose of The Children Speak is to prevent suicides and suicide attempts among Havasupai Indian Tribal youth ages 10-24. The project is guided BY THE Havasupai Indian Tribe HMAAN QAJ GWAAWJ, The Children Speak plan addressing bullying, violence and suicide prevention.The Children Speak focuses on gatekeeper training, early identification, follow-up and referral, strengthening cultural identity and promoting life skills and leadership using curriculum and interactive activities in partnership with families and the community.Community engagement and outreach will promote protective factors with activities with youth to strengthen cultural and traditional bonds. Gatekeeper training will be provided to persons 15 years or age and older. At least 265 community members will participate in gatekeeper training using the Applied Suicide Intervention Skills Training (ASIST) model, 15 community members will attain ASIST Trainer certification, and 106 youth will participate in life skill classes and leadership activities. A suicide prevention awareness campaign will reach all 733 Tribal members.The Havasupai live in Supai, a remote village at the bottom of the Grand Canyon accessible by foot, horseback or helicopter. It is the last place in the United States to which the U.S. Postal Service makes deliveries by mule. Students attend the Havasupai Elementary School for grades K-8. Parents must send their children to boarding school to attend high school.This project will enable the Havasupai Indian Tribe to develop the capacity to reduce suicides and suicide attempts. The proposed project is in collaboration with the Indian Health Services and the Bureau of Indian Education.

The Gila River Indian Community (GRIC) proposes to provide suicide prevention and early intervention services through the Gila River Youth Suicide Prevention Project. Services will include life skills/peer leadership training focusing on developing coping strategies for youth; two equine programs comprised of school site ground work prevention sessions and a weekend cultural riding program supported and developed by community elders which include historical and cultural relevance of horses. Gatekeeper trainings are conducted monthly for interested community members and professionals so that they may more effectively respond to suicide ideation and attempts; and social marketing to raise community awareness through the design, development and implementation of various media forms such as powerpoint presentations, highway billboards, tri-folds, information sheets, newspaper articles, PSAs, etc.? TeenScreen screening and assessment is used in 11 approved school sites serving Gila River youth, as a tool to identify youth who are at risk and need further assessment and intervention.? Indian Nations Camp is a weeklong camp conducted once per year that brings together 100 youth from various tribes across Arizona and New Mexico to share information relevant to suicide, substance use, and culture. The target population includes youth, parents, professionals, and community members within the Gila River Indian Community in central AZ. All services will be provided within the context of the Gila River Indian Community?s beliefs and culture and with great respect for individual and family needs.

Crow Creek Sioux Tribe Youth Suicide Prevention program’s focus population is youth aged 13 to 21 living on the Crow Creek Reservation. During the last thirty years, the Crow Creek Tribe has experienced a high suicide rate that has had a devastating and demoralizing impact on the community, leaving service providers almost totally overwhelmed. Buffalo County, in which most of the population of the reservation lives, had a suicide rate of 49.2 per 100,000 population from 1980 to 2001, the highest rate in South Dakota and well over the national figure. By comparison, the state’s rate during this period was 13.5 and the national figure was 10.8. Depression, violence, and physical and sexual abuse are far too common and show no signs of abating — the people are in despair. Unfortunately, the Tribe’s extreme poverty severely limits its ability to address the situation.

The goals and objectives of the project are as follows: 1) Promote suicide awareness in the community through a public information campaign to increase public knowledge and expanded suicide awareness in the school system; 2) Develop effective prevention and intervention services through community-based suicide prevention and improving services to people who have been affected by suicide; and 3) Enhance service provider capabilities by increasing collaboration among local partners, improving local data management techniques, and increasing capabilities of local partners involved in suicide

The Crow Creek Tribal Youth Suicide Prevention Program has programming that is designed specifically throughout the year in 3 phases:
1.  During the summer months of June, July & August, the program offers Peers Helping Peers which targets youth ages 12 to 21 years of age with a target population of 200 youth.  The youth are given education and skills training in various areas of high risk behavior.  The youth are than required to reach out to 10 of their friends or peers.  Included in the outreach is a tribal youth survey, questionnaire and other required forms.  The participants in the Peers Helping Peers are given a $200 incentive for their participation.
2.  During the school year there is a weekly after school program called Natural Helpers in which targets 100 youth who are challenged to address the problems of youth in school, in homes and in the community.  Each participant receives $20 for participation.
3.  During the holiday season the grant runs a program called SAFE House.  8 people are hired and trained and they provide a safe environment over the holiday season for youth to come to.  This program provides a safe place away from drinking in their homes or in the community.

The Crow Creek Sioux Tribe of South Dakota is submitting a grant request for federal assistance to the Department of Health and Human Services Substance Abuse and Mental Health Administrative for Cooperative Agreements for State-Sponsored Youth Suicide Prevention and Early Intervention.  The Tribe is requesting $479,300 for the first year of the project, and $1,429,489 over the course of the three-year project.  Funding will be used to enhance the activities and services now being provided through the Tribe’s current SAMHSA suicide prevention program.  This will enable the Tribe to reach a broader target population and fulfill the objectives of its suicide prevention plan.  The target population of this program is youth aged 12 to 24 living on the Crow Creek Reservation.

During the last 30 years, the Crow Creek Tribe has experienced a very high suicide rate that has had devastating and demoralizing impact on the community, leaving service providers overwhelmed.  Buffalo County, in which most of the population of the reservation lives, had a suicide rate of 49.2 per 100,000 population from 1980 to 2001, by far the highest rate in South Dakota and well over the national figure.  By comparison, the state’s rate during this period was 13.5 and the national figure was 10.8.

The Tribe’s current suicide prevention program has had a very positive impact on the youth, but much more needs to be done.  Depression, violence, substance abuse, and physical and sexual abuse are still common – the people are in despair.  Unfortunately, the Tribe’s extreme poverty severely limits its ability to address the situation, and those working toward prevention are getting tired and are wearing out, their emotions stretched to the limit.

The goals and objectives of the project include enhancing suicide awareness in the community and in the school system, enhancing and expanding effective prevention and intervention services, improving access to services for people who have been affected by suicide, enhancing service provider capabilities, enhancing collaboration among stakeholder groups, improving local data management techniques, and increasing capabilities of local partners involved in suicide prevention.

The project will advance the goals and objectives laid out in the Tribe’s suicide prevention plan, as well as those in the South Dakota Strategy for Suicide Prevention.  Federal aid will enable the Crow creek Tribe to enhance and expand its existing suicide prevention strategies, and to lay the groundwork for future sustainability.  It is truly a situation where federal funding can directly save lives.

This application titled Making suicide every ones business:  A Native American Community approach, builds on cultural strengths of balancing physical, mental, emotional, and spiritual lives.  Our four community-wide effort incorporates community members (parents, youth), point of entry staff, and health care provider trainings, multi-media awareness campaign, and solidifies community networks.  Suicide is a significant mental health problem among the members of the Confederated Tribes of the Colville Reservation (CCT), particularly the youth. In 2009 the youngest reported suicide attempt was 13 years old.  In 2006, the suicide rate among members of the CCT was five times greater as compared to other Washington Natives and 20 times greater than the national average. The rates decreased slightly in 2007 through 2008. However, in the last two years, after the Department of Health funding ceased, these four communities of 6000 members have witnessed an increase in suicide ideation, attempts and completions once again.

The Suicide Prevention Coalition, established by the CCT in 2007, is responsible for the review and implementation of culturally appropriate prevention and intervention initiatives to address the growing problem of suicide. The efforts of the Coalition have revealed the interrelated problems of historical trauma, grief, and loss maintains a high level of suicide risk potential among underserved members of the reservation.  This proposal requests a universal approach to reducing the rate and risk of suicide and interrelated social problems by using inherent cultural assets in order to strengthen and balance our physical, mental, emotional, and spiritual lives.  Using Evidence Based Practices and Best Practices, the proposed plan will:

Goal 1: Strengthen collaboration between the CCT Suicide Core Team with internal and external partnerships to create a safety net and maximize resources.
  1a) Solidify partnerships, sign MOUs with all (100%) partners, increase meeting participation to 75%;
  1b) Enhance the Coalition infrastructure: Establish data collection on 100% notification of ideation, attempts and suicides into the Suicide Registry.
  1c) Build Coalition sustainability by increasing knowledge and skills-all members attend at least one training a year.
 

Goal 2:Develop community awareness and identification on the specific needs and issues that lead to youth suicide.
  1) Hold 4 culturally responsive community workshops with 1260 parents, families, tribal employee, and community members.
  2) Promote the National Suicide Prevention Lifeline and suicide prevention awareness through multi-media outreach (reach approx. 10,000: number of broadcast, text messaging Facebook hits).
 

Goal 3:  Strengthen the identification, referral and treatment process at point of entry CCT Programs that connect youth who are at risk for suicide.
  3a) Enhance Suicide identification:  Suicide Triage and Risk Assessment training (n=23);
  3b) Increase (to 100%) referrals between behavioral health program and regional support network;
  3c) Increase (to 80%) the number (n=30) of providers trained to deliver culturally-responsive Behavior Therapy.

Target Population: American Indian youth, ages 10-24, who reside on the Flathead Indian Reservation in Montana.

Strategies/Interventions: Provide outreach to increase youth participation in treatment and prevention services; Provide screening and evidence-based programs to youth in schools, college, health agencies, vocational agencies, and youth agencies; Provide cultural activities to improve youth cultural attachment; Provide training to gatekeepers/professionals; Provide support groups and therapy to youth impacted by suicide, including young veterans. Support tribal/nontribal agencies in development and continuation of tribal youth early intervention/prevention activities; Implement systems-level change to improve continuity of care and outcomes for the target population.

Goals: Coordinate suicide prevention activities across multiple sectors and settings; Implement research-informed outreach and media efforts; Increase knowledge of the factors that offer protection from suicidal behaviors and promote wellness and recovery; Implement programs that prevent suicide and related behaviors; Promote efforts to reduce access to lethal means of suicide; Provide training to community and clinical service providers; Promote suicide prevention as a core component of health care services; Implement effective clinical and professional practices for assessing and treating those identified as at risk for suicidal behaviors; Provide care and support to individuals impacted by suicide and community strategies to prevent further suicides; Evaluate the impact of suicide prevention and intervention activities.

Numbers Served Annually/Throughout the Project: Total Number Served Throughout the Project: 6,365. Yr 1: 1217; Yr 2: 1287; Yr 3: 1287; Yr 4: 1287; Yr 5: 1287.

Provide outreach to increase youth participation in treatment and prevention services; Provide screening and evidence-based programs to youth in schools, youth agencies, and summer culture camps; Provide wrap-around support services to improve access to project activities; Provide training to gatekeeper/professionals; Support tribal/nontribal agencies in development and continuation of tribal youth early intervention/prevention activities; Provide support to Salish Kootenai College to implement youth early intervention/prevention activities; Collect and analyze data.

Goal One: Promote Awareness on the Flathead Indian Reservation that Suicide is a Preventable Public Health Problem
Goal Two: Develop Broad-based Support for Suicide Prevention
Goal Three: Develop and Implement Strategies to Reduce the Stigma Associated with Being a Consumer of Mental Health, Substance Abuse, and Suicide Prevention Programs
Goal Four: Promote Strategies to Reduce Access to Lethal Means and Access to Methods of Self Harm
Goal Five: Develop and Implement Suicide Early Intervention and Prevention Strategies
Goal Six: Implement Training for Recognition of At-Risk Behavior and Delivery of Effective Treatment
Goal Seven: Develop and Promote Effective Clinical and Professional Practices
Goal Eight: Improve Access to and Community Linkages with Mental Health and Substance Abuse Services
Goal Nine: Promote and Support Data Gathering and Research on Suicide and Suicide Prevention

Numbers Served Annually/Throughout the Project: Good Behavioral Games for Middle-School Youth in After-School Programs: 25/75; Good Behavior Games for Middle- and High-School Youth in School: 6,000/6,000; Summer Culture Camps for Middles- and High School Youth: 30/90; Teen Screen for Middle- and High-School Youth: 100/300; Coping Support Training (CAST) for High-School Youth: 8-16/24-48; ASIST and QPR Training for Gatekeepers/Professionals: 320/960; ASIST Training for SKC Students: 20/60; Support Group for Veterans: 25/75.